Recipes and Complementary Food for Babies

I did this project with Pigeon Malaysia early this month at My Town in Kuala Lumpur.  The event location, Good Times was a colorful and fun filled location for our event. 

A complementary diet introduces semi solid to infant who is ready to take food besides breast milk or formula during their forth to 6th month of life. Sharing as a feeding therapist cum a senior dietitian made me better able to share a full story about feeding our babies.

My sharing was followed by a cooking demonstration by Chef Samantha and parent-child hands on session.

Watching mom and child interaction during the session was the most rewarding for me. There were dad who took active roles in child care to support their spouses who were listening attentively during the sharing. 

  

The following recipes were developed for this event. We demonstrated two out of five below.

Recipe #1: Pear-y Brown Rice Puree Complementary food suitable for 4- 5 month old babies

Main Ingredients: Brown rice, cooked         ½ cup      Pear, ripe                          ¼ piece Full cream milk/EBM       ½ cup Ikan bilis                           10 1.      Cook brown rice with calcium rich ingredient (ikan bilis) 2.      Cut and slice pear, fresh on the spot. 3.      Blend all ingredients to create watery porridge. 4.      Serve/store in 2 oz tubs or bowl.

Recipe #2:  Green Congee Complementary food suitable for 4- 5 month old babies

Main Ingredients: White rice, cooked          ½ cup      Baby spinach                   3-4 leaves Full cream milk/EBM       ½ cup 1.      Cook rice porridge with kelp 2.      Off the fire on the stove. Add baby spinach to cook for a minute. 3.      Blend all ingredients to create watery porridge. 4.      Serve/store in 2 oz tubs or bowl.

Recipe #3:  Fruity Lunch Complementary food suitable for 5-6 month old babies

Main Ingredients: Brown rice, cooked         ½ cup      Green apple, ripe            ¼ piece Full cream milk                 ½ cup Banana, ripe, sliced 1.      Cook brown rice till soft. 2.      Scoop and stir soft brown rice with full cream milk. 3.      Peel, chopped and steam green apple. (optional) Sprinkle with cinnamon powder. 4.      Add green apple into soft porridge. 5.      Add sliced banana on top. 6.      Serve in bowl.

Recipe #4:  Mashed Potato Pumpkin Porridge Complementary food suitable for 7-8 month old babies

Main Ingredients: Peel, 1cm Cube, potato              1/3 cup Brown rice porridge (grainy)       1/4 cup      Pumpkin                                            ¼ cup Full cream milk/EBM (optional)  ½ cup 1.      Boil potato and brown rice with calcium rich (chicken bone/fish bone)  2.      Steam pumpkin. Scrap off flesh and serve with porridge. 3.      Mix milk for taste or texture. 4.      Serve in bowl.

Recipe #5:  Crunchy string beans and mushroom porridge (Vegetarian) Complementary food suitable for 9-10 month old babies
			Portion size: 1	Preparation time: 15min
	Steps	Ingredients	Amount	Utensils needed
1	Cook soft rice and kelp together	Rice	5 tbp	Pot with lid
		Warm water	160 ml	electric kettle
		Kelp
2	Chop string beans finely	String beans, young	3	cutting board #2
3	Cut mushroom finely	button mushroon, fresh	2	pairing knife
4	Steam all vegetables in a bowl for ~10min	Goji Berry	8 pc	bowls x 3
5	Mix vegetables into porridge and serve warm			Bowl (presentable)

Recipe: Vegetarian Tomato Tofu Wrap

This recipe was created for my talk with pregnant moms during a recent prenatal workshop with new parents. It's not exciting to talk about food without having to taste them. And it's a plus if i could show the audience nutrition balance vegetarian meal is very tasty.

This vegetarian dish serves us just right amount of taste and nutrition. Almost everyone who tasted it loved it. Replace the cheese with toufu cheese for vegan version of this.

Ingredients:
1 square Firm toufu 
2 tsp Soysauce
Dash of Turmeric powder
Dash of Pepper
Triple washed salad green.
1/2 Red tomato, freshly sliced

1 pieces Multigrain Tortilla Wrap

1/2 tsp Olive Oil Spread

1 slices Cheese, firm/sliced
2 tsp Sesame seeds/ dressing

Steps:
1. Slice firm toufu horizontally. Cut each half to 4 pieces of ¼ inch thick toufu
2. Grilled toufu slices dressed in soy sauce, in non stick pan. Sprinkled with tumeric powder and ground pepper.
3. Wash salad greens and whole tomato in 1% baking soda solution for 12-15 minutes.  
4. Slice clean tomatoes for immediate use.
5. Spread tortilla with olive oil spread
6. Layer with slices of grilled toufu, tomatoes, salad green and cheese.

7. Optionally, spinkle sesame seeds or oil.
8. Wrap and serve fresh (within 2 hours)

This recipe makes 1 tortilla wrap. It's a great snack that provide about 300kcal, 10g of protein, and 5g of fat. Just great for pregnant moms in their 2nd and 3rd trimester.

Tips for Food Safety at Home - some advice for those at risk.

Have you had tummy ache, vomiting or diarrhea after eaten unclean food? Food borne illness can be avoided by practicing safe food handling. These tips will keep your food safe while you enjoy cooking and nutritious meal.

1.               Wash your hands before cooking or eating

Your hands carry bacteria on them especially after playing sports, gardening and playing with your phones or pets. If you do not wash your hand before food handling, you will pass on the bacteria to food and then to your stomach

Remember to wash your hands after handling raw food, before moving on to handle ready to eat item. Pay extra attention to those areas often missed during hand washing.

2.               Keep hot foods hot

Cooked food if left to room temperature for more than 2 hours, may cause food borne illness as bacteria grow well at this temperature. Make sure you reheat leaf over food thoroughly before eating.

3.               Keep cold foods cold

Salad, milk and yogurt need to be kept in the refrigerator. Make sure you keep them back to the fridge right away after using them.

4.               Keep raw foods away from cooked food

Do not keep raw food and cooked food in the same plate or chopping board; bacteria from raw food will likely transfer to ready to eat cooked food.

5.               Expiry date

Expiry date is valid for packaged food in its unopened packaging. Food once unwrapped, exposed to air, or handled has a shorter expiry date, usually within 2 to 3 days in the refrigerator. 

6.               Thaw food safely

Frozen meat or poultry should be thawed in refrigerator rather than on the table. Bacteria can grow to dangerous level if raw or frozen meat has been left out at room temperature for long hours.

7.               When in doubt, throw it out

Never taste food that you think may be spoiled. If you are not sure if the food is safe to be eaten, throw it out.

Do diets affect the chances of getting pregnant?

Globally, infertility is getting more common for various environmental and lifestyle reasons. While couples can't control all of the causes of infertility, they can control their diet. Diet and weight management can have significant impact on the ability to conceive for most people.

A proper diet can increase the success rate of getting pregnant and continues to ensure lesser complication following conceive. In under privilege countries, malnourished moms have higher chance of infertility and miscarriage. These moms, or in our local society, teenage moms or poor-eater moms, develop more complications in pregnancies such as premature delivery or still birth.

Referring to those well designed study done oversea, Malaysians can benefit from them and improve our chances for more babies.

Weight Extremism

Among Asians, we have many young mothers who are underweight, who has a body mass index of below 19. These ladies might not be ovulating on schedule due to hormonal imbalance hence missing the target when they try to conceive.

On the flip side, overweight or obese partners, both men and women, are facing more chance of infertility. Data available in the US showed that 30 percent of infertility cases are due to hogging on too much weight. Overweight affects the timing of ovulation and the quality of active and alive sperms. Losing weight, especially through regular moderate exercise, appears to be a good measure to increase likelihood of conception among them. 

Iron

Women who are told to have ovulatory infertility shall try to get enough iron in the diet. It’s advisable to take iron-rich foods including all types of beans, eggs, lentils, spinach, fortified cereals, long-grain enriched rice and whole grains. Vitamin C from fresh citrus fruits, guava or mango added into meals further enhances iron absorption.  

Healthy Fats

Monounsaturated fats like olive oil or avocado, rather than trans fats like in shortening and normal margarine can be used as a spread for meals or snacks. For women with diabetes, making full use of healthy fat to achieve caloric need and fullness is especially important.

Plant Protein

Beans and lentils instead of red meat or other animal sources may be beneficial to be included. Those are higher in phytochemical, fibre and lesser in unhealthy fat and oxidants, while give you enough protein for you to prepare for your baby. Men too, who eat lesser red meat may have higher chance of producing healthy sperms.

Complex carbohydrate

Whole grain like oatmeal, barley, brown rice or atta flour rather than the polished simple carbohydrate found in white rice, white bread, Man Tou (Chinese bun) or white flour should be taken during most meals of the day. This change heightens your chance for fertility by another notch.

Dairy products

Eating full fat dairy products instead of the low fat dairy products for some unclear reason is associated with higher chance of conceiving a baby. Taking one to 2 servings of dairy for calcium without having to worry about its fat content may be advisable for you now.

Multivitamin and vitamin supplements

For you who eat out often or are too busy to prepare healthy meals, consistently taking your multivitamin (at least six times per week) may be good. Also, do not forget the folate supplement prescribed to you by your gynecologist too.

Other Lifestyle Changes

For men and women, staying away from cigarette and alcohol gives a better chance to those trying to have a baby.

As the effect of healthy lifestyle is greater than while you are preparing to have a baby, start sooner rather than later for its maximal and prolonged effects.

Note:

This article was first published on babytalk magazine in April 2015.

Radio Interview: Why Your Breast Milk is the Best for Your Own Child.

Here's the link to my interview on why your breast milk is the best for your own child.


http://www.bfm.my/we-are-what-our-grandmothers-ate-ng-yee-voon.html

Which is the Best Formula for My Infant?

I support breast feeding. I support parents who breast feed. Your breast milk is the best for your own baby.

Having said that, I have also met parents who decided to stop breast feeding for various reasons. As a dietitian, a counsellor, and/or a supportive friend, I stood by their choice.

Breast feeding moms, new or experienced, may go through stages of stress and are not comfortable to breast milk. They are in dire needs to "supplement" feed their growing infants, or to replace breast milk completely. We also know that human milk bank is not culturally acceptable for Muslim moms, and not readily available for other moms of other races, these parents need an alternative, at that juncture.  

I am sharing this post on how to choose infant formula or follow up milk for babies who have to stop taking breast milk and for parents who are worried about the choices they are about to make. I wish new parents are empowered, guided and can carry on with life. It would be extra jolly to me, if they come back to breast feed after the initial hurdle.

The Safety to Use Infant Formula in Malaysia

The content of infant food (below 1 year old) and follow up formula (6 to 12 month old) are tightly regulated by the Malaysia Ministry of Health (MOH). We can rest assured the formula bought from a reliable source is safe (halal) for our babies. 

The marketing or claims on the formula for children below 1 year old is by far tightly regulated by law. Soon, the regulation will also cover a wider scope, beyond 1  year old. That also means, if the label says it's not suitable for your child age, you shall then consult your pediatrician or dietitian on what other choices you have.

The Special Ingredients 

A growing numbers of findings have suggested the importance of various groups of nutrients for fetus or infant development. These are good science and those that are needed have been fortified in our formula recently. For some others which fortifications remain debatable, they might have been added into the formula at safety and presumed effective levels. It's then  expected of the parents to make informed choices.

Parents who could afford nutrients fortified formula or babies who can’t tolerate regular baby formula, are keen for an alternative or specialized formula, by choice or by need. So, let's learn a little about these additives that differentiate the formula.

1. Sufficient intakes of omega 3 fatty acids, namely Docosahaexaenoic Acid (DHA) and Arachidonic acid (ARA) have been linked to visual acuity and cognitive performance in babies. Babies absorb these nutrients either through the placenta or the breast milk, accumulate these nutrients in their eye and brain in the 3rd trimester (as a fetus) and during the first 2 year of life.

For baby formula, the recommended doses for infant below six month are established in Europe, US and adopted by the WHO. They are to mimic the human milk contents of parents with good intake of such fatty acids. The minimum effective doses have generally been added into the formulation that is globally known.

For these nutrients, more doesn’t equate better. Parents don’t have to worry about getting the product with the highest (and often more expensive) content.

During the second 6 month of life, a diet rich in DHA and AA should be continued, but experts do not have enough information to recommend exact amounts of those fatty acids so far. Giving your child a daily diet rich in seaweed or seafood, can increase his DHA and AA intakes. If this target for dietary intake can be achieved, the amount of DHA and AA in formula will be less concerning.

2. Hypoallergenic (HA) formula shall be used for the prevention of food allergy for infant below 6 months, before any sign of allergy. If either one parent or a sibling of a child has a history of allergic reaction, this baby is at a greater risk to develope allergy. They shall be given HA formula before starting any other form of milk. However the benefit to continue HA formula after the baby is 6month old is not convincing yet.

A family ought to know that for a baby who has been diagnosed with allergy by a pediatrician,HA formula won’t help to stop the allergy reaction activated earlier. An extensively hydrolyzed or amino-acid based formula, depending on the severity shall be used.

3.       Prebiotic and probiotic fortification creates a gut environment that is similar to healthy breastfed babies. It may help to reduce infections and risk of allergy. Early studies are encouraging, but again the need to provide them in infant formula and follow-on formula is uncertain yet. 

You may also have heard of neucleotides, Sialic Acid (SA), Selenium, Choline, or carotenoids fortified formula. There has been some evidence to fortify formula with them. However, the evidence is not strong and not conclusive yet, especially for a baby who is growing up well.

Nutrient discoveries won’t stop here and I believe it is for our benefits. However, whenever any new information comes out, parents do not have to rush to get the newest formulation. Usually medical institution or local authorities of developed countries would come out with guidelines in time to regulate the content in all formula.

Your own breast milk remains the best food for your child. It is the gold standard of all infant nutrition. When formula information is generally overhwelming, may be parents shall give breast milk another try, switch the focus onto the nutrition for herself. 

家里有挑食的小孩吗？

现今社会，为人父母者受的教育比较高，对孩子的付出和要求更高。父母常常为孩子饮食不均而操心，怕会拖累身心灵以及智能的发展。身为营养师，我时常会碰上类似的家庭。

父母的观点

造成挑食这弊端的可以有许多原因。然而，最常见的情况并不是孩子出现了任何问题。依统计，父母缺乏常识与耐性，误解了孩子，错误判断孩子挑食占最多数。

父母应该了解和体谅成长中的小孩需要许多时间和机会学习独立。当中包括认识，然后接受新的或少见的食物。小孩也和成人一样，有自己喜好或讨厌的。如果父母有意培养孩子常吃某某新食物，首先父母需要很有耐心地，让孩子对该食物有个完美的“邂逅”。

再来，让她和它多接触。久而久之，孩子便会喜欢上“它”了！一般来说，小孩需要有最少十个独立的接触，方能接受一个新奇的食物。

病理

有些孩子的的确确有理由针对并抗拒某一类的食物。营养师从病理的角度观察，这一组的小孩一般上会在首几次接触某某食物时，就已经表示出来。一般来说，是在孩子4至6个月大时，开始食用副食品时，就呈现不适的反应。

只要留意一下，父母会发现孩子用餐后，特别哭闹，甚至呕吐，腹绞痛或腹泻等。严重的情况下，长久以后孩子可能面对发育不全的现象。父母如果遇到这种情况，首先该观察并排除环境所造成的不适。比如，用餐的环境，人物，时间，分量，温度等等。仔细观察孩子对那一类食物特别有反应。记录下是什么样的反应。然后，在儿科检查时反映给儿科医生。一般上，医生或营养师会观察一两次后，便可以知道孩子是不是生病而呈现挑食的行为。

生理机能

吃东西需要时间学习。人类是灵长类，一定可以慢慢学会一种动作，一定可以慢慢学会接受新味觉（食物）。

当小孩有能力自己坐起来时，那大约也是孩子接触副食品的时候。头脑，肢体和消化系统已经微妙的发育成熟，准备开饭了。然而，每个小孩都很特别，都不一样。某一些小孩需要婉长的时间学习接受一种新食物。

当中，问题就可能出现在小孩脑部和肢体发育相对的慢。慢慢地拖累延长了其他发育过程。如果父母没有发觉这小孩的特殊需求，而认为小孩纯粹是挑食，那挑食的症状就无法解决。

这一组小孩可能需要饮食治疗师（feeding therapist）或者父母的特别督促。把食物以其性质分类，依孩子口腔，吐咽功能能力范围出发，一步步地展开训练。

心理/习惯

漫漫成长路，饮食习惯及对某食物的印象可能在不知不觉中形成。比如说，孩子几个月大时，在某一次尝试绿色的食物时，不小心被噎到。从此，小孩不再对绿色食物有兴趣，甚至产生抗拒，呕吐的反射反应。长大后，小时候的不快事件早已被淡忘了，小孩却还是不吃任何绿色食物。

偏食有很多原因。所幸，多数时候都可以直接克服。只要监护人稍加耐心，孩子便可以一天天增加他的食物选项。