Erica Jenkins looked down at the incubator and saw three new mouths to feed: triplets Jermelyn, Jermilyn and Jermaine Jr. Just what she should feed them "is a very big concern," said Ms. Jenkins, of Waynesboro.
But she knows she will receive training before the babies leave the Neonatal Intensive Care Unit at Medical College of Georgia Hospital and Clinics, perhaps as early as this week. And she knows she can call on the unit's director, Jatinder Bhatia, for advice.
"He talks to you himself," Ms. Jenkins said. "He's real concerned. He's great."
Dr. Bhatia will be offering advice to more than just the families in his unit. He was recently named chairman of the American Academy of Pediatrics Committee on Nutrition, effective in July. The committee, like others in the academy, looks at issues facing pediatricians and tries to offer guidelines to them on what they should tell their patients.
"A committee like ours is really focused more on educating the educators, if you will," said Dr. Bhatia, the chief of neonatology at MCG.
It also looks at previous statements and positions by the academy that come up for periodic review and need updating. The Committee on Nutrition, for instance, is getting ready to issue new guidelines on probiotics, a hot area of nutrition involving food enriched with "good" bacteria.
"It's everywhere," Dr. Bhatia said. "They're adding it to everything."
But whether it is helpful to all patients is an open question, he said.
"The evidence is there that there are specific issues and conditions under which you need to use probiotics," Dr. Bhatia said. "However, can you really make a healthy person healthier by giving probiotics? That's the million dollar question."
In even more narrow circumstances, is there a need to use "prebiotics," giving healthful bacteria to babies who lack it, as might be the case with premature babies who have not been "colonized" by bacteria from the mother?
"All of the systematic reviews say the same thing: Yes, there's a need; yes, there is evidence; but we don't really have enough evidence to say this is the exact dose, exact whatever," Dr. Bhatia said.
Focusing on nutrition is important for development, particularly for the premature babies in the NICU. Premature babies are at risk for hypertension, diabetes and obesity later in life, Dr. Bhatia said. Feeding them inappropriately puts them at higher risk of problems later in life. But finding the right balance of nutrition could allow them to develop normally, he said.
"We have to somewhere find a fair balance between too much and too little," Dr. Bhatia said.
What to feed children is a daily question that pediatrician Reginald Pilcher fields from parents, and it is one he tries to keep simple. Beyond about the age of 18 months or 2 years, children generally eat what their parents are eating. And often when a child is overweight, so are the parents. So if parents are not willing to change, chances are things won't change for the child, he said.
Dr. Pilcher said something he has been saying for years was recently vindicated by a recent study that found it was not the types of food eaten but the amount of calories consumed that determines weight loss.
"It's calories, and what the parents eat, that is going to determine the child's (diet)," said Dr. Pilcher, a pediatrician for 22 years. "Good eating habits are still going to come from what the parents do."
Dr. Bhatia would concur.
"It has to be a family unit," he said. "How will Johnny learn to eat properly if the parents don't?"
A focus on nutrition came naturally to Dr. Bhatia, whose father was a nutritionist and food scientist whose lab work sometimes made its way home.
"You never knew on Sundays what we were going to eat," he said. "It was a lot of fun growing up that way."
But not all of the experiments were winners.
"Peanut milk was the worst," said Dr. Bhatia, who did a fellowship in pediatric nutrition. "That was terrible. I didn't like that."
Peanut milk will likely not be on the menu when Ms. Jenkins takes her triplets home to Burke County. But with her mother, Essie Stidoms, who shares a birthday with the new babies, she is confident she can handle it.
"We are ready," Ms. Jenkins said.
Reach Tom Corwin at (706) 823-3213 or firstname.lastname@example.org.
The American Academy of Pediatrics Committee on Nutrition not only helps formulate guidelines for pediatricians but also liaisons with federal agencies, such as the U.S. Department of Agriculture, the U.S. Centers for Disease Control and the Food and Drug Administration.