if your toddler needs to gain weight, should you give her pediasure? or premium chocolate ice cream? as it turns out, the ice cream will do the same job the pediasure does (once you add in a vitamin supplement), and it's nutritionally superior and more healthful. plus, it's far less expensive! here's how i came to that conclusion:
as part of our goal of getting eva to gain some weight, i've been told to give her pediasure. pediasure is a child formula made by ross pediatrics, the company that makes similac infant formula. i know from extensive research in the past that infant formula is made out of the cheapest possible sources of the macronutrients (carbohydrates, fats, protein). the idea of giving that junk to my nursling makes me ill (as does the idea of supporting a formula company in any way if i don't have to). before making any decisions, however, i wanted to verify that i wasn't doing her any nutritional harm by withholding the pediasure. (gag.)
my theory was that i could make her some chocolate ice cream that was sweetened with maple syrup, and that would provide all those necessary macronutrients. to cover the micronutrients (vitamins and minerals), i'd continue giving her the schiff's children's chewable vitamins she loves so much. i've never seen her refuse either ice cream or vitamins, so this seemed like a hassle-free way to get these calories and the like into her little body (i have no confidence that she'd actually drink the pediasure, since she rejects milk after one sip and rarely drinks kefir yogurt or smoothies).
i went to nutritiondata.com to look up the nutrition facts on the ingredients of my ice cream (cream, whole milk, maple syrup, egg yolks, and cocoa) and totaled it all up. for fun, i compared this to the nutrition facts of haagen-dazs chocolate ice cream and found them to be similar (unsurprising, given they have the same five ingredients other than my substitution of maple syrup for sugar). next i compared this to pediasure. it was difficult to figure out what the serving size of pediasure should be. since it's a "medical food", it doesn't have the usual suggested serving size, and i assume one is to ask one's physician how much to offer. (1000 mL apparently would replace all food for the day.) i think 8 oz would be a reasonable assumption, but i doubt i'd ever get eva to drink that much, so i estimated 5 fl oz (well, 4.84, actually, because the calculations worked out that way). for the ice cream, i used 1/3 c since that's only a little more than what i've been giving her (or, 2.67 fl oz). that's nearly twice as much pediasure as ice cream by volume, but is similar in calories, etc, so i think it's a comparable serving. below are the results. (i apologize for the blank space preceding the table, i blame blogger :)
| Pediasure | Eva's Ice Cream | Haagen-Dazs | |
| Chocolate flavor | made by mama | Chocolate Ice Cream | |
| (4.84 fl oz) | (2.67 fl oz) | (2.67 fl oz) | |
| Total Calories | 148 | 210 | 180 |
| Calories from Fat | 64 | 108 | 108 |
| Total Fat (g) | 7 | 12 | 12 |
| Saturated Fat (g) | 1 | 7 | 7 |
| Cholesterol (mg) | 3 | 110 | 77 |
| Sodium (mg) | 54 | 26 | 40 |
| Carbohydrates (g) | 16 | 14 | 15 |
| Dietary Fiber (g) | 0 | 1 | 0 |
| Sugars (g) | 16 | 12 | 14 |
| Protein (g) | 4 | 3 | 3 |
(the astute observer will notice that a few of the numbers on eva's ice cream are off due to error propagation since the original data were rounded off, but it's close enough.) as i said above, the two kinds of ice cream come out basically the same. and in the grand sense, really, all three come out sufficiently similar: there's more saturated fat (and thus more fat calories) as well as more cholesterol in the ice cream than the pediasure. the carbohydrates and protein come out about the same (except notice that there are more sugars in the pediasure than the ice cream! and i plan to reduce the maple syrup next time, but i didn't want to undersweeten it the first time lest she reject it.) so, with regard to macronutrients, i'm satisfied.
eva's chewable vitamin contains as much or more than the (admittedly small) serving of pediasure when it comes to: vitamins A, B6, B12, C, D, E, and K, folic acid, thiamine, riboflavin, niacin, calcium, iron, magnesium, and zinc. and the maple syrup adds sufficient manganese. the pediasure also has (which is missing from the ice cream): choline, biotin, pantothenic acid, inositol, phosphorus, iodide, copper, chromium, molybdenum, and selenium, none of which i'm particularly concerned about, because i'm sure eva will be covered by the other whole foods she does eat. (i could be wrong, but i prefer to look at nutrition in terms of whole foods rather than at the nutrient level.) so, micronutrients, check!
let's look at the cost: according to amazon.com, i can get chocolate pediasure for $1.49 for the serving size above vs $0.70 for the serving size of haagen-dazs chocolate ice cream. the premium haagen-dazs ice cream is cheaper! and i guarantee i can make my own ice cream for about half that (or probably less). i realize i'm comparing a smaller serving (by volume) of ice cream, but it delivers the same or more macronutrients, so basically the difference in serving size comes down to the water content in the pediasure. even when factoring in the $0.08 per day for the vitamin supplement, and you still come out with an almost 50% savings buying premium ice cream and vitamins vs. buying pediasure (and a far greater savings if you make your own).
and just what, pray tell, are you buying when you buy pediasure? (ooh, i saved the best for last!) let's compare the ingredient lists, shall we?
eva's ice cream: cream, whole milk, maple syrup, egg yolk, and cocoa
haagen-dazs: cream, skim milk, sugar, egg, and cocoa
pediasure: water, sugar, corn maltodextrin (thickening agent), milk protein concentrate, high oleic safflower oil, soy oil, cocoa powder, soy protein isolate, medium chain triglycerides (a fatty acid). this is followed by "less than 0.5%" of the various vitamins and minerals as well as artificial flavors, dyes, gums, gels, stabilizers, and emulsifiers.
yum!
so, where the ice cream gets fat from cream, the pediasure gets it from safflower and soy oil. the ice cream gets carbs from milk (lactose) and maple syrup, in pediasure it's from sugar. the ice cream finds it's protien in eggs and milk, the pediasure in milk protein concentrate and soy protein isolate (which i try to limit in eva's diet for several reasons). i don't know about you, but why would i want to pay double for that pile of food-industry byproducts when i could feed her real food, which also happens to be tastier? (or to paraphrase michael pollan, i'd rather eat food made of food.) they make pediasure (like all infant formulas) out of the absolute cheapest ingredients available (never mind the quality of the various macronutrients, not when that would cut into profits) so it costs them just pennies on the dollar to make this processed stuff. then they charge you nearly double the cost of premium ice cream (remember: made from food), which is just as "nutritionally complete" once you add a multivitamin -- why not just eat the ice cream?! (heck, it's even got less sugar...)
(i'd like to say "i don't know how they get away with that crap" but sadly i do know. if you want to know, check out "milk, money, and madness" by baumsag and michaels. here's just one little fact: 1 to 2 million infants around the world still die each year due to formula feeding, according to WHO and UNICEF. i'm glad formula is available for the cases where it is needed, but the predatory marketing practices used by these companies are unconscionable.)
anyway, lest the ross people ever get ahold of this, i'm not saying ice cream is better than pediasure for all toddlers trying to gain weight. (i'm not a nutritionist or a medical professional, and you obviously should consult your child's physician as needed before making any changes.) but what i am saying that i've weighed the facts (which are presented here accurately to the best of my knowledge) and for my child and our situation, the ice cream wins hands (and spoons) down.
or, as eva would say, "more shoc-it ice keem, pease, mama?"
i welcome comments for any reason, but particularly if you find errors or have questions regarding my analysis.
23 comments:
Hello there!
I found your article (it is surely more than just a blog) very informative and interesting. I have a 19 month old daughter who is below the chart in weight and does not eat any whole food. Obviously I am a very concerned mother and want to find ways to help her gain weight. I am still giving her formula but add oatmeal cereal to it thinking that it is better than just giving regular milk but your article makes me wonder!! Also, I am trying to get some pediasure into her again with cereal added but she takes only 4-6 oz of that in a day. I like your idea of ice cream and would definitely go for it - cross my fingers that she eats it becuase she does not eat anything.
I am thinking maybe I should switch to regular milk (with cereal) but give her vitamins, pediasure and ice cream. What do you say ? (feel free to give your comments) Any other ideas from you would be greatly apprecited.
I am quite amazed and in awe of the time you spent in figuring out all the nutrients details - THANK YOU.
can you also share your recipe for ice cream?
anju, i'm glad you found it interesting. i do want to say that in our case, our daughter was (and is) eating solid foods, so i think yours may be a very different situation. i'm not a medical professional of any kind, so i hesitate to offer even opinions. but, if you find that she does eat the ice cream (more readily than the pediasure), it's probably worth discussing with her doctor. (i think most doctors wouldn't initially advise a parent to give ice cream if for no other reason than that it doesn't seem "medical", but if you showed the nutritional comparison, maybe they'd agree.)
best of luck to you -- though i didn't deal with the severity you're facing, i do know how frustrating it is day after day to try to get your small child to (please!) just eat something. sounds like you're doing a great job.
i'll find the recipe and see if i can type it up sometime. but really, any basic ice cream recipe will do; look for a "custard" recipe with egg yolks in it. (i substituted maple syrup, about half what you'd use of sugar.)
I am a nanny and I currently care for a 2 1/2 year old child who had some feeding issues around solid foods for awhile. He was underweight and wouldn't eat so the doc prescribed giving him a mixture of heavy whipping cream and Pedisure as a supplement. I have my own opinions about the merit of that, but I am not a doctor or nutritionist, so that aside, I want to say this much - this child is fine with eating solid food now, but he is completely addicted to this sugar-and-fat-laden concoction and demands that instead of food. It is the very first thing he wants in the morning, and the only thing he ever asks for. I have found that if I insist that he eat his meal first and then he can have some milk, he eats really well. If he gets the milk first, he chugs it and wants more and won't touch the food. Personally, I think the ingredients in Pediasure are horrifying and I would never give it to my own child.
Any suggestions, as parents, as to how I might approach this subject to his parents? This dietary issue has not been re-evaluated by their pediatritian for many months. I am honestly concerned for this little one's health but would never want to overstep my role as the nanny. Any thoughts are greatly appreciated.
Thank you so much for your very thorough and thoughtful post.
hmm, amy, that's a tough one. maybe just frame it in a positive way, as in "i've noticed that he's eating really well these days! do you think maybe you might want to let the doctor know that and see if s/he thinks we should change the plan regarding supplementing?" i agree with you, but i don't envy your position of trying to address this as the nanny. that's tricky. :)
I found your article because my 15 mos old son has been labeled "failure to thrive" and has an appointment with specialists coming up since he is not a big eater and is not gaining weight. I'm so worried that they are going to tell me to use pediasure or some other supplement and I was looking for something somewhere that would recommend real food over frankenfood. Thank you for your analysis. Maybe we should also make sure these supplements aren't being made in China after what happened with the formula there.
Could you please post your recipe for ice cream - many thanks for all your research
My only concern about the comparison is the assumption that all fats are equal. I agree that the quality and inherent "foodness" of what you are making is certainly more desirable, but you have no way of analyzing what the fat is comprised of. Yes, you cite the sources as safflower and soy oils, but are you accounting for the fact that these are often chosen because of the MCT's or medium chain triglycerides which are more easily assimilated? Can you compare the MUFA's or PUFA's? (mono/poly-unsaturated fatty acids)? While I've grown increasingly skeptical of "engineered" foods and the corporations behind them, I am a registered dietitian and I do appreciate that there are good reasons that these products are used as meal replacements. They are created to be exclusive food sources if necessary (meaning a child could live on pediasure alone) which also explains the inclusion of some of the micronutrients that you don't need to be as concerned with since your daughter eats. Just some food for thought. I'd probably go with the homemade ice cream as well, I just wanted to mention the fat thing.
smurfetterx, thank you for the comment. you are absolutely correct, i make no evaluation regarding the type of fats involved. that distinction may be quite important in some cases, so as i said above, people should *definitely* be clear about all of this with the health professionals handling their care.
again, i am not a professional. i'm a mom, and one who is skeptical that the first choice offered in the medical world is always the best option. i am an advocate of asking questions. and while, admittedly, i was a bit irritated/frustrated by the whole thing when i wrote this post (which explains the tone), that's all i am really trying to say: ask. ask your child's doctor or dietitian if another option might work in your case.
in our case, we just needed to increase her caloric intake. it wasn't a dire medical situation, or one where we were replacing all food. so this worked for us. i can't speak to how well it would work in other cases -- i would imagine many cases need to be treated with much more precision than ice cream can offer.
i think that maybe in trying to be clear, i might now be sounding defensive, and if so that doesn't reflect my feelings. i genuinely appreciate your willingness to offer your professional opinion here, which helps paint a more complete picture for the parents who find their way here (and wow this thing has had more hits in the last almost two years than i ever anticipated). i think a lot of people are having these same questions. so thank you.
Great article! It makes some very important points about the contents of commercial meal replacements and the assumptions about the healthiness of certain foods.
I wanted to note, partly for the benefit of the previous poster, that http://www.nal.usda.gov/fnic/foodcomp/search/ has an extremely thorough analysis of the nutritional breakdown of various foods, including a workup of the fats. I don't have a nutritiondata.com account, so I don't know how it compares to their output, but it might help make the comparison more detailed.
Kristy,
It's been a while since you posted on this thread, but I was very excited to find it. My 11 mo. old was prescribed pediasure, even though he is very healthy and eats fairly well. He is in the 10-20% of weight, but still breastfed, happy and active. I know that you're not a nutritionist, but do you think that your decision would have been any different had your daughter been as young as my son?
Thanks for any help.
megfutbol -- hmm, i don't know. you're right, it changes things when they're so young. i don't know that i'd be terribly excited about giving my 11 month old ice cream... but then again, i wouldn't be so excited to give them pediasure, either.
i obviously don't know the full situation, but based only on what you've said, being around 10-20%ile and seemingly thriving and breastfed... that in itself doesn't sound terribly alarming. it makes me wonder what the specific concern is, something beyond just size? (like has he stopped growing and is falling lower on the chart, etc...)
perhaps it would be helpful to get a second opinion from a doctor who is very supportive of breastfeeding (not implying yours isn't), or maybe ask advice or referrals from a group of breastfeeding moms (la leche league, a local attachment parenting group, or mothering.com forums are just a few ideas).
best of luck to you. navigating all this can be so trickly...
I just found your article. I have to tell you that I love this article as both a mom and as a physician. I frequently will recommend ice-cream or shake as a calorie supplement for both adults and children if it is needed. I usually do it as one option and the ensure/pediasure as another option, knowing that the ice cream is more appealing. I would say that as a food substitute, I would not recommend it totally, however.
At the same time, I am not as easily concerned with children on the low end of the growth curve as many of my counterparts. I have 2 children of my own well below the growth curve. However, I am not able to use either of these solutions to increase calories in my childrens' diets due to food allergies. I am aware that the source of their size issue is probably 2-fold. The food allergies cause inflammation and absorption issues, and the foods they can eat are lacking in calories. We have had to resort to a specially made protein-free formula (amino-acid only) for the sole source of diet for my youngest and as a calorie supplement for the older ones.
Anyway, I got off track and just wanted to say thank you.
Wow! Such good information! I also loved reading the opinions coming from all sides (moms, a physician, a dietician...). I have a 12month old who is below 3% on weight. She's happy and active, however has decided she wants to be on her "own" *slow* growth curve - not what the doctors want of course! Anyway, she doesn't like to drink pediasure, so the other day I tried to make ice cream out of it...it didn't work. Was hard as a brick :( Personally I thought I'd hit on a brilliant idea! I decided to search for pediasure ice cream and found your blog. Now I'm thinking I'll scratch the pediasure idea and just make some good ol' fashioned ice cream. We're just looking to get some extra calories in her. I'm going to try making goat's cream/milk ice cream. Thanks so much for the idea!!!
2/10/10
It is a relief to find other parents with my same concerns and frustrations regarding pediasure supplementation. My pediatrician had recommended pediasure for my child at 12 months of age (she is now 28 months). I breastfed her until 16 months (she has had plenty of DHA). Her height has been in the 70% percentile and her weight in the 20%'s. When she began walking her weight gain trajectory dropped quite a bit. She has a very high energy level and 2 older sisters she tries to keep up with. She is a great eater, so thankfully the concern with her weight is minor. Keeping her caloric intake up to match her energy level has been our goal.
After reading the label, I was never very thrilled at the idea of giving her pediasure. Although I admit, we have given her plenty of pediasure, we have also given her plenty of ice-cream (Haagan Daaz has the highest calories/fat) and a multivitamin instead. As she is on whole milk now, I will add a tablespoon (or 2) of cream to her milk and some maple syrup to give her the extra fat and calories that seem to be required. Some yogurt with probiotics here and there adds to the health of her diet. Using the cream, maple syrup & agave syrup, and a multi-vitamin seems more natural. It also seems to be meeting the goals of providing the extra calories and nutrition for her growing body.
As our daughter is now 28 months old and our pediatrician still wants her to continue with a daily bottle – just note that 16 months of pediasure = 485 days which is roughly 80 six packs at $10 each = $800 (without coupons) from our family alone to the Pediasure manufacturers. It sickens me to think about it.
It is pretty frustrating that there are not some readily available home made recipes from a registered dietician that would meet the same goals as a bottle of pediasure. The second ingredient on the bottle is sugar. Milk and sugar are not expensive in the big scheme of things. If some safflower and soy oil are needed for a homemade recipe (per the pediasure ingredient label), that seems easily accomplished. The only thing I don’t quite know what to make of is the “medium chain triglyceride” on the ingredient list. This labeling leads me to believe there is a sort of a conspiracy theory regarding the ingredients so that a consumer may believe there is something really complex about this formula and parents would be irresponsible to attempt an at home-made formula. Food formulation is not as complex as some seem to make it out. Foods are made of fats (oils), proteins, and carbohydrates.
Anyway that is my rant and input. Best wishes to you for broaching this subject - glad to see I am not alone. Best wishes also to the rest of you with pediasure recommendation dilemmas
I appreciate the blog post - my 4 year old is SO skinny and I have a hard time getting him to eat anything that doesn't end in "dog." (corn dog, hot dog!) He will eat ice cream though - and I am glad to see your research. I wasted $10 on Nutripals today and he and my 19 month old won't drink it.
Thanks a lot!
Very happy to find this! My daughter had horrible reactions to similac. (She nursed, but due to heart defects tired before getting full. She only ate enough to stay alive, not grow.) The similac added to breast milk caused her to refuse all feedings. And here we are a year later and she's in the "zero" percentile as far as weight, but the heart surgery is done. I've been using Nature's One Baby's Only organic formula in her feeding tube, and now they want to switch to PediaSure. Water and sugar? Seriously? Can't I make that myself? And it doesn't seem very wholesome! So I'm glad other parents are looking for "real" food alternatives! I'm going to suggest this to my pediatrician for approval/feedback!
I am sooooooooooooo happy I found your article, thank you thank you thank you!!
I am a breastfeeding mumma to a 13 month old boy who is tall for his age, but only weighs 9.2kg. Interestingly, he was 8kgs at 6 months, so since introducing solids his weight gains have dropped heaps.
I was told to use pediasure, but as a counsellor for the Australian Breastfeeding Assc, I know what they use in infant formula's and honestly would rather feed him nutella straight out of the jar then ever give him formula!
So I am off now to make some of your home made ice cream, and I thank you for a wonderful article!
OMG, did you compare the saturated fat. It's seven times higher (thats the bad fat). No time to read the entire article.
Almost unrelated, but you've motivated me for at least another couple more months of pumping before I need a booster shot of some additional motivation. Thanks!
I'd probably choose plant based ingredients such as avocado, canola oil for the fat (NOTsafflower NORsoy -not healthy)& fruit puree: PRUNE & banana! (for balance & iron & potassium) for the sugar instead of saturated fat sources NOTwhite sugar (yucky)
& how about MOLASSES (w/ IRON) instead of other sweeteners
I'm not an expert, but I've done lots of solo amateur nutrition research & got a lot of info from my mother who is sort of a nutritionist, (due to her collegiate focus) but not as a profession.
isn't there also available, powdered egg protein stuff, like that in Ovaltine!
I give my son both lol. He is in the 2% for height and weight but has improved since he began drinking pediasure 3 or four times a day... plus real food...and lots of ice cream. Just be warned ... ice cream can become a habit wheras pediasure can be replaced with lower calorie milks later on when weight gain has been achieved . ;) dont want a little fatty either!
Why not just up your kids intakes of good fats? Raw milk, pasture butter, avacados, coconut oil? You can make "chocolate pudding" with avacados, and coconut oil can be added to anything. My 2 yr old likes to eat it as a snack, straight off a spoon. Idk why people are so worried about "growth charts"...its ridiculous that there's a standard weight a child should be around. If I took my son to the doctor when he was going through his major growth spurts there's no doubt I would have been told he was underweight. But I knew he was healthy, and he didn't eat much, but if he needed to eat more, no doubt he would eat more. Kids eat when they are healthy (unless they have health problems). Pediasure is disgusting and I hate that doctors push it on unsuspecting parents. And fats from cream...that's what growing babies need! Don't be scared of what our ancestors thrived on. :)
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