​In my gastro clinic the topic of 'meal planning' comes up almost as regularly as discussions about 'bowel habits'. When patients are embarking on a radical shift to their dietary intake to improve their health, meal planning can be a helpful tool to navigate the first few weeks and months of meal times. Certainly in the early days it can be stressful for patients to not only deal with a new diagnosis but also to have to  think carefully every time they open the fridge or go to the supermarket to ensure they are eating the right foods!

An example of this is patients newly diagnosed with coeliac disease. They have a lot to contend with in terms of understanding this autoimmune condition and it may be the first time they have ever heard the word 'gluten' which needs to be removed from their diet (for life!) as their body deems it a toxin. As part of the introductory clinic session we talk extensively about the condition and what it means to them, but the session also includes information about the benefits of meal planning and getting organised at home. My article 'Going Gluten-free' published in CN Magazine in a couple of years ago (available in an earlier post) talks a little bit about this.


I have to admit meal planning when you do not have a dietary restriction can be difficult enough. We have tried several times to meal plan at home and it makes our life so much easier! But it is just as easy to fall into old habits and shop several times a week based on what we 'feel' like eating.

However, more recent times involving weaning Max has forced me to become more organised! Although still the early stages of exploration, he is fast approaching the need to have three set meals a day (albeit in very small portions). I'm certainly an advocate of not making 'special meals' as we want Max to enjoy the meals we eat eventually. However, when I'm in a rush and quickly make a cheese sandwich, Max certainly isn't at the stage to have something this convenient. The range of nutrients he requires (in particular iron) now that his milk intake is reducing requires a bit more thought and planning. And so I hear the echos of my own voice in clinic stating the benefits of meal planning! Ah here we go!
In an attempt to get organised I have been compiling a list of the foods max has tried so far for each meal and am attempting to add to them as time goes by and rotate them accordingly!
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Breakfast is by far the easiest! Currently I make my normal portion of breakfast and give him some teaspoons of it (though I will add my dried figs and whole nuts and seeds separately). Initially I blitzed the oats in the NutriBullet to make them more fine but now Max seems to take whole oats on board fine.  The breakfasts we have tried so far are listed in the bubble below. I tend to rotate these in the week. I'm now adding ground down linseed into the yoghurt for some additional good fats. Luckily max loves banana and berries and he has not reacted to nuts and seeds (phew!).

So now I just need to refine lunches and evening meals..which I will endeavour to explore in part II

 It is great fun to watch Max enjoy new foods and textures. He seems quite confident now with a spoon which still amazes me! We started off wearing a standard bib which covers his arms and body...but quickly realised that the food making it into his mouth, certainly in the early days, more often than not will be spat out or thrown around! These bibs allow food to slide down into their lap onto their seat and the floor...lovely.
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So asking around and reading some reviews, we came across the BiBADO. Lots of mums rave about this bib which not only covers the baby, but is stretched across the high chair to create a 'well' where food can be caught. 
The bib was created by a mum with twins who was sick of clearing up the mess after meal times, after several redesigns this 'award-winning' bib was launched. The bib is wipe clean, waterproof and states that it will save 20-30 minutes of cleaning up after meal times. 
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We managed to find a £5 off code so the bib cost us £15. It fits Max well, though I find the velcro fastener slightly difficult at the back. It certainly catches his food which is a lot less messy and does save time afterwards. However, one thing I did notice that because of the brightly coloured and detailed design of the bib coverall Max seemed to find it more difficult locating the food in front of him. This may be because his weaning journey is just starting and he is learning that the items in front of him are food..but I would be interested to hear if anyone else found this with their babies? we solved it pretty quickly by only placing a small section of the bib on the eating area so the food wasn't lost. The downside is that sometimes food slips off and defeats the whole purpose of the bib! Hopefully, this will improve in the future!

It is fascinating to think that environmental factors such as nutrition from conception to the age of two can have such a profound impact on your lifelong health. There is strong research which shows that a good maternal diet is important not only for the prevention of neural tube defects (spina bifida for example) but also to set the blueprint for their baby's health and disease risk. Scientists talk about the importance of the first 1000 days in terms of a child's ability to thrive, specifically related to the growth and development of the brain.

Pregnant women are well versed in taking folic acid, but other nutrients such as Vitamin D, iron, iodine, and omega-3 are also integral for foetal development.
During my pregnancy I had 'morning' sickness (i.e. horrific all day and evening nausea) for about two months where I ate plain pasta, cheese, quorn sausages and yoghurt; not the balanced diet I normally enjoy! Luckily I was taking a supplement...and luckily the sickness only lasted 2 months as my diet was the only source of nutrition for Max!

Within these 1000 days are key stages. The weaning stage is of particular importance. Moving a baby on from breastmilk and/ or formula milk onto solids is an interesting time for babies and parents! It is also a key opportunity to expose babies to a range of different, nutritious foods. Taste exposure is critical to ensure that babies are more willing to eat a variety of wholesome foods setting them up for life, and on an aside, reducing the risk of fussy eating. It is startling to know that in 2012 the National Obesity Observatory reported that most children aged 5–15 years eat just one portion of vegetables each day, and 7% of children ate no fruit or vegetables at all. This highlights the importance of weaning babies onto a good range of fruit and vegetables (whether the parents like them or not!) at the time when they are most receptive to them.

Interestingly a study published in the journal Appetite in 2015 highlighted the improved acceptance of vegetables in quite a complex trial involving infants starting their weaning journey. The babies had repeated exposure to individual vegetables such as green beans, spinach and broccoli, which on the whole improved acceptance, and led to the babies trying and accepting other vegetables. Additionally, this team of scientists argued that whilst hiding veg in meals can lead to increased intake, the child will not learn to like, eat and recognise vegetables and their distinctive tastes. So perhaps keeping the vegetable whole rather than mixing it in with other flavours initially is of some benefit?

Over the last two decades there are countless studies which show that repeated exposure up to 10 times can increase acceptance of fruit and vegetables. So when your baby spits out foods, rejects them or simply pulls a 'what the!?' kind of face...don't give up..try that food again (and again and again!).

I was disappointed today that Max tried avocado and wasn't massively fussed about it. I LOVE avocado and am hoping it will become a staple in his diet. So based on the above he will certainly be trying it a few more times...lucky little fella.
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It is advisable to chop the veg into baton shaped portions so the baby can hold and place part of the vegetable or fruit into their mouth. It is incredible that a baby is born with the innate ability to grasp objects. I waited until Max was 6 months to start baby led weaning as I wanted to give him the best chance of success! The above picture of Max shows him using what is called a 'palmar grasp' which he then draws to his mouth. He hasn't mastered the 'pincer grasp' just yet so I placed peas slightly squished onto a spoon for him to place in his mouth. He loved them! It was great seeing him use a spoon so confidently as well. Certainly a surprise to me!

Just before I started my maternity leave, I attended an interesting session on synbiotics and their use for babies and children. We learnt that Synbiotics (a combination of pre and probiotics that work synergistically) are now being used (though not routinely!) to help with allergies in children and can help to restore a healthy gut composition following use of antibiotics. I suppose to a certain degree this was a pharma company showing off their products, so they were keen to emphasize the positives, but it did get me thinking about the role of our gut in our key development years.

The slide below was from a virtual talk I attended recently. It highlights the stages of development of our gut bacteria which starts pre-birth stabilising in adulthood. The pharma company were suggesting that babies delivered by c-section would benefit from some kind of pre/probiotic intervention as they would not have been exposed to their mother’s bacteria in the same way as a vaginal delivery. There is ongoing research in this area so it will be interesting to see whether this emerges as official guidance for mothers having c-sections.

The gut microbiome is a fascinating topic and thankfully more and more research is being completed within this area. Back in 2014 I attended a Nutrition conference in Glasgow and first heard about some interesting research regarding the role of our gut microbiome in influencing our health and immunity. The chap talking at this conference said that 'Our gut bacteria have their own circadian rhythm' (a mechanism that times daily events like our sleep-wake cycle, temperature, hormone secretion etc.) which at the time I thought was amazing! How incredible they could even know that!?
Our little gut bacteria have particular functions which occur during the day and night, and get busy with them based on environmental cues (light /dark etc). But what I found interesting was that if we alter our rhythm due to lack of sleep for example (something I know a lot about!) it can influence our health, immune system and metabolism.
>> if we are altering our sleep patterns...(shift work/feeding babies etc,) it often means we are altering our eating patterns>>which means that the gut microbiota are receiving food at times which don’t correspond to their own schedule >> which can affect the breakdown and absorption of nutrients by the gut bacteria>>possibly then having an adverse effect on our health and immunity….(type 2 diabetes as one example) with 70% of our immune system residing in our gut….it certainly pays to be kind to our gut microbiota!
But how can we be kind to our gut?...I reflect on that in part II.