This past week I attended the conference “Advances in Neonatal and Pediatric Nutrition 2015” in San Francisco, hosted by UC San Diego, School of Medicine. I wanted to share my key take away, the things that got me excited. Current topics included food allergy, celiac disease, probiotics & probiotics, feeding the premature infant and feeding challenging toddlers.
Dr. Fleischer, an allergist based out of Children’s Hospital of Colorado spoke on Food Allergy. He shared with us results from the LEAP (Learning Early About Peanut Allergy) study. The results were quite promising. They showed a significant decrease in the frequency of developing a peanut allergy among children at high risk primarily by introducing small amounts of peanut to children at 4-11 months. The 2013 guidelines put out by the AAAAI (American Academy of Allergy Asthma and Immunology) already advices against delayed introduction of foods beyond 4-6 months if standard risk. Both the AAP (American Academy of Pediatrics) and AAAAI recommend an allergist’s evaluation prior to highly allergenic food introduction in patients with a history of food allergy or with moderate to severe atopic dermatitis.
Another hot topic was Prebiotics and Probiotics. Speaker, Kelly Tappenden, PhD, RD, FASPEN out of Illinois, spoke on “Therapeutic Opportunities for Pre and Probiotics”. Probiotics have come a long way from just eating yogurt to get the benefits of these immune enhancing bacteria that live in the gut. Numerous specific strains have been identified and studies have shown their benefits when used under certain clinical conditions in children, reflected in the chart below.
|Diarrhea- Infectious Childhood Treatment||LGG, Lactobacillus Reuteri|
|Prevention of Antibiotic Associated Diarrhea||S. Boulardii, LGG, L. Casei, Bulgaricus, S. Thermophilus.|
|Immune Response||LGG, L.acidophilus, L.plantarum, B. Lactis, L. Johnsonii,|
|Atopic Eczema Associated with Cow’s Milk Allergy; Prevention & Treatment||LGG, B. Lactis|
|Colic, Excessive Crying||L. Reuteri|
Prebiotics have been shown to be just as beneficial for a healthy gut’s microflora. Prebiotics, a non-digestible fiber, is a food source for probiotics and can be found in onions, garlic, bananas, asparagus and artichokes. Jo Ann Hattner, MPH RDN, spoke on “The Use of Food for Sources of Pre and Probiotics”. It was a great reminder on why it’s important to be eating and serving our children a variety of foods that contain natural occurring Pre and Probiotics. Breastmilk is a natural synbiotic since it’s an excellent source of both pre and probiotics. I am pleased to report the USDA will now offer Greek yogurt as a meat alternative in schools nationwide starting in fall 2015. This will help our children get more probiotics in their diet.
The last speaker I will review was Haven Qualman, MA, CCC-SLP, BCS-S, speech pathologist at Rady Children’s Hospital in San Diego. She has lots of experience working on a feeding team, treating children for disordered eating. Qualman spoke on “Tackling Feeding Problems of Little Tots”. Some of the issues she has tackled included oral aversions, food refusals, table avoidance and overall poor intake. Many of these challenges were related to sensory or oral motor delays and required feeding therapy. Other causes for these disorders were most often learned behavior and she referred to Ellyn Satter’s philosophy in regards to treatment in these situations. This approach I referred to in my last blog post. Parent’s decide the what, where and when of feeding and it’s up to the child to decide the how much and whether to eat. Qualman reminded us that in all of these situations when we attempt behavior change, things will get worse before they get better. This talk just reinforced the important job parents have to help their children develop a healthy relationship with food and eating.