Metabolic Tips for Parents Video Series – Part 3

If you are just tuning in to our Low Protein Living blog, this is the final part of the Metabolic Tips for Parents, a series of ten short videos to help ease your metabolic disorder journey. The highlighted videos below focus on a few feeding topics you may encounter as your infant grows into a toddler. If your child is still in the infant phase, check out part 1 and part 2 of our Metabolic Tips for Parents blog series.

Transitioning to the Next Stage Formula

In this two-video segment of the Metabolic Tips for Parents video series, Medical Affairs Advisor Rachel Powers, RD shares ways to help your infant transition from one of our Early Years® formulas to one of our Next Stage formulas.

At around age one, your baby may be showing signs of readiness for a next-stage formula. We understand that this is another important milestone in your child’s feeding journey and have created these two videos to help make the transition as easy as possible.

Transitioning to next stage formula: When and why (Part 1)

The time surrounding your baby’s 1st birthday is filled with transitions. Traditionally, this is when many children transition from a bottle to a cup and begin fully participating in family meals.

For children with inborn errors of metabolism, 12-24 months marks the start of another transition: moving from their metabolic infant formula to their metabolic next-stage or childhood formula.

My name is Rachel and I’m a registered dietitian here to talk about formula transitions. Changing your child’s formula may sound overwhelming, but it’s important for a few reasons:

  • As your child grows, the nutrients they need change. Typically, children need a higher protein formula and their vitamin and mineral needs change.
  • Secondly, this is the time that your child really begins to eat more and more table foods. Transitioning to a next stage formula with fewer calories and more protein means they will have less to drink each day. This helps them save room for solid foods and can help reduce a child’s resistance to finishing their formula.

Check out Part 2 to learn more about what to expect when your child transitions to their next stage formula.

Transitioning to next stage formula: What to expect (Part 2)

Hi! I’m Rachel, a registered dietitian. In part 1 of our formula transition videos, we discussed when and why transitioning from infant to next stage metabolic formula is important. Now, let’s talk about what to expect for your child’s formula transition:

Your child’s metabolic dietitian will provide complete guidance on how to transition your child from their metabolic infant formula to their next stage formula. If at any point you have questions or concerns, be sure to reach out to your dietitian.

Typically, your child’s dietitian will give you a step-by-step plan to transition to the new formula. The number of steps may vary based on your clinic’s practice or your child’s specific needs, but usually you will start by reducing the infant formula very slightly and adding a small amount of the new formula to it.

You’ll do this for a few days to a week or two, then move on to the next step, which will have a little more of the new formula and a little less of the infant formula. You’ll continue to do this until your child is only taking the new formula and the infant formula has been eliminated.

The new formula will have a different taste than your child is used to. By gradually adding it to their metabolic infant formula, they will gradually become accustomed to the flavor and will be less likely to refuse the new formula.

Because the next-stage formula will be lower in calories, it will also mean that the volume or amount your child has to drink will decrease. A slow transition gives your child time to adjust to fewer calories coming from their formula, which means they will be hungrier for foods and likely start eating more.

Next-stage formulas are more concentrated and often have different nutritional components than metabolic infant formulas like added fiber. Incorporating the new formula gradually over time can help your child slowly adjust to the new formulation.

Most children have no issues transitioning to their next stage formula, but some children may require some patience. Remember, you can always slow down the transition and stay at one step longer.

Communicate with your metabolic clinic regularly. They want to make this as easy as possible for you and your child. Ask your clinic for a Nutricia Toddler Kit to receive a box with educational resources, a fun activity book for your child, and other tools to help you with this stage.

Thanks for watching and be sure to check out our other videos at and on our YouTube channel.

Feeding Challenges with Toddlers

It is not uncommon for toddlers to encounter some form of feeding challenge.  Some of these challenges may include formula refusal, solid food refusal, or simply an unwillingness to let go of the bottle. We want to help take the stress out of managing some of your toddler’s feeding challenges and make feeding time more enjoyable for you and your child.

In this two-video segment of the Metabolic Tips for Parents video series, Medical Affairs Advisor Rachel Powers, RD discusses helpful tips for managing some feeding challenges that your child may be facing. 

Giving up the bottle: why is it so hard?

Hi there! I’m Rachel I’m a registered dietitian and today we’re going to talk about weaning your child off the bottle. Achieving this milestone is challenging for most parents and their little ones, so don’t feel discouraged! You’ll get there!

First, let’s talk about introducing the cup. Giving your child the chance to experiment and feel comfortable drinking from a cup before there’s pressure to drink their metabolic formula from one is so valuable. Start with small amounts of water in a small open cup, then move to a cup with a straw so your child can get used to it and figure it out.

Part of the reason it can be so hard for a child to drink their metabolic formula from a cup after they’ve gotten used to drinking it from a bottle is taste! When you drink from a bottle, the formula hits the inside of the mouth towards the back of the tongue and palette, away from all those tastebuds at the front of the tongue. Put that same formula in an open cup and it’s going to taste way different than what they’re used to.

So what should you do? Well, a cup with a straw is a great option because the straw is also placed further back in the mouth, more like what they’re used to with a bottle. There are lots of different styles of straw cups for kids.

It’s best to choose one with a free-flowing straw. Bite straws and hard spouted sippy cups can actually delay oral motor skills and feeding skills so opt for an option like one of these

When it comes to weaning from the bottle, you’ll want to remove 1 bottle feeding at a time. Be sure your child is comfortable drinking their formula in a cup first. Typically, it’s easiest to remove the first bottle feeding of the day and the feedings after naps. These feedings are typically less emotional and it’s easy to distract your child with a meal or snack, along with their formula in a cup.

Once you cut a bottle feeding, there’s no going back! It’s important to stick to your new routine with each bottle feeding you cut. The last bottle feedings to go are usually the comfort feedings: right before nap and right before bed. Try to establish another routine to provide comfort instead of the bottle, like singing a special song, reading a short well-loved book, or rocking them before putting them down.

At the end of the day, your child will get off the bottle. Some children take longer than others and that’s okay. The most important thing is that your child gets their metabolic formula as prescribed by your metabolic clinician every day. Work with your clinic to come up with the best plan for you and your child.

Thanks for watching and be sure to check out our other videos at and on our YouTube channel.

PKU Toddlers: Dealing with Formula Refusal

As a metabolic dietitian, I received countless calls from panicked parents saying their toddler would not finish their PKU formula. My name’s Rachel and I understand how frustrating and scary it can be when your child won’t drink their formula! Let’s talk through some considerations and tips to help you help your child finish their formula.

First, it can be helpful to understand why your child is refusing their formula. Sometimes, it’s related to how they’re feeling physically. If they’re full from a large snack or a meal, or if they’re constipated or their stomach’s upset, drinking their formula is not going to be at the top of their list.

Try offering the formula at the start of the meal or snack, while you’re still putting the meal together. Those few sips at the start of the meal go a long way!

Another reason your child may be struggling with their formula is that it’s just too much to drink at a time! Toddlers have small stomachs and drinks can fill them up quickly. You should already be spreading out the servings of formula throughout the day, but maybe try spreading them out even more.

If you mix individual servings of formula, ask your metabolic dietitian how you can mix smaller, more frequent servings. If you mix a 24-hour batch of formula, just split this into 5 servings instead of 3. That way, your child has less to drink at each sitting.

If it still seems like too much to drink, ask your metabolic dietitian if they can adjust the formula recipe to be more concentrated, meaning your child will get the same amount of protein equivalents, but it will be mixed with less fluid.

Some children love the taste of their formula and never want it to change, but for other children, they can get tired of the same old taste every single day. Get creative with adding flavorings to your child’s formula to transform the taste.

Check out some of these mixing ideas or visit for some great formula recipe ideas. Just be sure to account for any additional PHE or protein the mixers may provide. And be sure to avoid anything with the artificial sweetener called aspartame, as it contains PHE.

If your child is still struggling with their formula, it may be time to discuss a different formula option with your metabolic dietitian. There are lots of different PKU formulas available nowadays. There are different flavors, formats, and formulations. For example, formulas made with GMP or glycomacropeptide, which are made from a whole protein source, are known for their mild taste. Learn more about Nutricia’s variety of PKU formulas at where you can request formula samples, find more videos, blogs, recipes and more.

Always consult your metabolic healthcare professional team prior to making any changes to your child’s diet or condition management.

Brought to you by Nutricia North America. ©Nutricia North America

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