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Common childhood nutrition concerns

A nutritionist from University of Maryland Medical System regularly provides a post to the Picture of Health blog. The latest post is from Faith Hicks.

For new parents, it can be difficult to sort fact from folklore when it comes to your child's nutrition. They receive feeding advice from all directions – relatives, the media and other parents. Here is a registered dietitian's take on four common childhood nutrition myths.

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1. High blood pressure and heart disease are middle age problems, so I don't need to worry about my child's diet contributing to those diseases now.

Actually, cardiovascular disease can start in the kindergarten years. We know that children as young as five can have pre-atherosclerotic streaking in arteries. How can you minimize your child's risk? The first step begins with breastfeeding if you can. Formula fed children develop these early vascular changes at a younger age than children who were breastfed.

The next step would be to start a heart healthy diet in the toddler years. This means using low fat dairy products beginning at age 2. Consider introducing seafood and poultry early and avoid fried foods. Make a habit of eating at home. Children who have more meals at home tend to consume less fat than those who eat out often.

Hypertension, or high blood pressure, does occur in children and is being diagnosed more frequently. Recent guidelines from the American Academy of Pediatrics suggest children with hypertension follow the DASH diet (which is also recommended for adults). The DASH diet emphasizes fruits, vegetables, low fat dairy, whole grains, poultry, seafood, nuts and lean meats. A lower intake of sugar and sodium is also recommended.

2. Avoiding peanuts, fish, eggs and other common food allergens in the first year of life helps protect against food allergies.

There is an expanding body of knowledge and research that is turning this long held theory upside down. The introduction of some common food allergens in the 4 to 6 month age range may help prevent allergies. Talk to your physician though, particularly if your child has already developed an allergy or if a parent or sibling has a known allergy. It should also be noted that breastfeeding continues to be recommended for the prevention of food allergies, among other benefits.

3. Spinach, broccoli and other green vegetables are a good source of iron.

This is sort of true and false. While these vegetables do contain a fair amount of iron per serving, the amount that is absorbed is low. If you have been advised to increase the iron in your child's diet, emphasize beef, pork, chicken, and fish. These meats contain heme iron, which has a higher rate of absorption. Clams and mussels are also great sources of iron. You can increase iron absorption by consuming vitamin C and iron at the same time. For example, eating a high iron cereal in the morning with a good source of vitamin C, like oranges, may help optimize iron absorption.

4. When a child has diarrhea, it will resolve more quickly with the BRATT diet (Bananas, Rice, Applesauce, Tea and Toast)

Limiting a child's diet during a mild case of diarrhea could prolong its course. The BRATT diet also falls short in providing several nutrients. The American Academy of Pediatrics recommends that mild diarrhea in a healthy child be managed by resuming a well-balanced diet within 24 hours of rehydration. It may be wise to avoid foods containing a fair amount of simple sugars and emphasize complex carbohydrates. A breastfed child should continue to breastfeed. Children who are old enough to drink cow's milk should also continue to drink that.

Discuss your child's nutrition at regular intervals with your child's care provider. This is especially true when you have concerns about diet, acute illness, allergies, or any other chronic medical condition.

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