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Family Health Magazine - CHILDHOOD

Feeding Your Toddler
Healthy Variety is Key

What do you want first – the good news or the bad news? The bad news is that there is no simple, universal nutritional guide to feeding a child ‘properly.’ The good news is that most kids, offered a range of healthy foods, will eat enough to get the nutrition they need to grow well. Simply put, an energetic toddler who is meeting his individual growth pattern at regular check-ups is getting enough nutrition – even if his grandma complains that he never eats!

Nutritional needs

Offer, never force, a balance of healthy foods.

Children use nutrients as the building blocks for normal growth. Toddlers take the nutrients they need – including carbohydrates, protein, fats, minerals, and vitamins – from food. Your responsibility is to offer, never force, a balance of healthy foods.

During the toddler years, when so much physical and developmental growth occurs, many children become picky and difficult to feed. We tend to want children to eat as much as we think they should – which may be too much. This can be a problem.

A toddler has a small stomach, so smaller but more frequent meals may be more appropriate. Remember that in the first year of life a baby triples his weight, but between the first and second birthday only gains another two kilograms. It is not surprising that parents often notice a drop in appetite and increasing pickiness. Still, children do need nutrient-rich foods to get the vitamins and minerals they need to thrive and fight off disease.

You want to be sure that your toddler is eating a healthy, balanced diet with the right amounts of food. The nutritional advice in Eating Well with Canada’s Food Guide ( can help. Here, you will find a list of the daily servings from each food group that children aged two to eight should eat.

Healthy eating habits

It is never too early to start building healthy eating habits. Your toddler closely watches the way you prepare food and act at mealtimes. Try to set a good example!
There is no correct schedule for eating that all families must follow. Many toddlers like to graze – eat frequent smaller meals rather than fewer larger meals. Whatever schedule your family follows, offering a variety of healthy options is more important than when or how often meals occur. Do not be tempted to solve scheduling problems with pre-packaged processed foods or fast foods. They offer much less nutrition than fresh foods or home cooked meals.

Eating meals together as a family offers a chance to model healthy eating behaviour and choices. Avoid feeding toddlers as they run and play. This increases the risk of choking in addition to not being very good table manners! As well, snacking while watching TV is associated with overeating – at any age.

Picky eating is one of the most common challenges faced by families during the toddler years and beyond. Not only are picky eaters too busy to sit and eat, the amount they take in is small. To make things even worse, healthy foods like fruits, vegetables, and meat are often rejected for less nutritious, refined carbohydrates including white bread, crackers, and plain pasta.

Appetites change during the toddler years for many reasons.

Growth changes. During the toddler years, weight gain slows considerably. Yearly weight increases of two to four pounds are normal. Keep in mind that the parts of the brain controlling appetite and the feeling of fullness may send a message to slow down on the eating.

Behaviour changes. Toddlers are stubborn. Part of this stubbornness and defiance is the desire to be independent. The choice of what and how much to eat is one area over which they can exercise control. A wise parent will choose not to fight this battle.

If your child is active, energetic, and able to keep up with normal activities, he is almost certainly getting adequate nutrition. Worry only if your child’s overall energy level drops or growth and development are not progressing as expected.

Developing eating skills

Understanding your toddler’s development will help you know what to expect when feeding him. Parents with strong ideas about what their child should be eating often butt heads with a stubborn toddler who has vastly different tastes and preferences.

Remember that your toddler is just learning how to use utensils, so do not expect him to be neat. Anticipating spills, perhaps even covering the floor under his chair, may make mealtime less stressful.

Each child has his own nutritional requirements and tastes. Still, you may want to expand his food horizons to ensure a well-balanced diet. You are also introducing good eating habits. Bear in mind that that some toddlers need to be offered a new food five or more times before they decide to eat it.

Drink up!

Milk, juice and water are the best beverage options.

Despite their smaller body size, toddlers need more fluid per unit of body weight than adults. Many parents lament the fact that their children do not seem to drink enough. Fortunately, the human body carefully regulates fluid balance to ensure that the right amount of liquid is consumed.

Milk, juice and water are the best basic beverage options. Milk is an excellent source of protein and key minerals, such as calcium and vitamin D. However, too much milk is associated with iron deficiency and anemia. Most authorities recommend a maximum of 16 to 20 ounces (455 to 570 millilitres) of milk daily for toddlers. Children who do not like milk should not be forced to drink it. They will need an alternative source of calcium and vitamin D. Full-fat milk (homogenized or 3.25 per cent milk fat) is advised for children between one and two years of age. After age two, you can choose any milk.

Juice is often thought of as healthier than water because it contains vitamins and nutrients not found in water alone. Unfortunately, even natural unsweetened fruit juices generally contain lots of sugar, which contributes to cavities. For some kids, juice can cause weight problems. Offer no more than four to six ounces (115 to 170 millilitres) of juice per day to children under six.

Soft drinks are very high in sugar and other unhealthy ingredients, such as caffeine. Do not give them to children.

Water is the most suitable thirst-quenching beverage for children. Water will meet a child’s fluid requirements without filling them with calories. A child who refuses water likely is not really thirsty – or hopes to get milk, juice or a soft drink instead.

Essential vitamins and minerals

Adequate iron is crucial, especially for growing and developing children

The terms vitamin and mineral refer to parts of the diet that are essential for healthy growth and development. While these account for very little of a child’s total daily food intake, they play important roles in various body systems. At this age, calcium, vitamin D, and iron are essential to growth and
prevention of vitamin and mineral deficiency diseases.

Calcium is the basic building block for bones and teeth. Children aged one to three should get 500 milligrams per day in the diet. Children between four and eight need 800 milligrams per day. In both cases, calcium intake can be met with two to three daily servings of milk or milk products. Yogurt, cheese and other calcium-rich foods (such as calcium-enriched orange juice, rice, and soy beverages) are good choices.

Vitamin D is needed for the body to absorb and use calcium in bones and teeth. This vitamin is unique because it can be eaten as part of the diet or absorbed by exposing the skin to sun (though this is difficult in western Canada for much of the year). For children over age one, the recommended daily requirement of vitamin D is 400 IU. The only foods naturally containing it are fish, liver, and egg yolk.

Iron is an essential part of hemoglobin, the part of the red blood cell that carries oxygen to important parts of the body. All body tissues and organs require oxygen to perform their tasks. Adequate iron is crucial, especially for growing and developing children. If your child is eating a balanced diet, there is little concern about meeting the iron requirement. Foods rich in iron include meats, fish, eggs, grains and cereals, legumes, and vegetables.

Problems with food

The term allergy is often incorrectly used to describe any poor reaction to food, such as bloating, abdominal cramps, changes in behaviour, diarrhea, and some skin rashes. Most health care providers call these symptoms food intolerances, not allergies. Food allergies can cause these same reactions, along with other, more serious symptoms.

Mild allergic reactions are typically limited to the skin, usually appearing as hives. While itchy and uncomfortable, on their own hives are not dangerous. They can usually be treated with over-the-counter oral antihistamines.

With a serious allergic reaction, a child’s lips, tongue or face may swell. This alone can lead to breathing difficulties. In addition, serious allergic reactions can also make bronchial tubes in the lungs spasm. This may or may not be accompanied by wheezing. The medical term for severe reactions is anaphylaxis, a rapid and life-threatening allergic reaction.

If you suspect a food allergy, consult a doctor specifically trained in diagnosing and treating allergies. Diagnosis involves a combination of an accurate and detailed history, a physical exam, specific skin tests and sometimes blood tests. The most common allergy-inducing foods are cow’s milk, eggs, legumes (especially peanuts and soybeans), tree nuts (almonds, cashews, pecans, pine nuts, pistachios and walnuts), fish, shellfish, and wheat products. Children with allergies to milk and eggs tend to outgrow them over time. Other allergies, such as peanut allergies, may be lifelong.

Can you keep your child from developing a food allergy? The short answer is probably not. We do know that genetics play a role. A family history of allergies certainly increases a child’s risk. Children who have specific atopic conditions, such as eczema, hay fever and asthma, are more likely to have allergies in general. Research does suggest that breast-feeding may protect against developing food allergies.

Lactose is the main source of sugar in most dairy products, including human breast milk, cow’s milk, cheeses and yogurts. The term lactose intolerance refers to a condition where someone has difficulty digesting lactose. This condition leads to a variety of symptoms, including abdominal pain, nausea, bloating, flatulence (gas), and sometimes diarrhea. Intolerances are more common, and less dangerous, than real allergies.

Eating issues

Eating meals together models healthy eating behaviours.

Other nutritional issues can affect toddlers and preschoolers. Too much weight is a common problem. Weight gain during childhood is healthy and desirable. Children tend to thin and stretch between two and five years of age. However, toddlers can become overweight or obese.

Preventing obesity is far preferable to treating it, but requires lifestyle changes for the whole family. You need to model healthy eating habits for your toddler, as parents with better habits tend to pass them on to their children. Serve homemade meals rather than prepared or convenience foods whenever possible. Focus on better health rather than on losing weight when teaching children about eating and dietary habits.

All children must stay active to grow and develop well. Pick fun activities that the whole family can do, like swimming, cycling or hiking.

Last but not least, limit time spent in front of a screen. Activities without movement, such as watching television or playing computer and video games, too often take the place of physical activity. Limit your preschooler’s screen time to one to two hours per day, preferably even less.

It is never too early to start building healthy eating habits. Supplying a balance of healthy foods allows your toddler to thrive with zest, spirit and curiosity. Be aware of your child’s nutritional needs, developmental stage, fluid, and vitamin and mineral requirements, as well as any food allergies or intolerances. In so doing, you help your child with the ‘right’ amount of nutrition.

FAMILY HEALTH is written with the assistance of
Alberta College of Family Physicians
FAMILY HEALTH is written with the assistance of
Alberta College of Family Physicians
While effort is made to reflect accepted medical knowledge and practice, articles in Family Health Online should not be relied upon for the treatment or management of any specified medical problem or concern and Family Health accepts no liability for reliance on the articles. For proper diagnosis and care, you should always consult your family physician promptly. © Copyright 2019, Family Health Magazine, a special publication of the Edmonton Journal, a division of Postmedia Network Inc., 10006 - 101 Street, Edmonton, AB T5J 0S1    [CH_FHb09]
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