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Jesse
Hsieh, MD
Medical
Editor, Michiana Family Magazine
Dr.
Hsieh has been in practice at Granger Family
Medicine for almost 20 years. He also serves
as President of the South Bend Clinic, Memorial
Hospital Board, Clinical Associate Professor
at IU Med School-SB, and lead guitarist for
Vyagrafalls, at Vyagrafalls.com
Sherri
Isaak, RD
Sherri
Isaak, RD, has a Master's Degree is Board Certified
in Advanced Diabeties Management, and is a Certified
Diabetes Medical Eductor. Her 12 years of experience
include cardiovascular dietician at the University
of Michigan. She now resides in Florida with
er 6 month old daughter.
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Current
studies report that the most common vegetable eaten by 18-month
olds is French fries. Most French fries are laden with unhealthy
trans fat, void of much nutritional value, and shouldn't even
be counted as a vegetable! Most parents know that vegetables
are important for a healthy diet but may stop serving them
if they are not eaten. Feeding toddlers can be challenging
at times, especially when the meal you prepared ends up on
the floor. It is tempting to serve only their favorites. It
is possible however, to provide healthy, balanced meals by
following some of the strategies below.
Tips
for Feeding Toddlers
-
Offer
food in fun ways. Use a variety of colors, shapes and textures.
-
Limit
juice and sweetened beverages. Little tummies can fill up
on liquid calories and leave no room for meals or snacks.
Even limit 100% fruit juice to no more than 4-6 ounces per
day.
-
Serve
regular meals and snacks. 3 meals and 2-3 snacks daily.
-
Eat
dinner together as a family. Try to minimize distractions.
Turn off the TV.
-
Offer
at least four food groups per meal.
-
Between
ages one and two children shouldn't be fed a low fat diet.
They need this fat for growth and development
-
Serve child size amounts, not adult portions.
-
Refrain
from using food as a reward or punishment.
-
Be
a role model for healthy eating.
New
Ways to Handle Fussy Eaters
It
is no longer helpful to force a child to eat by enacting the
"clean your plate" rule. According to Pediatric Dietitian
Ellyn Satter, parents are responsible for what (type of food),
when (time of the day) and where (preferably the kitchen table).
The child is responsible for how much and whether to eat.
Appetites will vary from day to day, and even meal to meal.
It can be tempting to force continued eating, especially if
it seems your child is done even before the meal has started.
It is important to know, however, that pressuring children
to eat may lead to their disliking some foods.
Be
a persistent cook. It may seem like your toddler is not interested
in a particular food, but just because your child rejects
certain foods doesn't mean they won't ever be interested.
Children go through what is referred to as food jags. They
may ask for the same food day after day for a period of time.
When this happens, continue to offer a variety of foods. If
it persists for a long period of time or is affecting your
child's growth, talk with your physician.
Foods
need to be offered 10-15 times before a child may accept a
new food. A study published in the December 2007 issue of
Pediatrics confirmed that repeated exposure of foods increases
acceptance. The authors of this study also noted that preferences
for sweet food tend to be innate while preferences for other
foods, like vegetables, tend to be learned. So just because
they turn their nose up once doesn't mean they always will.
This is why some children will only eat a very limited variety.
It may be premature to conclude that your child will never
eat a particular food, when in fact they may just need it
offered to them a few more times. The bottom line is that
if your child does not seem to like certain foods, such as
vegetables, don't give up - stick with it!
Snacks
Many
toddlers fill up quickly. Two to three snacks per day are
usually needed. Nutritious snacks are important to help fill
those gaps left at meals. Here are a few snack suggestions:
Healthy
Snack Ideas
Whole grain crackers and sliced cheese
Whole grain graham crackers and milk
Fruit parfait (fruit, yogurt, crumbled graham cracker)
Fruit smoothies
Hummus and whole grain crackers or pita
Chopped boiled egg
Steamed and chopped carrots with dip*
Diced or mashed avocado
Whole grain muffins, cut into small pieces
Chopped fresh fruit with yogurt dip
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*(Caution: always steam, grate and/or chop your vegetables first.
Children under 5 can easily choke on raw vegetables. Other choking
hazards include grapes, raisins, nuts, popcorn, hot dogs, large
chunks of any food.)
How
Much?
The
American Dietetic Association recommends serving 1 tablespoon
of food per each year of life, offering more if needed. Below
is a portion guide. Your child may eat more of a particular
food on some days, and very little of the same food on other
days. Look for a balance over time.
Milk
and Dairy. Whole milk until 2 years of age, after 2 years
(per physician approval) lower fat is acceptable. Serving size:
½ cup milk or yogurt, 4-5 servings per day.
Protein
(meat, eggs, beans). Serving size: 1-2 ounces, 2 servings per
day.
Fruits.
Serving size: 2-4 tablespoons, 3 or more servings per day.
Vegetables.
Serving Size: 2-4 tablespoon, 3 or more servings per day.
Grains/
Breads. Serving size: ¼- ½ cup cereal, pasta or rice, ½
slice bread, 4-6 servings per day.
Adapted
from the American Dietetic Association's Pocket Guide to Pediatric
Assessment
Teaching
children healthful eating early on helps develop those habits
for a lifetime. Do your best to offer a variety of whole grains,
fruits, dairy, vegetables, and protein. Help your entire family
and be a role model by following healthful eating habits yourself
too.
Toddler
Nutrition Resources
Books
Child
of Mine: Feeding with Love and Good Sense, by Ellyn Satter,
MS, RD, CICSW.
Baby
Bites, by Bridget Swinney, MS,RD.
Food Fights, by Laura A. Jana, MD, FAAP and Jennifer Shu, MD,
FAAP
The Moms' Guide to Meal Makeovers: Improving the Way Your Family
Eats, One Meal at a Time, by Janice Newell Bissex, MS, RD and
Elizabeth Weiss, MS, RD
Websites
www.kidshealth.org
www.fruitsandveggiesmorematters.org
www.mypyramid.gov
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