Milestone or Modern Convenience Part II: What to do when the convenience becomes a hard habit to break

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Lacy recently wrote a blog for Virginia’s Early Intervention Program – specifically geared for therapists that work for that program, but the information is important for clinicians AND parents and caregivers. We have reposted it here but you can find the original HERE.

 

Written by: Lacy Morise, M.S. CCC/SLP

 
If you haven’t read it yet, be sure to check out the first blog post in this 2-part series, Milestone or Modern Convenience? – Part I: Overuse of the Sippy Cup and Pacifier, to learn important information about an infant’s need for sucking and the risks involved with overuse of the pacifier and sippy, cup!

 
Now that you are familiar with the pluses and minuses of pacifier and sippy cup use, what about when the parents are ready to help baby “give up” the sucking habit? Again, as the resource for all things infant and toddler, we can suggest the following tried and true strategies.

 
Cut back – When ready to begin weaning, cut back on the time that the pacifier and/or sippy cup is available to the child. If the pacifier has been available to the child all day, every day suggest cutting back its availability to only nap and bedtime. As for the sippy cup, cut back its use to only when the family is out and about. When at home suggest offering the child a straw or open cup in its place.

 
Go cold turkey…if the child is ready – If going cold turkey is the method of choice pass along this wisdom: if the child is not ready, he may find something else to suck on, like a thumb or fingers. However, if ready, this method may work just fine. Suggest that, if going cold turkey, it is a good idea to rid the house (or at least baby’s line of sight) of all pacifiers and/or sippy cups. If they remain in the cabinet or drawer, baby will know and will want them!

 
Provide additional comfort – In preparation of weaning a baby from the pacifier and/or sippy cup, provide him with an additional comfort item. If the child’s only “lovey” is the pacifier or sippy cup, having a back up “lovey” will still allow the child a comfort when his first choice is gone.
Understand that routines may change – Warn your families that routines may change when weaning baby from the pacifier and/or sippy cup, especially if it is used as the child’s primary comfort item. When the pacifier/sippy cup is gone, the child may need assistance with calming, temporarily; swaddling, rocking, singing and some extra cuddles may be necessary until baby learns how to calm himself without the help of his pacifier or sippy cup.

 
Give the pacifier or sippy away to a new baby – Sometimes parents can convince the child to give up these items with some incentive. However, it is suggested that the new baby receiving the child’s old pacifiers/sippy cups not live in the same house. It will be more difficult for the child not to suck on a pacifier if there is one nearby. Some parents are also able to negotiate a trade with their child: “If you leave your pacifier under the Christmas tree, Santa will take it with him and leave you a present!” If the child is ready, this trick is a gem!

 
Some tips to warn parents to not try are:
Never, ever cut the pacifier nipple and give it to the child – Yes, if there is no nipple for the child to latch onto they will be less interested in sucking the pacifier. However, the risk of choking is too great to ever recommend this as a means of pacifier weaning. Pacifiers have to pass what is called a “pull test” during manufacturing. A cut nipple would not pass this pull test and would be deemed as unsafe for a child to have.

 
Do not shame the child for wanting to suck on his pacifier or sippy cup – Toddlers and preschoolers typically do not respond to being shamed into giving up the pacifier or sippy cup. Telling the child that in order to be a “big kid” he must give up his most prized possession may just make him want it more. And who can blame him, who really wants to “grow up” anyway?!

 
Do not recommend putting something that tastes bad on the nipple of the pacifier and/or sippy cup – I have known families to dip the nipple in chili powder to convince their toddler to stop sucking on his pacifier. One sweet little guy I knew still wanted his pacifier so badly that he licked the chili powder off, little by little, chased it with water and eventually got his paci back. Again, this is a case of the parent wanting the child to make the decision to give up the comfort item. Not gonna happen! Sometimes the parent has to be just that and take control.

 
So we wish you good luck as you head into the magical world of the paci and sippy cup. It holds a strong spell on many little ones, but with the right guidance and when our families are ready, we can help them help their children kick the habit!

 
Do you have any suggested weaning methods to add to this list? What would you say to encourage your families to follow through with weaning their child?
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Lacy Morise, M.S. CCC/SLP educates families on the risks involved with over-use of the pacifier and sippy as an early intervention speech-language pathologist in the West Virginia Birth to Three Program. She guiltily confesses to allowing all of her children to abuse the use of the pacifier! She owns Milestones & Miracles, LLC a company devoted to educating families about child development and the importance of PLAY! Check out her website and blog and follow her on Facebook, Pinterest, Twitter and YouTube.

Milestone or Modern Convenience? Part 1: OverUse of the Sippy Cup or Pacifier

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Lacy recently wrote a blog for Virginia’s Early Intervention Program – specifically geared for therapists that work for that program, but the information is important for clinicians AND parents and caregivers. We have reposted it here but you can find the original HERE.

 

Written by: Lacy Morise, M.S. CCC/SLP

Although shocking to many, the sippy cup is NOT a developmental milestone. Nor is sucking on a pacifier, for that matter. But why do we (therapists,??????????????????????????????? parents and caregivers) celebrate these acquired “skills” as developmentally appropriate achievements? Why do we allow these “skills” to happen for much longer than they should? Is it just easier to always have a pacifier (aka mute button) in the baby/toddler’s mouth? Sippy cups are so easy to take along with us everywhere, how can it be harmful if a preschooler continues to exclusively drink from one?
The pacifier is a great thing for infants. It meets a physiological need to suck and allows baby a way to comfort himself. It may reduce the risk of SIDS as it appears to allow baby’s airway to remain more open and prevent baby from falling into a deeper sleep. Not to mention the other fringe benefits like quieting rowdy babes, helping them sleep longer and making outings and car rides more enjoyable for all. It certainly has a “place” in an infant’s world! And the sippy cup is an awesome convenience must-have. Drinks can be toted everywhere with baby/toddler and a sippy’s use means less spills to stain the carpet! Beautiful!
But aside from these benefits, there are risks associated with the over-use of both. Pediatricians and family physicians recommend weaning or stopping pacifier use in the second six months of life. Shocking I know considering how many toddlers we see with pacifiers in their mouths! The sippy cup can be skipped all together if natural development is occurring with no issue. Created for convenience, the sippy cup now has an entire market (and aisle in most stores) devoted to it! However a baby can transition to a straw (as early as 9 months) or open cup just as easily and drinking from both of these IS developmentally appropriate.

 

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As trusted resources on development, it is our job as early interventionists to inform families of both the positives and negatives of (prolonged) sucking. Some points to keep in mind as you discuss these “milestones” with parents and caregivers:
Prolonged sucking on a pacifier puts children at (a higher) risk for misaligned teeth. As those tiny white pearls are erupting, the pressure of the nipple of the pacifier can cause teeth to move around and shift. Also, the pressure can cause their hard palate, the roof of their mouth directly behind the front teeth, to change. It can push the palate forward, again changing the position of the teeth. In his research, J. Poyak concludes, “The greater the longevity and duration of pacifier use, the greater the potential for harmful results.”
A sippy often allows access to drinks all day long for a toddler. Not necessarily a bad thing, depending on what is in the sippy. If it is a sugary drink, the sugar increases the risk of developing cavities. The Medline Plus article titled, “Tooth decay – early childhood” states, “When children sleep or walk around with a bottle or sippy cup in their mouth, sugar coats their teeth for longer periods of time, causing teeth to decay more quickly.” Also, if a sippy is the only way a child gets liquids the developmentally appropriate skills of drinking through a straw and open cup are inhibited.
If children are allowed to have a drink (in a sippy or other cup) all the time, they may fill up on liquids and not eat meals as well, negatively impacting their nutrition. 

 

Although inconsistent, research suggests a relationship between prolonged sucking and speech delays. Barbosa et al. (2009) concluded in their research of 128 Patagonian preschoolers that, “The results suggest extended use of sucking outside of breastfeeding may have detrimental effects on speech development in young children.” When speech sound development is negatively impacted, so is the child’s intelligibility of speech making it difficult for others to understand them.
Sucking on a pacifier increases a child’s risk of developing otitis media (ear infection). The AAP (American Academy of Pediatrics) and AAFP (American Academy of Family Physicians) advocate for limited to no use of the pacifier in the second six months of the child’s life to decrease this risk.
A pacifier or sippy cup that is always in the mouth of a child, even when the child is walking around, puts him/her at a higher risk for mouth injuries. A 2012 study by Dr. Sarah Keim of Nationwide Children’s Hospital in Columbus, found that “a young child is rushed to a hospital every four hours in the U.S. due to an injury from a bottle, sippy cup or pacifier.” When little ones are just learning to walk, doing two things at once requires a bit more coordination than they are capable of!
Besides the physical risks, beyond the age of 1 a stronger emotional attachment to the pacifier (or sippy cup) makes it increasingly difficult for the child to detach. The pacifier/sippy goes from meeting a physiological need during infancy to providing emotional comfort to the toddler when scared, upset or sleepy.
However, it is our job to know and respect the individuality of each child. Therefore it is best practice to reassure parents that we recognize they know their child best. We all want our children to be happy and if using a pacifier and/or sippy is what’s best for them and their family, that is okay. Our job is to inform the families we serve the best we can. Equipping them with knowledge on why prolonged sucking may be detrimental to their child allows the family to make the final call. Education and Support, that’s what we are there for.
Have you ever had the “prolonged sucking” discussion with any of the families you serve? How might you begin this conversation with a family?
Today’s blog is Part I of a two-part series on prolonged sucking and what we can do to educate families about it. Stay tuned for “Part II – What to do When the Convenience Becomes a Hard to Break Habit” next week featuring ideas you can share with families who are ready to wean their child off of the pacifier or sippy!
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References
Barbosa, Clarita, Sandra Vasquez, Mary Parada, Juan Carlos Velez Gonzalez, Chanaye Jackson, N David Yanez, Bizu Gelaye, and Annette Fitzpatrick. “The Relationship of Bottle Feeding and Other Sucking Behaviors with Speech Disorder in Patagonian Preschoolers.” BMC Pediatrics. N.p., n.d. Web. 20 Mar. 2015. http://www.biomedcentral.com/1471-2431/9/66
EG, Gois, HC Rubeiro-Junior, MP Vale, SM Paiva, JM Serra-Negra, ML Ramos-Jorge, and IA Pordeus. “Influence of Nonnutritive Sucking Habits, Breathing Pattern and Adenoid Size on the Development of Malocclusion.” Angle Orthod.4 (2008): 647-54. Print. http://www.ncbi.nlm.nih.gov/pubmed/18302463
Guideline on Periodicity of Examination, Preventive Dental Services, Anticipatory Guidance/Counseling, and Oral Treatment for Infants, Children, and Adolescents (n.d.): n. pag. Web. 18 Mar. 2015. http://www.aapd.org/media/Policies_Guidelines/G_Periodicity.pdf
Hauck, Fern R., MD, MS, Olanrewaju O. Omojokun, MD, and Mir S. Siadaty, MD, MS. “Do Pacifiers Reduce the Risk of Sudden Infant Death Syndrome? A Meta-analysis.” PEDIATRICS5 (2005): E716-723. Do Pacifiers Reduce the Risk of Sudden Infant Death Syndrome? A Meta-analysis. PEDIATRICS. Web. 17 Mar. 2015. http://pediatrics.aappublications.org/content/116/5/e716
Keim, Sarah A., MA, MS, Erica N. Fletcher, MPH, Megan R.W. Tepoel, MS, and Lara B. McKenzie, PhD, MA. “Injuries Associated With Bottles, Pacifiers, and Sippy Cups in the United States, 1991-2010.” N.p., n.d. Web. 19 Mar. 2015. http://pediatrics.aappublications.org/content/129/6/1104.long
Natale, Ruby, PhD, PsyD. “Risks and Benefits of Pacifiers.” American Family Physician79 (2009): 681-85. – American Family Physician. Web. 18 Mar. 2015. http://www.aafp.org/afp/2009/0415/p681.html
Poyak, J. “Effects of Pacifiers on Early Oral Development.” Int J Orthod Milwaukee4 (2006): 13-6. Print. http://www.ncbi.nlm.nih.gov/pubmed/17256438
Regulatory Summary for Pacifier (n.d.): n. pag. U.S. Consumer Product Safety Commission. Web. 18 Mar. 2015. http://www.cpsc.gov//PageFiles/120645/regsumpacifier.pdf
“Tooth Decay – Early Childhood: MedlinePlus Medical Encyclopedia.” S National Library of Medicine. U.S. National Library of Medicine, n.d. Web. 17 Mar. 2015. http://www.nlm.nih.gov/medlineplus/ency/article/002061.htm
Zardetto, CG, CR Rodrigues, and FM Stefani. “Effects of Different Pacifiers on the Primary Dentition and Oral Myofunction Structures of Preschool Children.” Pediatric Dentistry6 (2002): 552-60. Print. http://www.ncbi.nlm.nih.gov/pubmed/12528948
____________________________________________________________________
Lacy Morise, M.S. CCC/SLP educates families on the risks involved with over-use of the pacifier and sippy as an early intervention speech-language pathologist in the West Virginia Birth to Three Program. She guiltily confesses to allowing all of her children to abuse the use of the pacifier! She owns Milestones & Miracles, LLC a company devoted to educating families about child development and the importance of PLAY! Check out her website and blog and follow her on Facebook, Pinterest, Twitter and YouTube.
Website: www.milestonesandmiracles.com
Blog: www.milestonesandmiraces.com/blog/
Facebook: https://www.facebook.com/milestonesandmiracles
Pinterest: https://www.pinterest.com/milestonesm/
Twitter: https://twitter.com/MilestonesM
YouTube: https://www.youtube.com/watch?v=HmuWPFDcqZ4

WHAT’S IN YOUR BUGGY? A visual guide to help you dive into Feingold.

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I am more of a visual learner.  That being said, I really struggled (and often dreaded) those first grocery store trips when we  started following Feingold.  I knew a lot of the foods we were eating were not on the diet so I couldn’t breeze through the store in automatic mode tossing in our weekly ration like I always had.  It took more planning on my part; making a list and researching the possibilities in my Feingold Food List book all before hitting the store.  Thankfully I was fortunate enough to make those first trips alone…no kids in the cart (or do you call it a buggy?), no distractions from the playing field.  I HIGHLY recommend the same for you.  Being by yourself while you figure this out will equal less frustration and a quicker trip.  My first trip, the one I referred to in this blog, took 2 hours!!!  I’m not telling you this to frighten you, just prepare you!  My husband thought I was in a ditch on the side of the road when in reality I was just blocking traffic in the organic aisle of Martin’s!

Don’t be discouraged, it gets easier, MUCH easier.  I can now recognize labels and items that are Feingold friendly and our family has established our favorites, our go-tos in the weekly meal rotation, that I toss in the cart with ease.  In the beginning I would read my book, try to familiarize myself with the brand and product names prior to grocery store arrival but this really didn’t help me out much.  What I think would’ve helped me is a picture, a real photo of the what the item looks like on the shelf.  Because we all know when you are juggling the baby in the cart who suddenly can unbuckle herself, the 5 year old who insists on grabbing every glass jar off the shelf and the 7 year old who keeps wandering off you don’t have time to read labels in the aisle.  You need to have the visual of that item in your mind so you can quickly glance, grab, and drop it in the cart before the baby gets a concussion, the 5 year old splatters glass and spaghetti sauce everywhere and the 7 year old gets kidnapped!

The items pictured below were (mostly) all on the approved list (The Feingold Approved Foods List Book, Stages 1 and 2) in 2013.  I have yet to receive my 2014 book.  Because food companies change ingredients from time to time I cannot guarantee that these items remain on the approved list.  To be certain you should join the Feingold Association to receive their materials and know for sure that what you are getting is salicylate, preservative, artificial flavor and color free.  The only true way to follow this diet is by purchasing the Feingold materials.  Unfortunately food companies don’t always disclose all ingredients on their food labels.  Feingold has done the work of writing food companies asking them to list all ingredients in their products so that they can place the item on the approved (or not approved) list.  Not all companies participate, but thankfully a lot do.  Variety is always a good thing!  Also, I can’t stress enough the importance of going ALL IN if you want to try this diet.  Feingold is strict and trying to do it on your own will not give the diet a fair chance for success.  Salicylates are found in many fruits and a few vegetables (the Feingold book lists those offenders) and in Stage 1 (the first 6 weeks of the diet) these have to be avoided.  Stage 1 is like detox from foods containing salicylates, preservatives, artificial colorings and flavorings.  In Stage 1 an item that is organic and all natural may not be “safe” because it is colored with berries (berries contain salicylates, therefore they are not permitted in Stage 1).  Another thing to consider is personal hygiene products.  Most soaps, lotions, toothpastes, and shampoos contain scents which are not permitted on Feingold.  Again, don’t be inimidated.  If I can do it, you CERTAINLY can!  I just believe to do Feingold the right way, you need to purchase their materials.

I find the majority of the items listed below at my local Food Lion and Martin’s.  Thankfully, with the growing popularity of eating clean, grocery stores are beginning to expand their organic offerings.  The store that I prefer to go to and satisfies most everything I need (except for O’s favorite hot chocolate that can only be found at Whole Foods!) is Wegman’s.  Have you been to one yet?  Seriously, you should go!  You could spend like a whole day there…it’s AWESOME!

 

Okay, so now you’re ready!  With these images burned into your mind and your sneakers laced up tight you’re sure to have Feingold success with these items in your BUGGY!

TRUSTING MY GUT. AND HIS. One Mom’s journey in understanding the gut to brain connection.

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I always felt destined that I would have a child with special needs.  I felt that because of my love for special needs children it would be completely natural for me to love and raise such a unique child.  This was not a fantasy…I never imagined it would be easy or that I could do it alone, but I felt by the grace of God I could and would handle it.  I knew from an early age I had a special talent or gift in working with children with special needs.  The first thing I told others I wanted to be when I grew up was a special education teacher.  I would spend my recess playing with Lacey and Albert, whom both had Down’s Syndrome, helping them learn to see-saw (I know, I am dating myself!) or play ball.  From an early age I had the gift of patience.  And even then I remember after spending time with Lacey and Albert, I felt full, renewed, satisfied that I had done something that day that mattered.  As I got older my dream of becoming a special education teacher changed to wanting to become a speech-language pathologist, which is what I ended up getting my master’s degree in from WVU (Go Mountaineers!).  This profession has fit me perfectly.  I get to play with children every day that I work all while helping them achieve one of the greatest gifts we too often take for granted, communication.

 

So after graduating, getting my first job and getting married it was soon time to start discussing children with my husband.  We started our family and after 3 healthy children were born we decided we were complete.  Despite them all being healthy, I still had this urge that I was meant to mother a special needs child.

 

While my second child, Big O (as we lovingly call him, he was 9lbs. 4 oz at birth!), has never officially been diagnosed with a medical condition, he has taught me A LOT about unique challenges in his short 5 years of existence.  All the things I did right (and had no guilt over) in raising his older sister were all WRONG with him.  He didn’t sleep as well as she did, he nursed ALL the time, he didn’t respond to traditional discipline methods and he wasn’t (and still isn’t) scared of my “angry” voice.  While he stole hearts with his unique look and deep toddler voice, he had a tendency toward ornery-ness and everyone described him as “all boy”.  The day he turned two, something changed in him.  He upped his game.  But I just regarded it as the terrible two’s and didn’t give his acting out much more thought than that.  Then he turned 3…and he upped his game even more.  But I just attributed his behavior fluctuations to the tumultuous threes, and blamed the fact that he was about to become a middle child and that we had just moved into a new house, neighborhood and state.  Then he turned 4.  My third child had just been born a couple of months before so his world had been turned upside down, I was hormonal and definitely more impatient than normal and he was just (very) strong willed.  Needless to say, over the past year or so we (my husband and I) have begun figuring out the puzzle of our Big O.

 

Allow me to elaborate:

 

Owen is strong willed, he was described by his preschool teacher (with 15+ years experience) as the strongest willed child she had ever worked with…thanks, I guess.  He had his own ideas and there was no persuading, bribing or convincing him otherwise.  I found nothing that motivated him consistently, nor did I find a discipline method/punishment that worked consistently.  I searched, discussed, cried, prayed and felt ashamed that I, being a person who works with young children daily, couldn’t figure out my own child.  After my third child was born I hit a breaking point.  I couldn’t do it anymore.  I wasn’t myself.  I had become so impatient with my children and husband, some mornings I didn’t want to get out of bed for fear it would be another “bad” day for Owen/me/us.  He argued with me over EVERYTHING…what to eat for breakfast, what to wear, whether or not he would brush his teeth, leaving for preschool was a fight, drop off at preschool was sometimes difficult, and the list goes on.  At its peak, he began to have small outbursts where he would get upset over something that made no sense to me and there seemed to be no trigger…I couldn’t figure it out.

 

I started where most parents turn for help – Books. I read books on strong willed children and talked to friends about discipline methods they recommended.  The Strong Willed Child, You Can’t Make Me But I Can Be Persuaded, 1-2-3 Magic (for the 3rd time!) all resonated in me.  I gathered different tips from all of their talented authors but none “fixed” our situation completely.

 

God bless my BFF and business partner, Nicole and my mother.  They spent hours on the phone with me counseling, encouraging and listening.  Finally during a phone conversation with Nicole on a weekday morning after an awful weekend of trying soccer with Owen, she helped me realize I had to reach out for help.  What was going on was more than I could figure out on my own.  My ego was bruised, but I felt relief at the same time.  It was time to surrender.  Sometimes you just have to know when to fold ‘em.

 

We started with our pediatrician at O’s yearly well visit.  After O left the room she and I had a lengthy discussion about what was going on with Owen’s behavior.  She was wonderful, attentive and concerned.  She reassured me by saying she felt it was mostly a matter of maturation and that she didn’t believe any diet out there would help transform his behavior. Whew…I was off the hook with the whole diet thing.  I had heard of a diet that could possibly help kids with symptoms similar to O’s but I was afraid to try it.  It would be a lot of work and I mean, seriously, if my pediatrician doesn’t believe in it, then really, it must not be worth even a try…or was it?

 

So I walked away not feeling like that was the end of the story.  That wasn’t enough for me.  So I decided it was time to reach out to the wonderful women I am blessed to work with every day in my job as an early interventionist.  I contacted Leslie, one of the most awesome and knowledgeable Occupational Therapists I have ever known.  She recommended a brushing program to address O’s sensory needs.

 

Next, I spoke to Chrissy, the most patient, wise and amazing behavior analyst EVER!  She sacrificed 4 hours on a Saturday afternoon to discuss our concerns and get to know O.  Her suggested behavioral strategies were so simple, yet so profoundly impactful.  She educated me on “the beast” that made it hard for O to listen, follow through, and give up control.  Understanding how his mind was working helped me to understand why what we were doing wasn’t working and why what she was suggesting would work.  I wish she could move in with us!

 

I knew if we were going to give O (and us) the best chance for positive change, we had to go full throttle.  It was a combination of my years working as a therapist and hearing of parents doing the Feingold diet, Leslie’s experience using the diet with her children and Chrissy’s encouragement (You can do anything for 30 days!) that drove us to give Feingold a shot.

 

Except for the little I knew about the diet through my work, I didn’t really have a good understanding of the Feingold diet.  I overheard some moms at the local book fair discussing how red dye made their sons “crazy”.  My ears perked up as I eavesdropped on their conversation and the wheels in my head began to turn…could this be something that might help O?  Did he really get that much red and yellow food dye anyway?  In December 2012 my husband and I began reading food labels and eliminating anything that had red dye #40 and yellow #5.  These two food dyes have the worst reputation of the bunch, so it was obvious for us to cut them out first.  After a couple of weeks we noticed a change; O was more in tune with us and what was going on in his environment.  Hmmmm…this is when we began to wonder if there was something to this.

 

January started out good with preschool and O’s overall behavior at home.  Then about half way through the month things started getting back to his “normal”.  All in one month, his teacher asked me to stay so she could speak with me about O’s day, I broke down in front of his teachers, and I lost my cool with O in the car after a not-so-good note came home from school.  I couldn’t keep keeping on like this…

 

When I would speak to O about what “bad” things happened at school or at home during the day he would say to me, “But mom, it’s just so hard for me to be nice” or “It’s just too hard for me to do my work”.  And after hearing this a few times I began to believe him.  I finally began to realize there was something in him that he couldn’t control.  He knew he should resist, he knew right from wrong, but something wouldn’t allow him to do the right thing.  Something inside his little mind wouldn’t allow him to give up the control.

 

So by now it was March.  We were still cutting out obvious food dyes and I had just been in contact with Chrissy, my behavior analyst friend who encouraged me to give Feingold a try for at least 30 days.  Because if I didn’t, I would always wonder, “What if…”.  So nearly kicking and screaming I borrowed the materials from a friend who had done the diet with her boys in the past.  And they sat on my office desk for weeks…then one day I picked them up.  This turned out to be one of the best moves of my life, and O’s.

 

My first trip to the grocery store was grueling.  Book in hand, Coke (my indulgent beverage of choice!) in cart, and cash, lots of cash in my wallet I made it through the organic aisle and walked out with a cart full of what I hoped were Feingold friendly groceries.  The next day I visited Whole Foods…whoa…cha-ching!  I have only made two trips there in 8 months.  There are certainly a few things I can only get from there, but thankfully my local store can supply most of our weekly essentials and Whole Foods is proving to be only a quarterly necessity.  My budget is thankful for that!

 

After those first trips my head hurt!  I had decided that for this to work the whole family had to go on the diet in the beginning, for at least the first 6 weeks (stage 1 of the Feingold Diet).  It certainly wouldn’t hurt any of us to eat a little cleaner!  So that’s where we started.  All in.  Feingold followers we were all becoming!

 

It has been nearly 10 months since we began following Feingold.  We will not turn back now.  With each passing week the food shopping and planning becomes easier and the change in my son is all I need to know we are doing the right thing.  As thankful as I am for the verbal support and encouragement I received in the beginning, I longed for more practical tips, recipes and guidance to get me started.  That’s why I wanted to write this blog.

 

As moms we all belong to each other, I believe.  What I know about raising kids I am happy to share with someone who is struggling.  And what I don’t know (diet, behavior strategies, sensory help, etc.) I want others to share with me.  That was the motivation behind Nicole and I developing 1-2-3 Just Play With Me; a resource that shares with others what we know helps infants and toddlers grow, develop and build bonds with their families.  As we have pushed forward promoting our product we have remained mothers at home to our collective 5 children, who daily teach us MORE that we want to share.

 

I hope this blog encourages all those that can identify with our story.  I pray that you too reach out for help, lighten the load on your own shoulders, stop blaming yourself for what you can’t fix and find support in those you call upon.  In the weeks to follow I will be posting more from our Feingold journey thus far.  If you are on a similar journey, we would love to hear from you.  We all belong to each other…we are all in this together!

 

O enjoying a red Hug Jug pre-Feingold!

O enjoying a red Hug Jug pre-Feingold!

 

To learn more about the Feingold Diet and The Feingold Association of the United States please visit www.feingold.org.

You Really Are What You Eat & So Are Your Children: The Effect of Nutrition on Development

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This article was originally written & published for Child Guide Magazine, which provides excellent resources and activities for families. The January 2014 issue can be found in it’s entirety HERE.

You are what you eat. How many times have you heard that? As adults, we certainly have considered this when considering our own food intake, but what about our children?

One local family has been considering every bite of what enters their son’s mouth.  Finn Csordas is 2 ½ years old, who is affectionate, silly, and quite the charmer to his 3 older adoring sisters, but this was not always the case. Shortly after his birth, his parents, Jennifer & Alex, noticed how frequently Finn was fussy. His original pediatrician initially felt this was simply colic, but as Finn grew older, his parents’ concerns also grew. Finn spit up more frequently than other babies.  He had frequent hives in many places on his body that the family was told were eczema patches. He was fussy more than he was content and could not find a way to self-soothe or to be soothed by his parents. More concerning, Finn seemed “spaced out,” and had significant delays in social, language, and motor skills that became more noticeable the older he became. The most alarming observation though, was head banging.  It started at night when Finn would bang his head against his crib to fall asleep but progressed to banging throughout the night, and then even during the day, while playing.  Finn would find the corner of the wall and bang his head until a bald spot appeared and didn’t seem concerned by the discomfort.

 

Jennifer & Alex persisted in their belief that these symptoms had to be more than eczema or colic – but their journey wasn’t an easy one.  After switching pediatricians, they began a search for what was going on with Finn. He started medication for acid reflux, which helped somewhat with spitting up, but not with other symptoms. Because he did have a history of reoccurring ear infections, he had tubes placed in his ears.  Shortly after this procedure, he did start to walk, but the communication and social skills continued to become more delayed and the head banging intensified.  The Csordas’ worked with a team of early interventionists from West Virginia Birth To Three, including speech, physical, and occupational therapists that offered strategies from sensory integration and balance activities to teaching basic imitation skills during play as a basis for eventual language development.  A developmental specialist with experience in behavior observed Finn and worked on providing self soothing options and deterring techniques for the head banging. A service coordinator helped link the family to specialists to help find a solution. When sensory strategies weren’t very successful, an MRI of Finn’s brain revealed no concerns, and he passed a detailed screening for Autism at Children’s National Medical Center, the team called on a registered dietician through the West Virginia Birth To Three Program.

 

Finn was evaluated by a gastroenterologist to determine if he had an allergic inflammatory condition of the esophagus called Eosinophilic Esophagitis (EE). When it was clear that he did not, a final referral to a pediatric allergist was made. After blood testing and 3 days of extended patch testing, the Csordas’ finally got their answer – Finn is allergic to soy, wheat, dairy, oats, and has a significant phenol intolerance (Phenol is a chemical found in many natural foods and in common artificial preservatives).

 

While some of their larger fears were put to rest, Jennifer & Alex had a whole new world to learn about.  Finding foods that were safe for Finn and that he would actually eat while maintaining the required calories and nutrients for his age is no easy task, but was one that they took on without reservation. Jennifer shares, “To be completely honest, I wasn’t sure that I believed all the diet changes would help, I prayed that they would, but deep down I was skeptical. To think a handful of goldfish crackers or a couple grapes could cause him to struggle for days and completely alter the course of the entire family is something I would have never thought possible, had I not lived it! “

 

After 2 weeks of eliminating the foods Finn was allergic to, there was a dramatic change in his demeanor and development. His mother recalls, “We had food journals and had to document everything he ate, all his skin reactions, behaviors, and try to make sense of all the parallels. About two weeks after we had changed his diet, he went from having about 5 words to over 70 words, and no longer needed weekly speech therapy!” Within 5 months of changing his diet, Finn has made over a years worth of progress with development.  He is walking, running, and climbing, talking in complete sentences, initiating social greetings, and is most importantly – he is a happy 2 ½ year old. While his speech is still slightly behind for his age and the head banging still remains in smaller amounts (it is likely more a learned behavior, which was originally caused by the allergic reactions), Jennifer and Alex are thrilled that they can finally get to know the little boy he actually is and not the one who could only react to pain & discomfort.

 

Finn is not alone in his diagnosis of food allergies. According to a study by the Center for Disease Control, food allergies increased 50% from 1997-2011. And while the number of people who have a food allergy is growing, there is no clear answer as to why.  And while many “traditional” allergic symptoms, such as facial swelling and hives, are well known and well recognized, those such as the ones that Finn experienced are often misdiagnosed as something other than a food allergy or intolerance.

 

Georgeann Freimuth, MS, RD, LDN, is the Registered Dietician who spearheaded solving Finn’s developmental puzzle. Freimuth, a Licensed Dietician Nutritionist and a part time professor at Shepherd University, works with children and families through the West Virginia Birth To Three Program and privately through consultations.   She sees more and more children having behavioral and developmental consequences from what they eat. When people question the relationship between the two, Freimuth jokes, “Think there’s not a gut to brain connection? Come have a glass of wine with me!”  In all seriousness, the connection of nutrition’s affect on the body should not be ignored. Freimuth says, “The gut to brain connection should not be overlooked when dealing with a child who is sensitive to emotion anger, anxiety or who has behavioral concerns. This is important because the brain and the gastrointestinal system are intimately connected. Certain foods and food intolerances or allergies can adversely affect a child’s behavior and attentiveness, while certain nutritional deficiencies can cause aggressiveness disorders and behavioral disorders as well as subtle and occasionally dramatic effects on the child’s behavior.”

 

Some food allergies are severe with defined noticeable reactions, like Finn’s, but others can be subtler.  Either way, nutrition should be included in the complete list of possibilities when assessing a child’s well being. Freimuth says,  “Food allergies or food intolerances can affect the nervous system causing the brain to have alterations in brain chemistry which then can affect a child’s behavior. Understanding if a child has food allergies and/or food intolerances along with nutritional imbalances could be helpful when trying to help a child’s behavior or development.” Often elimination diets (where certain foods are removed one by one) are suggested to determine what is the potentially offensive food.  However she cautions, “It is recommended if a parent wants to try a trial and elimination diet at home to see if their child’s diet is related to their behavior they should consult a Registered Dietitian. The caution used with trial and elimination diets are sudden nutritional deficiencies when certain food groups are removed.”

Jennifer Csordas agrees. “Before we knew all Finn was allergic too, it was like having a toddler with colic. He was always unhappy and no matter what we did, we couldn’t change that. Now he smiles all the time, laughs and plays, things that I took for granted when my girls did them. It takes a lot of planning and can be a challenge at times keeping up with his diet, but to know he isn’t in pain is a huge blessing. “

While eliminating aversive foods can be helpful in some cases, increasing particular nutrients and minerals that are lower than typical are necessary in others. For example, in some cases, increasing zinc levels can improve symptoms associated with ADHD.

As the trend for extremely busy families continues in America, so will the market for convenience foods, which are often full of too many ingredients to count and enough preservatives to frighten any parent. While it does take pre-planning and self-packaging on the part of parents, ensuring children have whole foods (ones your great grandmother would recognize. Yes to the apple. No to the bright orange cheese puff) is a great place to start.  Remember that whether your child has a diagnosed condition or developmental concerns or not – foods that we all eat certainly affect us in some way.   The effect of nutrition on an individual is certainly more far reaching than allergies alone. An individual can have developmental or behavioral concerns from intolerances to certain foods or reactions to the chemicals and preservatives found in many foods children are fed, or from low levels of essential vitamins and nutrients.  Freimuth advises, “Intolerances to foods, food additives or looking into food allergies may have a crucial role in your child’s behavior. Behavior and cognition in children and adolescents can be influenced by what they eat and their nutritional statuses.”

While nutrition is not the culprit for all developmental or behavioral concerns, it certainly is a possibility. If you have concerns about the role nutrition is playing with your child, speak to your Pediatrician or a Registered Dietician who specializes in pediatric care. Prepare for the conversation by logging 3 days worth of everything your child eats to share specific intake (including medications) and list frequently observed behaviors or developmental concerns for discussion.  Each parent may have individual standards for what they are able and comfortable to provide their child to eat, but all parents wish for happiness and health for their child. Let’s help our children live out “You are what you eat.” We can do this first by remembering that what they put in their bellies has a huge impact on their brains.  We can also start with small changes to provide nutrition that helps them to be happy and healthy for many years.

 

Georgeann Freimuth is dedicated to helping families learn more about the gut to brain connection and how it could be affecting their child. She can be reached at: georgeann.freimuth@yahoo.com The author thanks her and the Csordas family for their contributions to this article.

 

Nicole Sergent, MPT is a Pediatric Physical Therapist & co-author of 1-2-3 Just Play With Me. Her favorite processed food is a Reese Cup, but she feels happier & knows she is smarter when she eats her many favorite non-processed foods – especially nectarines & brussel sprouts!

 

 

Invite Your Kids (Even Babies) To Sunday Dinner! Why We Need To Fight Against The Extinction Of Family Meals.

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It’s Sunday. Are you having Family Dinner? What does it look like for you?

Is it this?

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Or this?

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Or even this?

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Is your table where you serve your food, or your back seat?

Let me start by saying that a friend of mine recently commented that she felt guilty that her son had to eat dinner on the way to soccer practice and I reassured her of her Mommy-Awesomeness by revealing the impressive fact that my daughter ate Mac-N-Cheese for dinner on the way to dance that was served in a glass measuring cup because all the bowls were dirty! (Who can beat that I ask you?)

The strong current of society pushing the average family (mine included) so swiftly that it somehow keeps up from remembering the importance of how a family meal contributes to a child’s development and frankly, the health of all of us.

Before we had children, my husband and I are at the kitchen table at times, but more often than not, we ate in front of the good old TV. Not a proud admission, but when there is just two of you, setting the table seems a bit – much. Or at least it did for me EVERY night. When we started having children, that shifted. MANY of my memories of childhood centered around the table. From secrets at the “kid table” (which I sat at until a few years ago) with my cousins to reading the morning paper with my parents over breakfast, sharing a meal together was part of our regular existence and for good reason. I wanted the same for my daughters.

Children who eat at the table with their parents learn many things, and I am not talking about what fork to use first. At family meals, children learn to make EYE CONTACT. They learn to use MANNERS. They practice the fine ART OF CONVERSATION (with actual voices and not just text messages). They learn SOCIAL ETIQUETTE such as taking turns when speaking and LISTENING to what matters to someone they care about. The greatest part of all of this – they get to practice all of this in the safety net of the people who love them most in the world – their parents and siblings! The family meal is where children can take a stab at the something besides the entree – they can explore social relationships with people of various ages and learn from real experiences how to connect with others over a meal. And guess what? As adults – this is a skill they will NEED.

Do you know how early this starts? Ready for it?… IMMEDIATELY.

Here are some ideas to make this look real for our families.

A newborn can be held during dinner or placed in a safe place near the table (this may be my only endorsement of what I call the “baby container.” Usually I am not a fan, HERE’S WHY). Hearing the voices of his/her family members and smelling new smells are important SENSORY EXPERIENCES.

An older baby will watch you eat before he/she does. Yes, sucking is a natural reflex, but chewing is a learned one. I remember a bright and loving parent, whose daughter was blind, ask me how she could teach her to chew and spit out toothpaste. (With help – we found a way, but the example illustrates that activities as simple as chewing must be modeled). If a baby is not given a place at the table, he/she is denied the modeled example of many DAILY SKILLS, like chewing, but also drinking from a cup, using a spoon etc.

An even older baby, learns to IMITATE at the table. The meal provides opportunity to mimic behaviors he/she views. In addition to the chewing example, the baby learns to self feed using both hands and utensils. Yes, this is MESSY, but that’s what wipes are for. Babies don’t learn to feed themselves (or do anything else) without PRACTICE first. (Plus one day that spaghetti face picture will be really funny). Did you know that once a child can imitate a motor behavior (sometimes as subtle as sticking out his/her tongue), he/she can imitate language? Think about it,modeling simple movements (blinking eyes, clapping hands, banging toy on tray) all come before language. Family meal times are a great place to practice this essential skill. More about that HERE.

Children learn WHO THEIR PEOPLE ARE at the table. Receptive language (understanding) comes before verbal language (expression of words). Ask your baby where his/her sibling, parent, dog are – they’ll surprise you by looking right at them, before they can call them by name. Practicing this at meal time with people or objects (where is the banana?) gives baby an opportunity to recognize and  eventually verbalize to “their people.” Think of it as your 1st family conversation. Soak it up!

Children develop a variety of PREFERENCES for food at the family meal. Experiment with different textures, colors, smells, tastes, and temperatures (all as your pediatrician advises) and you will quickly learn even more about your child. My 9 year old is not a fan of meat – and in true form, at her first taste of the baby food version of chicken, she promptly vomited it right back out at me.  Meat clearly was not her preference. Note taken. (Pass the wipes please, Honey).

Meal times are also a place to share early information about NUTRITION. If I let my daughter make her own decisions, she would chose noodles, rice, pizza, and bread every night. It’s not been an easy road to her seat at our dinner table, but she finally understands that she needs all of the food groups at each meal and why. This can start at an early age for any child. Keep it simple and in terms children can understand at their age – “Fruits provide vitamins that help keep you from getting sick. Dairy keeps your bones and teeth strong. Vegetables are important for your eyes, skin, and hair. Protein helps build muscles so you can lift heavy things and complex carbohydrates give you energy to run for a long time.”  Trust me, kids understand this much more than “clear your plate because I said so.” Let’s be real – they come out selfish little people and if they realize there is something in it for them, they are often more motivated.  (My latest attempt for my vertically challenged offspring is that to get out of the booster seat like their pals, they’ll need to eat well to grow. I’m hoping this works before I drop them off at their first junior high dance.)  Teaching this can be fun! Have younger kids? Model balanced nutrition with pretend play foods! We use My Plate. I keep a copy on the side of the fridge and they need to compare their plate to this example.

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If they don’t want the salmon I made, that’s fine with us, as long as they 1) choose another healthy protein (nuts or peanut butter are popular choices in our house) and 2) I don’t have to make it. (Nope, I do wear many hats but short order cook is not one I claim).  I wish my children were more adventurous with foods, but I gave up the battle for a wide variety long ago and focused on healthy balance. I hear variety should increase with age – I’m not holding but breath but found this information on answering the question of “Is your Child a Picky Eater or Problem Feeder” helpful.  More ideas for including kids in mealtime HERE.  I love this idea for hands on learning about food!

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In addition, exposure to varied food can teach kids early on about different CULTURES and WHERE AND HOW FOOD is grown. Visit local farms to show them how real food actually grows on trees and in the ground. Enjoy self picking if you have orchards that provide the option or garden if you have the talent that I do not! Do you have a dairy farm near by? (We have one that delivers milk in old fashioned glass jars to a cooler in our driveway. Our girls love him and call him the Milk Fairy. I call him HEAVEN SENT because I am no longer running to the store all the time!)  Learning about the process of getting food from garden to table helps children value their nutrition and take ownership of it. I love this idea pinned on our Pinterest Board to share where different foods come from.

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So meals are important, but let’s keep our focus on reasonable goals. Maybe one person in your family works late. Yes, you might have to feed the kids early, but they could sit with the spouse that works late while he/she eats and have a small dessert. Maybe your kids have activities or practice many nights a week. Aim for sitting together 2-3 times a week. And breakfast on a weekend can count. Maybe you don’t have time every night to cook or plan — in my humble opinion, a quality family experience together over bowls of cereal, outweighs anything alone in front of a screen any day. Two thirds of American families eat dinner with a T.V. on. Think of it as the T.V. robbing you from the limited number of conversations you can have with your 3 year old (there are fewer than you realize). Let’s change that statistic and together raise children who can share the highlights of their day while asking to pass the cereal (oops, I meant, quinoa with tilapia and asparagus).

Family meals are too important to become extinct. We need them to raise independent and healthy children. So, get to thinking about some practical, realistic ways, you can invite your favorite little guest to dinner! Here are some from our Pinterest Board – PLAY With Food to get you started.  Share your ideas with us here or on Facebook! Bon appetite!

Like these ideas? We believe that linking child development to PLAY makes both parents & children smarter and happier. So we offer hundreds of examples of just that. Bonus is – they come in card form so while you can have time to digest that family dinner together because you can learn about your child while only digesting small bits of specific information at EACH stage of infant/toddler development. Want to hear more? Check out 1-2-3 Just Play With Me (great as a baby gift! and WE SHIP FOR FREE!)