Peds and Nutrition Help!!!

Pediatric Critical Care Columnist · Mar 21, 2011

Great questions!! There are a lot of nutritional issues that I see in my practice. Some are a result of simply not knowing and others are a symptom of our culture. I live in northern Canada and there is a significant lack of Vitamin D in most people's diets here, given that we have winter for half the year! Lots of moms don't realize that they need to supplement their children's diets with Vitamin D - breast or bottle makes little difference. Many also don't know that breastfed babies may need an iron supplement so we'll get significantly anemic babies on the unit. All the oxygen in the world isn't going to help if you don't have any hemoglobin to carry it around. Another common feeding issue that I used to see in my previous job, but not so much now is that low-income mothers from remote areas would feed their babies Carnation evaporated milk with a little brown sugar or corn syrup in it to help with the taste. SO not an optimal choice, but it's what's readily available and affordable. These same moms will give their children soda and potato chips because they're so much cheaper and shelf-stable than fruit and juices. They may not have access to potable water either so what can they do?

Older urban kids eat far too much fast food and junk too. Advertising to children has convinced the kids and their parents that it's normal and a good thing to eat at - oh, let's use Burger King - for a fun experience. Never mind that the calories, sodium, fat and sugar content of the food is off the charts! When we're admitting prepubescent adolescents with poorly-controlled asthma that weigh 100 kg, there's obviously a problem. The province of Manitoba has the highest incidence of childhood Type II diabetes in the world. Yes, kids can and do develop Type II.

One of my biggest pet peeves on this topic is the advertising of things like Pediasure to parents as a solution to poor dietary habits. Oh, yes... if your child isn't eating a good, nutritious and varied diet, just give them Pediasure or Boost and that'll take care of any deficiencies they may have. But they don't exactly state that these formulae are actually a complete nutritional replacement, not a supplement. So they feed them Lucky Charms for breakfast, toss them a PB&J for lunch and then take 'em to BK, feed 'em Whoppers and fries washed down with a soft drink loaded with sugar and bone-destroying phosphorus, then take 'em home and give them a can of chocolate Boost at bedtime - the equivalent of another entire meal. Meanwhile they've provided them with an X-Box, PVR, iPhone and admonished them to stay indoors where they're "safe". Then they wonder why Junior is obese.

I hope I've given you some ideas about where to go with this. Good luck!