Feeding Toddlers is Tough

Part 1 in the Feeding Toddlers Series

You’ve made it! Your infant has grown into an energetic and funny little toddler.  You get to put the Magic Bullet away and serve up meals as a family. 

Or do you?

familydinnermeme

If you’re reading this, it’s because you are committed to raising a connected, healthy, somewhat sane family.  I’m going to guess you attempt at least one meal a day where everyone sits down together to eat.  Kudos for more than one family meal!  No TVs, no cell phones.  Asking everyone open-ended questions; “What was the favorite part of your day? Who did you play with? What did we learn?” etc etc.  Isn’t this the recipe of family dinner bliss?

Or do you find yourself standing most of the meal, getting more milk, cleaning up spilled milk, reheating cold food, handing out toast because no one will eat reheated food, and generally feeling harried & overwhelmed?  Well guess what.  You’re normal.  Congratulations on being a great parent, providing the nutrients and home environment every child needs in order to become a functioning member of society.  Yet you’re not feeling so great because after 15min of chaos everyone has left the table and you’re still eating over the sink.

Here’s the good news:  you can follow a simple set of toddler nutrition guidelines when it comes to quality and variety of food for your child (and here I’m talking about roughly 15-30months of age) and then focus on your meal!  Your job is to provide the food in a warm, welcoming environment.  It is their job to eat it.  There’s nothing wrong with encouraging or even requiring 1-2 bites of a new food, but having battles every night?  No way.  If your child isn’t into whatever you’ve offered then don’t press the issue.  Theres always fruit for dessert, right? Or make it yogurt that night if you’re concerned they’ll go to bed hungry.  Do not bribe, cajole, guilt, or panic if a meal goes uneaten.  By lowering your expectations at the table you will naturally lower the stress level that can sky rocket during a hectic weeknight meal.

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Toddler Nutrition Guidelines

Toddler Nutrition Guidelines (1)

Family Meals” come in all shapes and sizes, just like families!   If you have a child under age 3 then asking them to sit at the table for dinner is excellent practice and I encourage it.  Then let them leave the table after a few bites, or take a break and come back, because modeling good meal time behavior (meaning you sit and eat) is way more important at this stage than asking them to do something they’re not yet developmentally ready to do. Iam not a nutritionist.  I am in awe of those who dedicate themselves to the science of food.!  I am a pediatrician and a Mom, and thankfully have a lot of resources at my disposal to give you general recommendations and my personal strategies. If at any point you are concerned about your child’s growth, vitamin deficiencies, or abnormal eating, behaviors then please call your doctor.

How Many Calories Should My Child Eat?

Toddlers between the ages of 2 and 3 require 1,000-1,400 calories a day, divided into anywhere between 5 and 7 meals & snacks!  When I hear “my child eats all day!” then you know they’re right on track.   Imagine a normal dinner for you, which could be between 500-800 calories.  Now break it down into 4 portions. That would be a majority of what your toddler would eat in the course of a day.  This is why being realistic with portion sizes (small!) is important, and focus more on the variety of foods tried at any meal or snack versus the overall quantity of food consumed.  Even one bite of green bean will set the stage for two bites next time, or for the child to be more willing try to something green because they’ve done so successfully before.

Portion size is a big deal, especially in the US.  Toddlers need 1 cup of vegetables, 1 cup of fruit, 2-3 ounces of protein, 2-3 ounces of grains, 2 cups of milk, and a couple tablespoons of healthy fats in the course of a day.

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However, carbohydrates often predominate the diet (dry cereal, pasta, crackers, and bread), which doesn’t leave a lot of room for exploration of fruit and vegetables.  The image above from a UK study (www.dailymail.co.uk) offers a great visual.  Three tablespoons of spaghetti with meat sauce! I know I gave my toddlers more than that, and then don’t understand why they aren’t trying the salad or cucumber.  You can always give more if they finish the serving they started with, but ask for a bite of whatever it is they are reluctant to try before offering seconds.  My good friend and Mom of three also suggests offering both a raw and cooked version of a vegetable (or fruit!), and whenever possible incorporate the vegetable into the starch.  Sautéed spinach under the cheese in pizza, pureed pumpkin & flax seed in pancakes,  shredded zucchini in meatballs.

1 cup of vegetables is not a lot! If you’re worried your child isn’t getting the fruit/vegetables they need think back over the last 2 weeks and add up the number of servings they ate (or at least tried to).  You’d be surprised at the amount they’re really taking in.

What Type of Vitamins Should I Give My Toddler?

Iron –  Children ages 1-3 need around 7mg of iron daily, ideally from food only.  Toddlers run the risk of being anemic due to a combination of poor protein intake and consuming too much cow’s milk.  The amount of calcium in more than 24oz of milk a day inadvertently blocks the absorption of iron in the gut, thus toddler’s should have closer to 16oz of whole milk a day and change over to 1% milk over the age of 2.

Iron deficiency can affect growth and may lead to learning and behavioral problems. If iron deficiency isn’t corrected, it can lead to iron-deficiency anemia.

Kidshealth.org

Flintstone’s children’s vitamins contain iron but are only for children over the age of two.  Under two, child with iron deficiency anemia would take Poly-Vi-Sol with iron 1mL daily.  Ideally though early screening of a child’s hemoglobin by their pediatrician would alert parents to signs of anemia.  This gives the family time to adjust the diet and increase iron fortified cereals, meat, beans, and leafy greens before having to resort to vitamin supplementation.  Using both an iron supplement for a short time while adjusting the diet (reducing the volume of cow’s milk offered daily, increasing iron containing foods) generally solves most mild anemias.

Vitamin D – If you live in an area of the world that doesn’t get a lot of sunlight certain times of the year, then your child will need Vitamin D supplementation.  They’ll need it to absorb calcium for strong bones, and to boost their immune system.  Some cultures have diets naturally high in Vitamin D, those who consume oily fish regularly.  These days, it is unlikely you are eating sardines, cod fish liver oil, or even salmon in the quanities required to keep your Vitamin D levels up.  Thankfully Vitamin D is made by the first layer of our skin when exposed to UV light, so in the summer we have a chance to stock up.  Infants and toddlers, however, are generally protected from too much UV exposure (see my post on sunscreen guidelines here) and while they do get some Vitamin D from fortified dairy, non-dairy milk, and even orange juice, it’s generally not enough.  I generally dislike picking out vitamins, and feel they are often nothing more than over priced fruit snacks.  Except when it comes to Vitamin D.  This is one nutrient that is difficult to get naturally and really should be given to children daily.  Thankfully there are liquid preparations like Baby D Drops, where 1 drop a day provides the required amount, with very few ingredients.

Unsafe food choices

Healthychildren.org has the absolute best post on what is NOT safe for a toddler.  Check this link for what NOT to do. While coins of hot dog and whole grapes are fairly obviously no-no’s due to their extreme risk of choking, there are other foods that you may not always think of as being not the best choices.  Raw carrot or celery isn’t easy for the oral muscles to manage yet and pose a choking hazard.  Just like you wouldn’t start dead lifting 300lbs on your first day at Cross Fit, let those new toddler jaw muscles work on roasted vegetables and ripe fruit first.  Avoid salty snacks or, if you do have them available, offer 4 or 5 potato chips or crisps, not a snack bag.  Sodium content of foods is a problem even for the youngest patients and can be limited if parents are aware of what a safe portion can look like.

In summary: offer small, frequent meals and snacks that always contain at least one fruit or vegetable, limit salty snacks, keep whole milk to less than 16oz a day, and give a liquid Vitamin D 400U drop every day!

If you like having simple routines and guidelines like these at your fingertips, then pre-order the Parent Like a Pro Ebook, available now for a discounted price until it’s release December 2018!

 

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