This blog post is a follow up to the previous post discussing how to successfully manage your child on pureed diets. This post will address many of the practical questions that are asked along with some “pearls” provided by our parents. We also wanted to provide you with some tasty, nutritious recipes to get you started. Enjoy!
“Where do I start with purees? What kind of blender should I buy? “
|Blendtec® HP3 blender
||Range from 300.00 refurbished to 700.00 professional series new
||www.blendtec.com (800) 253-6383-there is patient assistance program available for this.
||Wide range of 400-700.00
||Inquire about Medical Needs Discount Program which is available to all eligible candidates at (800) 848-2469 or email: email@example.com reference code 07-0036-0011
There are also refurbished models that are less expensive
|Ninja Kitchen System Plus
||Average 75.00 (varies per site)
||Some come with storage/pureed recipes
|Oster Immersion Blender
||Per parent report one with a flat blade tends to puree best
||95-120.00 (varied per site)
||Baby food machine and cooks and purees-holds 2 ½ cups at one time
|NutriBullet (also a Magic Bullet)
||Contains attachments and storage containers
Parents often ask us whether they need to buy the more expensive blenders to make effective purees. Our parents have given us great feedback and have found this not to be true. In fact, the primary inpatient intensive feeding program we often work with typically use the Immersion Blender which is the least expensive option.
“A lot of foods on the pureed diet look bland and boring and don’t seem to contain much nutrition. My child needs to gain weight. How can I achieve this? How can I add calories and protein to a pureed diet?”
|TYPE OF FOOD
|Liquid fish oil (adds omega-3s)
|Canned tuna/salmon (adds omega-3s)
|Ground Beef or Chicken
||1 ounce (3 oz is “palm of hand”)
||100-150/ 13 gm protein
|Cooked Brown Rice or Quinoa
||55 (also great Iron Source)
Written by Sharon Wallace, RD, CSP, LDN
You may hear some surprising things when your child comes to the UNC Pediatric Feeding Team clinic. For example, you may hear that we would like your child to return to eating puree textured foods (yes, we are referring to baby foods…but also to homemade high calorie blends that are of the pureed variety). We thought a post explaining this recommendation would be helpful.
Our team will first observe your child eating and drinking foods from home.
Foods we commonly see:
- chopped foods (cut fruit, cut vegetables, cut granola bars/nutri-grain bars)
- crunchy snacks (chips, crackers, wafers, cookies, dry cereals)
- solid foods (hamburgers, French fries, granola bars, mini pizzas, dessert bars)
- juice, water, milk supplements
Things we observe while your child eats:
- Volume of food eaten
- Speed/Rate at which they eat
- Sophistication of chew and swallow
- Demeanor/comfort while eating
Using a combination of key findings from our very detailed history and the expertise of our pediatric speech therapist, we will determine if the food texture given is the most appropriate for your child. This can have a direct impact on how well your child will grow and thrive. Based on the findings, we may ask that you “back down” to a pureed diet texture in order to assist in overall ease of eating. Your child’s oral motor skills may be delayed and not sufficient for an age appropriate meal of solid foods. Your child also may be underweight and require higher calorie purees/mashed foods or liquids. It is far easier to add in supplemental powders and additives to purees than it is to solid foods.
See below for some frequently asked questions related to this topic:
- My child is four years old. Why would they need to have a pureed diet? Eating is actually a much more complex process than people realize. Biting and chewing skills are developing as early as six to twelve months of age. Children do this by accepting new tastes and textures introduced around five to six months of age first with spoon feeding of purees, beginner dissolvable solids and then real solids foods. As babies move into chewing, they move from sucking in the middle of their mouth to moving foods with their tongue to the side of their mouth with coordinated biting. With time and practice this process becomes easier and easier as more complex foods can be introduced. The transition from sucking to chewing takes a typically developing child a long time to develop. They start around six months and do not achieve fully mature chewing skills until age three.
- What can cause this process to get off track? Medical issues such as chronic disease, surgery, prematurity or prolonged hospital stays can interrupt this process. Untreated reflux over time causing pain or discomfort with eating, which can lead to volume limiting and refusing of foods. We often hear reports of babies and children who hold foods in their cheeks, turn their head to refuse, and cry at meal times. Some children are extremely picky eaters, taking 30, 40 and even 60 minutes to eat a meal. Some of our patients refuse to try any new foods. Our team can quickly identify when the “normal” eating process has been interrupted and when a pureed diet might be necessary to get your child back on track.
- How will my child grow and gain weight eating baby foods? Ensuring that your child gets proper nutrition is the primary role of the dietitian on the feeding team. A pureed diet needs to have as much thought as any other diet you would prepare for your child. We work with families to use the best purees and mashed foods possible, which may mean higher calorie store bought purees or homemade purees. Our goal is to assist you in avoiding serving the same flavors repeatedly. Every day we watch our pediatric patients come back to clinic with stories of improved developmental milestones, improved sleep and overall better temperament as a result of an improved nutritional intake, often beginning in the pureed form.
- What are some things I should think about when making a pureed diet? We want to see a variety of tastes and flavors being offered- and foods coming from at least two food groups per meal. For example: breakfast might consist of yogurt and pureed fruit, lunch might consist of a pureed peanut butter and jelly sandwich with fruit, and dinner might consist of pureed spaghetti with meatballs and green beans. Many parents ask us about using store bought baby foods. Baby foods (usually stage 2) often have the texture of a smooth puree and can certainly be used when traveling or “on the run”. Additionally, there are many pureed pouches with a wide variety of flavors that are the perfect smooth texture our feeding kids tolerate best. The “best case scenario” would be to use a combination of baby foods and pouches with homemade purees (this is especially true when using a pureed diet is new and parents are still trying to figure out the best way to make tasty smooth purees). Keep in mind, we are here to help…and enjoy doing it…
Part Two: Tune into part two of our pureed diet blog this month to find out more about comparing blenders to get the job done, healthy but high calorie additions to a pureed diet and some fun recipes!
Written by Sharon Wallace, RD, CSP, LDN