5 Healthy New Year’s Resolutions

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While discussing the topic of New Year’s Resolutions, health-related resolutions must be the most popular. With this in mind, hownew years resolution many of these resolutions are actually kept through the year’s end?   This is a list of healthy resolutions that involve small changes and have a significant impact on health.  These resolutions are achievable if you are able to make them a priority. One or more of these habits can become your new lifestyle in 2013.

5 Healthy New Year’s Resolutions:

  1. Eat vegetables at least twice a day. We are aiming to be realistic. Many individuals do not get veggies at least once per day. Eat one of these fresh veggies as opposed to cooked or canned. If you are already eating vegetables twice a day, increase it to three times per day. For the kids, the goal is to offer vegetables at least twice a day and model the good habit. Here are some ideas to incorporate more vegetables into your diet:
    1. Roasted vegetables. Chop a variety of colors, such as red or green peppers, cauliflower, sweet potatoes, mushrooms, etc. Toss in a bowl with olive oil, salt and any of your favorite spices. Put in the oven at 375 until softened and slightly browned. Great for dinner or leftover for lunch.
    2. Have plenty of prepared vegetables available for quick snacks or lunches. This can be sliced carrots, pre-washed salad greens, sliced or diced broccoli and cauliflower, snow peas, sugar snap peas or roasted vegetables leftover from dinner.
    3. Spinach or other baby greens blended in smoothies.
    4. Stir fry a variety of chopped veggies with meat, shrimp or tofu and your favorite sauce.
  2. Switch to whole grain. Once you make the switch from white to whole grain, your body will thank you. When you are used to eating whole grain products, your taste preference will adjust and the difference will not be as noticeable. Whole grain contains the fiber and nutrients that have been stripped from “white” grain products. The fiber slows the glycemic load of the carbohydrates that are digested into the blood stream so that your blood sugar does not spike and then drop as drastically after meals. Fiber also keeps things moving along in the gut as well as indirectly lowers cholesterol.
  3. Eat out once per week or less. This probably means you will need to revamp your grocery shopping routine so you always have food for meals in the house. It also means you will need to do some time management and planning so that you are able to prepare meals each week. In addition, you may need to get new recipes that will fit into this lifestyle change. Although cooking may seem more time-consuming, eating from home is one of the healthiest habits you can have. Eating out most often means consuming calories, more sodium, more additives and spending more money.
  4. Eat three meals per day, including breakfast. Eating breakfast gives your body and brain fuel to get through the day. In addition, individuals that do not eat breakfast each day tend to overeat later in the day. Aim to include whole grains, fruit and protein at each breakfast.
  5. Schedule an appointment to see a registered dietitian. All of the above ideas are great recommendations for anyone but by meeting with a dietitian, you will receive a personal assessment of your current health status. You will also receive a nutrition plan that is created just for you and your family in order to improve health and quality of life. Our dietitians can provide meal planning, recipes, grocery store meetings and in-home cooking demonstrations. They can also recommend dietary changes to improve gastrointestinal problems, food sensitivity issues, weight issues and more.

To schedule an appointment with a registered dietitian, click here.

 

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Ways to Handle Tragedy with Children

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Co-Authored by: Ali Wein, LCSW and Michelle Winterstein, LCSW

What happens when a tragedy occurs? When the unthinkable happens, both adults and children access their darkest fears and concernsboy watching the news about national, community, and personal safety. Trauma is an emotional response to a terrible event and can be expressed in a variety of ways. Children may display acute signs of anxiety such as excessive worry, school refusal, sleeplessness, nightmares, headaches, stomachaches, loss of interest in previous enjoyed activities, changes in relationships with peers, and changes in school performance. It is important to note that children may appear unhinged by trauma initially, but may demonstrate more delayed symptoms of anxiety after the exposure to the tragedy.

How To Approach A Tragedy With Your Child:

In the aftermath of tragic events, children benefit most from validation of their feelings, opportunities to talk and be listened to, and reassurance that many people are working hard to ensure their safety (i.e. policemen, teachers, doctors, volunteers, parents, and teachers.) When managing your child’s reaction to tragedy, first and foremost, it is imperative for the parent to understand their own thoughts and feelings regarding the event. Getting any parental concerns and anxieties under wraps will be essential prior to managing children’s anxieties and concerns. Children, by nature, are dependent and vulnerable and rely upon their parents to exude a sense of control, protection, and care. If a parent is highly reactive to their own anxieties, children can pick up on this and in turn, will mirror their parent’s anxieties. If a parent is calm and objective, the child can experience a solid sense that their parent is in control of the situation and give the child permission to feel safe and cared for.

Talk about the event. Not talking about the event can make things even more threatening in your child’s mind. Validate and acknowledge children’s fears and insecurities regarding the tragedy. Provide outlets and opportunities for your child to express their feelings and insecurities. Brushing over their feelings of sadness , anger, fear, and anxiety with “don’t feel this way” and “don’t worry, it won’t ever happen to you” can prove invalidating and deny the child the opportunity to effectively process their responses. Acknowledging your child’s fears and concerns will help them process the event and encourage self expression.

Limiting screen time to avoid continued media coverage regarding the event will help to reduce anxiety and re-traumatization. The most important part of dealing with trauma and tragedy is to process your and your child’s interpretation of the event, not the actual facts and details (i.e. how many people died, who killed them, the severity of this national tragedy, how it compares to other national tragedies, etc.). Exploring with your child how they interpret the event and what they think has happened is more therapeutic than rehashing the gory details. Furthermore, it is important to clear up any misconceptions your child may have as they will likely be hearing bits of information from various sources.

Uncontrollable tragedies occur and have the power to threaten our perceptions about our safety and understanding of our world around us. Providing a safe space to process the feelings that our children have is the best way to acknowledge the legitimacy of their concerns and regain a sense of normalcy.

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Finding a Gift that Has Therapeutic Value

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When buying presents for kids these days, it may be difficult to find a toy or game in which the value will last longer than the amount ofscience project time it takes to unwrap it. It can also be challenging to find a gift that will remain valuable throughout any of the “fads” and “trends.” With that said, below are some gift ideas that are sure to please your kids, keep them engaged as well as have added therapeutic value:

Board Games With A Therapeutic Value:

  • Hulabaloo is a game that incorporates auditory processing, visual scanning, following directions, gross motor skills and motor planning. It’s great for pre-school and early elementary-aged children and can be played with one child or a group.
  • Cat and the Hat-I Can Do That is a game that incorporates sequencing skills, following directions, gross motor skills and motor planning. This game can be played with children of all ages as it offers motor challenges that involve props.

Art Supplies With A Therapeutic Value:

  • Color by number activities are excellent for children that need to modify their fine motor skills, visual motor and executive functioning skills (planning, initiation, attention and organizing). This is a way to provide more structure to a coloring task as well as adding expectations.
  • Craft projects, such as beading kits, painting and pre-made wooden structures (mailbox, picture frames, tool boxes, etc). These can promote executive functioning skills, such as following written directions, planning, initiation, sequencing, and organization as well as fine motor skills. These activities can also be modified to incorporate sensory experiences.
  • Lite Brite is an activity that promotes fine motor skill development as well as attention, sequencing and organization. This activity may also be motivating as children are able to witness the progression of the design as it takes shape. This will allow for longer engagement in the activity.
  • Science Experiments/Kits are great gifts for children of all ages as they cover so various therapeutic areas. Activity kits, such a building a volcano, require many executive functioning skills and they often incorporate sensory components and fine motor skills that are both intriguing as well as interesting to many children.

Puzzles and Puzzle books With A Therapeutic Value:

  • Jigsaw puzzles are a great way to incorporate fine motor, visual motor and visual perceptual skills into a fun activity for children of any age. For older children, puzzles with 3-D images can increase the difficulty.
  • Word Searches and other similar puzzles in a puzzle book require many executive functioning skills, including problem-solving, sequencing and organization of thoughts and information. Many of these puzzles also incorporate visual skills, such as visual scanning. These books can be found for children as young as kindergarten through adulthood.

These are just a few gift ideas for children that may offer therapeutic value as well as the “fun factor.” When considering a gift for a specific child, think about their interests, but also keep in mind of the activities or experiences that they generally avoid as these are often the most challenging for them and the activities they need to pay attention to most. By selecting a game that incorporates challenging experiences as well as skills, you will be buying a gift that both the child and parents will enjoy.

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‘Tis the Season to Teach your Children to Give

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During the holiday season, it is easy for children to get caught up in the “give me” or “I want” moments. It’s entirely natural for them toDonating with Kids be focused on the excitement of presents that come along with the holidays, but this can also be a time to illustrate the joy of not only receiving, but giving as well. Taking the time to demonstrate and teach your children the true meaning of the season will allow them to discover the personal satisfaction that comes along with getting involved and helping others.

Ways for your child to give:

  • Give Clothes. Have your children look through their closets and dresser drawers to find gently-used clothes that they no longer wear or do not fit into anymore. Give these clothes to organizations, such as Goodwill, the Salvation Army or other local thrift stores. Discuss with your children about how the winter season can leave many people cold and in need of warm clothes and blankets. Every little item that your child gives is helpful.
  • Give Toys. Have your children collect their toys, books and stuffed animals that they no longer play with. Although your son or daughter is looking forward to receiving new presents this holiday, there are many children that are not as fortunate. Help your children see that a beloved toy that once gave them so much joy can now bring happiness to another young boy or girl. These items can also be given to places such as a local children’s home, Goodwill or the Salvation Army.
  • Give Food. Your children as well as yourself can go through the pantry and kitchen cabinets to find different canned foods and boxed food items that you can give to a local shelter. If you have older children, consider taking them directly to the pantry and helping unload the food and stock the shelves. Holidays are a wonderful time for feasting and over-indulging; use this opportunity to demonstrate the need not only throughout the world, but also close to home.
  • Give Time. Your children can give some of their time to help elderly neighbors or family members with decorating for the holidays, wrapping presents, shoveling snow or other projects/tasks throughout the house. Older children can also give their time by volunteering at organizations, such as Habitat for Humanity, soup kitchens, making meals for Ronald McDonald’s House or animal shelters. Speak with your children and allow them to take ownership in deciding on how and where they think they can help by using their talents to brighten someone’s day.
  • Give Holiday Cards and Crafts. Have your children create holiday cards and crafts. You and your children can deliver the holiday cards and crafts to a local nursing home or children’s hospital. Show your son or daughter that a “gift” doesn’t necessarily have to cost a lot of money in order to be appreciated. No matter the cost of a gift or if the gift is purchased from a store, the best presents are those that come from the heart.
  • Give Money. You and your children can choose an organization that you would like to donate money to. Selecting an organization that grows and provides food for families, saves endangered animals, builds homes for families or no kill animal shelters are just a few organizations that you may donate to. Deciding on an organization that is close to your family’s heart will help make the gesture more meaningful.

We are all guilty of losing sight of the true meaning of the holiday season. Use this time to teach your children that it is more important to give than just receive. Volunteering and donating as a family is a wonderful bonding experience as well as a way to demonstrate the importance of helping others. It does not take much to spread the holiday spirit. Remind our children that the holidays are so much more than getting the latest toy or video game. With commitment, these are qualities and traits that your children will begin to demonstrate all year long.

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Exercise Hydration: What is the Right Beverage for my Child?

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With so many sports beverage and enhanced water products on the market, it’s good to know when they are actually useful. Many of these products have an ingredient list quite similar to soda, which is not something you typically would give your child or athlete after a workout. However, there are circumstances where nutrient and electrolyte replacement is very important for children and teens.

Child drinking a glass of water

Carbohydrates are an important nutrient to replenish because glycogen is the fuel which gets used up from muscle and liver stores during physical activity. Electrolytes, specifically sodium, potassium, and bicarbonate are important for nerve conduction and respiration. Some amounts are expired through sweat and given off with heavy breathing that comes with intense physical activity. For these reasons, carbohydrates and electrolytes need to be “replaced” after intense, continuous workouts lasting longer than 60 minutes, and can be achieved with electrolyte replacement beverages. This would apply to long distance runners, college or elite athletes in training, and swimmers, soccer, or basketball players who are doing continuous intense cardio training for more than an hour during workouts.

However, for most people hitting the gym for an hour or so, or kids playing in team sports or outside at the playground, nutrient and electrolyte replacement can be achieved from eating a normal, well-rounded diet. Eating a balanced meal or snack within an hour after physical activity is sufficient in this case. Drinking additional sports drinks will only provide extra calories and sugar (or diet sweeteners), and often artificial food coloring.

Use this table as a guide:

Commercial (or homemade*) electrolyte replacement beverage

  • Intense continuous physical activity lasting an hour or more such as running; drink 16-32 ounces of electrolyte replacement beverage. 30 grams of carb should be consumed for every 60 minutes of intense continuous cardio, within 30 minutes of activity. Electrolyte replacement is important if intense physical activity is in extreme heat, when sweating is excessive.

Chocolate milk (carb + pro + electrolytes)

  • College or elite athletes in training for several hours per day who need a quick, small meal + electrolyte replacement during or after long workouts lasting several hours. These athletes should consult with a dietitian who specializes in sports nutrition.

Coconut water

  • Natural electrolyte replacement beverage; high in potassium and lower in sodium and sugar than commercial electrolyte replacement beverages. Appropriate for moderate-high physical activity with sweating, such as spinning class, kickboxing, “boot camps”, outdoor sports in heat with continuous cardio 30-60 minutes, etc.

Water + well-rounded diet

  • As needed during and after any level of physical activity. This is all that is necessary for low or moderate physical activity such as playing outside, playing team sports, hitting the gym for 30-60 minutes, etc. A rule of thumb is 1 oz water for every 2 lbs body wt (50 oz/day for 100 lb person) daily. Increase as needed in heat or more strenuous activity.

*Recipe for homemade electrolyte replacement beverage, from Nancy Clark’s Sports Nutrition Guidebook

1/4 cup sugar
1/4 teaspoon salt
1/4 cup hot water
1/4 cup orange juice (not concentrate) plus 2 tablespoons lemon juice
3 1/2 cups cold water

  1. In the bottom of a pitcher, dissolve the sugar and salt in the hot water.
  2. Add the juice and the remaining water; chill.

Recipe makes 1 quart.
Per 8 ounce serving, recipe provides: 50 calories, 12 grams carbohydrate, 110 mg sodium, 43 mg potassium.
Compared to original Gatorade per 8 ounce serving: 50 calories, 14 g carbohydrate, 110 mg sodium, 30 mg potassium.

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What Does my Child’s ‘Engine Level’ Refer to?

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Many therapists use the term ‘Engine Level’ throughout your child’s therapy sessions, and possibly within her goals as well.  ‘Engine Level’ refers to your child’s energy level and the way her body is feeling in various environments and in various times throughout the day.  A child’s body is typically functioning at one of three ‘Engine Levels’.   Ideally, the goal is to be at the ‘just right’ level, in which your child can accomplish the most and focus on the task at hand.

Below are some explanations and examples of how your child’s engine level can be moving too fast, too slow, or just rightHappy child jumping

  • An engine level which is too fast means that you might notice rushing; distractibility; decreased body awareness; and decreased organization.  This might look like your child is running around aimlessly, touching her friends and neglecting personal space, or ignoring instructions and what her body should be doing.
  • An engine level which is too slow means that you might notice low energy and decreased endurance, inattention, and that your child is lethargic, sleepy, or unmotivated.  This might look like your child is slouching or falling out of her chair, propping herself up or leaning on a peer, not listening, or not attempting the task at hand.
  • An engine level which is just right means that you might notice that your child is refreshed and energized, that she is alert and ready to focus on the task at hand, and that she is aware of how her body is moving around her environment.  This might look like your child is maintaining an erect posture at the table to complete her homework or engage in mealtime, and she is correctly following directions and using her listening ears.

Try to use this ‘Engine Level’ lingo in a consistent manner so that your child can ideally develop increased body awareness and self-regulation.  Make sure you provide your child with examples of how your own body is feeling, or how you perceive her body to be feeling, so she can best understand what you are referring to (e.g. “It looks like your engine is moving too fast.  Your body keeps falling out of your chair.  Why don’t you stand-up and do 10 jumping jacks, and then try sitting in your chair again.”)  Stay tuned for my next blog on strategies to obtain a just right ‘Engine Level’.

Reference: Williams, Mary Sue and Shellenberger, Sherry. (1996,) “How Does Your Engine Run?”:  A Leader’s Guide to The Alert Program for Self-Regulation.  Therapy Works, Inc.

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Inclusion: How to Make it Work

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What is Inclusion?

Inclusion has been a common school term for decades.  It is a philosophy and strategy in which students with special needs spend most or all of their time with non-disabled peers, rather than being educated in separate classrooms or schools.

When students are part of a full inclusion program, they receive additional academic assistance or instruction in the general education classroom, whenever possible. Happy child in school More commonly, though, schools provide education to the students in a variety of degrees from separated classrooms to mainstreaming (general education classes for less than half the day and usually for less academically rigorous classes such as PE, art, music, story time, etc), to inclusion, and determine the setting that would most likely help the students achieve their individualized educational goals.  Specialized services such as speech, OT, PT, and social work are provided outside the regular classroom, but can also be inclusive and have peers from the regular education classroom participate with them, when appropriate.

When I worked as a school social worker, I often created “friendship groups” where I would have three or four peers from the classroom join the child with special needs each week.  The regular education students would rotate from a list of all classmates whose parents gave consent.  Kids would beg to participate in these groups which often helped the regular education peers as much as the “targeted” student.  It was a positive experience for all because a trained professional facilitated the group as they navigated social skills, assertiveness training, and conflict resolution with small group instruction, role play, games, social stories, etc.  The peers from the regular education classroom had a fun time with their peer whom they thought could not keep up with them on the playground during recess and would often subsequently ask the child to join them.  I often recommend this type of group for children who have difficulty integrating with their peers.

Is Inclusion Right for Your Child?

Before deciding whether inclusion is right for your child, remember that schools are legislated to provide the least restrictive environment (LRE) for the child that will meet the child’s needs and Individualized Education Plan (IEP).  The child’s plan should indeed be individualized and always have the child’s best interest in mind.  A child with severe behavioral problems or severe sensory processing deficits may negatively impact the classroom setting within the regular education classroom and be disruptive, which would negatively impact the learning environment as well as friendships.  A child who is delayed in learning academic skills or who has behavioral or emotional struggles may need individualized instruction or small group instruction in order to make appropriate gains.  Placing that child strictly in a regular education classroom may create added anxiety for the child and may increase negative behaviors because of heightened stimulation in the larger regular education setting.  A child with these struggles may initially benefit from integrating with same-age peers in classes such as physical education, art, music, library, or computers with an aide present to help the child.

Best Practice for Inclusion Success

To obtain the optimal success rates of including the child within the regular education classroom, the school setting should provide:

  • tailored individualized education programs (IEPs)
  • adequate support and services for the student
  • diversity training and professional development for all educators working with the child
  • weekly planning times for all teachers on the child’s team to collaborate and create the optimal learning environment for the child and regular education peers
  • smaller class sizes, depending on the student’s special needs
  • training in cooperative learning, peer mentoring, and curriculum adaptation to address the child’s needs
  • funding to develop appropriate programs to continue to meet these needs
  • most importantly, ongoing communication with the child’s support team (educators, specialists, parents, and administrative officers) will provide the most appropriate programming to meet the child’s individualized academic, social, and behavioral needs.

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Tips for Summer: Making Swimming Fun!

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Swimming is a great activity for a hot day that provides entertainment and exercise. Swimming helps children develop strength and coordination, and is considered an important life-saving skill. As a former child swim instructor, I have met many parents who struggle with a child who is afraid of water.

Here are some tips on making swimming fun and encouraging your child to enjoy the water

  • If your child is afraid of water, ask him/her why. Many times, children don’t like it when they can’t see the bottom of a lake or pond. Start in a shallow pool with clear water.
  • Play games while sitting on the steps. You can play “drums” on the water, hitting the surface with your hands and making big splashes. Work your way down the steps, deeper and deeper.Mother with child at the pool.
  • Blow bubbles in the water. If your child doesn’t want to put his/her face in the water, use a straw to make bubbles. You can pretend you’re fish or sing a song underwater. Or you can have competitions to see who can hold their breath the longest.
  • Fetch sinkable toys from the bottom of the pool. There are colored rings, boats, and other objects that are available for this purpose. This will encourage kids to submerge their whole bodies and help them figure out how to move in the water. You can start shallow and move deeper.

Once your child is feeling more comfortable in the water, there are plenty of games you can play to make pool time more fun and encourage exercise and gross motor play

  • Marco-Polo
  • 1-2-3-Trophy: Make up different ways of moving your legs while doing a handstand in the water. For example, the “trophy” handstand involves keeping your legs straight, while the “scissor” handstand involves scissoring your legs back and forth. See how many you and your child can think of!
  • Water basketball: Floatable basketball hoops or hoops set up at the edge of the pool are great.
  • Water volleyball
  • Jumping Simon-Says: As one person is about to jump in the pool, someone has to yell out what kind of jump they have to do (cannonball, pencil, star, etc). The jumper has to quickly make that position in the air before they hit the water.
  • Races: Race from one end of the pool to the other, or race to collect sunken objects.
  • Shark-Attack: For groups of 3 or more, one person plays the shark, who turns his/her back to the pool. The other people have to make it from one side of the pool to the other without being tagged by the shark. If the shark thinks the others have started swimming, he/she can jump in and try to tag them.
  • Monkey-in-the-Middle

Swimming is a great outdoor activity that promotes exercise and gross motor development. Use these tips if your child doesn’t enjoy swimming or is afraid of the water.

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Handwriting Quickies: 5 easy ways to work on your child’s grasp and letter formation for handwriting

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Handwriting involves many different components, such as using an age-appropriate grasp, stabilizing the paper, and identifying and forming uppercase and lowercase letters.  Luckily, there are lots of simple strategies to boost your child’s confidence and performance.

Here are a few brief suggestions to try at home:

Child practicing handwriting skills

  • Hold a marble:  Have your child hold onto a marble with his ring finger and pinky finger against his palm.  This will help him to keep his “extra” fingers out of the way, and better promote a tripod posture on the writing utensil (pencil is held between the thumb and index finger, with the pencil resting on the middle finger).
  • Varied grasp:  Place the writing utensil between your child’s pointer finger and long finger to promote a variation of the tripod posture.  This is a good option if your child is older and has an incorrect grasp which cannot be corrected, or to provide a “break” for your child if he fatigues easily during handwriting activities.
  • Use a golf-sized pencil:  A small pencil works well for small hands (approximately 6 years and younger).  This will offer your child more control over the writing utensil, and may require less strength and endurance as it is lighter.
  • Practice letter recognition:  Have your child trace letters onto your back, or trace letters onto your child’s back.  This will help him practice recognizing the shape and formation of the letters, and also feel the letters, providing tactile input.  Similarly, you and your child can take turns drawing letters in the air (make movements extremely large and exaggerated); again, this will help your child see the lines and curves of the letters and feel them as well.  (Note:  during the summertime, sparklers are a fun way to practice forming letters/words in the air for others to guess!  Just make sure that children are monitored by adults for safety purposes)
  • I spy with my little eye:  Change up the game “I spy” by incorporating spelling.  For example, “I spy with my little eye, something that starts with the letter S.”  This will help your child sound out which letter the object starts with.  To make the activity harder, ask your child to spell out the entire word at the end of each round.

Handwriting and learning to recognize the alphabet can feel like daunting tasks to parents, as there are many components to think about in order to best teach your child.  However, as stated above, there are many “tricks” to provide your child with greater success and, therefore, increased confidence.  Try one of these strategies today, and watch your child blossom!

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Preemies: Special Little Ones with Special Nutrition Needs

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When going through pregnancy, most mothers expect to have nine months to prepare for a newborn. Caring for a preemie, however, is not something that pregnancy books and newborn care classes cover.

In terms of preemie nutrition and feeding, the following information can help prepare you or provide insight into what you may be experiencing:

Mother eating with infant

1. Nutrition support

This refers to an alternate route of nutrition for your baby. Babies may require nutrition support if they have low birth weight or other medical complications. If born before 34 weeks, he or she may not be able to coordinate sucking, swallowing, and breathing during oral feeding. Your baby may receive breastmilk or formula through a tiny tube that goes into the nostril or mouth and down to the gut (enteral nutrition). In cases of very early preemies, many have to receive parenteral nutrition, or nutrition through an IV (intravenous). This is because their digestive system is not yet developed enough to handle the full volume of breastmilk or formula that is required to sustain growth. There can be a number of factors that limit an infant’s ability to tolerate enteral nutrition, and parenteral nutrition becomes necessary.

2. Fortified breast milk or special formulas

Being outside the womb early presents challenges and demands on the infant’s body that can increase nutrition needs. Preemies with low birth weight need more calories, protein, vitamins and minerals than infants born at full term, to promote “catch up growth”. Human breastmilk has been analyzed from mothers of preemies and mothers of term infants, and preemie breastmilk actually contains more calories, protein, vitamins and minerals than term breastmilk. Often times, preemie breastmilk needs to be fortified further to meet the infant’s needs. There are also formulas designed for premature infants in the event that breastmilk is not available. Proper nutrition is critical for the development of vital organs like the lungs, heart, brain, and gut. Neonatologists and registered dietitians assess each baby in the NICU for nutrition needs, and create individualized recipes and feeding regimens. Sometimes these special recipes and feeding regimens need to be continued once the baby goes home from the NICU, and parents get educated by the medical team on how to do this.

3. Swallowing or oral feeding issues

Babies develop the ability to coordinate sucking, swallowing, and breathing around 33 or 34 weeks. There are a number of circumstances that may impact this developmental stage for preemies born prior to that. The baby may require a ventilator for oxygen, which would not allow oral feeding to occur. Or, the baby may require nutrition support during this time for a variety of reasons, and oral feeding attempts may not be possible. These scenarios can have lingering effects on how the baby feeds and swallows in the future. Babies may require special feeding techniques or “thickened” liquids if they have swallowing difficulties. Sometimes babies develop oral sensory issues and aversion to oral feeds, in which case tube feedings may continue until this is overcome.

An article published in Neonatology in 2008 titled “Strategies for feeding the preterm infant”, by Dr. William Hay, provides a review of preemie nutrition (for free full text, click here). As your infant gets older, his or her nutrition needs will change. Growth should be monitored closely by your child’s doctor.  Nutrition is critical, and expert care should be provided to ensure maximum development. If you or your doctor has concerns about growth, nutrition, or feeding, schedule an appointment with a dietitian at North Shore Pediatric Therapy.

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