Nutrition services are now available at Plateau Pediatrics. Patients may make appointments for personal nutrition counseling with our new dietician, Lacey Raburn. You may make an appointment with Ms. Lacey by calling our office at (931) 707-8700 or online.
Our website has a new look. Feel free to create an account to send messages, check out our new social media links, or just look around!
Due to patient feedback, we are now reminding our patients regarding their appointments with a live human as opposed to an automated message! This will go into effect February 1, 2012.
A BMI above the 95th percentile is considered obese.
To give you an idea of what BMIs are by age and sex, look at the tables below.
You can download a complete BMI percentile chart (in PDF format) for boys ages 2-20 and for girls ages 2-20.
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Get Fit Tennessee also allows you to create a free personal account to track goals, progress, intake, and exercise. It includes useful calculators and a food journal. Earn points by completing activities.
The USDA’s MyPlate.gov has a variety of interactive tools and lots of useful information.
KidsHealth has lots of frequently asked questions about nutrition and fitness.
Our Knoxville pediatric GI colleagues run BeeFit4Kids.com, a children’s weight loss program.
The American Academy of Pediatrics has a toolkit of ideas families can use at home, with resources for nutrition and fitness.
Healthier Generation features a Parenting to Prevent Obesity section, as well as other helpful tips and ideas.
Kidnetic, designed for kids, has games and activities that teach about nutrition and fitness.
There is a growing and very appropriate concern today about childhood obesity and the effects that it has on children in our community.There is a great deal of information available through the Internet, news media and popular magazines about what children should not eat. It can be very easy to get discouraged and to ask the question, “What CAN my kids eat?” The good news is that there are simple, easy-to-follow guidelines available to help you make good food choices for your children.
In 2005, the United States Department of Agriculture created a special Food Pyramid to provide nutritional guidance for children. The key concepts of the 2005 Food Pyramid include activity, moderation, personalization, proportionality, variety, and gradual improvement.
The following are food group serving recommendations found in this pyramid:
The guidelines listed are very helpful, but many parents wonder how many calories their child should consume each day. The chart below is based on physical activity. If your child is not very active, your goal should be for him or her to consume the lower range of calories. If you child is extremely active, you may need to increase his or her daily calories accordingly.
The USDA recommendation for children who are already overweight is to reduce the rate of body weight gain while still allowing for growth and development. Weight reduction diets in children should never be undertaken without consulting with child’s primary care provider.
Here are a few of the on-line resources available to parents who wish to learn more about nutrition and fitness in children:
Food is important for your baby’s healthy growth and development. This information is designed to answer questions you may have about feeding your baby.
Remember: these are general guidelines. Every baby will progress at his or her own rate. If you have questions about your infant’s feeding or nutrition, please let us know.
During the first 4-6 months, the only food your baby needs is breast milk or iron-fortified formula. The baby doesn’t need any extra water, juice, rice cereal, baby foods or table foods until 4 months.
Although many people used to advocate earlier feeding, we know now it’s not a good idea because:
Rarely, we will recommend using a small amount of water or juice for a severely constipated baby, or thickening bottle feedings with rice cereal for severe reflux (spitting up.) We’ll tell you if your baby needs these changes. Otherwise, just stick with formula or breast milk until age 4 months.
Tips on feeding a very young infant:
Babies are ready to begin spoon feedings when they can:
Some babies may be ready by 4 months and others need to wait until 6 months. Don’t rush – your baby is the best guide. Nutritionally, your baby’s milk still provides his complete needs. Spoon feedings are to practice developmental skills – and for fun. Don’t get stressed, keep feeding time calm, and enjoy this time of discovery together.
Tips for starting spoon feedings:
How do you know if your baby is food sensitive?
Severe diarrhea or vomiting, a rash, or wheezing may be symptoms of sensitivity to a specific food. On the other hand, they may just be coincidence. If you think your baby reacts to a food, stop feeding that food. Try it again in a few weeks. If the problem continues, let us know.
Sample meal plan: 5-6 month old infants
This is a good time to add fruits. You can also offer a little juice in a sippy cup. Be sure to continue offering cereal and vegetables.
Now is a good time to add meats. (If you are raising your child as a vegetarian, we can suggest alternative sources of protein.) You can use commercially prepared baby food meats, or you can make your own as follows:
When your baby can sit alone without support, pick up little things with the thumb and forefinger, and has a few teeth, you can start to offer table foods:
Sample meal plan: 8-12 month old infants
After the first year of life, growth slows down – and so does the appetite of most children. Infants who were voracious eaters may seem picky as toddlers. This is very normal, but not concerning as long as toddlers eat balanced diets. Let us know if you are concerned about your toddler’s intake.Tips on feeding young toddlers:
By this time, toddlers should be eating smaller portions of whatever everyone else is eating (except for potentially dangerous foods like popcorn, peanuts, raisins, granola, etc – wait until age 4 to introduce these.)
Tips for feeding older toddlers:
Picky eaters are children who are growing and developing well, but who refuse most foods and refuse to try new foods.Does the following example sound like your house?
Devon is a 4 year old who refuses most fruits and vegetables even though his mother has tried offering a variety. After picking at his meat and bread, Devon refuses to eat the corn and peas on his plate. His mother, concerned about his nutrition, urges and cajoles him to try the vegetables. The rest of the family finish eating long before Devon, who sits stubbornly in his chair. Devon and his mother are both in tears at the end of dinner, which spoils the rest of the evening for everyone.
This rule should be your guideline in dealing with your picky eater:
Here are some examples where not following this rule causes trouble:Devon’s mother tries picking up his spoon and tries feeding him like a baby, but Devon keeps his lips zipped tight. Devon’s father, angry at the way Devon is behaving, pinches Devon’s nose and pries his jaws open. Devon’s mom scoops the food into his mouth.
Devon isn’t determining how much he’s going to eat (the first half of the rule.) In fact, his parents are force-feeding him, even though Devon is probably not even hungry. Never trick children into eating, spoon-feed children who are old enough to feed themselves, or force-feed them. Not only are you giving them attention for bad behavior, you’re making mealtime into battletime.
Devon’s mother gives up and excuses Devon from the table. She cleans up the kitchen and puts the food away. An hour later, Devon starts crying and says he is hungry. His mother, not wanting him to have to wait till breakfast, gives him some cookies and a glass of milk.
This violates the second part of the rule – that the parent should choose what to feed the child. On the surface, it looks like Devon’s mother chose to give cookies and milk to Devon. Unfortunately, the message this sends to Devon is: “If I can hold out for an hour after dinner, I won’t have to eat vegetables, and I can have cookies instead!” Devon’s mother chose a well-balanced meal for Devon, but within an hour, Devon manipulated her into unmaking her choice.
Devon’s mother puts the food away after informing Devon, “That’s it until breakfast.” An hour later, Devon’s grandmother, who thinks Devon’s mother is too strict with him, secretly gives Devon some crackers, to “tide him over” until breakfast.
This also violates the second half of the rule, and is a classic problem in disciplining children – a parent’s choices and authority are undermined by another parent, a grandparent, a babysitter, a neighbor, etc. This tells Devon that if he doesn’t like what his mother says, he can always go to Grandma. This usually causes arguments between Mom and Grandma without anyone realizing that the child is manipulating them both. Decide early in your child’s life who has the authority to make or change rules for your child. Both parents must agree to support each other’s decisions with regard to the child.
Devon won’t eat corn and peas, but he will eat peanut butter and banana sandwiches and canned peaches. Since some fruit is better than none, Devon’s mother prepares special lunches and dinners for Devon that are always different from what the rest of the family is eating.
This, again, violates the second half of the rule: the child is allowed to choose what he wants to eat, rather than being expected to eat what the rest of the family is eating. This is called “short order cook syndrome.” Often the household’s food preparer ends up making separate meals for dad (who likes his steak and potatoes), mom (who’s on a diet), and each child (who will only eat a limited number of items.) While preparing a special meal for a child is fine if the child is sick, has a food allergy, or for a special occasion like a birthday, it should be the exception rather than the rule.
If you are concerned about your child’s weight, growth, or nutrition, ask us.Good luck — and stick to your guns!
A “diet diary” is the first step towards making better, healthier choices for losing or controlling weight.
Keeping track of what a child eats, how much, and how often, gives us good clues about eating patterns and habits. Trying to remember what a child ate last week is much less accurate than writing it down as it happens. You may be surprised at what your child is eating once you start writing it down!
Example:
At or about one year of age, we recommend switching from formula to whole milk. When toddlers discover that cow’s milk tastes a lot different from formula, many will initially refuse the cow’s milk. Here are some things to try:
We don’t generally recommend this because babies who get cow’s milk before age 1 can have:
Children usually refuse a new formula if they are switched from one to another for cost reasons. You can use some of the transition tips listed above to make formula switching easier. Best of all: stay on the same formula until 12 months.
As long as your baby is breastfed, he or she does not need cow’s milk and will get all the calcium he or she needs from breast milk.
The American Heart Association (AHA) recommends the following for children’s daily fiber intake:
Fiber content can be found on the food label of any packaged food product. Examples of high fiber foods include:
Grain Products:
Fruits:
Vegetables:
Nuts and Seeds: nuts and seeds such as almonds, whole flaxseed and soynuts
Many parents want to know if their young son or daughter is the right size. Pediatricians also want to ensure children grow properly, so height and weight (and head size on young children) are checked at every well baby or well child visit. We compare a child to growth charts compiled by the National Center for Health Statistics, which show the expected heights and weights for American children from birth to young adulthood.
There are growth charts for both boys and girls. There are even special growth charts for children with special health needs (such as Down syndrome) whom we expect to grow at a different speed.
View growth chart for:
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A child’s height or weight can be about average (25th -75th percentile), above average (greater than the 75th percentile), or below average (less than the 25th percentile.) Above average or below average does not necessarily mean that your child is too big or small. For example, if a child’s parents are 5’4″ and 5’2,” he or she will probably be petite. Besides, no one’s child is the “average child” !
Generally, we expect a child’s height and weight to be proportionate. A child who is somewhere in the middle for height should have a weight that is about average. Tall children, on the average, weigh more. Short children should weigh less. Disproportionate growth, when a child is very heavy or very slim for his height, can be a cause for concern. Your doctor will let you know if he or she is worried about this.
In recent years, more and more school aged children have become overweight, even obese. We also have body mass index (BMI) charts that show what children should weigh for their heights. Again, boys and girls have separate charts.
Calculate body mass index (BMI) here. View BMI chart for:
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You might be interested to know that, although pediatricians have been using growth charts for over thirty years, the growth charts in use were revised about ten years ago to include children from more diverse cultural and racial backgrounds.
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