Infant Reflux and Celiac Disease

As you may know, I've been a PA in general pediatrics for 7 years. And hands down, the number 1 concern parents present with is that their baby spits up.... ALOT! Nearly every day, I walk in the room and see two exhausted parents, with vomit all over their clothes, holding a perfect baby who's flashing a gummy smile at me.

After a brief introduction and the opening question, "do you have any concerns today?" they begin explaining, with blood-shot eyes, that their baby vomits all the time and that something must be wrong with her. In desperation they ask, "Can we change her formula? Or can we give her the medicine that my neighbor's sister's baby used and it helped her."

Does this sound familiar? 

On The Podcast

Infant reflux occurs in 40-70% of all infants. While it usually is normal and self-resolves by age 1, dismissing the parents concern isn't helpful. In this week's episode, we explore practical strategies you can offer your anxious parents to alleviate their baby's reflux symptoms.

Listen to the podcast TODAY! 

"Oh, By The Way ..."

You end the visit (or so you thought) and your patient catches you as you stand up to leave and says, "Oh, by the way..." Rather than ignoring them or telling them to Google It, let's walk through how a dietitian would answer this in 1 minute.

Let's answer this week's question: "Oh, by the way, what can I eat to lower my blood pressure?"

"I'd suggest you follow The DASH eating plan because it focuses on 3 important nutrients that lower your blood pressure: potassium, calcium and magnesium. These nutrients are found in beans, lentils, potatoes, fruits, vegetables and low-fat dairy. Eating a variety of those foods helps open your blood vessels and removes extra water and sodium through the kidneys. It's also important to eat less than 1500mg of sodium per day (which is less than 1 tsp). Try to eat less processed, packaged and restaurant foods, in addition to not using the salt shaker." 

*always adjust diet recommendations based on your patients comorbidities, allergies and medications.

What "Oh, by the way..." questions do your patients ask you? Email me at Colleen@examroomnutrition.com and I'll feature it next week!

Learn more about the DASH Eating Plan here

Disease Spotlight | Celiac Disease

May is celiac disease awareness month! While a gluten-free diet is the primary treatment for celiac disease, maintaining balanced nutrition can be challenging. This is because many essential vitamins and minerals, like iron, vitamin D, calcium, vitamin B12, folic acid and zinc are found in gluten-containing grains. Additionally, gut damage from celiac disease can hinder nutrient absorption. Consider evaluating nutrient levels at the time of diagnosis as well as regularly during follow-up, so you can tailor your recommendations for each patient. 

 Clinical Application: Educate your patients about gluten avoidance, but also ensure they understand which nutrient-rich foods can replace what they might be missing in their diet. Here are a few nutrient-dense foods patients with celiac disease should consume regularly:

• Grains: buckwheat, quinoa and amaranth. For a good source of carbohydrates, protein, dietary fiber, vitamins, minerals, and polyunsaturated fatty acids. 
• Produce: All fruit and vegetables are naturally gluten-free and are an excellent source of fiber, vitamins and antioxidants.
• Beans, Lentils, seeds and nuts: An excellent plant-based protein that provides iron, potassium, magnesium, folate and fiber. 
• Animal Protein: Meat, fish, and poultry provide optimal protein, iron, zinc and vitamin B12.
• Eggs: Excellent source of vitamin A, Vitamin B12, riboflavin and choline.  

What about supplementation? Targeted supplementation based on laboratory findings or a multivitamin and mineral supplement may be beneficial. Notably, vitamin B12 and folic acid supplementation have been shown to be clinically relevant in preventing or reducing neurological and psychological symptoms. For children and adolescents, vitamin D and calcium supplementation are of particular importance for their growing bones.

 Reference: Narrative Review: Nutrient Deficiencies in Adults and Children with Treated and Untreated Celiac Disease

This review gave you a sneak peak into next week's podcast episode topic!

Your Questions, Answered

“When can babies drink water and how much can they have?”

According to the CDC and American Academy of Pediatrics, babies can start drinking water when they are 6 months old and can consume 4–8 ounces per day. It is important for families to understand that water should not replace milk feeds, and for the first 6 months of life, babies should ONLY receive breast milk or infant formula. Offering small sips of water from an open cup or straw cup is an excellent way to teach the baby how to swallow water safely. I like to instruct my parents to start offering water with meals from a small medicine cup (yep, the one's that come in the over-the-counter meds). Learning to drink water is a new skill, so encourage your families to be patient and enjoy the mess. 

Submit your question HERE

What the Trend?!

With all the insane diet trends and weight loss hacks out there, it's tough to stay on top of it all. But, I got you friend. I've unpacked current trends and what you need to know so you can properly guide your patients. This week I discuss The Raw Water Movement. 

I'll leave you with a quote from David Simon: "The beauty of love is that in giving it away, you are left with more than you had before."

Thanks for being here and for loving your patients. I hope the joy you receive is worth the sacrifice you make. 

Have a great week!