Katie Ferraro (1s):

It worries me. If somebody says to catch up growth, you need to start solids and growth center is not there to tell you what a growth center is just there to say for your individual child, where are you? And I'm going to follow you there. Hey, there I'm Katie Ferraro, registered dietitian, college nutrition professor and mom of seven specializing in baby led weaning here on the baby led weaning made easy podcast. I help you strip out all of the noise and nonsense about feeding, leaving you with the competence and knowledge. You need to give your baby a safe start to solid foods using baby led weaning.

Katie Ferraro (42s):

Well, Hey guys, welcome back today's episode. We're talking about a frequently asked question. I get from parents a lot, which is I was instructed by my pediatrician to start solids early, to help with catch-up weight. And my response is always, that's an asinine recommendation cause babies who don't know how to eat, can't possibly use food to help them gain weight. But rather than just giving that quick answer, I wanted to invite an expert in this area. Pediatric dietitian, Rosan Meyer is here today to talk about why starting solids early will not help your baby with catch-up. Wait. Now Roseanne's bio is incredibly impressive. She has a PhD. She's a pediatric dietitian. We did the interview from France where she currently lives, but she did her training in London, in the UK.

Katie Ferraro (1m 27s):

She has a pediatric practice specializing in food allergy, feeding difficulties, nutrition, support, and growth faltering. And she has a number of academic appointments as well. So she publishes articles on topics like pediatric nutrition and allergies that she talks about the association between growth and food allergy. So she's one of those unique people. Who's not only working in research and academia, but also working directly with parents like you and me every day. She is the chair of the European section of the international network for diet and allergy. She sits on like every single board, fluent in German, fluent in English. Africans speaks French works with children's birth to 16 years old, but today is here to talk about why starting solids early is not going to help your baby gain weight or have their catch-up weight.

Katie Ferraro (2m 11s):

This is Roseanne Meyer, pediatric dietitian. Well, hello, Roseanne. Welcome to the podcast and thank you so much for joining me today.

Rosan Meyer (2m 19s):

Thank you for having me, Katie.

Katie Ferraro (2m 20s):

I am so excited for the opportunity to interview. I have so many questions, but before we get started, could you just tell us a little bit about yourself and your background, what you do and how you got to where you are at

Rosan Meyer (2m 30s):

Today? Absolutely. Katie, I have a bit of a mix of a background and not sure if you can understand from my accent, but I'm originally from South Africa. I moved over to the UK in 1996. And since then I now live part-time in France, still practice in the UK. I specialized in pediatrics in the UK, did my MSC as well as my PhD, all of it in pediatrics and my research areas very much so I do gastro and I do allergy, but it's very much around nutritional status. So growth, how gross the directs with vitamins and minerals, feeding difficulties because all of that interacts. So it's an area that I find fascinating and it's an area I can see the challenge for health care professionals, but in particular for parents as well.

Katie Ferraro (3m 15s):

And what do you do in your day to day practice? I know you are doing a virtual practice at this point in pediatric nutrition.

Rosan Meyer (3m 21s):

Absolutely. So I specialize, as I said before, feeding difficulties, gastroenterology food allergy and growth faltering is really my speciality. So I really struggle the area of when parents come to me and saying my child is not growing well. Or when a doctor refers to a child that's not growing well to help make signs or a diagnosis, more real and provide parents with advice of how to rectify that

Katie Ferraro (3m 46s):

You mentioned the term growth faltering. So from a terminology standpoint, could you set us straight on? And I know it's kind of a loaded question, growth faltering, failure to thrive, catch up, wait. These terms get thrown around so much oftentimes in the lay community as well. And I think it's important for parents to understand that they really do have clinical underlying diagnostic criteria.

Rosan Meyer (4m 4s):

Great question. So I'm going to start with growth, faltering and failure to thrive. Growth, faltering and failure to thrive are interchangeable. What you'll see is that within Europe, we use more growth faltering in the U S it's more failure to thrive. And the reason we've moved away from failure to thrive within Europe and in particular in the UK is that failure to thrive, implies that there's a failure from a parenting perspective. And we felt that that terminology failure is not a positive terminology. So we've really switched away from using a failure to thrive, to grow faltering, but actually they are interchangeable growth, faltering or failure to thrive. Or we explain to parents is the journey downwards.

Rosan Meyer (4m 48s):

Okay. So that means you have your growth charts and your pediatrician or your dietitian is supposed to, as you, your child grows, track you on yours growth charts. And the crossing downwards in terms of centers is when you have growth faltering. Now this is where it comes because in the U S you're slightly different growth charts than what you have in the UK. So some work work with that score some work with standard deviation, some with, with cental drops. So generally a growth faltering or failure to thrive is seen over at least a month period of time, at least a two central drops. And the reason I'm saying over a period of time, you can have a child today that for five days has diarrhea loses half a pound or more than a pound.

Rosan Meyer (5m 34s):

And that would not be seen as gross faltering because we know once they start eating. So it needs to be over time. Conversely, malnutrition actually is very well defined by the world health organization. So whilst faltering growth is the journey downwards. Malnutrition is I am already down. Okay. So I'm already down at a cutoff who is very clear and that's based on Zed scores with the who growth charts at below minus two standard deviations, Zed score rate for age, weight for height and height for age. So you do not use the term malnutrition unless you've reached that point, just dropping centers, that's faltering growth or failure to time.

Katie Ferraro (6m 17s):

And so parents like the term catch-up growth. I know that's also a very not controversial term, but it is a term that gets misused. Pediatricians will tell parents, oh, your baby needs to start solids early for catch-up weight. And that puts a lot of pressure on parents that think something is wrong with their child, and then they should be using food to fix it. How should we respond when parents are given that instruction? And also loaded question, but what is catch-up growth.

Rosan Meyer (6m 42s):

Yes, Katie? What an amazing question to ask catch-up growth in order to understand that you actually have to understand what is normal growth for that individual child. Okay. So first of all, is that you have normal growth and normal growth. And I always say this to parents, every child will drop over the course of the first two, three years of life. They will have periods where their weight or their length drops. That is actually normal. Although a central line looks very smooth. When you look at the raw data, you will see kind of goes up and down. So if we're saying that catch up, then you need to say, what do you catch up to?

Rosan Meyer (7m 23s):

So what is normal for that child? Now, a lot of parents say to me, but what is normal for that child? You cannot make an assessment of what is normal based on weight. Only you have to take length and length is done up to two years of age and then its height and head circumference as well. So if you've got a child, for example, that is, I'm going to use the 50th center because I know that the U S you've got a 50th centile as well, and they've dropped one center and you've said to me, but reserve, this child has always been one Centel lower in terms of length. Then I'm going to say to you, Katie, well, you do not need to catch up because actually you're now matching exactly where the height is at the moment.

Rosan Meyer (8m 7s):

So the term catch-up needs to be used, correct the term catch-up for the individual child. As you catch up to what we were expecting, you need to normally grow. And that's where it becomes quite confusing. Because for us as healthcare professionals, we had a pre discussion prior to this podcast. We discussed that to you at four hours, discussion yesterday, academically to say, what is catch up? So you need somebody that really understands the genetics. So I always take the parent's height. I calculate the mid parental height. You don't look at your individual points for me as a dietitian. You can't just go, what is your length? What is your way today? You go and take a trombone.

Rosan Meyer (8m 48s):

You go and take the links from birth and say, I think this is where you need to be. Okay. And then the next aspect is you don't need to do catch-up. If you've not got a faltering growth or failure to thrive, if you've come to me and saying, Roseanne, the weight is just dropped slightly, then I would say to you, all we need to do is we monitor you now because what I really am concerned about, and I'm sure Katie you're aware of is this pressure on catch up and pushing nutrients. And when the child actually does not need it metabolically, we know that if a child then becomes overweight at an early stage, it actually predisposes them to syndrome X and later life obesity, diabetes, cardiovascular disease.

Rosan Meyer (9m 32s):

So my advice to parents is when somebody gives you advice and say, you need to catch up. The question is first going to be, why are you asking me to do this? Show me on the growth chart and tell me where my child needs to be. Because if it's just a central line dropped, then I would say to you, I would rather say let's monitor and wait in a month's time measure in a months time again, and monitor. Second question is going to be, is it actually appropriate for me to catch up? Now? Is this just a normal? Has my child had a cough or a cold, because that can actually also explain. So it can be just a natural process. So I am very reluctant to use term catch-up unless there's actually vulture and growth.

Rosan Meyer (10m 16s):

And if there's actual faltering growth, then the term catch up is you catch up to where a child was before not to higher to where they were before. And

Katie Ferraro (10m 24s):

Let's talk, talk about the inherent inaccuracies in measurement. At least I don't know how it is in the UK, but in the United States, the way we obtain height is laughable. They don't use a stadiometer. They push a baby down on the measurement table. Who's cold. So they're crying. They put a pen underneath the foot. They put a pen line over the head. They measure the distance in between. And at that baby squirms or are, is up you're off by an inch or two, which throws parents into like a terrible downward spiral, because it looks like the baby is falling off the growth curve. And oftentimes it's just a matter of inaccurate measurement. I always ask parents that, you know, be an advocate for your baby. I am a little bit anal, but I will measure my babies and weigh them before I go to the doctor. Just so I know what I think the baseline is because if they plot wrong data, you look like a failure as the parent.

Katie Ferraro (11m 8s):

When in fact that might not even really be a problem.

Rosan Meyer (11m 11s):

Absolutely. And to be honest, it's actually, Katie's so reassuring to hear that it's not only happening in the UK, but it's happening in the U S as well. So if you look at the data from the UK, the length measurements are in fact in primary care. So bad that at the moment they are saying, don't do it. If you do not know how to do it accurately. And it is for me, of course, as a dietitian, this is the wrong way about going about it. I'm saying train everybody, not don't say because you can't interpret a weight unless you've got a length. Because as you, you talked to me about catch-up growth. I have so many children sent to me that are essential because they are on the highest centiles where if they were measured correctly, they would see the length is also in the highest centers.

Rosan Meyer (11m 55s):

You are a hundred percent correct. So I actually, I have produced a video now during the pandemic for parents to do the measurements accurately at home. And I always say to them, if you've got a measurement, which looks like, oh my gosh, this looks like you've dropped. Then I always say, no, we're not going to take this measurement. That could be an outlier. We're going to remeasure. So I don't, if there's a measurement that has just kind of dropped suddenly, I always say to parents, we are going to remeasure. And I always go, if I get a referral with saying this child, the length has dropped quite dramatically. I would say the first step is we are remeasuring it. And that is really important for parents. You have to advocate, and I think parents play a crucial role also to help health care staff.

Rosan Meyer (12m 40s):

Katie, you know, you can't take a length measurement by yourself. You have to have two people. So I always say to parents read a little bit up on length measurements. And I normally give them, I said, and tell that when you go and have a measurement, done by a health professional saying, I'm here. I can do the foot side. Do I do the head side? And I can, you know, I can tilt the head and all of those, the other problem I really have is that lying down and standing up. I'm sure you've got the same problem that line down often we do it only until one year of age. And then suddenly when they started walking, they need to be standing up where in fact, our growth charts, it's up till two it's supine and from two it's standing up.

Rosan Meyer (13m 20s):

So yes, absolutely. And you know, if I may say, so we are taking it so seriously, we are now have developed with one of the university of Winchester here, an virtual online training course for healthcare professionals only just on gross measurements, nothing else.

Katie Ferraro (13m 36s):

Well, that's amazing because in the United States, it's the medical assistants who do it in the pediatrician's office, who are completely overwhelmed. They do everything from the finger, stick to the temperatures, to the, I mean they do it all. And so oftentimes they're just in such a hurry. I think half the time parents don't even realize what just happened was they just took a length that may be potentially inaccurate. And so I appreciate what you're saying to be an advocate and don't be scared to speak up. I'm sorry. Can I please request? I mean, I literally have asked for like three different finger sticks when the hemoglobin comes back low in my kids. Cause I'm like, sorry, I saw the way you did it. Like, you know, not to be disparaging, but if we do have inaccurate measurements, all of the data becomes inaccurate. That becomes a part of your child's medical record. And as a parent to see failure to thrive is like, cause we still use that term here, which I agree with you is it makes you feel awful as a parent is totally preventable.

Katie Ferraro (14m 23s):

So can we speak for a second about premature babies? I know as a mom, I had quadruplets, I carried to 34 weeks. They were all born between two and three pounds. So there's six weeks premature. They always tracked at the 10th to 15th percentile and weight for length or weight for age. And even when we started solids or wait until they were six months adjusted plus showing the other signs of readiness to feed. But you know, it took one of my quads in additional six weeks. So he was almost nine months chronological age before he really even began eating. And I feel like without a background, I would have been so stressed about that and thinking, gosh, he's only the 10th percentile. He's not eating. I have other friends with nine month old babies that eat like full meals. How do you speak to parents who are concerned about their child's weight because they were premature and are now moving into the era where it's time to start solid food again,

Rosan Meyer (15m 10s):

A wonderful question. I think, I think the first aspect is when we talked about catch-up and growth, there's actually much more data on premature babies in regards to growth rates so that, you know, as switched on neonatologists and a dietitian can really help you better from that. But I want to just reset. And normally my discussion starts with what is what you want to achieve, because I think often my discussion is around expectations that are not vulnerable because most parents that have preterm infants, they want their child to be chubby and big. Like, you know, my friend's baby, that's not going to be achievable. And that's also not healthy for a preterm child.

Rosan Meyer (15m 50s):

So in a preterm infants, the evidence in terms of too fast catch-up and syndrome X is extremely strong. So I first of all, have a discussion of what you're expecting and maybe not what you want to do, have them shift over and have these little factories is not actually in a viable, achievable goal. And the second aspect is that's also not what you want to have. I get very concerned if I have a preterm child that moves too fast up on the same timelines. So that's the first thing, the second aspect, Katie, you know, I don't know how long you've been working in the nutrition field, but I started off beginning of the nineties. And when all of these who guidelines, those guidelines and those guidelines, you basically looked at the child and said, this child is ready to, you know, we'll start with solids and another child is not ready.

Rosan Meyer (16m 39s):

So the evidence that we've got really is, as you know, you think about preterm Jordan saying, okay, they were born preterm. We think about the gastrointestinal tract. We think about the physiology. And we know at a certain age, the physiology as they were born, preterm would be ready to receive foods. But what's happening with the physiology what's happening with the mouth might not correlate. So the way I work it, I optimize whether that's breastfeeding, where to fortify breast milk or whether that is, you know, formula feeding. I make sure iron vitamins go and optimally. And then I calm down the parents saying, look, forcing the child. Now a pretend child that's not ready to feed is not going to be used the right way forward.

Rosan Meyer (17m 22s):

It might be that we agree, let's say from six months corrected age, not that the child could take some lip swipes, you know, and they enjoy that. But because the percentage of feeding difficulties, as you know, so much high in preterm infants because of invasive medical procedures, whether that's oxygen, nasal problems, they are sensory so much aware. We have to be really careful in forcing these preterm infants to have, because calorie-wise protein wise. I couldn't get much more. Let me tell you from my breast milk and from my, you know, formula milks with the right addition, your protein energy ratios.

Katie Ferraro (18m 2s):

Can you speak a little bit about how starting solids too early has the potential to displace the important nutrition from breast milk or formula on top of the fact that physiologically babies aren't ready to eat anything except that not only is it dangerous, but nutritionally, what's this doing to babies? If we start too early.

Rosan Meyer (18m 18s):

Yeah, I see that now quite a lot. And it worries me. If somebody says to catch up growth, you need to start solids. So there are a couple of things you've already highlighted the oral motor skills. So that goes without saying, had control all of that, which actually means that it can be dangerous. But I think that two aspect from a nutritional perspective that worry me the first one, if I just use numbers. So breast milk has got around 70 kilocalories. If you say for the rich hind milk and your formulas, unless you took it, take an energy dense formula. It's very similar. But when you start with complimentary foods, you start with vegetables, fruit, you know, your porridges and those, they are inherently not very energy dense, but baby's stomach capacity are low.

Rosan Meyer (19m 3s):

So therefore what you're doing is even if you say, I'm just going to give a small amount, number one, you're giving a small amount for what benefit for 10, 15 kilocalories and three to four teaspoons. If I could have had, you know, an ounce more in terms of formula or in terms of breast milk. So calorie protein wise, I would get much more. So that's a wrong argument to say, okay, I'm going to use solids now for catch up the next argument. So let's say your pediatrician actually all forces you. I want to say, actually you need to start with the energy dense foods in a non-allergic child that might be yogurt. Jesus, you know, anything that has got fats, protein and calories.

Rosan Meyer (19m 45s):

Then my second concern is that breast milk is the ideal source of nutrition. So when we measure what you want to give you say breast milk has got 6% of energy has protein. The evidence that we've got at the moment is if you force a child to give two high approaching too early on, it actually starts a cascade of metabolic responses within the child that increases the risk of obesity in later life. So although you might not see your child at that stage, you know, growing really fast, it actually sets a metabolic cascade off. So high protein diets. And I think per se, I want to just say very, very high protein diets very early on.

Rosan Meyer (20m 27s):

It's really not recommended for babies

Katie Ferraro (20m 29s):

On top of the fact that it's an asinine recommendation because babies can't actually even physiologically eat those foods safely before they are actually ready.

Rosan Meyer (20m 40s):

Like I said, you know, from an oral motor, you know, from all of those kinds of things, you know, there are two other format just purely dietetic, you know, you're displacing food. And even if you were then saying, okay, I'm using energy dense, then what are you giving? Therefore, you know, if they were supposed to have breast milk, what is the consequence of the type of pressure you putting physiologically on the child?

Katie Ferraro (21m 3s):

Roseanne, what do you recommend to parents who are getting this pressure? Let's just make up a case. Study babies born, maybe three to four weeks. Premature has always been 10 to 15 percentile weight for length, weight for age. And the pediatrician says to the mom's face oh four month appointment, you should start solid foods. So your baby can catch up. Wait, what language should parents use to give the correct response? It's not being disrespectful, but to protect their child.

Rosan Meyer (21m 28s):

I'm A firm believer Katie and I think most many healthcare professionals now is in the triangular medical service. That means the healthcare professional does not talk down to a parent, but that there is a shared decision-making and part of the triangle. So you've got the healthcare professional, you've got parents and you've got the internet.

Katie Ferraro (21m 47s):

I did not think the third one you were going to say was the internet. I'm sorry. I love it, obviously,

Rosan Meyer (21m 53s):

Because that means we now. And, and I think it's wonderful. We now have parents that come informed to a consultation. So I always say to parents, I think that with this healthcare model, you want to be able to say, look, I want you to explain because a healthcare professional that understands the physiology of catch-up should be able to explain. So the explanation should be, what do you want me to catch up? Because how much have I dropped? Where do you actually want me to catch up to? Because that's where the length is. We're taking this hypothetical case. This is where the heads are conference. Are you expecting something that is not physiologically?

Rosan Meyer (22m 33s):

Right? And my child has only four months still. Hasn't got head control, shows no interest in food. And I know that if we are now doing this, there is a risk of feeding difficulties. What are the long-term consequences? So I would really say to the healthcare professional, explain to me why. And I think the why is important. So therefore the healthcare professional has to in the head saying, okay, this parent actually understands. And really, I need to understand why second thing is, if there was a reasonable reason, why to, you need to say, where do you want me to catch up? Then the third thing is, is my child actually safe to have it? And the last thing is because, you know, Katie, I have been in situations and there are clinical situation where I want to say to you, I've got children that are from a gastrointestinal perspective.

Rosan Meyer (23m 20s):

So severely unwell that we don't tolerate any feeds. For example, the only way we can do as hypoallergenic weaning, you know, to kind of get some nutrients in. But then those cases I always say to parents, ask, when are you going to see me again? You cannot make a recommendation without saying, I am going to monitor you and see that you are okay. So once you're reassured that, that is in fact for your child, the decision and it often is not. But you know, let's say you've been reassured it's for your child. Then you want to know, when am I going to be seen again, to monitor that this is still for my child, the right decision

Katie Ferraro (23m 58s):

Roseanne, I would love to do like a whole separate interview on growth charts, because I think they're really confusing, but also very fascinating and can be a wonderful aid if they're used properly. And it can be horribly anxiety-inducing if they're used incorrectly, but I want to ask real quick because parents don't always understand the concept of percentile. We live in this like hyper competitive environment where parents will think, oh, my baby's only at the 15th or 20th percentile implying that the gold standard is a hundred. And I'm like, no, if your baby's always tracked at that, and you're staying on that, that's an indicator that your guys are doing a great job. And parents feel like that the goal is a hundred. So could you just break down how the centile actually works on a growth chart?

Rosan Meyer (24m 35s):

Absolutely. So the us also, like for us in the UK, for your young children, you've switched over to using your WHO, although you've got the sill same percentile. So the first one to say it's a growth reference. Okay. So are they are breastfed children. And secondly, and I think that's also very important too, because you also have a very, very big multicultural society. I always say to people, I have my family's from India, from Pakistan who say to me, but you can't use your UK growth charts. And I'm sure the same because you know, my child is here on the 15th center. And if I used an Indian growth chart, no, actually knew it is the current growth track for our children. From the WHO that have abused by the U S have got a population that represents developed developing countries, Asian, African, you know, all of those populations.

Rosan Meyer (25m 25s):

So if we are looking at the grace shot your 50th center, and I have to bring in a bit of statistics here. So that means if you've got a nice little bell curve. So that means the middle of it means 50% of your population grows along that if you go, your bell kind of curve comes to the left and it comes to the right. So you can say, say, okay, 25% stock drive at the lowest center below the 50th and 25 grow above the 25th center. And then you're going to where you go 200 on the one side and two zero on the other side. And that means that a very small percentage of the population grow with that center. That does not mean exactly. Like you said, that your aim is to be on the 50th or beyond the hundred percent center.

Rosan Meyer (26m 10s):

The aim is to be where genetically, where nutritionally, you started off your journey, where you moving up to whether that's on the 50th center. But my child has always gone on the 50th center. All the growth chart is saying that worth in a big population. It would be only X percentage, a lower percentage group on that percentile. And that's all the growth center growth center. I was not there to tell you off a growth center is just there to say for your individual child, where are you? And I'm going to follow you there. And you made a very important point that for pretend child, they might be on the 10th center, but they're growing beautifully on the 10th center.

Rosan Meyer (26m 51s):

That's fine. I know I have so many sessions where I hand out tissues because the growth chart has caused so much pressure. And yes, I'd love to do a separate session because the growth charts, they are wonderfully fascinating, but I find if they are used negatively to actually show it and I'll come back to the terminology of failure, you know, failing to thrive where that's really not what a gross job it's not showing any failure. It's just shows if there's faltering.

Katie Ferraro (27m 21s):

Oh, I love that. I think you've given a lot of parents, a lot of sense of calm and peace that it's, this is nothing that you're doing wrong. It's that you may be going in the wrong direction, but it's not the end point.

Rosan Meyer (27m 33s):

And going in the wrong direction sometimes just means I'm holding your hand. We're just going to monitor you and we then need to interact. Now, I'm just looking, I'm just monitoring. And that's such an important message for parents to say that for me, a growth chart is I'm holding your hand. I'm there for you. And that's the way when do I need help? And that's all that it is

Katie Ferraro (27m 55s):

After college. I was a peace Corps volunteer in Nepal. So I lived in a rural community for two and a half years. And I worked in maternal and child health. And the growth chart was maybe the one piece of paper or documentation in addition to a birth certificate that the family would have. And one thing I loved was the terminology that we learned to use in the local language was to describe it as the path to health. And just explaining that this is the path that you are on. And right now maybe we went off the path, but we can do this and that. And the other thing to get back on the past, and that always stayed with me

Rosan Meyer (28m 24s):

Sometimes. And I want to also say during this lockdown period, food insecurity has grown hugely. And I know once that might necessarily not affect, you know, breastfed infant, that's just starting with some, it's certainly want to say that this pathway for us as health care professionals is an important pathway also to make sure that the family is safe and that you get the help. Because sometimes I certainly am finding that with food insecurity questions. A lot of time, I see it first in a growth chart where I can say, are you okay? And I want to say that again to parents is this path I've, I may use your term. You might have just kind of dropped a little bit from the path, but we're here to help whether that is with supporting with the right advice, but it might just be also a monitoring.

Katie Ferraro (29m 10s):

You Roussanne thank you so much for all of your insightful guidance for parents. And I think reassuring words, and then also bringing your expertise into around which I think sometimes a lot of times parents don't realize, oh, maybe my doctor doesn't know everything about this. So I loved your mention of the triangulation. And I really appreciate that. You mentioned the internet as a valuable resource for parents. I mean, parents say, I learned about how to feed my babies from your podcast or your Instagram. We're not supplanting your primary care practitioner. We're just augmenting the information that's out there. So tell our audience, please, where can we go to learn more about the work that you do? Sorry,

Rosan Meyer (29m 45s):

Kind of unit. I want to just say any healthcare professional that tells you, they know everything is not a healthcare professional because health data changes every year and I can never stay up to date. And I appreciate if parents saying Roseanne, I've read this. So I, of course I can't tell myself it was like no way at all, but I have my own website. I run under step-by-step kids' nutrition. I also have Instagram accounts. If you look at Roseanne pediatric dietitian, you'll find me there. I am very much about using food. For me. Food is the most wonderful nutrient you can get. And I want to always produce recipes and produce ideas that parents can atone adjust for their families.

Rosan Meyer (30m 29s):

As I said, I primarily work in clinical nutrition. So gastro in an allergy, so do a lot of free from foods, but it's about seeing what you've got at home and how you can make something that's really nutritious for your

Katie Ferraro (30m 42s):

Baby. And can I ask you if it would be possible to share the video on how to do the measurement at home that you mentioned is that completed? I could

Rosan Meyer (30m 48s):

Find that already. I always tended to you. You can already find that. The only thing I want to say to you is I do the measurements, but I also give the advice on how to clot. So the plotting, I just want to say for all of your listeners in the U S the plotting is on UK gross charts. So measurement all is very same based on who methods, but the plotting, if it looks slightly different to what you've got, that's the only deviation from what you've got. But I want to end up in saying it's not just the pediatrician, the dietitian's role to plot. I know somehow people kind of think I can't touch this chart. I always say to parents, you can, you can touch it. You can look at it because that way we find it.

Katie Ferraro (31m 29s):

Well, thank you so much. This has been a fabulous conversation. I really appreciate your time. Big pleasure. Well, I hope you guys enjoyed that episode with Rosan Meyer. I literally, I kept talking to her like, well, after the podcast interview with I could talk to her forever. I think she's fascinating, such an incredible way of explaining like stuff. I don't know if you guys think it's boring. Like, I think ProStart stuff is amazing. I'm doing a whole separate episode on growth chart stuff, but she has such a great way of explaining what can otherwise be sometimes kind of dry topics in a really relatable manner. So that was her take on. Catch-up wait, we'll definitely have to have her back to talk more about growth charts. And then she has a specialty in gut health and gut nutrition. So there's a couple of intestinal related things she wants to come back on and speak about, which will be wonderful.

Katie Ferraro (32m 10s):

So I do want to link to everything Rosan Meyer talked about in today's episode, in the show notes for this episode. So if you go to BLW podcast.com forward slash one, one zero, I'm also going to get a link to the video that she was mentioning inside of the interview. That was talking about how you can do measurements at home of your baby's height and weight. And I'll be sharing that on the show notes also. So again, BLW podcast.com forward slash one 10 for all of the info from this interview about catch-up weight. Why starting solids early will not help your baby gain weight Rosan Meyer.