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خرید پکیج
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Behavioral tips for caregivers of children with poor weight gain

Behavioral tips for caregivers of children with poor weight gain
Dietary advice
Consumption of excessive fluid reduces the intake of solid foods. At mealtimes, offer solids before liquids. (Liquids are filling and provide fewer calories.)
Fruit juices should not be offered to children before 12 months of age. After 12 months, give only 100% fruit juice and limit to 4 ounces (120 mL) per day. Limit all sweetened or carbonated beverages. Breast milk, formula, or milk (over 1 year of age) is best.
Do not worry if your child wants to eat the same food every day. Variety is not important. Total calories and protein are.
Junk foods have little protein and fewer calories than some other food choices. Junk foods will not help growth; they only take up valuable space in the stomach.
Offer foods that are easy for your child to handle (eg, cereal, slices of banana, or green beans).
Add margarine, mayonnaise, gravies, and grated cheese. For snacks, use cheese, pudding, bananas, or dried fruit.
Feeding times
Children need to eat often, not constantly. Offer something every 2 to 3 hours, to allow 3 meals and 2 to 3 snacks per day. Avoid snacks right after an unfinished meal.
Children work well with schedules. Try to keep mealtimes and snack times about the same each day.
Allow 1 hour without food or drink (except water) before a meal to stimulate the appetite.
Do not make mealtime too long for your child. (15 minutes is probably long enough for a toddler.)
Feeding behavior
Try to relax; feeding/eating and mealtimes should be pleasant for everyone.
Recognize your child's cues indicating hunger, satiety, and food preferences.
You are responsible for deciding what food your child is offered (with consideration for your child's preferences); your child decides how much to eat.
Avoid battles over eating. Encourage your child, but avoid forced feeding, threatening, bribing, or punitive approaches. Instead, use positive reinforcement (eg, praise for eating well).
Do not withhold food as a form of punishment.
Allow your child to feed themself. Try very small amounts at first. Offer seconds later. Expect messiness and be prepared for easy clean-up (bibs, newspaper under high chair, etc).
Some babies want to control the spoon - for such babies, use two spoons, one for the baby to control and one for you to use to feed.
Feeding environment
Try to eat together as a family. Good eating behavior can be modeled, and young children like to mimic older siblings and parents.
Limit possible distractions during meals (eg, television).
Make sure your child can reach the food. (Use a high chair, booster seat, or small table.)
Data from:
  1. Bithoney WG, Dubowitz H, Egan H. Failure to thrive/growth deficiency. Pediatr Rev 1992; 13:453.
  2. Frank DA, Zeisel SH. Failure to thrive. Pediatr Clin North Am 1988; 35:1187.
  3. Frank D, Silva M, Needlman R. Failure to thrive: Mystery, myth and method. Contemp Pediatr 1993; 10:114.
  4. Heyman MB, Abrams SA, Section on Gastroenterology, Hepatology, and Nutrition, Committee on Nutrition. Fruit juice in infants, children, and adolescents: Current recommendations. Pediatrics 2017; 139.
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