Postpartum Depression

Having a baby is a huge life change which can cause parents to experience a wide range of feelings from joy and excitement to guilt and sadness

One in every five parents experiences depression and/or anxiety

Postpartum depression is a deeper depression that lasts much longer than other types of depression. You may feel:

  • Exhausted and overwhelmed

  • A loss of interest in activities that once made you happy

  • Sadness, anger, loneliness, worthless, hopeless

  • Changes in appetite

  • Constant worry and guilt

  • Thoughts of hurting yourself or your baby

Diagnostic criteria for major depressive episode – please seek help from a professional!

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  • At least 5 symptoms present for at least 2 weeks, for most of nearly every day

  • One symptom must include – depressed mood or diminished interest in activities

  • Other symptoms include – weight loss or weight gain, insomnia, fatigue, loss of energy, feeling worthless, inappropriate guilt, diminished ability to think or concentrate, indecisiveness

  • Symptoms cause distress or impairment in social, occupational, or other important areas of function

Depression is a mental illness that affects your mood and how you feel. Our mood impacts how we think about ourselves, how we relate to others, and how we interact with the world

A parent with postpartum depression may not enjoy the baby and have frequent thoughts that they are a bad parent

Take care of yourself!

  • The first step is recognizing that you are going through a major change in your life

  • Don’t be scared or embarrassed to ask for help, whether from a loved one or a professional

  • Get a healthy amount of sleep each night

  • Eat plenty of healthy foods

  • Be active each day

  • Integrate one activity into each day that makes you happy

How can you help your loved one dealing with postpartum depression?

  • Adjust your expectations of them and ensure their day-to-day abilities are realistic

  • Never compare them to another person who is struggling with postpartum depression – we are all unique!

  • Accept that they may wish to spend some time alone – they are trying to cope with their illness

  • Offer help with their responsibilities – take a chore off their hands so they can have some time to relax

  • Help with child care, especially during the night – take turns getting up at night

  • Recognize their efforts to manage their illness, regardless of outcomes

Counselling and support

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References

City of Toronto. (2018). Pregnancy and Parenting. Retrieved from https://www.toronto.ca/community-people/children-parenting/

Canadian Mental Health Association. (2018). Postpartum Depression. Retrieved from https://cmha.ca/documents/postpartum-depression

The Centre for Addiction and Mental Health. (2018). Postpartum Depression. Retrieved from

https://www.camh.ca/en/health-info/mental-illness-and-addiction-index/postpartum-depression

Anxiety Canada. (2018). New moms: Feeling anxious? Retrieved from https://www.anxietycanada.com/parents/new-moms/feeling-anxious/recognizing-post-partum-anxiety

Steward, D., & Vigod, S. (2016). Postpartum Depression. The New England Journal of Medicine. doi:10.1056/NEJMcp1607649

Beck, C. (2006). Postpartum Depression. American Journal of Nursing, 106(5), 40-50.

Postpartum Anxiety

Women often experience signs of anxiety with postpartum depression, but it can also happen on its own               

Anxiety is a natural and adaptive response that we experience when we feel unsafe or threatened

Having a newborn at home is an emotional upheaval and can create many new fears and worries – this is normal!

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Anxiety is a normal emotion that humans experience throughout their life, but anxiety disorders are different. It is important to recognize symptoms of anxiety disorders which interfere with a person’s ability to live a normal life

  • Excessive worry

  • Scary of upsetting thoughts

  • Feeling on edge, restless and irritable

  • Avoiding people and places

  • Difficulty concentrating

  • Trouble sleeping

  • Shortness of breath and light-headedness

Panic disorders are uncomfortable and shadow us with intense fear. It can sometimes feel like you are having a heart attack or nervous breakdown. Recognize the symptoms

  • Racing heart and chest pain

  • Sweating, hot/cold flashes

  • Shaking

  • A choking sensation

  • Upset stomach, which can lead to vomiting and dry heaving

  • Dizziness

  • Fear of dying

Post Traumatic Stress Disorder (PTSD) can happen after a difficult or traumatic labour and birth. Be aware of the symptoms.

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  • Thoughts and dreams of the event

  • Feeling numb and detached

  • Difficulty sleeping

  • Avoiding your baby

  • Sexual problems

  • Avoiding further pregnancies

  • Avoiding places that remind you of the trauma

We experience anxiety in our bodies, minds, and actions/behaviours

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  • Bodies: increased heart rate, sore stomach, tight chest and throat, shallow breathing, loss of appetite

  • Mind: racing thoughts, imaging the worst-case scenario, excessive worry

  • Actions/behaviours: avoiding certain situations, activities or people, over-controlling, asking others for constant reassurance, repeatedly checking things

Settle your anxieties using the NEST-S technique

  1. Nutrition
    - Nutrition after a baby is hard – you may not feel hungry or you may find that you mainly eat unhealthy foods
    - Eat nutritious foods regularly and throughout the day to help you feel better
    - Keep a glass or bottle of water with you at all times
    - Even if you are not hungry, try a few mouthfuls. Snacking every 2 hours from the four food groups is a good way to keep your body filled with healthy foods
    - Prepare when you are out of the house – bring a bottle of water and easy snacks such as granola bars or fruit with you

  2. Exercise
    - Even a small amount of exercise can boost mental and physical wellbeing
    - Regular exercise can boost your mood and energy levels and reduce your anxiety! It can also help reduce muscle tension and create feelings of relaxation
    - Talk to your doctor about any limitations to your activity
    - Choose activities that work for you – whether walking, yoga, or going for a run
    - Consistency is key! Regular and short exercise sessions are better than occasional and long sessions
    - Find a friend! Walking with a friend, whether or not they have a stroller too, is a great way to keep in contact with others while doing activities with your baby

  3. Sleep and Rest
    - Put in effort to work on getting more sleep and rest – they are important for your physical and mental health
    - Your anxiety can worsen when you are sleep deprived
    - Ask for help with getting rest and sleep – you may need to ask your partner or a loved one to mind the baby or take over a few chores so you can catch up on sleep
    - Create a bedtime routine or ritual – whether you take a warm bath before bed or enjoy 20 minutes of light reading
    - Value your rest – even if you are not sleeping, lying down and resting is important to ease your mind
    - Adjust your expectations of yourself

  4. Time for yourself
    - Mothers often neglect taking time for themselves, which can increase their symptoms of anxiety
    - Having time to relax and unwind is important
    - Doing things that make you feel good and cared for are important. Daily uplifts can protect mothers from negative mental effects of stress
    - Find hobbies that appeal to you – sewing, doing a word puzzle, watching a video
    - Connect with others – spend time on your relationships
    - Have some alone time – even for 5 minutes

  5. Support
    - Social support and health relationships are a protective factor against anxiety
    - These relationships are important for mothers coping with anxieties and trying to make changes in their daily activities to reduced their symptoms
    - Emotional support – having someone to talk to about your struggles and concerns
    - Practical support – having someone to help with errands, household chores
    - Social network support – a group where you experience a sense of belonging (the drop-in program!)
    - Information support – access to reliable information and knowledge

References

City of Toronto. (2018). Pregnancy and Parenting. Retrieved from https://www.toronto.ca/community-people/children-parenting/

Canadian Mental Health Association. (2018). Postpartum Depression. Retrieved from https://cmha.ca/documents/postpartum-depression

The Centre for Addiction and Mental Health. (2018). Postpartum Depression. Retrieved from

https://www.camh.ca/en/health-info/mental-illness-and-addiction-index/postpartum-depression

Anxiety Canada. (2018). New moms: Feeling anxious? Retrieved from https://www.anxietycanada.com/parents/new-moms/feeling-anxious/recognizing-post-partum-anxiety

Steward, D., & Vigod, S. (2016). Postpartum Depression. The New England Journal of Medicine. doi:10.1056/NEJMcp1607649

Beck, C. (2006). Postpartum Depression. American Journal of Nursing, 106(5), 40-50.

Self Care

Parenting and caregiving is stressful. It requires life changes and the need to balance responsibilities.

We often feel tired, angry, depressed, nervous, and guilty – yes, its normal

Sometimes, it even affects your health – skin rashes, headaches, and backaches

Make time for yourself

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  • You will become a better parent/caregiver if you take time to look after yourself!

  • Slow down – Relax and remember. to take deep breaths

  • Take time to eat well and eat enough. This may mean many little meals throughout the day to ensure you remain full of energy when taking care of your children

  • Get enough rest and sleep. Aim for 7-8 hours a night and make it a priority. Stick to a sleep schedule and practice a relaxing bedtime ritual

  • Be active each day whether by walking or using physical activity services such as a gym. Being physically active increases your energy and self-esteem, improves your sleep, and reduces your risk of developing chronic diseases!

  • Be open to learning and trying new things. Challenge yourself to try one new thing a week!

  • Take some quiet time for yourself each day, even if it is only 20 minutes to read a chapter of a book!

  • Talk to someone you trust when you are feeling overwhelmed

Make time for your partner

  • A healthy relationship is important when caring for yourself and your child

  • Speak honestly and respectfully

  • Share responsibility

  • Trust each other

Self-care should be practiced regularly, throughout your life!

Self-care are actions that we incorporate into our everyday life that enable us to maintain and improve health, wellbeing, and wellness

Why is self-care good for us?

  • Self-care are individualized choices that we make each day in regard to our lifestyle

  • It empowers people to look after themselves and helps to prevent ill health in the future

  • It provides people with confidence and a sense of happiness

  • It helps people recover from illness, manage ongoing physical and mental health conditions and live longer lives

Tips for self-care

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  • Recognize that self-care is an effective strategy for positive mental and physical health

  • Even five minutes can help! Set aside 5 minutes per day to do something for your overall wellness, even it is something as simple as a face-mask!

  • Love yourself from the inside out! Whether it be a yoga class to relax your mind, going for a run, or drinking plenty of water each day, keep up with things that make you feel good on the inside and outside.

  • Be social – do not be afraid to talk about your feelings and/or struggles.

  • Identify what you enjoy doing and integrate it into your day, or at least your week.

  • Debrief after a long day. Take a walk at the end of the day or listen to some music at the end of the night to relax after a stressful day

References

Self Care Forum. (2018). Retrieved from http://www.selfcareforum.org/

Baratta, M. (2018, May 27). Self Care 101: 10 ways to take better care of you. Psychology Today. Retrieved from https://www.psychologytoday.com/us/blog/skinny-revisited/201805/self-care-101

Kofsky, D. (17, September 15). Why is Everyday Self-Care So Important? Wellness Styled. Retrieved from https://wellnessstyled.com/why-is-everyday-self-care-so-important/

National Sleep Foundation. (2018). How Much Sleep Do We Really Need? Retrieved from https://www.sleepfoundation.org/excessivesleepiness/content/how-much-sleep-do-we-really-need-0

Feeding a Picky Eater

Be creative, stay patient and calm, and continue to offer new foods

Why is your child refusing to eat foods or eating less?

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  • How they are feeling – they may be tired or stressed

  • Distractions – they would rather play or watch TV

  • Pressure – if a child feels pressured to eat something, they will not eat it

  • Taste – some children have a sensitivity to taste, smell, shape and texture

  • Fear – some children are fearful to try new things

  • Drinking too much – some children fill up on milk or water

Work on building healthy habits!

  1. Offer a variety of foods
    - Integrate finger foods into their meals such as sandwiches or cut up vegetables
    - Offer a new food in combination with familiar foods when your child is hungry
    - Offer new foods regularly starting with a small amount
    - Don’t feel discouraged: It may take up to 15 times for your child to like a food!
    - Make food interesting and fun by using different shapes, textures and colours

  2. Make a routine
    - Having a regular meal and snack time helps children. It leaves space between eating to allow your child to build an appetite
    - Offer 3 meals and 2-3 snacks daily in child-sized portions with child-sized cups, plates, and utensils
    - Limit sweets and snack foods such as candy and chips
    - Limit sweet beverages such as juice
    - Limit milk to no more than 3 cups each day as it can replace other foods
    - Offer water to satisfy thirst in between meals

  3. Make meals fun!
    - Eat meals as a family
    - Be a good role model – eat well as a parent, and eat a variety of foods
    - Encourage all family members to eat healthy
    - Avoid distractions during meal times by turning off the TV
    - Let your child leave the table if they are full – they don’t like to sit for too long
    - Let your child help you when you plan and prepare meals

  4. Give your child a choice
    - Parents get to make a lot of decisions during meal time.
    - Parents decide which foods to offer, when to offer them, and where everyone will eat
    - Let your child decide how much they want to eat and respect their decision if they want to refuse

References

City of Toronto. (2018). Feeding your child. Retrieved from http://www.toronto.ca/community-people/children-parenting/pregnancy-and-parenting/parenting/feeding-your-child

Introducing Solides

Signs your baby is ready for solids!

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  • Hold their head up on their own

  • Sit up in a high chair

  • Open their mouth open WIDE when offered a spoon

  • Turn their face away if they don’t want food

  • Close their lips over the spoon

  • Keep food in their mouth and swallow instead of pushing it out

Usually, babies are ready to start solids at 6 months old

  • Solids provide the extra iron and nutrition that babies need for healthy growth and development

  • But don’t forget… Breast milk is still important!

What are hunger cues?

  • Open mouth when offered food on a spoon

  • Putting hands in mouth

  • Shows interest in eating

  • Leans forward towards food/spoon

What are fullness cues?

  • Pushes spoon with food away

  • Keeps mouth closed and/or turns head away

  • Seems upset or disinterested

  • Spits food out

What foods should be introduced?

  • Introduce foods that are rich in iron

  • These include: infant cereals, beef, chicken, turkey, eggs, beans, lentils and chickpeas

  • Offer iron rich foods two or more times per day

Allergies

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  • Foods that caused allergic reactions like peanuts, eggs, or milk products can be introduced at 6 months

  • If you are introducing a food that is a “common” allergy, avoid offering more than one per day

  • Also, wait two days before introducing another food

  • This makes it easier to identify which food causes the reaction

Textures

  • Introduce a variety of soft textures – this can be lumpy, minced, pureed, mashed, or ground

  • Offer finger foods such as soft ripe fruit or grated cheese to encourage your child to feed themselves!

  • Introduce different textures sooner than later – delaying the introduction or lumpy textures beyond nine months can cause feeding difficulties when your baby gets older

References

City of Toronto. (2018). Feeding your Child. Retrieved from https://www.toronto.ca/community-people/children-parenting/pregnancy-and-parenting/parenting/feeding-your-child/

Government of Canada. (2018). How Much Food You Need Every Day. Retrieved from https://www.canada.ca/en/health-canada/services/food-nutrition/canada-food-guide/food-guide-basics/much-food-you-need-every-day.html

Formula Feeding

Formula feeding is an alternative to breastfeeding, and is available in a variety of forms. Be sure to properly prepare the formula as per instructions. Consult your child’s health care provider before changing formula.

  • Powder

    • Powdered formula is not sterile and may contain bacteria that is harmful to babies

    • It is recommended to not give powdered formula to babies under 2 months of age

    • Use powdered formula within one month of opening - discard after 30 days

    • Once mixed, the unused formula should be refrigerated and used within 24 hours

  • Liquid Concentrate

    • Should be mixed at a one-to-one ratio with water

    • This type of formula can be refrigerated for up to 48 hours

  • Read-to-feed

    • Once opened, ready-to-feed formula should be refrigerated and used within 48 hours

A few key points to understand about formula feeding are as follows:

  • A prepared bottle of formula should be left at room temperature for no more than an hour

  • Use prepared bottles within 24 hours

  • Never freeze infant formula – it changes the fat in the formula

  • If you are going out of the house, put prepared bottles in a cooler with ice packs

  • If formula is re-warmed, it should be used within 2 hours

  • It is important to buy iron-fortified infant formula. This will help your baby grow and develop!

  • Infant formula is recommended until age 1, followed by whole milk until age 2

  • Follow the instructions and labels accordingly

    • Putting too much water in formula causes it to over dilute, and your baby will suffer from weight loss

    • Putting too much formula causes it to under dilute, and your baby can experience kidney damage from too much protein

References

City of Toronto. (2018). Feeding your Child. Retrieved from https://www.toronto.ca/community-people/children-parenting/pregnancy-and-parenting/parenting/feeding-your-child/

Smith, V. (2016). The importance of infant nutrition. International Journal of Childbirth Education, 31(1), 32-34. Retrieved from https://search-proquest- com.ezproxy.lib.ryerson.ca/docview/1789785141/fulltext/FDCF801D2303453FPQ/1?accountid=13631

Breastfeeding

Caring for your breasts is an important part of breastfeeding, and sometimes nipple and breast problems can arise

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  • Seek help if you have too much nipple pain to latch your baby, cannot soften your breasts, or have a red and painful area on your breast

  • Rinse your breasts with water only and air dry – do NOT use soap on the nipples as it may cause them to crack

  • Wear a bra that is not too tight and avoid bras with underwire

  • After feeding, allow some breastmilk to go onto your nipple and the surrounding dark area to protect the skin. Let the milk dry before putting on your bra

  • Breast feeding should not be painful as long as your baby is properly positioned and latched

Caring for hard breasts

  • Use heat or cold, whichever feels best

  • When applying a cold compress, wrap it in a cloth and limit the exposure to a few minutes to prevent skin trauma

  • When using heat, place a warm shower on your breast for a few minutes until milk starts to flow or have a warm shower until milk starts to flow

  • Once milk begins to flow, gently massage your breast milk around the area until your nipple feels soft

  • Breastfeed your baby often until your breasts are no longer hard

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You and your baby need time to learn how to breastfeed. It is important to care for yourself while breastfeeding, including getting enough sleep at night and asking for help when needed and accepting help when it is offered. Healthy eating is also an important way of caring for yourself while breastfeeding for many reasons:

  • Eating well when breast feeding helps you to feel good, recover after birth, and obtain proper nutrition

  • It is recommended that mother’s consume an extra 2-3 servings of food each day when breastfeeding

  • Eat small meals and snacks every 2-3 hours

  • Avoid skipping meals – this will make you more tired

  • Drink every time your baby feeds – remember to bring your water bottle with you everywhere

Many mothers require extra support or assistance from a clinic when breastfeeding. Below are a variety of resources in the neighbourhood that you may find helpful.

References

City of Toronto. (2018). Feeding your Child. Retrieved from https://www.toronto.ca/community-people/children-parenting/pregnancy-and-parenting/parenting/feeding-your-child/

Smith, V. (2016). The importance of infant nutrition. International Journal of Childbirth Education, 31(1), 32-34. Retrieved from https://search-proquest-com.ezproxy.lib.ryerson.ca/docview/1789785141/fulltext/FDCF801D2303453FPQ/1?accountid=13631

Bundle Up!

Winter is coming and it’s coming fast! The cold weather can have many impacts on the health of you and your children. Dress your child in appropriate clothing for the weather, especially those in school and daycare!

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  • The cold weather means snow and ice, which can be unsafe for children. Walk and play with caution!

  • Make sure they are dressed in layers. Sometimes the morning when they are going to school is colder than when they are in class. Ensure they can be dressed comfortably throughout the day

  • Wear a hat and keep ears covered at all times

  • Mittens are warmer than gloves – use these instead!

  • Use a neck warmer instead of a scarf

  • If your child may have an accident or get wet during outdoor play time, make sure to send them with extra clothes. Wet clothes and cold weather is a recipe to get sick!

Winter in Canada can mean frostbite and hypothermia, which are of serious concern to parents and caregivers.

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  • Layer your children’s clothing – use thermal clothing, undershirts, tracksuits, sweaters and boots

  • Cover exposed skin – exposed skin can become a victim of frostbite in as little as 30 seconds

  • Keep moving – try to limit the time spent standing still as moving around provides your body with better circulation.

  • Blankets and portable seats – sit on a blanket instead of the cold pavement or concrete to reduce the risk of hypothermia

  • Drink fluids – remain hydrated. It is easy to become dehydrated when the temperature is low

  • Recognize the signs of hypothermia – confusion, lethargy, weakness, paleness

  • Recognize the signs of frostbite – pale grey, waxy textured skin in affect area cold to the touch, numbness, localized pain

  • Be aware of alerts from Environment Canada for extreme cold weather alerts – and stay inside

Enjoy the cold weather safely!

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  • Wear waterproof and windproof outer layers, a hat, and warm mittens

  • Choose wool or silk inner layers - they hold more body heat than cotton

  • Change into dry clothing if your clothes get wet - from precipitation, sweat, or self-soiling

  • Wear several layers of warm, lightweight clothing when shovelling snow

  • Reschedule activities if there is a severe weather forecast

References

City of Toronto. (2018). Health and Wellness. Retrieved from https://www.toronto.ca/community-people/health-wellness-care/

Hand Washing

Our hands carry lots of germs, and they also touch our eyes, nose and mouth. Keeping our hands clean is important to ensure good hygiene and to help prevent the spread of germs.

When should you wash your hands?

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  • When they are visibly dirty

  • After sneezing, coughing, blowing your nose, using the washroom, handling garbage, changing diapers, handling raw foods, or playing outside

  • Before and after preparing and eating food, touching a cut or open sore, touching eyes, nose, or mouth

How do you properly wash your hands?

  • Wet hands with warm water

  • Apply soap

  • Lather for 15 seconds, rub between fingers, back of hands, fingertips, under nails

  • Rinse well under running, warm water

  • Dry hands with paper towel or hot air blower

  • Turn off tap

Make hand washing fun for your children! Encourage them to sing happy birthday twice, or sing the alphabet while washing their hands.

What if you don’t have access to soap and water?

  • Hand sanitizer can be used when soap and water is not available

  • It should be used when hands are not visibly soiled

Check out this awesome, kid-friendly video that explains the importance of hand washing!

References

City of Toronto. (2018). Health and Wellness. Retrieved from https://www.toronto.ca/community-people/health-wellness-care/

Moms Against Cooties. (2018). Health and Wellness. Water Quality and Health Council’s. Retrieved from https://momsagainstcooties.com/category/health-wellness/

Saskatchewan Health Authority. (2013, August 19). Germ Smart – Wash your Hands! YouTube. Retrieved from https://www.youtube.com/watch?v=NoxdS4eXy18

The Flu Shot

The flu shot is for everyone! Seniors are at a risk for serious complications from the flu, but kids get the flu most often and can easily spread flu germs to friends and family before they show any symptoms. Pregnant women should get the flu shot to protect themselves and their baby. Here are some ways to stay healthy this flu season

  • Get your flu shot EARLY

  • Wash your hands OFTEN

  • COVER your cough or sneeze

  • DISINFECT toys, door handles, and phones

  • REMEMBER: just because you don’t have any symptoms of flu doesn’t mean you aren’t contagious. Most people are contagious one day before symptoms develop and remain contagious until a week after they’re sick with the flu.

Young children can get very sick from a flu infection - it is important to get the flu shot to prevent this. Vaccines work well and protect us against 4 strands of the flu virus. Most children HATE needles, which can stress out parents and caregivers.

  • Parents - RELAX! It is okay to feel nervous, but do not convey it to your child

  • Keep the mood light and easy, and don’t forget to take some deep breaths

  • Children’s fears of vaccinations stem from their parents behaviour.

  • Children pick up on parent’s cues during scary situations

  • A child’s anxiety increases, as well as their pain perception, if a parent tries too hard to reassure them

Honesty is the best policy! Be honest with your child. Do not tell them that the needle won’t hurt. This will cause your child to lack trust. Rather, tell them it will only hurt for a few seconds and then they will get a lollipop!

Distraction goes a long way!

  • Have your child watch a video or do an activity to draw their attention away from the needle

  • Distractions should be the child’s choice, and can include small toys, bubbles or pop-up books

  • Do not spend time dwelling on the needle once it is over. Quickly wipe away the tears and change the subject - talk about the sticker they get from the doctor

Check out this awesome video of a doctor giving a baby some needles.

During the flu season, make sure you integrate some healthy habits into your daily routine

  • Avoid close contact with people who are sick

  • Stay home when you’re sick

  • Cover your mouth and nose when you sneeze or cough

  • Avoid touching your eyes, nose and mouth

  • Get rest, drink fluids, and eat healthy

Sick and Sports

  • Sports are a fun way to stay active and make friends, but can provide children with many germs

  • Stay home if your child is sick - real team players don’t want to spread any colds to their teammates

  • Don’t share water bottles - this is any easy way that promotes the transfer of germs

  • Wash and disinfect your mouthguard if you are sick

  • Wash hands thoroughly and often with soap and water

References

City of Toronto. (2018). Flu Prevention for 2018/2019. Retrieved from https://www.toronto.ca/community-people/health-wellness-care/health-programs-advice/immunization/flu-influenza/

Mulholland, A. (2016, May 26). 5 ways to make needles painless for kids. CTV News. Retrieved from https://www.ctvnews.ca/5things/5-ways-to-make-needles-painless-for-kids-1.291746

RM Videos. (2018, June 20). Doctor Distracts Baby From Shots with Goofy Song. YouTube. Retrieved from https://www.youtube.com/watch?v=6m-9itperOw

Introducing the 2018/2019 Ryerson Team

Hello, and welcome to the Ryerson Team page for the upcoming school year. Allow us to quickly introduce ourselves:

My name is Emily and I am in my third year of the Bachelor of Science in Nursing Program at Ryerson University. In my spare time I enjoy going to the gym and playing sports such as hockey or soccer.

My name is Esther and I am in my third year of the Bachelor of Social Work Program at Ryerson University. Outside of school I enjoy drawing, singing, reading and playing with my dog Teddy.

We look forward to getting to know you all this year, and are eager to provide you with access to a variety of resources.

Nutrition Guidelines

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There is a lot of confusion around what to feed your baby, when, and how much. Most importantly, all information often boils down to this: Every baby is different. It may take up to 15 times for your baby to accept a new food! 

Here is a break down of infant feeding nutrition provided by the Infant Feeding Joint Working Group. These are recommendations and guidelines that are supported by evidence and used in practice.
 

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Birth to 6 Months

Your baby does not require anything but breast milk (or formula) for the first six months. This is because it provides the optimal quantity, quality, and absorption of nutrients. The guidelines suggest that breastfeeding can occur for up to 2 years or longer with appropriate complementary feeding. Ultimately, it is up to the mother and baby on how long breastfeeding should continue. There are alternatives to breastfeeding, as this is not the only option.

 

6 to 12 Months

Your baby’s iron stores deplete after six months, so iron rich and nutrient dense foods (higher nutrients, less calories) are recommended as first complementary foods. This means they are consuming breastmilk and other foods. At first, the amount of food consumed may be very small (approximately 2-3 tablespoons). Here is a summary of the recommendations:

• Examples of iron rich foods include meat, meat alternatives (such eggs), and iron fortified cereals. It is encouraged to introduce foods from family meals in appropriate size and texture for older infants.
• While continuing to breastfeed, gradually increase the number of times a day complementary foods are offered. Your baby’s hunger cues, how they are feeling, time of day, and breast milk intake, all contribute to how much they will consume.
• No later than nine months, lumpy textures should be offered.
• Examples of what foods that can be offered for a 7 month old: mashed strawberries, grated hard boiled egg, or finely minced dark chicken. For an 11 month old: apple sauce, whole grain bread cut into strips, or brown rice.

 

12 to 24 Months

• From one year of age, high fat foods (like avocados) are encouraged. This is because they are great energy source that contribute to their development.
• A regular schedule of meals and snacks contribute to healthy eating habits.
• Little to no added salt or sugar used in foods will allow your child to experience natural flavours.
Examples of what foods that can be offered for a 17 month old: canned peaches, hummus, or boneless salmon with mayonnaise.

 

 Photo by monkeybusinessimages/iStock / Getty Images

Photo by monkeybusinessimages/iStock / Getty Images

Parents and caregivers can do their part by being a good role model when it comes to eating, as children are heavily influenced by what they see.  Children are more likely to eat a variety of foods when it is the same as what is offered on the family table. Involving your young children in food preparation heightens curiosity, eagerness to learn, and creates positive attitudes towards eating.

Welcome again!

Hello, my name is Christina and I am apart of the Ryerson Student Team for January-April. I will be continuing to update the Nutrition Corner with more evidence based nutrition information. If  you have topic suggests or would like any information, please feel free to ask while I am here on Tuesdays. 

 

Baby-Led Weaning. What is it all about?

First off, what is Baby-Led Weaning (BLW)? 

This is the practice of introducing foods by having the infant feed themselves rather than being spoon-fed by an adult. We are also talking about solid foods that are provided in addition to breastfeeding or formula.

 Things to know: 

 Photo by bit245/iStock / Getty Images

Photo by bit245/iStock / Getty Images

  • If you choose to start BLW, it should be at a point when the infant can sit upright, and can hold their head up
  • Provide Iron-rich foods, examples include: Poultry, cooked tofu, legumes, enriched infant cereals, and pureed meats.

WHY?

  • During pregnancy, newborns have stored sufficient Iron for their first 6 months. Afterwards, they need to consume Iron-rich foods along with being breastfed, to maintain Iron levels.

Choking? 

Many people avoid this method because to the fear of their child choking. 

General Rule for Avoiding Choking with BLW: width of infants' 5th finger (pinky) can be used to estimate the size of their airway. Keep this in may as a reference for size of food that can block the airway.

 

References:

Cichero, AJY. (2016). Introducing solid foods using Baby-Led Weaning vs. spoon-feeding. Nutrition Bulletin, 41:72-77

Cameron, SL., Heath, M., Taylor, RW. (2012). How feasible is Baby-Led Weaning as an approach to infant feeding? Nutrients, 4:1575-1609.

 

Let's Talk About Texture

Texture can be a tricky substance. We worry about what we feed our children, and how we serve it because we do not want they to choke on anything. This is a concern everywhere. Different countries have come up with there own food texture recommendations, and the main agreed on recommendation between them is that food consistency and variety should increase as the child grows older.  

In Canada, the recommendation is: 

* But before note that every child develops at their own pace, therefore remember that these are recommendations and not guidelines.  

At 6 months

Offer variety of texture: Pureed, Softly mashed, lumpy, grated, ground, finely minced.

No later than 9 months

Offer lumpy foods.

Before 10 months: 

Based on observations, there seems to be a window of opportunity  for the introduction of texture-modified solid foods to prevent risk of feeding difficulties later on.

At 12 months

Offer texture modified food family food. This means it is chopped, ground or mashed.

Chocking Hazards:

  • Hard, small, round, smooth and sticky solid foods

For example: Raw Vegetables, nuts, wieners, Hard Candies, Cough Drops, Gum, Raisins, Grapes, Pumpkin Seeds, Fish with Bones, Popcorn, Marshmallows, Peanut Butter spread thickly

However, what you can do is...

  • Cut into smaller pieces, ex: Grapes
  • Remove pits from fruits
  • Grate hard fruit and vegetable like carrots and apples
  • Dice or cut lengthwise like foods like sausages or wieners
  • Finely chop stringy fibrous and textured foods like pineapple and celery

References

Health Canada, Canadian Paediatric Society, Dietitians of Canada, Breastfeeding Committee for Canada. Nutrition for healthy term infants: recommendations from birth to six months. 2012 [cited 2012 Nov 21]. Available from: http://hc-sc.gc.ca/fn-an/nutrition/infant-nourisson/recom/index-eng.php

Health Canada, Canadian Paediatric Society, Dietitians of Canada, Breastfeeding Committee for Canada. Nutrition for healthy term infants: recommendations from six to 24 months. 2014 [cited 2014 Apr 25]. Available from: https://www.canada.ca/en/health-canada/services/food-nutrition/healthy-eating/infant-feeding/nutrition-healthy-term-infants-recommendations-birth-six-months/6-24-months.html

Harris CS, Baker S.P, Smith GA, Harris RM. Childhood asphyxiation by food: a national analysis and overview. JAMA. 1984 May 4 [cited 2012 May 16];251(17):2231-5. Abstract available from: https://www.ncbi.nlm.nih.gov/pubmed/6708272

Shim JE, Kim J, Mathai RA; STRONG Kids Research Team. Associations of infant feeding practices and picky eating behaviors of preschool children. J Am Diet Assoc. 2011 Sep [cited 2012 Jul 30];111(9):1363-8. Abstract available from: https://www.ncbi.nlm.nih.gov/pubmed/21872699

 

Welcome to the Nutrition Corner

Hi there,

My name is Meera. I am currently finishing my Nutrition and Food degree at Ryerson University.

Through this blog, I will be sharing evidence-based Nutrition information on some of the Hot Topics I hear on a daily basis at the Centre. For instance, Baby-Led Weaning (BLW), picky eaters, food textures are often conversation subjects between parents and caregivers of infants and toddlers. 

 

Picky Eaters

To start off, let's acknowledge how different our children are. Some parents and caregivers may have no issues feeding their children, and to others that is something completely unheard off as their children may refuse anything laid in front of them. So what do parents do in such cases? 

I would like to introduce you to Dietitians of Canada, this is a professional association of Registered Dietitians who's purpose is to advance health through food and nutrition. They have put together "Tips on Feeding Your Picky Toddler or Preschooler" which I will be summarizing in this Blog post.

Note that there is a shared responsibility between Parents/Caregivers and Child when feeding a child.

As the Parent/Caregiver, you would decide the What, Where & When

What foods...

- Try to make one family meal because when you child watches you eat they learn to eat those foods too

- Include a variety of healthy foods

- Canada's Food Guide, recommends 4 servings of Fruits and Vegetables for children 2-3 years of age 

 

When to eat...

- Set meal times

- Kids more likely to come to the table being hungry and willing to try new foods

- Have 3 meals and 2-3 snacks at regular times. Offer water in between. Even a bit of milk, juice or some crackers can spoil their appetite.

 

Where to eat

- Eating together is preferred. So that means Family Meal Tables

- Eating is a social process. Eating together helps your child learn healthy eating habits and is a time for you to a role model for healthy eating.

Your child will decide...

If and How much to eat..

- Your child will  tell you when he is full or hungry.

Other Tips from DC: 

Include Children in the Meal-Prep work (growing, shopping, picking & cooking together)

  • children will become more open-minded to new foods
  • Include them in your trips to the Grocery Stores. This would be great exposure to foods in their whole state

We want children to get excited and want to come back to the meal table .. SO Keep meal times pleasant and relaxed

  • For example, let children eat with their fingers

Have children focus on eating

  • Seat them at the meal table in a high chair or booster seat 
  • Avoid using phones, TV, computer, radios, toy to distract them

Kids do not eat well under pressure

  • Avoid praising, rewarding, tricking or punishing them for eating/not eating

Offer a variety of foods at each meal

  • Offer new foods in the presence of familiar foods
  • Try serving new foods in different ways. Change it up! Like Mashing or soft-boiling carrots, or grating them to put them in muffins or soups
  • Don't lose hope, DC says sometimes it takes 15 tastes before a child likes a new food

 

Reference

Dietitians of Canada. <PEN Handout/Tips for Feeding you Picky Toddlers and Preschoolers>. Practice-based Evidence in Nutrition [PEN] Knowledge Pathway <Population Health/Lifestyle>.<27 October 2014>. Available from :http://www.pennutrition.com. Access only by suscription. Free trials available.