As a follow up to our “Failure to Thrive: My child is underweight, what should I do?” blog, I would like to further explain the product Duocal.  It may be a good option for a child with failure to thrive (or FTT) as well as other conditions such as multiple food protein intolerance and conditions related to food allergies such as Eosinophilic Esophagitis (or EE), Gastroesophageal reflux disease (or GERD), and Atopic Dermatitis (or AD).

Duocal is a high calorie, protein-free powdered nutritional supplement that can be added to foods or beverages when additional calories are needed to gain adequate weight. Keep in mind that Duocal is not a formula and should not be used as a sole source of nutrition.

Duocal is made up of carbohydrates and fats. It is flavorless and super soluble so there are no changes to the taste and/or texture of the food it is being added to (which also helps with diet compliance). The Duocal 400g can comes with a scoop which provides about 25 extra calories per scoop.

The reason Duocal is unique is the fact that it does not contain proteins. This is important for a child who needs extra calories due to FTT or weight loss secondary to severe food allergies (keep in mind; only proteins can cause an allergic reaction).

Duocal is 100% milk free and is made in a milk free environment to ensure tolerance. Duocal is for children ages 1 and over. The amount of Duocal you or your little one may need per day is to be determined by your doctor or dietitian. The amount of Duocal needed per day really depends on what the specific nutritional needs are for the patient. Duocal is for children ages one year and older, so it can be used throughout ones life stages.

Duocal can be mixed with a wide variety of foods. Here are some quick tips on how to use Duocal to get you started.

(These are approximations, please check with your doctor or dietitian for exact amounts)

When using Duocal for:

· Beverages: Add 2 scoops of Duocal per 4 fl oz.

· Toddler Foods: Add 2 scoops of Duocal per ¼ cup of food.

· Mashed potatoes: Add 3-4 scoops Duocal per ½ cup of mashed potatoes.

· Soups: Add ~6 scoops of Duocal for a 16 oz serving (or one can) of soup.

The MyDuocal.com site has a lot of helpful recipes and complete nutritional information to help you better understand how to incorporate Duocal into your child’s diet.

Have you tried Duocal before? What kind of recipes did you make with it?

We are always excited to hear of new ways to use Duocal in helping patients thrive.

Christine

Continuing with our Vitamin Series, my post today will focus on the importance of calcium (although technically, we’re having a “Nutrient Series,” since calcium is a mineral)!

Calcium is best known for its role in bone health. In fact, the body stores more than 99% of calcium in bones and teeth to keep them strong^[1].  However, calcium also plays a critical role in many bodily functions including muscle contraction, hormone secretion and nerve transmission^[2].

The body must maintain constant levels of calcium in the blood, muscles and cells in order for the body to function properly. Although the level required for this is small (less than 1% of total body calcium), if you aren’t getting enough calcium from your diet, the body will use calcium stored in bones to maintain these processes, resulting in bone loss.

Calcium intake throughout childhood and adolescence sets the stage for your little one’s lifetime bone health because the development of peak bone mass during these years will reduce the risk of fractures and Osteoporosis later in adulthood.^[3]

The recommended intake of calcium for infants and children are^[4]:

• Birth-6 months: 210 mg per day
• 7-12 months: 270 mg per day
• 1-3 years: 500 mg per day
• 4-8 years: 800 mg per day
• 9-13 years: 1300 mg per day

The best sources of calcium are milk and milk products, soy products like tofu, leafy greens and of course, the extra calcium-rich sardines! For children with milk and soy allergies, its critical to supplement calcium with fortified foods or nutritional products (unless your kids are big sardine eaters! J). It’s also important to get enough Vitamin D because it plays a key role in the body’s absorption of calcium.

For those of you with Neocate-drinkers, you’ll be relieved to know that the Neocate products exceed the calcium requirements for infants and children up to age 13 when age-specific calorie intakes are met!

Another important factor for bone health is regular exercise and weight-bearing activities. So make sure that your children get adequate calcium and Vitamin D and encourage them to be active. They will thank you for a lifetime of bone health!

-Mallory

[2] http://dietary-supplements.info.nih.gov/factsheets/calcium.asp.

[3] PEDIATRICS Vol. 117 No. 2 February 2006, pp. 578-585 (doi:10.1542/peds.2005-2822).

[4] Institute of Medicine, Food and Nutrition Board. Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride. Washington, DC: National Academy Press;1997.

In light of parent concerns about Bisphenol A (BPA) in infant formula packaging, Nutricia announced that we’re taking the extra step to protect your little ones by packaging our powdered products in cans with BPA-free lining.   

Nutricia has provided a complete list of BPA-Free powdered Neocate products that will come in the new cans.

Our hope is that this change will help provide extra peace of mind to the many families with children with milk allergies and other gastrointestinal, metabolic and neurological conditions that require specialized nutrition. If you have any other questions about the new BPA-free lining, give us a call or ask us in the comments section.

- Nita

The first few years of a baby’s life are filled with so many exciting little milestones. One of them, of course, is transitioning your child to solid foods. Some parents find it a big relief and others feel a little sad because it’s a reminder that baby is growing up, (Don’t worry, she’s probably not ready for college quite yet!) but all in all it’s not too much of a big deal.

When you have a little guy or gal with a food allergy, like a milk allergy, this transition can cause a little angst. “How do I avoid an allergic reaction?” and “How do I make sure the baby’s getting enough to eat/the proper nutrition?” are questions we hear a lot around here.

Some parents also wonder if they should take the risk of introducing solid foods at all!

Unfortunately, it’s not that simple. Your little one actually needs solid foods so that they can start developing the necessary motor skills for chewing, biting (food, not people J) and speech development. So how can you safely begin introducing solid foods to your baby? Here are some important things to remember.

1. Wait until your baby is six months old to start them on solid foods, this will allow their immune system to mature a bit more.

2. Have a challenge phase where you introduce a few core foods to see what your baby can tolerate.

3. Introduce the foods least likely to cause allergic symptoms first.

4. Allow your baby to get used to the taste and texture of solid foods, as well as feeding from a spoon.

5. Introduce new textures in three stages:

• Stage 1:  thin and smooth
• Stage 2:  lumps and chunks
• Stage 3:  finger foods

6. In the later stages, the solid foods now in their diet should provide most of your child’s nutritional needs.

If you are nervous about allergic reactions in the challenge phase, check out Neocate Nutra. It’s a hypoallergenic, amino acid-based semi-solid medical food that you can give to children over six months old. The texture is similar to yogurt and it can be eaten by itself or you can mix it with other foods (my favorite is mixed with apple sauce!).

Have any tips for transitioning to solids? Let us know what you think below.

- Sarah

Great News – Neocate just launched new dairy-free Flavor Straws! Available in Strawberry, Banana and Cookies and Cream the straws are kid-friendly and designed to introduce new flavors to children on Neocate Junior and Neocate One+.

Interested in trying out the straws? Visit www.Nutricia-NA.com/flavorstraws. Nutricia is offering 20 Flavor Straws free for every case of Neocate Junior or Neocate One+ that you purchase.

Also, check with your healthcare provider for samples.

Do you think your children will enjoy Flavor Straws? Let us know what you think and which flavors are their favorites!

- Sarah