by Annie Durning-Canty, M.S., R.D.
General Clinical Research Center
UCSD Medical Center
As Presented During the 1997 Cystinosis Conference in San Diego.
- What Makes a Meal?
- - protein
- bread, cereal or grain
- fruit or vegetable
Offer a variety of food at mealtime. A meal could be hamburgers, salad and milk; roast beef, mashed potatoes, vegetables, bread and milk; stirfried chicken with vegetables, rice and milk; spaghetti with meat sauce, french break tossed salad, and milk; burritos with cheese, chopped lettuce, and tomatoes and milk. Even hot dogs, potato chips, carrot sticks and milk make a nutritious meal!
Refer to "Recommended Daily Pattern of Food Selection" below for nutritious patterns of eating for different age groups. Remember serving sizes for children are approximately 1/3 the size of an adult serving.
RECOMMENDED DAILY PATTERN OF FOOD SELECTION
2 - 10
Adult Milk 2 cups 4 cups 2 cups Meat, fish, poultry, cooked dried beans, nuts 2 - 3 oz 4 - 5 oz 4 - 5 oz Breads and cereals 4 serv. 4 serv. 4 serv. Fruits and vegetables 4 serv. 4 serv. 4 serv.
Assemble Yourself: Condiments: - Tacos - Salt, pepper - Burritos - Ketchup, mustard - Pizza - Relish, pickles, olives - Pasta or Salad Bar Salsa - Deli Sandwiches
FOOD FOOD GROUP Meat Milk Fruits/Vegetables Bread Taco * * * * Pizza * * * * Hot Dog * * w/cheese * * * Chili * * *
Food Suggestions for Adding Calories
MILK/DAIRY: PROTEIN: Full fat cheeses Hot Dogs Half n Half Luncheon meats Full fat ice cream Sausages/bacon Milkshakes Turkey or chicken thigh or leg, with skin Whole Milk Fried chicken/fish Yogurt Nuts, nut butters Pudding Eggs, omelettes
Avocado Bagels w/cream cheese or jelly Banana Chips, popcorn Olives Cookies Mashed Potatoes w/gravy Crackers Creamed corn Flour tortillas Cooked vegetables w/margarine Croissants, pastries French fries, onion rings Cakes, pies Fruit smoothies
SUPPLEMENTS: OILS, SAUCES: Pediasure Margarines Ensure Plus, Sustacal Canola, Olive oil Scandishake Cream sauces Instant Breakfast Gravies Nonfat dry milk powder Salad dressing Polycose Mayonnaise
COMBINATION FOODS: Pizza, tacos, burritos, spaghetti w/meatballs, macaroni and cheese, fettucine alfredo, fast food entrees, soups, stews, quesadillas (flour tortillas w/melted cheese), grilled cheese sandwich, baked potato with melted cheese, waffles, pancakes.
Problems with Swallowing
- Swallowing evaluation
- Modifying food consistency
- Rate of feeding
- Swallowing techniques
Progression of Food Textures
A. Pureed, Strained, BlenderizedDivision of Feeding Responsibility
YogurtB. Semi-lumpy (no discreet lumps)
Cream of wheat cereal
Bran soaked in milk
Thick milk shates
Strained fruit thinned with small amount juice/water
Custard thinned with small amount milk
Mashed bananasC. Solids that form easity into mass
Small curd cottage
Cooked winter squash
Soft scrambled eggs
soft macaroni and cheese partially cooked vegetables steamed apples chicken banana, not mashed french fries soft bread pancakes, waffles fish french toast
D. Foods that are difficult to tolerate
- more than one consistency: vegetable soup, fruited jello - crumbly foods: dry hamburger, dry cookies - foods with outer shell: peas, corn, lima beans, grapes, apples, hotdogs - thin liquids: travel quickly down throat. Jello
E. To thicken foods:
Wheat germ Powdered milk Cream of wheat cereal (powdered) Thick-It Mashed potatoes Avocado or instant breakfast = calories Corn starch Gravy Unflavored gelatin Ground graham crackers
- Parents are responsible for what is presented to eat and the manner in which it is presented.Summary
- Children are responsible for how much and even whether they eat.
Parents are responsible for what is presented to eat and the manner in which it is presented.
Selecting and buying food Making and presenting meals Regulating timing of meals and snacks Presenting foodin a form a child can handle Allowing eating methods a child can master Making family mealtimes pleasant Helping the child to participate in family meals Maintaining standards of behavior at the table
Parent are NOT responsible for
How much a child eats
Whether the child eats
from How To Get Your Kid To Eat... But Not Too Much, Ellyn Satter
Feeding Concerns Feeding Strategies - Food Preferences - Promote Balance in Food Choices - Food Intake - Optimize Food Intake - Establish a Positive Feeding Relationship
P- Be a Role Model
Provide Variety - food pyramid, Easy Entrees
Tolerate Food Jags
O - Scheduling Meals and Snacks
E - Division of Responsibility in Feeding