Our post today is courtesy of Denise A. Somsak, MD a pediatrician and mother with young children. Dr. Somsak (Dr_Som)blogs at
www.pensivepediatrician.com where she posts about areas of interest and concern for parents. In  this  post she speaks to  good nutrition, an area of major concern for all parents in this day of rising childhood obesity.

Pack your child’s lunch. You will learn a lot about what your kids like and correct portion sizes; you will naturally shop for healthier foods. Our two daughters attend a half day of preschool 5 days a week. We pack their lunches, which at first thought seemed like a huge inconvenience especially in the hustle bustle of the morning. Our new daycare demanded it (they have no kitchen), or we never would have tried it. We love it.

No more complaints about canned ravioli or guilt about the potential hazards of ground beef. The girls used to eat sugary canned mandarin oranges, pineapples, and peaches, along with frozen fish sticks, tater tots, and french toast sticks. No more snacks of graham crackers or gold fish crackers. Instead of the frozen white bagels topped with American cheese they were typically offered, I can pack whole grain (less sugar and more fiber) breads or organic white bread.

No more processed foods. No more high fructose corn syrup, hydrogenated oils, or trans-fat. Now they eat fruits and vegetables fresh from my refrigerator. Since the left overs come home, I know exactly what they consume. Even if my five year old says her friends tease her about her “stinky” hard boiled egg, I know see eats everything but the yolk.

Read labels and look for ingredients that you can understand. Generally, the longer the list of ingredients, the more processed the food. Many times organic food has a shorter and more understandable list of ingredients. The best food does not require a label or packaging: fresh produce. If in doubt, what comes out of the ground or off a tree is far better than something in a bag or box. Frozen or canned fruits and vegetables are OK as long as they don’t have added sugar or salt.

Know what to feed your children. The formula for feeding your children is quite simple. Offer a little protein, a little starch, and 2 fresh items (fruit and/or vegetables) 3 meals a day. Add a source of vitamin D and calcium which for most of us means fortified milk products (soy, rice or cow) and make sure there is iron, which for many of us means meat or seafood but peas, spinach, beans, dried apricots, almonds and greens work too. For snacks, lots more fresh produce. I have discussed this approach with parents of my patients, and I am amazed at how quickly they understand. They can easily apply it to good foods they serve at home.

The Institute of Medicine (IOM) developed recommendations assists the federal government in creating nutrition guidelines for daycare centers and after school programs. Use these basic IOM suggestions when you think about meal planning for your family.  If you want more specific and personalized information for your child use the USDA food pyramid calculator.

Know how much to feed your children. Portions have become super sized everywhere even for kids. I think offering appropriate amounts per the IOM guidelines cited above is a good start. If you want to read labels and count calories, you can check the National Institute of Health website to learn how many calories your child needs in a day . If you are trying to change your dietary habits, calorie counting for a few days is an informative exercise. Write down everything your child eats and drinks each day. Read the labels to include estimates of the calories. If you need help, bring the journal to your doctor and start the discussion about nutrition.

Know what to do if they are still hungry but ate a lot. Fruits and vegetables are vital to good health. Your children could never eat enough. Challenge your kids to eat a rainbow of produce everyday. I start in the office by seeing if they can name some green fruits or yellow vegetables (corn doesn’t count which gives me a chance to explain how it and potatoes are starch). Water is free and safe from your tap. Make it available and palatable (maybe with a little lemon or ice). It can help kids fill up faster at meal and snack time.

What they drink matters just as much as what they eat. Drink sitting down and mostly at snack or meal time. For children under 5 years, cups should be about 5 ounces. It is not easy to find cups this small especially in restaurants. We use espresso, sake, or 5 ounce dixie cups depending on the situation. I don’t know why they even make sippy cups bigger than 7 ounces. If a child carries a giant sippy cup full of juice into a check up, I know I need to address obesity and tooth decay not to mention the risk of infection because the kid drops the cup on the floor at least a dozen times during the visit. Children do not need juice. If you must offer it, no more than 4-8 ounces per day. Look for fruit and vegetable juices that contain the least sugar. If you must have soda in the house, make it diet. Splenda is a better sugar substitute than the artificial sweetener, Aspartame (NutraSweet). Low fat and non-fat milk are healthier options than whole milk and no more than 24 ounces in a day.

What you eat matters.  If you want to try to make your child’s food a bit healthier, start at home.  Studies reveal that kids will not succeed unless the whole family eats healthy.

Understand and get involved. We should offer fresh and nutritiously dense foods at daycare centers and schools, but we don’t.  If you have the time and the gumption, get involved at your child’s school. Kudos to First Lady Obama for tackling this difficult problem. Check out her website for more information on health and nutrition. Helping children eat healthy may seem simple, but it is politically charged. Check out Michael Pollan’s The Omnivore’s Dilemma or the movie Food, Inc. to see what First Lady Obama is confronting in an ever so gracious way.