Advice Archive | Annabel Karmel

Freezer Food: Last Night a Freezer Saved My Life

Phil Carlsson — Fri, 10 Dec 2021 14:57:00 +0000

These are the freezer hacks that you need to know about.

Freeze grapes and make some delicious frozen treats for the kids. Alternatively, for a more adult spin on them, pop them in your wine to keep it cool rather than dilute it with ice.
You can preserve and freeze herbs in oil. Just simmer with your onions at the base of your dish!
Getting chewing gum out of clothes is a doddle when you freeze it off! Rub the gum with ice until completely hardened, then with a blunt knife to lever it off!
For a breakfast smoothie on the go, prep and freeze your fruit and veggies ahead.
In fact, ziplock bags are your freezer’s best friends; make a large batch of Bolognese/casserole and save individual portions in bags.
Pack your freezer full. The fuller the freezer the less energy is needed to keep all your food cold.
And finally the ultimate hack for those days…

When you don’t want to cook

You have cooked and someone suddenly stamps their feet that they have changed their mind

You have no time to cook

You have attempted to cook and it was a disaster (it happens to all of us)

Annabel’s New Frozen Meals to the rescue!

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Toddler Top Tips to Healthy Food Habits

Madeleine Usher — Wed, 02 Feb 2022 15:27:34 +0000

That anticipation of wondering whether the meal you slaved over for hours will end up on the floor or not is a gamble with very little reward!

Most parents (myself included) are all too familiar with that sense of dread, especially when faced with a fussy eater on their hands, but fret not, there are ways to combat messy mealtimes.

Here are my and children’s behavioural experts ToddlersTeensAndBetween top tips to help your little eater develop healthy mealtimes habits and a smoother food experience for all!

Give them a choice

Giving toddlers a ‘this’ or ‘that’ choice allows them to have some autonomy and control during mealtimes. This choice doesn’t have to be what they’re eating, rather the order they can eat it in, what plate they have it from and where they sit to eat their meal!

Routine is supreme

Set and stick to firm boundaries around mealtimes: these might be that they sit down on their chair or where they eat each meal. This embedded routine will provide your toddlers with a cue for mealtime structures and will help build a good association with food and eating!

Remain impartial

Maintain a neutral reaction to food. All food is fuel. It all serves a purpose and when we relax our little ones begin to embody that relaxed energy and eat intuitively, listening to their own bodies cues to decide how much and what to eat. If we don’t label food as ‘good’ or ‘bad’ or ‘naughty’ then all food becomes what it is, fuel.

Get them involved with tasks

Most children adore assisting you in the kitchen with fun tasks. Things like squeezing fresh orange juice or cracking eggs are well within the capabilities of a young child. It’s amazing how being involved in the planning and preparation of a meal can stimulate a child’s appetite!

Let them eat with their eyes

Without going to unnecessary lengths, try to make your child’s food not only taste good but look good too. Make mini portions in ramekins, chicken skewers or thread bite sized pieces of fruit onto a straw. Salad lollipops are a great way to try lots of different foods and textures in one go.

Lead by example

Eat together to show your fussy eater how good the food is – your little ones love to mimic, it’s how they learn. Eating together and sharing the same, or parts of the same, meal can create a really positive atmosphere all around. When your little one sees their family enjoying their meals, it can be enough inspiration for them to give it a go themselves.

Hide those veggies

If you’re worried that your fussy eater isn’t getting enough nutrients then you can always sneak them in to their food! For example my Bolognese sauce contains multiple hidden veggies that even the most seasoned detective would struggle to spot!

Stay hydrated

Children are particularly at risk of becoming dehydrated because a child’s body is less effective at perspiring and produces more heat during physical exertion. Because children also tend to be more physically active than adults, heat and dehydration can happen more quickly. A child that is ‘always hungry for snacks’, could in fact, simply be thirsty. Try offering drinks instead of repeated snacks.

Get cooking

Getting kids in the kitchen and taking an active interest in what they’re eating is essential for their general health and wellbeing. Particularly if you have a fussy eater, as they’re far more likely to eat something that they have prepared themselves than something you’ve put in front of them. Plus, it’s such a wonderful and creative way to spend quality time together and cook up some memories to treasure for a lifetime – my Fun, Fast & Easy Children’s Cookbook was cooked up for exactly this reason!

Healthy ‘junk’ food

Try making your own healthy junk food using good quality lean meat for burgers, English muffins for pizza bases and a good way to coat homemade fish fingers is to dip them in seasoned flour, beaten egg and crushed cornflakes. For dessert it’s easy to make fresh fruit ice lollies from fruit juice and pureed fruits. Try swapping fast food McDonalds for Krispie chicken nuggets, or fries for sweet potato wedges, you can substitute greasy pizzas for cauliflower pizzas, and add extra veggies to hidden veggie burgers.

If you’d like more support with the behaviour of your toddler, you can subscribe to Toddlers Teens and Inbetweens’ course HERE or be in touch with Toddler expert Gemma on the AK expert page and book in a bespoke Troubleshooting Guidance Call today!

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Infertility and Iodine Deficiency: Everything You Need to Know

Madeleine Usher — Thu, 07 Apr 2022 13:50:59 +0000

Iodine boosts fertility and helps with conception

Iodine is a little-known supplement that supports conception and can help improve fertility levels. Get Pregnant Plan’s Annette is a certified functional nutritionist with over 30 years of experience. Here she explains everything we need to know about the relationship between iodine deficiency and fertility…

By Annette for The Ribbon Box

Under normal circumstances getting pregnant is no easy feat but iodine deficiency makes it virtually impossible. Iodine is (or should be) abundant in the endometrium, thyroid and ovaries.

Imagine baby-making as an epic party – it requires the right people there. The same applies with making a healthy baby, you need the right nutrients in attendance. And iodine is a crucial nutrient that is often in short supply – without it, there will be no baby.

The Halogen Family

Iodine is like Marilyn in the Muenster family – beautiful and normal in a family of monsters. And just like Marilyn, iodine loves her family even when they maltreat her, follow her everywhere and try to steal her spotlight.

All of your body’s sensors have iodine receptors that can bind to iodine or another member of the halogen family; bromide, chlorine and fluoride. Iodine is necessary as it helps the binding process which boosts fertility. Iodine’s family (bromide, chlorine and fluoride) like to kick iodine out of the way so they can bind to these receptors. But they are more like leaches and don’t have any life-giving properties.

The good news is you can get iodine to attend your party. The bad news is you will have to put up with her unfavorable family because they go wherever she goes and are nothing but trouble.

To make a healthy baby, you need the right nutrients and iodine is one of those nutrients that is often in short supply.

Flouride

Flouride is found in water, toothpaste and tea. Filtering water and using fluoride-free toothpaste can limit the damage done by fluoride.

Chlorine

Chlorine is found in water, swimming pools, perchlorate and Splenda, aka sucralose. Perchlorate is used in rocket fuel and has contaminated much ground water. The best way to limit chlorine is to drink and bathe in filtered water and avoid lettuce grown in southwestern states in the fall and winter as these crops tend to have high levels of perchlorate, even if they are organic. Use real sugar or honey if you can instead of Splenda.

Bromide

Bromide is found in fire retardant clothing and mattresses, furniture, computers, cars, baked goods made with brominated flour and some beverages. Bromide is not easily avoided but we can reign bromide in by avoiding baked goods made with brominated flour and beverages made with brominated vegetable oil.

Once you’ve corralled bromide, chlorine and fluoride, you want to make sure iodine has the spotlight. Iodine needs to dance with all the guests (in other words bind to the iodine receptors) as that is the only way to undo all the damage caused by her destructive family. The more iodine dances, the less you’ll see of her family on the dance floor – which is exactly what we want!

Iodine helps fertility success but there are other must-have guests we need at the party to improve the chances of fertility (ie thyroid hormones and reproductive hormones like progesterone, estrogen and testosterone). The hormones have an amazing dance routine that leaves other guests speechless when they perform in sync. But you have to keep your eye on estrogen because she does like to hog all of the attention for herself!

Estrogen has multiple personalities: estrone, estradiol and estriol, and needs the right balance of her personalities to dance in sync, which she can only do with the help of iodine. Iodine helps the body metabolize estrogen to its safer form, estriol.

When estrogen is metabolized to estrone and estradiol over estriol, it can cause things like fibroids, endometriosis, polycystic ovarian syndrome and cancer which is obviously not good for overall health and will subsequently make baby-making much more difficult.

Progesterone has a spotlight breakout to perform during the hormone dance, but she tends to be a bit shy and prone to stage fright. Iodine helps boost her confidence and give her the Dutch courage to perform.

The thyroid hormones must do their part in the dance too as they are critical for ovulation, and iodine is a main component. For an epic baby-creation party, you have to get iodine on the dance floor busting moves with everyone.

If you’re worried about how iodine deficiency impacts fertility, fortunately, iodine deficiency is easily fixable. All you need is a test to determine your level of deficiency and then to take an iodine supplement if necessary. The best tests are an iodine urine spot test which is ideal if you aren’t currently taking iodine. If you currently take iodine, you’ll need to take a 24-hour iodine loading test where you take 50mg of iodine and collect your urine for 24 hours.

I highly recommend working with an iodine-knowledgeable practitioner when supplementing with iodine as there are additional nutrients that need to be taken in unison with the iodine to prevent toxicity – and you may need support with detoxing.

It is also very important when taking iodine to get plenty of salt in the diet. Even if you don’t take iodine, you need adequate salt to make a healthy baby as it helps to detox the bromide. I recommend unprocessed sea salt like Real Salt, Celtic Sea Salt or Himalayan salt. While in terms of foods, seaweed and seafood are the best dietary sources of iodine. You can also add Maine Coast Kelp Flakes to food to boost iodine levels. However, to correct major deficiencies and improve fertility success you will need to take supplements.

The Ribbon Box guides and connects a likeminded community, from the highs and lows of pre-conception, through pregnancy and parenthood. Everything FHH does it rooted in a place of experience: from shared stories, useful giveaways and offers to daily expert advice and events.

For trying to conceive support, follow us here, and for parenting support, follow us here.

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The Best Foods for Boosting Fertility

Madeleine Usher — Fri, 08 Apr 2022 09:21:25 +0000

By The Ribbon Box

Nutrition during pregnancy comes with many dos and don’ts, but how should you eat when trying to conceive? Sometimes boosting fertility takes more than paying attention to your menstrual cycle, and requires monitoring bodily functions and overall health too. As with all body systems, the reproductive system benefits from a healthy lifestyle, which is why good nutrition is key to enhancing your fertility. Here are the best foods to boost fertility.

Avocados

Avocados are important before, during and after pregnancy. Studies show that avocados contain many nutrients important to prenatal, natal and neonatal health — such as Vitamin A, B6, B12, D, folate, iodine, and iron, among many others. Avocados also help your body absorb nutrients more effectively, so you should definitely consider incorporating the super fruit into your diet.

Berries

Blueberries, cranberries and raspberries are high in folate, vitamin C, and fibre. They’re also rich in antioxidants and anti-inflammatory phytonutrients — both of which help reduce damage to reproductive cells that are caused by environmental toxins and free radicals in the body.

Whole Fat Dairy

Fat-free and low-fat dairy products have been marketed as healthier substitutes for whole fat dairy, however this is simply not the case. It is possible that avoiding whole fat can be detrimental to the health of some individuals, including those who want to boost their fertility. Greek yogurt, in particular, is a superfood that contains a lot of other nutrients, such as protein and calcium. Bodies need fat in order to improve fertility, and whole fat provides fat-soluble vitamins like Vitamin A, E, D, and K. Vitamin D is especially helpful as it helps mature ovary follicles, regulate menstrual cycles, and balance sex hormones.

Bananas

Bananas are loaded with Vitamin B6, which helps regulate menstrual cycles and improve sperm and egg quality. They’re an excellent source of fibre as well. Bananas also help maintain a healthy weight, which is key for conception as obesity can make it more difficult to conceive.

Citrus Fruits

Citrus fruits are great sources of Vitamin C, which helps facilitate the release of eggs from the ovaries. But they’re also packed with folate, a B vitamin that helps regulate ovulation and create a healthy environment for eggs. Grapefruits and oranges, in particular, contain putrescine, a polyamine connected to potentially improving egg and semen health and quality.

Quinoa

Quinoa has the ability to control blood sugar levels and weight due to its high fibre content. Too much fluctuation in insulin and blood sugar levels can lead to diabetes and insulin resistance, which can negatively affect fertility. By keeping your blood sugar levels and weight regulated, you’ll also keep your hormones balanced – making quinoa a must have when trying to get pregnant!

For trying to conceive support, follow us here, and for parenting support, follow us here.

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Food Allergy Awareness

Phil Carlsson — Mon, 02 Aug 2021 15:35:47 +0000

With lots of families coping with food allergies we have dedicated an entire section of our website to supporting you with essential advice, support and simple recipe inspiration.

From nuts to wheat, dairy to eggs, we have all your concerns and questions covered by experts Dr Adam Fox and Allergy UK. From spotting symptoms in your baby or child to understanding the difference between allergy and intolerance, check out all the latest advice here.

Professor Adam Fox, paediatric allergy specialist

10th September 2019 No Comments

Professor Adam Fox is one of only a handful of UK doctors with recognised higher specialist training in Paediatric Allergy. He is a consultant at Guy’s & St Thomas’ Hospitals – the UK’s largest specialist children’s allergy centre, where he is Clinical Director. He has extensive experience in the management of food allergy, eczema, asthma,

Breastfeeding and food allergies

20th June 2017 No Comments

Apprehensive about breastfeeding and food allergies? Can breastfeeding your baby help stop allergies in their tracks? Consultant Paediatric Allergist Professor Adam Fox talks to us about the all-important benefits of breastfeeding during those first six months. The benefits of breastfeeding There are a number of reasons to breastfeed and this is widely accepted as

Travelling with children with food allergies

20th June 2017 No Comments

Travelling abroad to a holiday destination can be stressful for a family if a child has an allergy. Allergy UK’s Holly Shaw says that forward planning will help. Some careful thought and forward planning can help to reduce anxiety for both you and your child and help ensure that your holiday is enjoyable. The details

Food allergy vs. food intolerance

20th June 2017 No Comments

Many different names are used to describe adverse reactions to foods, including food hypersensitivity, food intolerance, food allergy and other medical and non-medical terms. This causes confusion for those who have recently started suffering from symptoms that could be an allergy or intolerance. An allergy, with delayed symptoms can also often be confused with an

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Top Tips for Washing Babies Hands

Lara Karmel — Fri, 06 Nov 2020 11:41:50 +0000

Anyone who has begun weaning their little one can sympathise it gets MESSY! But what about cleaning your baby before mealtimes?

We should always wash our own hands before eating and babies’ hands are no different… especially once they are old enough to start eating, crawling and getting into all sorts of mischief! Hand washing is the simplest, yet most effective way to stop the spread of bacteria and therefore keep our babies safe and protected from illnesses.

For some top tips on washing babies hands; including the logistics and what to use on baby’s skin, I’ve answered some of the common hand washing questions below….

Top Tips for Washing Babies Hands

How should you wash your baby’s hands?

One of the most straightforward ways to wash babies hands is of course to hold your baby over the sink, position them on your knee and wash their hands with soap and water as you would your own (being careful not to press little one’s tummy into the sink whilst doing so).

However, if the logistics of doing this isn’t for you (especially when your baby is little), then you can also apply soap to their hands using a dampened soapy washcloth instead, using another cloth dampened with just water to wipe away the soap.

Remember you can also wash babies hands by putting the bowl of soapy water in front of baby or toddler and use a cloth to make sure you get in between all of their fingers, again using a damp cloth after washing to clean off the soapy residue.

Just make sure when you’re drying their hands, the towel is clean and dry.

What to wash babies hands with?

Soap and water are always best for washing babies hands with… regardless of age!

However, if you’re worried that your regular kitchen soap might be a little too harsh for your baby’s delicate skin, then you can always use some of their body wash instead when they are little! Truth is…. anything ‘soapy’ will do the job when it comes to handwashing providing hands are washed thoroughly![1]

Washing babies hands when out and about

When out and about, always stick to using soap and water whenever and wherever you can.

However, if there is no soap and water available, hand sanitiser may be used if there is no alternative but make sure you rub it in until completely dry. Just be aware that hand sanitisers do not work as well as soap and water[2], particularly against germs such as Norovirus[3] or if hands are physically dirty or greasy, so you may want to wipe your little ones’ hands with a damp wipe first.

What about toddlers?

It is really important to embed a good hand washing routine as early on in life as possible. As your baby progresses into a toddler, it’s important to change your hand washing technique as they grow, keeping it fun whilst giving them lots of praise and encouragement! Here’s some ideas how you can start getting your toddler involved in washing their hands and help them to understand that it’s an important part of their daily routine…

Get a step stool so they can reach the sink themselves
Give them independence – Anyone with a toddler will know how much they LOVE a sense of independence and the feeling of being able to do something for themselves! It’s of course always best to supervise them to make sure they wash their hands properly but let them do the main work themselves.
Always communicate with them to tell them it’s time to wash their hands and why (for example…. it’s dinner time!)
Sing a song with them whilst they wash their hands. Hands should be washed for 20 seconds which is enough time to sing ‘Happy Birthday’ twice, but you could always sing along to a nursery rhyme or any other song your child loves to make sure they stay at the sink long enough! If you’re stuck for song ideas… check out the collaboration between the World Health Organisation and Peppa Pig here
Teach them the importance of washing their hands using body paint or glitter every so often so that they have a visual aid of how they need to wash their hands for them to be clean

.. And don’t forget to also wash your hands at the same time! Not only will this help keep everyone safe, but seeing you lead by example will be a great learning tool for your little one from any age.

We hope you find our top tips for washing babies hands helpful!

See our next article on teeth hygiene

[1] Holchem, In Safe Hands, 2018

[2] CDC, Handwashing: Clean Hands Save Lives, https://www.cdc.gov/handwashing/show-me-the-science-hand-sanitizer.html, 2020

[3] CDC, Preventing Norovirus, https://www.cdc.gov/norovirus/about/prevention.html, 2019

Jenna is a fully qualified Environmental Health Practitioner specialising in food safety and public health.

She obtained a first-class Batchelor (BSc) degree in Environmental Health and has since qualified as an Environmental Health Practitioner with the Chartered Institute of Environmental Health (CIEH). Over the past 12 years she has worked in both the public and private sector advising businesses on all things food safety and public health.

Since becoming a Mum to her 2-year-old little girl Mia, she understands first-hand how much things change when you have a little one to think about too! She has always been passionate about food safety and her mission as Food Safety Mum is to help give parents confidence when cooking at home or when eating out and about!

For lots more food safety advice, follow Jenna on Instagram

@Foodsafetymum

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Go to Guide: Handling Leftovers Safely

Lara Karmel — Fri, 06 Nov 2020 11:16:00 +0000

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Annabel Karmel’s Top 10 Weaning Tips

Lara Karmel — Thu, 01 Oct 2020 11:08:17 +0000

Weaning SHOULD be a really fun milestone, but in all honesty when you’re faced with so much conflicting advice…AND the pressure to fill them with goodness, it’s so easy to feel like you’re on the back foot before you’ve even begun.

That’s where my straight-talking, super practical online weaning course is here to help! Designed to fit around you and your baby, and supported with expertise from a team of registered dietitians and nutritionists from the Early Years Nutrition Partnership, I want to empower families and early years practitioners to feel confident and prepared.

As well as easy to follow bitesized audio tutorials providing the right information and practical advice, it is also packed with helpful lists, planners, videos and recipes.

To provide you with some food for thought, here are some of my top weaning tips to sail with solids!

1. Mighty milk

Weaning is a gentle process – it’s about introducing a variety of new tastes and textures rather than volume of foods that contribute nutrients and calories (not just yet anyway). So, it’s important to remember that your baby’s usual milk will still remain the most essential dish on the menu with around 500–700ml of breast milk or formula needed each day up until their first birthday.

2. Is my baby ready for solids?

Introducing complementary foods at around 6 months’ is the age advised by the World Health Organisation. Is your baby sitting up and supporting their own head? Have they developed hand-to-eye coordination? Are they showing signs that they have lost the tongue-thrust reflex? These are a few key signs that your baby may be ready to take that leap into the world of weaning.

3. You don’t have to choose one weaning method

While lots of parents have success with spoon-led or baby-led weaning alone, combining the two is most suited to lots of families. Giving purées when your baby is ready for first foods (particularly if slightly earlier than 6 months), with the introduction of finger foods and family meals from around 6 months is a fantastic flexible option. This is also advocated by the likes of the Department of Health and Social Care, the NHS and the British Nutrition Foundation. What’s important is that there is no right or wrong to weaning. Some babies thrive on purées, others on finger foods and yet some on both. Instead of committing to a certain feeding method, it’s OK to be flexible in your approach and to follow your intuition and your baby’s developmental signs.

4. First tastes

Babies are born with mature taste buds for sweet, bitter, sour and savoury tastes. However, they will be exposed to breast or formula milk first, which contains lactose, which is naturally sweet, and they will therefore happily accept sweet foods. Although their bitter and sour taste buds are mature at this age, as they have not been exposed to these tastes before, they will need to develop them through food exposure. It is absolutely fine to still offer sweet veg as a first food but you just need to ensure you are also offering the bitter vegetables, such as spinach or broccoli, during those early days too.

5. It can take up to 15 tries

Did you know that it can take up to 15 attempts for your baby to accept certain foods or tastes, so be sure to give them plenty of chances to try again! It’s likely that your baby will pull funny faces and refuse certain foods on their first attempt. But… these expressions tend to be those of surprise as your baby simply gets used to new tastes.

If your baby is showing signs of disliking a particular food, that’s ok. Leave it there and try again the next day or the day after. Just don’t strike it off your baby’s ‘like’ list straight away as they’ll need the opportunity to get to grips with it first.

6. Don’t delay in introducing critical nutrients

If you are starting at 6 months, it’s important to introduce foods containing critical nutrients, like protein, iron and omega 3 essential fatty acids fairly quickly. Offer fruit and veg for the first couple of weeks and then start introducing protein-rich foods like red meat, eggs and lentils and oily fish such as salmon.

Iron-rich foods should be offered to your baby twice a day, or if your baby is vegetarian then at every mealtime (around 3 times a day). It’s important that Omega 3 essential fatty acids from oily fish like salmon should be offered twice a week.

7. Fantastic finger foods

From 6 months you can introduce soft finger foods to your baby – these are great for encouraging their independence, introducing texture and practicing that hand to eye coordination too! They will need to be able to close their hand around the food so it’s best to start with pieces that are big enough for your baby to hold in their fist with some sticking out. Fairly long pieces (roughly 5–6cm) stand a better chance of being picked up. Try avocado wedges, banana ‘lollipops’, mango slices, steamed carrot batons and broccoli florets for starters!

8. How to tackle lumps and bumps

My advice is to take a gradual but swift approach. If you go from offering a puree-like consistency to straight up mashing, chances are your baby will find this too much of a big step. Instead, at first make a slightly thicker, less blended version, and then once they have got used to this, try mashing whilst ensuring the food is still fairly chunk-free. This gradual increase in texture will encourage your baby to adopt a more lateral tongue movement, which is another key learning step in mastering the art of eating. You can then start to let them explore the likes of rice, couscous, bulgur wheat and mini baby pasta shapes.

9. Introducing allergenic foods

The Department of Health and Social Care recommend that potential allergenic foods such as eggs or peanuts can be introduced from six months of age. In fact, for those babies who don’t have parents or siblings with allergies, or who don’t have early-onset eczema, start introducing allergenic foods in the same way you would with any other food. This is because delaying the introduction of these foods into the diet may increase the risk of allergies developing. If there are allergies in the family, or you think that your baby may be at risk because they suffer with eczema, then you should discuss this with your health visitor or GP.

10. Snack attack!

Crafting healthy snacks can be another way of getting those all-important nutrients into your baby’s diet. From 10 months, your baby can have one to two small but nutritious snacks per day in between meals. Try to make sure that snacks contain at least two critical nutrient food items, one of which could be her milk. It is important to note that this is just a guide. We want baby to be hungry for their next main meal, and some babies will need smaller or fewer snacks than others.

Feed your baby confidently with Annabel Karmel’s

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Top tips for cooking with kids

Lara Karmel — Tue, 29 Sep 2020 12:33:41 +0000

Getting dinner on the table is a major feat in every busy family. But getting them to eat what is on their plate is another challenge all together!

Did you know that children who are involved in the meal prep are more likely to try the fruits of their labour? So before you ban the kids from the kitchen so you can cook in peace, think about roping them in to help out.

From whisking to weighing, pouring to peeling, stirring to serving, little chefs who regularly roll their sleeves up will reap the benefits. Not only does it create an interest in food and cooking, but it helps them to develop their fine motor skills, eye hand coordination, measuring, counting, reading, and so much more! It is also a great way for them to feel a real sense of accomplishment.

For me, having my kids in the kitchen cooking with me is second nature, but it’s not always plain sailing. The important rule is that cooking with the kids doesn’t have to mean producing elaborate, time-consuming meals. The best way to ensure maximum fun (especially in the week), is be keeping the recipes simple, quick and easy-to-follow.

Discover these handy top tips for cooking with kids for winning in the kitchen

No pressure to taste

Getting kids in the kitchen and preparing foods is one of my top tips for helping with picky and fussy eating. But try not to pressure them to taste either the ingredients or the final meal. If they do that is brilliant. But if they don’t, that is ok too.

Time it right

Don’t wait until the kids are hungry or too tired before bringing them into the kitchen. Young attention spans are short as it is and attempting to cook with a cranky toddler will certainly try your patience!

Ingredients check

Make sure you have all the ingredient you need you need before you whistle for your sous chefs! Freestyling isn’t to easy when you have keen kids at your feet.

Fun first

You might have a few resignations of you try and control your little chefs too much.

Getting them engrossed and interacting with food is far more important that the end result. Put pay to ‘perfection’ and instead focus on the fun – and that means embracing a little mess too!

Kitchen playdate

The kitchen is the perfect spot for an after-school social! Let’s face it, entertaining our own children is hard enough work, so why not get them putting that post-school energy to good use and helping you out – it’s also an ideal environment to get the kids talking and sharing about their day. Bonus!

An everyday activity

Baking is a great introduction to the culinary world (and let’s face it, we all have memories of licking the spoon when making cake!). But a healthy love all foods comes from involving them in everyday meal prep too. From making the morning toast and rolling the lunchtime wraps, to having a hand in making dinner, helping to preparing tasty, good food should be part of daily life.

Inner Picasso!

Dabbling in cooking and food prep is the ideal opportunity to feed young imaginations and unleash that inner Picasso! Kids eat with their eyes, so try out recipes that encourage them to assemble their own creations. With Halloween creeping up on us, they will love my Spooky Spider Fishcakes with Scary Sweet Potato Faces. Or dive into my Deep Sea Flipper Dinner – a great way to fuel fun, play and learning.

Discover more great recipes to cook with the kids here.

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How to get kids eating fish

Lara Karmel — Mon, 28 Sep 2020 15:21:14 +0000

Fish is a fantastic food for the whole family – it’s packed with essential nutrients such as protein and vitamin D. Fish is also a great source of omega-3 fatty acids, which are incredibly important for your body and brain.

But how do you sell it to the younger crowd without the cries of ‘I don’t like the fishy taste’ and ‘it’s got bones in it’? Here are my simple hacks for packing in their 2-a-week.

If at first you don’t succeed…

Serving fish consistently every week allows your child the opportunity to establish familiarity with its taste, texture and smell. The more familiar your child is with a food the more likely they are to eat it or try it prepared in a different way. It can take children up to 15 attempts to accept a new food, so patience is a virtue!

Time-saving twists

Saving time doesn’t have to mean compromising on goodness. When you need a quick midweek meal up your sleeve, pre-prepared fish that you can pop in the microwave is a saviour. Check out my 5 Veggie Rainbow Rice using pre-prepared cod steaks in a butter sauce. Add a rainbow of veggies, and voila! A family pleaser in under 15 minutes.

Make it mild

When first introducing fish, try a milder type. Cod, salmon and plaice are great choices. I love to serve a healthy twist on traditional fish and chips with cod in a Rice Krispie coating with baked sweet potato wedges. Fishcakes are also really child friendly, so keep a stash in the freezer for midweek meals.

Add the fun-factor

Kids love to play with their food, and that’s ok if it means they are more likely to try new foods. Using fish as your meal centre, look at what you can serve it with to feed little imaginations. Pop colourful veggies into separate bowls and challenge them to make their own work of art. Deep Sea Flipper Dinner is a great idea for some underwater dinner fun!

Natural sweetness

Sometimes adding a slight sweetness to fish can make it even more appealing to children.

Flavour exploration is so important in a child’s food journey, so adding something like grated apple to a recipe, or a sweet dipping sauce is a good way to entice them to discover new tastes. This is one of my favourite recipes trending right now – Popcorn Scampi with Fruity Curry Dipping Sauce.

DIY with fish

Kids love a bit of DIY dining…building tacos, fajitas, pizzas. So why not switch it up and swap out your meat for fish next time? These are the perfect dishes to bring the whole family together, so set out a toppings bar full of fresh cut veggies to accompany the fish, plus some saucy toppings like sour cream, guacamole, and salsa.

From making the morning toast and rolling the lunchtime wraps, to having a hand in making dinner, helping to preparing tasty, good food should be part of daily life.

The post How to get kids eating fish appeared first on Annabel Karmel.

Jenna Brown – Environmental Health Practitioner

Lara Karmel — Fri, 18 Sep 2020 10:59:36 +0000

Jenna is a fully qualified Environmental Health Practitioner specialising in food safety and public health.

For lots more food safety advice, follow Jenna on Instagram:

@Foodsafetymum

Jenna’s Articles:

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Top tips for thinning baby purees

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Weaning Equipment – Getting your kitchen ready for weaning

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Go to guide: preparing, freezing and reheating foods for baby

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Go to Guide: Handling Leftovers Safely

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Go to guide: preparing, freezing and reheating foods for baby

Lara Karmel — Fri, 18 Sep 2020 09:50:38 +0000

There’s no doubt that there are so many exciting things to think about when you begin your weaning journey with your little one; choosing a highchair, shopping for snazzy bibs, debating which cup and cutlery is best and deciding what amazing tastes to expose your baby to first… but it’s important not to forget that amongst all of this, any food you serve needs to be safe! Babies and young children don’t have the same immune system as us adults (or even older children) so food safety is essential. We need to make sure we’re extra careful with their little tummies!

It is estimated that there are 2.4 million cases of food-borne illness in the UK every year but it’s not just restaurants that cause food poisoning – cooking at home can also make you (or your family) sick. The good news is that there are so many things you can do whilst preparing food to prevent this happening. Below, we give our top tips for baby food safety.

Keep it clean

When it comes to food safety, keeping clean is so important. In reality, this doesn’t mean having a ‘spotless’ kitchen but instead, a clean environment where you prepare food, with clean hands, using clean equipment! Here are some top tips to help you organise your kitchen and help you safely prepare meals for your baby and the rest of the family:

Wash your hands – always wash your hands thoroughly before preparing any food, and particularly after handling raw meat
Clean work surfaces – disinfect food preparation surfaces using a clean dishcloth before starting any food prep. If you can, use a paper towel squirted with antibacterial spray to clean surfaces after preparing raw meat and poultry as this will help to make sure that you don’t pick up food poisoning germs and spread them around the kitchen
Clean utensils – make sure equipment is clean before you start using it and if you can, opt for colour coded equipment to reduce the risk of cross contamination between raw and ready to eat foods. Never prepare ready to eat food such as salad on a board that was previously used to prepare raw meat
Wash fruit and veg – they might be low risk foods, but bacteria can also be found on fruit and veggies too so don’t forget to wash these thoroughly under cold running water before serving to baby. If you’re using frozen veggies in baby’s food, make sure that these are cooked according to the back of pack information before serving to your baby.
Don’t be tempted to wash raw chicken! – washing your chicken will not ‘wash off’ the bacteria (only cooking will make it safe to eat!). If you wash chicken, instead you are more likely to cause food poisoning by inadvertently spreading more bacteria around the kitchen.

Food Safety – Cooking food for your baby checklist!

Cooking veggies by steaming, boiling or roasting is pretty straightforward, but those first tastes don’t last for long and you’ll soon be branching out to more exciting foods for your baby to try, many of which may include meat or fish. Regardless of how you serve meat to your little one, it’s important to make sure that it is thoroughly cooked.

Remember – just because it’s cooked on the outside, doesn’t mean it’s cooked on the inside! Here’s how you can check that meat is safe for your baby to eat…

Use a food probe - checking the temperature of the thickest part of the meat is the most accurate way (and the way I would recommend) to check food is cooked, whilst also making sure it is not overcooked! If using a probe, make sure the probe is clean and the meat has a core temperature of 75C for at least 30 seconds.
Cut into the thickest part of the meat to make sure there is no pink meat visible
The meat must be steaming hot throughout
Meat juices run clear

If you find your baby puree needs thinning after cooking, check out Jenna’s article Top tips for thinning baby purees

Cool foods quickly

I am a huge fan of keeping leftovers to use as an easy meal another day! After cooking, make sure you cool any leftovers and pop into the fridge or freezer as soon as possible. Never allow food to sit out on the side for more than 2 hours after cooking.

Be aware that simply putting your hot food in the fridge may not be enough to make sure it is cooled down quickly and safely. There are lots of things you can do to help speed up the cooling of food, such as dividing into smaller portions, using an ice bath or stirring regularly.

Keep leftovers for another day

Whatever your situation, whether you have children or not… reheating leftovers is always a good idea! As a rule of thumb, leftover food can be kept in the fridge and used within 2 days (1 day for rice) but if you want longer than this, then pop your leftovers in the freezer.

Even if you used raw meat or veg which was previously frozen, once cooked you can freeze the leftovers. Freezing “pauses” the growth of bacteria, locks in nutrients, prevents spoilage and ultimately helps reduce wastage!

Defrosting baby purees

If defrosting baby purees, the best way to do this would be overnight in the fridge and use within 24 hours. But, did you know that you can cook baby purees from frozen?!

Reheating baby purees

Baby purees are often best served at room temperature, but don’t be tempted to partially reheat food for your baby to avoid having to wait for it to cool. Unless served cold straight from the fridge, baby purees should always be reheated until piping hot, which means steaming throughout, to kill off bacteria.

The best ways to reheat baby purees are:

On the hob
In the microwave

If cooking a portion of baby puree from frozen, make sure you increase the cooking time and stir regularly (every 20 – 30 seconds) to ensure there are no hidden hot spots and that the puree is evenly heated so it is piping hot throughout.

Remember that foods can only be reheated once so make sure you divide your puree into baby friendly portions before storing in the fridge or freezer!

We hope these tips and tricks have helped you become more confident when it comes to food safety for your little ones!

Jenna is a fully qualified Environmental Health Practitioner specialising in food safety and public health.

For lots more food safety advice, follow Jenna on Instagram

@Foodsafetymum

The post Go to guide: preparing, freezing and reheating foods for baby appeared first on Annabel Karmel.

Top tips for thinning baby purees

Lara Karmel — Fri, 18 Sep 2020 09:47:15 +0000

As you start preparing those first few purees for your baby, you are likely to find that you need some extra liquid to help loosen the consistency.

There are so many options available when thinning purees for babies over 6 months and rest assured you can use anything from tap water, cow’s milk or plant-based milks as well as a splash of your baby’s usual breast milk or formula milk; which will not only help loosen the consistency but also adds a familiar taste.

Whatever you choose to thin your baby’s puree, there are a couple of things you might need to keep in mind if you want to keep the puree for another day…

Top tips for thinning baby purees

Thinning baby purees with formula milk

Whilst you shouldn’t keep leftover bottles of formula milk, it IS perfectly fine to use freshly prepared formula milk as an ingredient within a meal or puree that you wish to keep and reheat another day! Just make sure that if you choose to use formula milk to thin your baby’s puree, you follow these simple guidelines to make sure the leftovers are safe:

Before adding to food, make up formula fresh – don’t use leftover milk from a previous feed
Make sure any leftovers are cooled quickly and put into the fridge or freezer as soon as possible; ideally within an hour and half but no more than 2 hours
Ensure you follow the shelf life guidance in the table below

	Shelf life in the fridge	Suitable for freezing	Shelf life in the freezer
Purees made with formula milk	1 day	Yes	3 months
All leftovers must only be reheated once and any defrosted purees must be used within 24 hours

Thinning baby purees with expressed breast milk

Breast milk is great for your baby for so many reasons, its ideal for thinning baby purees too, especially in the early days of weaning!

You can either….

Add fresh breast milk – this is the best option if you’re adding to the puree when cooking as it means you can keep the leftovers in the fridge or freezer

Add a small ice cube of frozen, or a splash of defrosted breastmilk – the most important thing to remember here is that breastmilk must never be refrozen. So, if you’re using previously frozen breast milk, it’s best to add just a splash to the portion you are serving so you don’t end up wasting more than you need to

	Shelf life in the fridge	Suitable for freezing	Shelf life in the freezer
Thinning baby purees using freshly expressed breast milk	2 days	Yes	3 months
Thinning purees using previously frozen breast milk	Dispose of leftovers	No	N/A
All leftovers must only be reheated once and any defrosted purees must be used within 24 hours

Thinning baby purees using water or cow’s milk / plant-based milk

You can also thin baby purees using cow’s milk or plant-based milk. Using cow’s milk or plant based milk in cooking is absolutely fine for babies over 6 months. Just don’t substitute their usual milk (breast milk or formula) for any of these varieties until they are at least 1 year old.

Does the water need to be boiled?

No. Tap water is fine for babies over 6 months – although if you can, make use of the water you used to cook your veggies in as this will also help to sneak in an extra splash of nutrients that leached from the vegetables as they were cooked.

Here’s a quick summary of the guidelines…

	Shelf life in the fridge	Suitable for freezing	Shelf life in the freezer
Thinning baby purees with cow’s milk or plant-based milk	2 days	Yes	3 months
Purees without additions	2 days	Yes	3 months
All leftovers must only be reheated once and any defrosted purees must be used within 24 hours

See our next article for more advice on preparing, reheating and freezing food for baby.

Jenna is a fully qualified Environmental Health Practitioner specialising in food safety and public health.

For lots more food safety advice, follow Jenna on Instagram

@Foodsafetymum

The post Top tips for thinning baby purees appeared first on Annabel Karmel.

Weaning Equipment – Getting your kitchen ready for weaning

Lara Karmel — Fri, 18 Sep 2020 09:40:48 +0000

Beginning your weaning journey with your baby is such an exciting time for so many reasons but it can also be a bit overwhelming with so much to think about and prepare for.

Get ready to wean by getting organised in the kitchen, it will make your life so much easier… and I’m not just talking about the dreaded Tupperware cupboard! In this article I have put together your weaning equipment essentials, as well as a few tips to help you get ready to wean and make sure your kitchen is as prepped as possible! This will help make sure the food you serve your little ones is safe, allowing you to relax and enjoy the weaning process.

How to organise your fridge

How to get ready to wean? First things first, start with organising your fridge. Knowing how to store food once you get it home from the supermarket and organise your fridge correctly will help you avoid food poisoning by reducing the risk of cross contamination between raw and ready to eat foods as well as helping you to reduce food wastage.

Did you know? The average household with children could save around £60 per month by reducing their food waste and saving food that could have been eaten from being thrown away?![1]

So, how exactly should you organise your fridge and what else do you need to know to help keep the food in your fridge safer for longer?

Most importantly, check the temperature of your fridge. To reduce the risk of food poisoning, make sure your fridge is running between 1-5⁰C. If your fridge doesn’t have a built-in thermometer, then you can check this using a fridge thermometer or a food probe.
Organise your fridge to make sure you store raw meat and fish separately from ready to eat foods. The best place to store raw meat and raw fish is the bottom shelf – not only does this prevent cross contamination of juices dripping onto other foods below, but is also the coldest part of the fridge
Keep cooked and ready to eat foods higher up, saving the doors for condiments, jams and juices as the doors are most at risk of temperature fluctuations
It’s best to store eggs in the fridge for safety and freshness as this ensures eggs are stored at a constant temperature below 20⁰C.
First in, first out – when returning from the supermarket, put new foods at the back so using older products first will come naturally!
Don’t forget to also keep an eye on packs in the fridge that have been opened! Opening a product with a ‘use by’ date (more on these next) such as ham or milk, will change the shelf life and usually means it will need to be used within the next few days, or popped in the freezer.

Plan ahead when preparing your baby’s meals

Planning ahead the meals you want to cook for baby (and yourself!) for the next couple of days will help you decide what foods you can keep in the fridge, and which foods to freeze!

It’s important when planning your meals to be aware of the difference between ‘use by’ dates and ‘best before’ dates. Put simply, ‘use by’ dates are there for your safety and mustn’t be ignored whereas, ‘best before’ dates are about quality. Whilst food is safe to eat past its ‘best before’ date (but might not taste as good), food past its ‘use by’ date is not safe to eat especially as you often can’t tell if a food is unsafe by its appearance, smell or taste, so it’s not worth the risk; particularly when there are little ones involved.

The good news is that it is perfectly safe to cook or freeze food right up until (and including) the ‘use by’ date. So, if you’re not going to use something before it’s ‘use by’ date, either pop it in the freezer or cook it and use the leftovers within the next 2 days.

Don’t be put off freezing your foods as this has no impact on being able to freeze the leftovers.

Did you know? Even if you use previously frozen raw meat when cooking, you can still portion and freeze the cooked leftovers to reheat another day?!

Kitchen essentials for weaning your baby

Get ready to wean by making sure you have all the kitchen essentials.

When you start out on your weaning journey, there are so many weaning ‘essentials’ covering everything from choosing the right highchair, spoons, bibs, plates (and so much more…) but don’t forget to stock up your kitchen with essential items that will help make your food prep easier and safer.

I’ve put together a list of my top 10 weaning kitchen essentials to help make sure the food you serve is safe, that little bit easier!

1. Food probe

I consider a food probe a must-have for any kitchen. You can’t tell from the outside whether food is cooked, so a food probe eliminates the guesswork whilst also helping to prevent overcooking – it’s a win-win!

2. Colour coded equipment

Choosing colour coded chopping boards is the simplest and easiest way to reduce the risk of cross contamination between raw and ready to eat foods.

3. Freezer labels

Ever pulled a random container of food out of the freezer having no idea what it is or how long it’s been in there?! No, me neither……. I’m a huge fan of batch cooking with a little one at home so keeping track of what is in your freezer is a must!

4. Portion pots

Babies have small appetites so being able to portion their food is a must! Remember, when grabbing food from the freezer you can only reheat food once so having small portions will help make sure you are only reheating as much as you need and reducing your food wastage.

5. Antibacterial cleaner

Make sure you have a decent cleaner to help keep your kitchen counter clean before cooking and after handling high risk foods such as raw meat and poultry.

6. A selection of cloths and tea towels

It’s best to make sure you have enough cloths and tea towels so you can change these daily. If you can, I would always recommend that when cleaning up after preparing raw foods such as raw meat, poultry and soiled vegetables, that you use a paper towel squirted with anti-bacterial spray. This will help make sure that you don’t pick up food poisoning germs and spread them around the kitchen.

7. Airtight containers

These containers are great for storing dry food items as well as leftovers in the fridge. By keeping moisture out, airtight containers help keep food fresher and safer for longer.

8. Food cover

A mesh food cover is a must have for any kitchen to make sure those pesky flies don’t land on your food – whether you’re dining alfresco or cooling your leftovers.

9. Fridge thermometer

If your fridge has a built-in thermometer, you might not need one of these but if not, then it would be worth investing in a fridge thermometer to make sure your fridge is running below 5⁰C and the best part is, you can usually pick one of these up for less than £5!

10. Colander

Okay so you probably do already have one of these but don’t forget that you’ll need to wash all fruit and veg before giving it to baby! Did you know? Even Norovirus (the most common cause of gastroenteritis) can be found on foods such as lettuce and raspberries?[2]

[1] WRAP, ‘Food surplus and waste in the UK – key facts’ (2020)

[2] Food Standards Agency, ‘Assessing the contribution made by the food chain to the burden of UK-acquired norovirus infection’ (2019)

Jenna is a fully qualified Environmental Health Practitioner specialising in food safety and public health.

For lots more food safety advice, follow Jenna on Instagram

@Foodsafetymum

The post Weaning Equipment – Getting your kitchen ready for weaning appeared first on Annabel Karmel.

Gagging vs Choking: The differences you need to know when weaning your baby

Lara Karmel — Thu, 27 Aug 2020 11:11:41 +0000

Introducing solid foods to your baby and starting to wean is a big milestone for parents. The process of slowly moving from milk feeds to trying a variety of different tastes and textures can be exciting and daunting at the same time. One question I am always asked by parents at the start of their weaning journey is ‘what do I do if my baby chokes?’ alongside ‘I don’t want to offer my baby finger foods as they might choke’.

It’s a common misperception that gagging and choking are the same thing and they are often confused… but they are most definitely not the same and it’s important to be able to recognise the difference between the two.

Is gagging normal when weaning my baby?

Think of gagging as your baby’s in-built protective mechanism against choking. Babies have highly sensitive gag reflexes that are triggered very close to the front of the tongue, especially at the start of weaning.

This means that your baby will often gag when they first start on solid foods and for the first few weeks of weaning. This might mean they simply push food out of their mouth with their tongue, or they may retch or look like they are about to be sick. They are rarely distressed by this and will often simply continue eating again straight after.

Gagging occurs because your baby needs to develop and mature their oral motor movements with time as they learn to eat. They don’t yet have the control to coordinate chewing and moving food to the back of their mouth to swallow, so they gag to stop food going down the wrong way. It’s quite clever really!

Therefore, don’t be put off if your baby gags during the early stages of weaning. They are simply learning to train their oral muscles to work in a new and different way and move food from the front of their mouth to the back in order to swallow.

As your baby continues on their weaning journey and practices eating, the gag reflex will move further back in their mouth and they will naturally gag less.

It’s important to note that some babies may have more pronounced gag reflexes, for example if they have suffered with reflux, vomiting, or had tubes for feeding for example. If you’re worried about your baby’s gag reflex always seek help from your GP who can then refer you to a specialist speech and language therapist.

What do I do if my baby gags during feeding?

Firstly, try not to panic and remain calm. This is easier said than done I know, but if you recognise that they are gagging (and not choking) it is important to let their body naturally sort it out for itself rather than intervening.

Try waiting a few seconds, maybe count to ten slowly in your head. It is very likely they will bring the offending food to the front of their mouth and spit it out or start to eat it again.

By stepping back and allowing them to gag, you are allowing them to learn how to coordinate their muscles and perfect this new skill.

It’s important to remember that you should never leave your baby alone whilst feeding and make sure that they are always well supported or able to sit in an upright position. This will significantly reduce the risk of choking as the gag reflex may not be as effective if they are leaning backwards.

How do I tell the difference between gagging and choking?

Choking is very different to gagging. This is when your baby’s airway becomes blocked. They may be coughing and trying to remove the offending obstacle, but they may also be unable to cry, cough or make any noise at all. They may be unable to breathe and you may see their lips or face turn blue.

This is a medical emergency and they will need immediate help.

What foods are a choking risk for my baby?

Whole nuts – always give nuts ground or as a smooth nut butter
Whole grapes, blueberries or cherry tomatoes – always serve them quartered
Fruits with stones such as cherries – remove the stones and serve quartered
Bony fish – check and remove all bones before offering to your baby
Cook vegetables so that they are nice and soft for them to chew

What do I do if my baby chokes?

The NHS website, Resuscitation Council UK & the Red Cross websites all have great advice as well as step by step videos to teach you basic first aid and support. You may want to attend a local First Aid Course and your GP should be able to advise you about local courses to you.

If you baby is showing signs of choking, here are some simple steps you can take as advised by the NHS.

If you can see the object, try to remove it. Don’t poke blindly or repeatedly or you could push it further back and make things worse.
If your baby is coughing, encourage them to keep coughing, this might help to bring up what they are choking on. Don’t leave them.
If the coughing isn’t effective (its silent or they can’t breathe in properly) shout for help immediately.
If you baby is still conscious, but they are either not coughing or their coughing isn’t effective, use back blows.

Back blows for babies under 1 years old

Sit down and lay you baby face down along your thighs, supporting their head with your hand.
Give up to 5 sharp back blows, with the heel of one hand in the middle of the back between the shoulder blades.
If back blows don’t relieve the choking and your baby is still conscious, give chest thrusts.

Chest Thrusts for babies under 1 year old:

Lay your baby face up along the length of your thighs.
Find the breastbone and place 2 fingers in the middle.
Give 5 sharp chest thrusts (pushes) compressing the chest by about a third.

Following back blows and chest thrusts reassess your baby or child as follows:

If the object still hasn’t dislodged and your child is still conscious, continue the sequence of back blows and chest thrusts.
Call out or send for help if you’re still on your own. Don’t leave your child.

Call 999 if the blockage doesn’t come out after trying back blows and chest thrusts. Keep trying this cycle until help arrives.
Even if the object has come out, get medical help. Part of the object might have been left behind, or your child might have been affected by the procedure.

If your baby or becomes unconscious with choking:

Put them on a firm flat surface and shout for help.
Call 999, putting the phone on speakerphone so your hands are free.
Don’t leave them at any stage.
Open the their mouth. If the object is clearly visible and you can grasp it easily remove it.
Start CPR

It is important to be able to recognise the difference between gagging and choking and the different ways you should treat both.

Remember, gagging is your baby’s natural in-built protective mechanism to prevent them choking as they learn to feed themselves. Choking however, is when their airway is blocked, and they will need immediate help and First Aid.

This article is written by Dr Chintal Patel.

Dr Chintal Patel is a NHS General Practitioner in London. She works with families and children and specialises in women’s health. She also writes a recipe blog sharing health and nutrition information and runs cookery classes for families.

For more helpful advice visit Dr Chintal Patel’s website www.drchintalskitchen.com and Instagram account @drchintalskitchen

The post Gagging vs Choking: The differences you need to know when weaning your baby appeared first on Annabel Karmel.

Weaning premature babies

Lara Karmel — Tue, 15 Oct 2019 08:55:11 +0000

There is a lot of weaning guidance available for babies born on or around their due date (from week 37 of pregnancy onwards), however, not a lot for those whose baby decides to make an early appearance, which is actually around 10% of all babies!

What is premature?

A baby is called premature (or preterm) if they were born before 37 weeks. Just because they are born early, does not mean they will need specialist weaning advice, because babies born after 34 weeks who are healthy and growing well can follow standard weaning advice for babies born at full term.

Corrected age and actual age

You might have heard the term ‘corrected age’. This takes into account how early a baby was born and is counted from their due date. For example, a baby born at 32 weeks who is 14 weeks old, would be 6 weeks corrected. ‘Actual age’ is the baby’s age from the date they were born.

The corrected age allows healthcare professionals to assess your baby’s development appropriately. In this example, the expectation would be for your baby to be reaching the usual milestones of a 6-week old rather than a 14-week old baby.

Why does being born prematurely affect nutrition?

It is likely your baby will have missed some or all of the third trimester of pregnancy, which is when most of their important nutritional stores, such as iron, are laid down. It’s also when protein and energy is used for a large growth spurt.

Over the last decade the nutritional care that babies receive on the special care baby unit has improved dramatically, so lots of preterm babies manage to catch up with their nutritional status in the first few weeks.

However, because all babies are different, some may still be at risk of under-nutrition or poor growth needing individualised weaning guidance. Your healthcare team will advise.

What is the current guidance on premature weaning?

The general weaning NHS guidelines that advise that weaning should start at around 6 months of age, don’t apply to most premature babies.

Currently, there is a lack of government guidance on when and how parents should start weaning their preterm baby and that’s because there is very little research available specifically on preterm babies.

The key is understanding your baby’s developmental milestones and looking out for their readiness cues.

Consider the three signs for being ‘ready for weaning’ for term babies and see how the preterm baby might differ:

1) The tongue-thrust reflex – This is nearly always present in preterm babies and actually eating food regularly helps it go.

2) Being able to sit unaided – A lot of preterm babies don’t have the motor skills to be able to sit up unaided, but as long as they are appropriately supported in their highchair/seating, you can start weaning.

3) Good hand-eye coordination – Many preterm babies won’t have mastered hand-eye coordination at the start of weaning and will need to practice this as they learn to eat.

What are the readiness cues for weaning a premature baby

As you can see, the usual developmental readiness cues do not apply to a preterm baby, however, the following cues can be helpful to decide whether a baby is ready to start solids. Babies don’t need to have all of these in place, and I’m a great believer that parents are often the best judge of when their baby is ready:

• Holding their head steady when sitting upright in a supported position – Many babies achieve this at around 4 months corrected age.

• Picking up toys and putting them to their mouth to explore.

• Leaning forward, mouth open ‘asking’ for food.

• Some feel that showing an interest in the food that others are eating could be a sign for being ready for weaning, but many babies do this anyway and so should not be taken as a cue in isolation.

They are not:
• When your baby appears hungry and is demanding more milk.
• When your baby is waking more frequently through the night to feed.
• When they reach a certain weight.
• When they reach a certain age.

Is nutrition a reason to start solids?

Yes, it can be, as there comes a point when a baby’s energy and nutrient requirements can’t be met by milk alone (breast or formula) and so starting solids is necessary. However, fruits and vegetables, which are traditional first weaning foods, are low in energy. At the same time, starting solids may lead to their milk intake decreasing as it becomes displaced by food. Therefore, a steady progression towards a balanced diet including meat, fish, dairy foods and starchy carbohydrates is important to provide the additional nutrients required.

Are there risks in delaying weaning in a preterm baby

Yes, aside from the risk of poor nutritional status and growth, many babies benefit from the challenges that weaning brings and it may actually enhance the progression of their eating and drinking skills.

However, it is not uncommon for parents to want to delay the introduction of solids as they feel that their baby is not yet developmentally ready and so getting regular support from your healthcare team if you are feeling unsure is important.

In addition, we often see premature babies remaining on pureed food for longer than necessary due to concerns that they may not cope with lumpy textures and choke.

Because challenging textures are necessary to develop the muscles in the mouth at the right time, research suggests that a delay beyond 9 months uncorrected age for the introduction of lumpy textures could lead to feeding problems later on.
There is a developmental ‘window of opportunity’ when babies are open to accepting new flavours and textures and it is important that premature babies don’t miss this.

Can premature baby do baby-led weaning?

There are two approaches to weaning:

• Traditional weaning – this involves feeding the baby smooth purees from a spoon, gradually increasing the texture and finger foods alongside.
• Baby-led weaning (BLW) – this involves providing food in its whole form and allowing the baby to explore the food and self-feed.

Safety is the most important factor to consider. If you are considering BLW your baby must have adequate stability in an upright seated position to minimise the risk of choking.

Effective hand-eye coordination is also needed for successful BLW, without this, babies simply aren’t capable of bringing the food up to their mouths.

Nevertheless, hand-eye coordination is a skill babies need to learn through regular practice, so a combined approach by offering finger foods alongside purees can be helpful.

It is known too that BLW babies consume less nutrition at the start of weaning while skills are being learned [5]. Therefore, if growth is an issue and a carefully planned weaning diet is important, BLW may not be possible in order to achieve the required catch up growth.

Cup introduction

At the start of weaning it’s also important to introduce a cup to teach your baby drinking skills. At the very start the cup is more about practice and familiarity rather than a way of getting fluid in to your little one.

Use a free-flow, two handled spouted beaker, which is filled no more than half full, so it doesn’t need to be tipped too far for the water to flow, and so it isn’t too heavy for the baby to lift.

An open cup is good too but the water may flow too fast for premature babies and so starting with a free flow spouted beaker which controls the flow is often helpful.

Can I prevent fussy eating?

Repeated exposure to rejected foods is important for preterm babies just as it is for term babies in order to help them like new tastes and flavours. The wider the variety of flavours offered in the early stages of weaning before 9 months corrected age, the more likely a child will be to eat a wide range of foods when they are older.

Including your baby at family mealtimes whenever you can, bring the highchair up to the table and let your baby have some of what you are having. This is known to be very beneficial in terms of learning how to eat and drink. Babies watch and mimic others and learn how to eat this way. Evidence suggests that children who join in at family mealtimes accept a wider range of foods than those who eat alone.

Do premature babies need supplements?

All babies, regardless of when they were born, are recommended to have a daily supplement of Vitamin A, C and D (the exception to this is babies having more than 500ml formula/day as they will be receiving these already from the formula):

Vitamin D 8.5 – 10mcg
Vitamin A 200mcg
Vitamin C 20mg

Many premature babies will also be on iron supplements until they are eating well enough, when their dietitian will advise them to stop.

Responsive feeding

It’s important to take notice of and respond to your baby’s cues when it comes to feeding. For example, when your baby has had enough food, they will turn their head away or if they want more they will lean forward with an open mouth.

We know that from around 4 months both premature babies and babies born at term can communicate their needs to their parents.

If you would like to learn more about nutrition and feeding for babies and toddlers head over to my blog www.childrensutrition.co.uk

The post Weaning premature babies appeared first on Annabel Karmel.

Paced bottle feeding

Lara Karmel — Wed, 18 Sep 2019 14:23:22 +0000

What is Paced Bottle Feeding? Whether you are fully bottle feeding formula milk or breastmilk, it is always important to know how to do it in a baby-friendly manner so your baby can learn how to gain control over the feed as well as avoiding overfeeding.

Here are my useful tips:

Paced bottle feeding is an important method to practice when offering the bottle. Not only does it avoid overfeeding it also helps the baby digest the milk and signals when the baby is full. Much like on the breast, it makes it a bit harder for babies to drink. So you are really pacing the amount baby will get which makes this very breastfeeding friendly.
The mechanisms on the baby’s mouth are different when bottle feeding and breastfeeding, so making sure to take it steady to feed the bottle in a more upright position. It will help the baby not to get lazy on the breast after.
Start off by nursing baby in an upright position, offering a bottle that has a slow flow teat – you do not need to buy different flowing teats for growing babies. This is more a marketing campaign than anything. The flow of your milk from the breast is always the same so the rest should also stay as a slow flow option.
If you pick up certain signs, for example, nose crinkles, hands splay or get tense, eyes widen or the swallowing motions change, offer a little pause during the feed.
Just simply lean baby forwards a little with the bottle in the mouth and allow a little time for the milk to go down and for baby to relax again. Restart the feed slowly again.
You could also remove the bottle gently and let the baby indicate if more is needed.
Taking a little break gives time for signals in the stomach to tell the brain if it is truly full, just like when you eat a meal. Taking breaks is natural for the baby much like feeding on the breast. And like this, you are really feeding to baby’s appetite and won’t be overfeeding.

Visit @milkmakingmama for more advice and support.

Also read this interesting article on Responsive Bottle Feeding.

The post Paced bottle feeding appeared first on Annabel Karmel.

Professor Adam Fox, paediatric allergy specialist

Lara Karmel — Tue, 10 Sep 2019 11:04:21 +0000

He has extensive experience in the management of food allergy, eczema, asthma, rhinitis (hayfever) and conjunctivitis as well as drug and insect sting allergy. Professor Fox runs the largest allergen desensitisation programme in the UK and is actively involved in cutting edge research in desensitisation, asthma prevention and food allergy.

He is senior author of the Milk Allergy in Primary Care guideline, which has been widely adopted across the world and Chairman of the Paediatric Committee of the British Society of Allergy & Clinical Immunology.

Professor Fox was awarded ‘Paediatric Allergist of the Year’ from Allergy UK in 2007. His doctoral thesis on peanut allergy received the Raymond Horton Smith prize from Cambridge University in 2012 and he was included in The Times ‘Britain’s 100 Best Children’s Doctor’s’ as well as The Tatler Doctor’s List (Top UK 250 consultants).

Professor Fox received the William Frankland Award for Outstanding contribution to Allergy by the British Society of Allergy & Clinical Immunology in 2015 and a National Clinical Excellence award from the UK Department of Health in 2016.

www.allergylondon.com

Professor Fox's articles:

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