Picky Eater at Home? What Parents Should do 10 times to help

Posted on September 24, 2013August 12, 2015 by speechies

If your toddler is a “picky eater,” you are not alone; 25% of parents in the U.S. are dreading feeding times, and that number is increasing. So how do we create all accepting omnivores in our kiddos? Well, the researchers say to start as early as possible.

The Rule of 10: Your child should try a new food 10 times, before deciding whether they like it or not

How do you decide if your child likes or dislikes a food? Researchers have probed as to how children make this decision. Their findings: children need multiple exposures to new foods before they accept it. Studies have looked at infants acceptance of vegetables, as young as four months. Results showed that after 10 opportunities to consume the vegetables, all infants significantly increased their intake.

While other studies showed that the average parent only offers their child a new food 3-5 times, less than half the times of the recommended opportunities!

Children like what they know, and eat what they like

Children’s food preferences and intake patterns are shaped via early experience with food and eating. Giving your a child a wide variety of food tastes is crucial to creating the omnivore.Exposure to food is generalized. That means, if you start out by giving your child only sweet purees (carrots, sweet potatoes, pears, etc.) and then try something bitter (like broccoli), they are most likely to reject it the first few times.

Don’t shy away from spiced up foods! Children’s experience with food influence their preferences and the amount that they consume. Research suggests that the earlier and broader the experience, the healthier the child’s diet.

So, San Francisco moms: what are you waiting for? Check out the weekly menu at Fresh Baby Bites and start giving your child a broader experience with food... and get lots of these fresh, delicious, and local tastes... remember your tot needs 10 opportunities to try it!

3 Reasons to Say No to the Sippy Cup

Posted on August 27, 2013August 12, 2015 by speechies

At the 9-12 month mark, you should start thinking about weaning your baby from the bottle. Prolonged bottle use can lead to a misshapen palate, protruded teeth, and can cause articulation delays, such as a lisp, later on.

And although the seemingly logical transition would be to move on to a sippy cup, there is some evidence to say otherwise. Using a sippy cup is actually too similar to using a bottle and can have adverse long-term effects.

3 Reasons to Say No to the Sippy and Go Straight for the Straw

1. A sippy cup can alter tongue placement (which also happens when using a bottle). This means that the tongue is pushed in a forward position, which can also cause the teeth to protrude over time. These structural changes are what can lead to speech and articulation delays. When using a straw or a regular cup, the tongue is placed behind the teeth.

2. Babies do a similar “head back” motion + sucking, in order to get liquid out when using a sippy cup. Moving the head back to get liquid does not engage the facial muscles (e.g. cheeks, lips, tongue) as they should be worked for continued sensorimotor development. Sippy cups don’t provide the oral-motor workout, but using a straw does!

3. Use of sippy cups have been tied to an increase in cavities and tooth decay. When babies and toddlers drink from sippy cups, they immerse the six upper teeth, which means constant exposure to the liquid, leading to tooth decay if there is something sugary (like juice) inside.

If you are using a sippy cup, think of it only as a transition to a straw or a regular cup to get less attached to the bottle. And although straw cups and regular cups can be more of a mess (because they don’t have the valve that sippy cups do), it is better developmentally for your baby.

Try the Oxo Straw Cup and Oxo Training Cup to help with transition to say sayonara to sippy cups!

50 Words to Teach Your Toddler in the High Chair

Posted on August 14, 2013August 12, 2015 by speechies

Using daily routines, like bath-time and getting dressed, are all great times for a language learning opportunity. Breakfast, lunch, snack, and dinner times can be important learning times in your child’s daily schedule too. Talking and eating is something social that we all do as adults, so make mealtime another language building opportunity with your little one.

Remember that your child is learning words from you. So it is important to be that ideal language model.

As always, use the five methods of word learning to reinforce and teach your child new words and concepts. Since mealtime can be repetitious, its a great opportunity to give your child multiple exposures to certain words and concepts. Here are a few to use:

Objects Actions Concepts Location

spoon sit down mine/yours on the plate
fork pour more/less next to the cup
cup stir, mix all/none under the table
plate, dish cut hot/cold in/inside your belly
milk, water bite, chew empty/full
food names wash crunchy/mushy
napkin clean up all gone

Phrases

Time to eat, Wash hands, Sit down, your chair, Hot!, Blow on it
My spoon, my plate, my chair, Pour it- Psshh, Want more?
Milk please, Stir it up , Clean face, clean hands

Describing foods by their shape, texture, size, and taste is another great opportunity to use words that your child might not otherwise hear in their day. For example, This carrot is crunchy, This cookie is chewy, This tomato is round, This cracker is rough

You can also work on identifying foods and related items:

Identifying by Name: Show me carrots, show me banana, show me spoon, etc.

Identifying by Attribute: Which one is long, Which one is round, Which one is green, etc.

Using daily routines, like eating, bathing, and dressing are the best times to enhance your child’s language skills. These suggestions can help to expand receptive vocabulary and continue to provide the opportunity for hearing that ideal language model for enhanced language production later on.

Need more information on feeding times? Check out the 10 Must-Know Food Rules, or our Feeding Milestone chart to see if your child is on-track.

When to Start Solids & Other Feeding Milestones

Posted on July 9, 2013August 11, 2015 by speechies

Wondering when to start solids with your little one? It seems that the months go by so fast and that time is here before you know it.

Parents should know that feeding skills are directly correlated with very important motor skills. So check out the chart below to make sure your little one is ready for the next texture.

Age	Motor Skills	Textures
Birth to 6 months	-Roots for nipple, suckles	Liquids only (e.g. breast milk)
5 to 7 months	-Begins sitting unsupported -Follows food with eyes -Opens mouth for spoon -Lips close over spoon	Smooth purees
6 to 8 months	-Tongue moves side to side -Controls position of food in mouth -Vertical munching/chewing (up and down motion) -Begins putting hand to mouth for finger food	Purees with grains + lumps
7 to 10 months	-Chew patterns turns to rotary chew -Moves food from side to side -Curves lips around cup -Palmer grasp develops (folds fingers over palm)	Mashed/chunky table foods Dissolvable solids (puffs)
8 to 12 months	-Interest in solids increases -Cup drinking improves -Pincher grasp develops (thumb and fingers work together)	More mashed table foods, soft foods (like breads, pasta, and cheese) and other finger foods
12 to 18 months	-Self feeding, grasps spoon -Holds cup with two hands -Uses straw	Chewing broad range of foods

You can create an adventurous eater in your baby or toddler, but the pressure is on us to offer options.

When you are introducing something new, like a new taste or a new texture, babies often feel more comfortable sitting on your lap. Let your baby look at the food or taste it using his own fingers (you wouldn’t eat something unfamiliar, would you?). Talk to him in an encouraging way, to make sure he knows its safe.

Wait for him to open his mouth as you give him his first bite, and continue to talk and smile so he feels safe and comfortable.

Also, remember the Rule of 10 (though some experts even argue 12): your baby needs to try something 10 times before he can develop an actual like/dislike for that food. And that means 10 different meals, not just 10 different spoonfuls in one sitting. So if you see him grimace at the first bite, keep a positive face and smile in reassurance, and just keep going at his pace.

Remember The Food Rules; and that to present food well to a child, you have to feel good about it yourself. Ellyn Satter, R.D., A.C.S.W says “Feeding is a metaphor for the parent/child relationship. Children learn from feeding what to expect from the world. It teaches them about themselves and about other people.”

So get eating 🙂

Speech Therapy in Ghana

Posted on June 5, 2013August 12, 2015 by speechies

On May 20th, I embarked on a two week expedition to Ghana, Africa, working as the Chief Clinical Supervisor for 13 graduate students in the speech-language pathology program at Columbia University. There is so much to share about this amazing trip. Being in a country so different than the United States, yet realizing how similar these people and patients are.

A mother with her twins at Korle Bu Hospital

I just wanted to share one particular story that truly touched me (there really are so many!). As we were taking a day off from clinical work on a Saturday, we were seeing some tourist sites. I had a conversation with one of the park rangers at the National Park in Mole, Ghana. He asked what we were doing in Ghana and I shared our work with him. He took a particular interest in cleft lip/palate, probing and asking more questions. We soon found out that he knew of a child in a neighboring village with cleft lip and palate, and he asked if we could see the baby.

On Sunday, we arrived in the small remote village, and the mother of the baby was not expecting us. Though still, she welcomed us inside her one-room home as she heard of our purpose. Her baby, Faruk, was 3-months old with a complete unilateral cleft lip. There is a large stigma in place, and often parents and people reject children with disabilities, or children that are just different. The father of the baby left the mother and his son after seeing him, and the mother was left alone to care for her son.

Embarrassed and unknowing, she moved in with a friend, and kept her son inside for the entire 3 months of his life. She shared her story, becoming emotional and looking helpless- and a bit malnourished herself, since she couldn’t work (and take the baby to work to have the rest of the village see him). We treated the baby, observed how he fed, using a bottle and breast feeding. We educated mom about how much the baby should be eating to maintain a healthy weight, and provided some strategies for safe and efficient feeding, which nearly instantly improved. We informed her of the Operation Smile and Smile Train teams, which were to arrive in a hospital 2 hours away, and helped her financially to assist in payment for transportation to the hospital (which was equivalent to $6 US each way, money she just did not have). The surgeons provide free repairs for cleft lip and palate.

After about an hour of working with this mother, in her home, and getting to know baby Faruk, we knew we had made an impact. As we were leaving, the mother proudly brought baby Faruk outside of the house, in the light of the day, for the first time. She held him facing out, as the rest of the villagers watched. We gave hugs and said our goodbyes.

A little one trying to get into some trouble

This trip reinforces how important communication is between parents and children, and caregivers and their loved ones, world wide. The children are just as playful and fun, the parents are eager to learn and apply new tricks and techniques, and the professionals are always ready to collaborate. It was humbling to see first hand, how happy people are with the such little resources they have. And of the 50+ patients we worked with, we were able to establish a sustainable treatment plan for bettering communication and/or feeding and swallowing.

Interested in more pictures? Check out our facebook page.

Columbia University has partnered with several hospitals and schools throughout Ghana, and this marked the seventh visit to the country, as master’s level students educated other professionals, treated patients, and taught parents about all things related to speech, language, and feeding.

The Food Rules

Posted on April 23, 2013August 12, 2015 by speechies

10 Mealtime Practices for a Happy Eating Environment

By parent report, an average of one in every four children is said to have a “feeding difficulty.” That means that 25% of parents are dreading feeding times. Here are some good rules to work by to ensure that both you and your child are enjoying eating and meals:

Meals AND snacks, should be given at regularly scheduled times (typically eating every 2-3 hours)
Meals and snacks happen at the same place (e.g. in a high chair) while eating. Avoid “grazing,” or eating all over the house.
Solids should be offered first, fluids last
Meals should last no longer than 30 minutes
Encourage your child to feed herself as much as possible (finger feed or using a spoon)
Learning to eat without approval or disapproval is important. It should be a neutral environment, free of bribes or comments on “how much.”
Refrain from using games or distractions during meals
Food should be removed after 10-15 minutes if the child seems to play with food without eating
Clean-up AFTER the meal, wipe the mouth and hands only when the meal is done
Relax, and remember that its ok for a child to miss a meal once in a while*

Remember that you can get your child to come to the table, but you can’t make your child eat. Its our job as parents to be a good eating model. That means that parents should be eating meals WITH kids. The importance of participating in family mealtimes is crucial.

These are only guidelines for mealtime practices, and if you have a specific question about your child’s feeding or nutrition, consult with your pediatrician.

*adapted from Joan Arvedson and multiple sources

Hey San Francisco Moms - Looking for a local, fresh, and tasty alternative to jarred baby foods? Fresh Baby Bites is my first choice for offering delicious foods from purees to snacks.