Questions to our dietitian Christel Vondermans

Christel Vondermans (1976) is a dietitian and works as a copywriter for Scriptum communication about nutrition. She has years of experience in giving dietary advice and dietary treatment to pregnant women and (young) children.
A website about real and pure food, without packages and bags and certainly suitable for young families.

Christel has 2 children: a daughter born in 2007 and a son who came into the world in 2009. As a result, her interest in infant nutrition has only increased more. In 2010 her book "Growing as a cabbage, Healthy food for children" was published, written for employees in childcare.

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Unfortunately, it is no longer possible to ask questions to Christel Vondermans. You can still read the previous questions and answers. Perhaps your question is here between.

Our visitors asked her the following questions:

A similar question was asked recently, but unfortunately the answer does not apply to us. Hopefully you have a tip for our problem.
My 11-week son had a difficult start. He has been diagnosed with serious reflux medication for 6 weeks and after a long way of different foods he is now using nutramens because of suspected KMA (there are intestinal problems and considerable allergies in the immediate family, with the nutramigen it went so much better with him!) .
From day one of the nutramigs, however, he is constantly hungry. He gets the maximum nutrition at his weight (6/7 feeds of which 4 or 5 × 150-5 and 2x 180-6 at 5.3 kg) and does long enough for his bottles. His technique is good (I am a prelogopedist) The pediatrician indicated that this is probably due to the easily digestible diet and recommended adding rice flour to each bottle from two months, because he did not respond well to pure carob gum and gellilact. However, the rice flour was more affected by reflux and then from his intestines. While he was finally saturated for two weeks and completely flourished. Because of the intestinal cramps stopped again. Now we are again with a frequently crying child because he is hungry, we are no longer allowed to give and both the pediatrician, the general practitioner and the CB doctor do not know. Do you have a tip for us? giving smaller bottles more often does not help, it comes even faster.

Thank you for your clear story!
The only thing I can think of is that you can give some lukewarm water from the bottle between bottle feeds. Hopefully your son will be able to maintain it easier until the next feeding. Keep in mind that he just continues to drink from his milk feeds and not leave those bottles because he has already drunk water.
If this does not help him, I would advise you to consult a child dietitian.

My son does not want to eat hot. Ever since I gave him jars of vegetables, he kept the snacks in his mouth for a long time until there is so much saliva in his mouth that he can no longer keep it in his mouth. I only think about giving him bread and fruit. But what does he come short of and is there a food supplement that I can give him? He eats bread well and he likes various meat products and cheese. He does eat fruit but not so many different types.
Incidentally, I have eaten very badly during the pregnancy because I have been terribly ill and sick for nine months. Could it be that my son is so unwilling?
I am very tired of the battle about hot food. I am very curious if you still have ideas to deal with it differently.

Understandably that you are tired of the battle over hot food! But if you choose a menu with only bread, meat, cheese and fruit, your son can get shortages. In vegetables there are still other nutrients than in fruit and bread for example. Moreover, the first years of life are important to build up a taste palette for later. Children who eat varied food in the first few years are also easier to eat later. I therefore advise you to seek help from a dietitian. This is too difficult a problem to solve on your own. You can also consider giving your son a vitamin supplement with 100% of the RDA (recommended daily amount). That can be a good addition for now.
Your pregnancy can play a minor role. In the stomach an unborn child takes small sips of amniotic fluid. And amniotic fluid takes (a bit) the taste of the mother's food. For example, a baby in the stomach already tastes a bit of carrots and broccoli and the chances are that it will later appreciate these vegetables more. Probably your son could do this less than other children. But this does not really have to be the cause of his aversion to hot food. He just needs a little more help to learn this!
Some small tips that might help you:

  • Maybe your son will find the mashed vegetables from a jar of nothing, but a stew of cooked broccoli is interesting. Give it to him in his hands. Who knows, he may playfully take a bite and discover a new taste.
  • Let your baby eat at the table as much as possible with you at the same time. He thus has no exception
  • See if you can make your food and that of him look alike. Do you eat potatoes with carrot and a piece of fish? Then boil it without salt, puree (separately from each other) potato and carrot and finely make the fish. Your child has 3 colors on his plate that match those on your plate. Add some flavors for yourself
  • If he does not want to eat, slide the plate away, but eat it with flavor. So you give the good example and maybe he will taste after a few times
  • You can also give vegetables cold, maybe he likes less of hot food.
  • Maybe he gets used to the taste more easily if you combine it with something he likes? A puree of peas (or other vegetables) can also be used on bread.
  • As difficult as possible, try to keep the atmosphere cozy.
  • Do not give an alternative during that meal. Then you teach your child that there will be something tasty if he continues to refuse to take a bite of the ordinary hot meal. If he does not want to eat his vegetable snack, then he will not eat anything. Big chance he automatically takes a little more with a next meal (at breakfast). That is not a problem, of course.

As a youth nurse, I am involved in a family with a 15-week-old baby. The baby receives artificial nutrition. At the time of the first vaccinations at 8 weeks he was seeing,: snotty, coughing, catching a cold. From that moment on he began to cry as soon as he tasted the baby food. Strange is that he does drink water from the bottle.
He continues to protest until he is so tired and almost falls asleep, then he suddenly drinks the bottle empty.
There are no further indications for allergy. He patented it. Is very satisfied as long as you do not try to feed him. Further normal growth and development. I have made a reference to prelogopedics that confirmed that the problem seems to be in the taste of the milk. Mother has tried to thicken the milk with locust bean gum to see if that makes a difference. It went well twice and then the protest started again. Now we want to experiment with a different taste. The child is less than four months old. What could you add to the diet to make the food more attractive? (eg natural vanilla ??) I am very curious what you would advise.

I assume that the prelogopist has already looked if she could still stimulate the reflexes?
If you want to try this family with the current food, then you can offer the bottle the best if the baby just starts to wake up and is still sleepy. The chances are that the baby will start sucking reflexively instead of randomly sucking.
If babies really do not want the bottle, then as a bridging you can thicken the food with, for example, rice flour and give it with a spoon. Try to relax the bottle occasionally. Many babies want, when they are about 5 months old, the bottle all of a sudden. That has to do with the development.
You could also try another brand of nutrition. Do not substitute food too often because the baby's bowel needs time to get used to the diet. Therefore, always try the other diet for at least two weeks and do not switch for that time. This can cause a lot of unnecessary unrest.
You ask whether the food can be made more attractive with, for example, natural vanilla. The disadvantage of this is that the child gets used to (even more) a sweet taste and later will not appreciate other flavors such as acid and bitter. The chance of a difficult eater (solid food) is getting bigger ... That's not my preference.

My 7-week-old son has utility-loving 1 lg. Now I always have the idea that he will not be satisfied. Can this be the light food, or what can I do about this?

If your child begins to cry within 2 hours and does not sleep through, he may not have eaten enough. Often he will make tapping sounds, search with his mouth or suck on his hand.
Do not give your baby unlimited bottle-feeding. Your child can get too much by it and it is also not good for your child's body: the kidneys and the gastrointestinal tract can not always process larger amounts of food. What can you do:

  • Controller (again) well on the packaging whether you give the right amount of food for the weight of your child. Maybe you give less nutrition than your son according to his growth curve may have and then it is not crazy that he is hungry.
  • Check how fast your son is drinking. 15 to 20 minutes for a bottle is normal (not counting breaks). If your child drinks greedily and quickly, the chances of hunger and sucking need are greater. Take a teat with a smaller hole if your child drinks quickly.

My child was 18.5 kilos with 2.2 years and 92cm.obesitas said cb.hij had to lose weight.with 2.5years 96cm and 19.5 still seriously overweight.on t cb they say that he should lose weight and that it is now can no longer be baby fat. Is this correct? I also read and hear everywhere that small children should not lose weight but should stay on the same weight. Is not it too early to be so moody with food? his birth weight was 4200 gr and 56 cm. was already a chubby baby and had a big belly at birth. It seems to me a bit of talent because his grandfather has the same construction.

If I look purely at the lengths and the weight your child had at 2.2 years and 2.5 years, then there is indeed overweight. What I do not know now is whether he has continued to follow his own growth curve, or whether there is an upward trend in the growth curve. Especially when there is a rising line, it is good to try to reduce that line again. For small children, the advice is indeed: try to keep the weight stable, while the length does increase. Your child will eventually become a little slimmer.
Being very strict with the food is often not necessary. But there are things you can pay attention to. Do not prefer sugary drinks such as soft drinks, fruit juice, preparation lemonade and thick juice. For small children, water or lukewarm fruit tea (without sugar) is good enough. If your child drinks a lot of sugar-rich drinks, you can slowly reduce this by adding more and more water to the drink. Also with apple juice and orange juice for example. In between you can of course give fruit, but also raisins, a breadstick, rice wafer or raw vegetables (snack tomatoes and cucumber are often favorite). For example, save a biscuit for the weekend.
And move nicely with your child. Running, climbing and scrambling and walking together. Also a balance bike or tricycle find many children fun.

My daughter will be 2 years old on Sunday. On the last visit to the CB it appears to have a weight of 13.7 kg (+2 on the curve) with a length of 85 cm (-1 on the curve). With this she is clearly too heavy for her height. We ourselves are both above 1.80 and slim. We eat very healthy. They have breakfast with oatmeal porridge, fruit in between, 1.5 wholemeal sandwich with siege as lunch, cracotte cracker in between, sometimes some cucumber and evening food. She only drinks water and tea (no juices). She never watches TV for more than 15 minutes. Despite all this, her weight continues to increase in proportion. DO you still have tips? I'm assuming that it's a matter of growing in length too ... but do not want us to have done something different.

Congratulations on the birthday of your daughter.
And then first my compliments: her eating pattern looks very good!
Because you are both tall and slender, I suspect the same: it is good because of the height growth. Keep a close eye on it, and make sure you let her move a lot too. On the website of Beweegkriebels van Huis voor Beweging (googling) you can find all sorts of fun games and tips for moving with young children.

Sigh, is so worried every week by the CB. My girl is about 10 days old 5 months old and weighs only 5.5 kg and is 60cm. She was at -1 and is heading towards the -2 / -2.5 growth curve. I give full BV and no additional food. She is always cheerful and has poo and slush every day. However, often spray diapers. I am also not big: 1.52 cm and 54 kg. Now I have to give the CB rice flour, but she looks at me so dirty and spits it out. I have been trying to offer it for 2 days. Actually, I did not want to give any additional food because of severe eczema in Dad, but because of her ever decreasing line I have no choice. Do not want to get her through the windmill because she was born in the hospital because of a strange skin abnormality.

Good to read that your daughter is happy and has poo- and plasluiers every day. Spray veils are a bit of a breastfeeding. Your daughter is indeed small for her age, but that does not have to be a problem. Probably it is in the family. As long as she follows her "own line" and there is no deflection in the growth curve, she grows well. Now her growth curve does deviate. Probably she needs more energy than her body now gets with the milk. That is an important signal to take seriously.
Regarding the supplementation and the severe eczema in daddy: it is good to give children from 4 months small amounts of supplementary feeding. First fruit and vegetables, later also other products such as egg, fish, peanut and cereals. This is stated in the new JGZ guideline on food hypersensitivity that appeared at the beginning of this year. In the past it was thought that later on this supplement would prevent allergy. The opposite appears to be true. This new guideline also focuses on the prevention of celiac disease. Also for grains, small quantities from 4 months onwards help protect against gluten intolerance, especially if the baby is still breastfed. Think of bits of rusks in a vegetable or fruit snack. That is a lot earlier than the recommended 6-month age limit.
So you can try with peace of mind if your daughter wants to taste different from that of breast milk. Keep breastfeeding for the time at the times your daughter is drinking now, the other snacks come extra.

I am a 17-year-old girl.
I started to line 1 year ago. In the beginning I succeeded very well. But in the end I found out that I have developed an eating disorder. Because I have eaten too little for a long time, I now arrive. But huge. Meanwhile already 20kilo. I want to learn to accept my body, but it is difficult if my body changes every other week. I already eat a lot more than before, but then I keep coming.
This is what I eat.
O: 1boterham with a pot of low-fat yoghurt and muesli
T: apple
L 2 slices of bread with a jar of muesli.
T: apple
A: what the pot does, always healthy and slightly less than a normal portion.
In the late evening I eat some muesli or fruit.
Do I eat enough? And what can I do with it?

The best advice I can give you: make an appointment with a dietitian in your area. It is very difficult to give you online advice, especially because you indicate that you have developed an eating disorder. And besides that you do not eat much and you arrive ... A dietitian can look with you at how your food looks like and what are difficult moments for you. This way you can slowly change your diet and hopefully learn to accept your body.
For now I can give you some "small" advice. You do not eat very varied now. Your body needs different nutrients (such as proteins, vitamins and minerals) to work properly. And what you get in, you mainly produce carbohydrates. Carbohydrates (a collective name for sugars) are in your sandwiches, muesli, fruit and probably also in your dinner. You could look at how it feels for you to start with low-fat yoghurt, a few tablespoons of oatmeal or muesli (preferably not crispy) and some fruit for breakfast, followed by fruit in between. At your lunch, the 2 sandwiches with (if you have lunch at home) a cup of vegetable soup, (or if you're at school or work) some raw vegetables such as tomatoes, carrot, cucumber, a tray of corn grains or a salad. And take a glass of milk with it. In between, a piece of fruit is fine again (all types of fruit are good, it is preferable to vary). In the evening you just take what the pot does.
And in the evening you can think of low-fat yoghurt with fruit.
Do not drink too many sugary drinks. Prefer water, tea, soup, broth, milk, buttermilk, or coffee.
For the dietitian you visit, write down what you ate so far. And if you start with my advice above (or a few points of it), then it is wise to write down a couple of days that you have eaten exactly. Then the dietitian can ask you specific questions and help you further.

I am a district nurse with a 10-month-old girl with a muscle disease. She has some thick solid hard stools. What can I do with regard to greeting. I searched the Internet for a while and found a number of tips such as cauliflower, broccoli, little oil by the vegetable snack, roseivicee laxo based on prune juice, apple, pear, grape plums and kiwi? Are all these recommendations correct?

In terms of vegetables, everything is actually good. It concerns the fibers and they are in all types of vegetables.If the girl can handle it, it is better not to grind the vegetables too finely. This will prevent you from destroying all fibers.
Fibers are not only in vegetables, but also fruits, whole grain products, legumes (kidney beans, white beans, kidney beans, etc.) are rich in fiber. Especially prunes are known to promote bowel movements. Plum jam can be made on bread, you can also make prune sauce and if necessary stir with some yoghurt or custard.
At least as important is sufficient moisture. A healthy child needs 100 ml of fluid per kg of body weight per 24 hours. Moisture causes some fibers in the intestines to swell and thus form a smooth (re) stool.
Finally, exercise is important. Moving is good for the functioning of the intestines. If the girl herself can not be so active, you can stimulate movement by, for example, cycling her legs in the air. With that you massage the intestines at the same time.

Our son is 8 weeks old and already weighs 6 kilos. He grows well via the highest curve and the consultation office is satisfied. In terms of bottle-feeding, he is already almost at the maximum of 1 liter and we are advised not to go to the maximum now. However, our hamster has a huge appetite and comes several times at night and is very restless. We have been advised to give bottle feeding for Nutrilon's hungry baby. But we would like to give him only organic bottle-feeding because of the soya lecithin that is present in Nutrilon and other baby foods. Our organic brand (AH pure and honest) does not have a 'hungry baby' variant and I can not find a comparable product elsewhere. Is it true that rice flour has been added to the 'hungry baby' variant? Can I just add organic rice flour myself or do I deliver blockages and abdominal pain? And if so, how much on a bottle of 150ml of water and 5 scoops of food. Perhaps you have another advice? Thank you in advance for your answer.

Actually, my first question is how quickly your son has emptied his bottle. If your child drinks fast or greedy, the chance of hunger is greater. Take at least 20 minutes for the bottle, not counting breaks. It is therefore the effective drinking time. If your child is much faster, you can try a teat with a smaller hole. This way drinking takes longer and that can help. After fifteen minutes of drinking your child will only feel satisfied after all.
A sip of water in between can fill your child. Keep in mind that it is not at the expense of his current milk feeds. You can also add extra water to the food (about 10%).
It is still a bit early for rice flour; you can give that from 4-5 months. Consult the consultation office about the correct dosage at that time.
Unfortunately I do not know organic food for hungry children ... If you find something yourself then it is good to know that if you switch to a different diet, the intestines of your child need time to get used to. Give your child that time and do not change bottle-feeding often.

Is it true that there is a substance in chicory that makes you lose weight? This wrote lien demol who also writes cookbooks.

Perhaps the author is based on a Dutch study published in the British Journal of Nutrition. 31 healthy subjects participated in this study with a BMI of about 25. Half of the subjects received a placebo for 13 days, the other half received oligofructose. Oligofructose is a dietary fiber and was extracted for this study from chicory, a plant family that includes chicory.
At the beginning and at the end of the study it was calculated what the subjects had received with their nutrition. At the higher dose, energy consumption had dropped by 10% after 13 days. Increased concentrations of satiety hormones in the blood were also measured.
This does not mean, however, that you lose weight when you put large amounts of chicory on your menu. The research was carried out with a very small group of people. Too small to eat differently as a result. However, you can take advantage of the fact that oligofructose is not digestible and has the same effect in the intestines as dietary fiber. Dietary fiber gives you a full feeling and can help you eat less. Dietary fiber is mainly found in vegetables, fruit, legumes, whole grain products, nuts and seeds. So some more vegetable food is good for your weight!

My two-year old daughter has already given up a few times after eating an organic broth. I have compared the stock with one of another brand and the only thing that differs is the ingredient mace. I can not really find anything on the net, except that you have to use it in moderation ...
Do you know anything about hypersensitivity to mace?

A hypersensitivity to mace exists. Eczema and hay fever like symptoms are often the complaints.
Mace is a spice. It is the casing of the seeds of the mace tree. Nutmeg comes from this tree as well, these are the seeds.
It is wise to go to a doctor, so that you can possibly test for a hypersensitivity to mace. To reduce the chance of complaints, you can better avoid spiced products such as gingerbread, gingerbread, spice mixes with mace and nutmeg.

My daughter Mees is 15 months old. She has been breastfed for 10 months. When we switched to bottle feeding she got asthma like symptoms. We then switched to nutrilon pepti and they reacted better. Once a month I try with a little yogurt if she has grown over her allergy, this is not the case so far.
My question is to what age can / should she drink nutrilon pepti.
Are there other / better / cheaper options? How much pepti does she need at this moment per day?

Nutrilon Pepti 2 is suitable for children from 6 months and can be used as long as your child has allergic symptoms.
There are several brands with infant formula for children with a cow's milk allergy. For children older than 6 months there are follow-on nutrients based on protein hydrolyzate and soy protein, such as: Nutrilon Pepti 2, Frisopep 2, Friso AllergyCare (Friso), Nutramigen 2 or Pregestimil (Mead Johnson). Soy milk is also an option, but consult this with your pediatrician or clinic. Young children with a cow's milk allergy can also develop a soy allergy.
Children older than 1 year daily need 300 ml of milk (products). So you could give 300 ml of infant formula or soy drink / soy sauce.

My 1-year-old son has type 4 allergies (invisible in blood and on the skin, have to grow out of his 2nd birthday) to just about everything that contains cabbagehyrates.
- potatoes (reaction: exzema)
- rice (reaction balls result)
- semolina (reaction: exzema)
- pasta (reaction dependent on brand: exzema, very itchy rash, acid flat bowel movements)
- other allergies: soy, spinach, endive, cauliflower and celeriac
We have already gone all the medical way, all the way to the baby allergenologist.
The only thing the doctors could say was that there is nothing left but to wait until he grows out (to be tested every few months). He must eat pasta. Only the reaction to pasta is getting fiercer.
Can we, in one way or another, banish all these foods (and thus unfortunately all carbohydrates) from his diet without harming his body and its development?

Annoying, but the allergy of your son is too serious and too extensive to answer by mail. I advise you to go to a dietitian who specializes in allergies. Such a dietitian can give tailor-made advice on the basis of your child's blood tests and research.
There are dieticians who are used to advising nutrition with less carbohydrates. Google on 'paleo-diet' or 'oerdis'. This is a diet like our distant ancestors who ate. They took their nourishment from nature around them. The base consists of vegetables, fruit, meat, fish, oil, nuts and seeds and hardly any grains or dairy products. Perhaps the diet of your son can be based on such a diet.

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