From picky eaters to overeating…childhood nutrition in a nutshell
Childhood nutrition has been in the spotlight, especially since childhood obesity has at least tripled in the past three decades. Many parents are seeking answers to the questions “What should my child eat?”, “How much?”, and “Why?”.
Although we are currently living in the “information age”, information overload has caused some parents to be confused, making it challenging for them to understand good nutritional recommendations. In this article, I will attempt to summarize some basic recommendations regarding childhood nutrition.
Infants (birth to 1 year)
Milk is the primary source of food in this age group. Breast milk is preferred, but whether its breast milk, formula, or a combination of the two, this is the infant’s only requirement for the first six months of life.
Vitamin D supplementation is recommended for breastfed infants since breast milk alone does not contain enough to meet daily recommended requirements of this vitamin
Solid foods should be introduced at 6 months of age (or no sooner than 4 months). Start gradually, and avoid foods with high salt and sugar. Soft pureed foods are recommended (baby cereals/foods, pureed vegetables, etc…) with slow introduction of more textured foods as the infant is able to chew. Neither water or juice is needed or recommended at this age!
Behaviors related to eating at this age:
Look for feeding cues in young infants (e.g. can baby hold head up, open mouth for spoon, able to move food from spoon to back of throat/swallow without difficulty).
When infant is able to sit unsupported, placing in high chair to feed is recommended.
Toddlers/Preschool (~1 yr to 4)
It is important to offer a healthful selection of foods at this age. Variety is key, especially with fruits and vegetables. Resources such as healthychildren.org (sponsored by the American Academy of Pediatrics) or choosemyplate.gov provide additional information on serving sizes and food groups, or get specific recommendations from your child’s medical provider.
Milk can be introduced at one year of age. Most agree that whole milk is appropriate until age 2, then transition to reduced fat milk. Depending on the individual needs of your child, however, this recommendation may vary. Soy, Rice, and Almond milk are also alternatives to those who do not tolerate cow’s milk (or parental preference). Twenty-four ounces (no more than 2-3 cups a day) is recommended. Calcium and Vitamin D is important for strong bones and teeth. Cheese, yogurt, and foods fortified with these are also options.
Foods high in fiber are important for bowel regularity, as well as other important health benefits. Fresh fruits and vegetables are a good source.
Limit processed foods, foods high in fat, salt, and sugar.
No sodas! Juice should be limited to 4-6 oz a day, however, juice and other sugary drinks are not recommended or preferred.
Drink water
Behaviors related to eating at this age:
You may experience an age-related decrease in appetite in the early toddler years. Don’t force your child to eat.
Don’t’ fret about the “picky eater”; some children may need up to 15 exposures of a food before accepting that new food!
Aim to wean off bottle by 12-15 months. No sleeping with bottles! No juice or sugary drinks in bottles!
Healthy modeling by parents on what foods to eat, and eating at the table together is key!
School Age (5 yr-13 yr)
Continue to offer variety of foods (follow recommended food pyramid for servings and portion sizes)
Three meals and 1-2 snacks (low in fat, salt, sugar; may need to pack lunch for school to assure healthy selections)
Continue reduced fat milk or alternative
Limit sugar-sweetened beverages to no more than 8 oz (1 cup) a day.
Fiber and whole grains continue to be important
Drink water
Behaviors related to eating at this age:
Recommend eating at the table with family.
Television and electronics off/no screen time, including phones.
Your child may go through a “vegetarian/vegan phase” once they find out about the source of meat (or decide this as a lifestyle). This should be supported. Just continue to offer healthy alternatives to meet requirements. Plant-based, whole food eating offers equivalent nutritional value. A vitamin supplement may be necessary.
Adolescents
Generally, same recommendations for school age children, however calcium needs are increased due to puberty and growth spurt. An additional serving of milk (or calcium alternative) should be added. Resources such as healthychildren.org (sponsored by the American Academy of Pediatrics) or choosemyplate.gov provide more information, especially for specific caloric needs based on the individual child and their lifestyle.
Iron is important for menstruating females, so make sure the diet is rich in iron-containing foods.
Drink water
Behaviors related to eating at this age:
Recommend eating at table with family.
Television and electronics off/no screen time, including phones.
Have healthy “on-the-go” snacks available.
Be familiar with signs of an eating disorder which often present at this age.
Establishing healthy eating habits in childhood is key to building a strong foundation for good health and well-being as an adult. As a parent, this responsibility starts with you, however, remember that you are not alone in this journey and there are plenty of people, like myself, who are here to help you through. As always, information may change as we discover best practice and ways to be well, so always consult with your medical provider.
Best Wishes!
Written by: Dr. Tamiko (Morgan) Foster
Previously printed in the Minnesota Spokesman-Recorder newspaper.
http://spokesman-recorder.com/