Good nutrition is essential to your child's overall health, happiness, and wellbeing. We have written this guide to assist you in keeping your child on a path of good life-long nutrition. Our first nutrition guide (Nutrition: A guide for the first year of life) left off at 1 year of age. So, this guide is designed to assist you during the toddler years. Please remember that all children are unique individuals and what is best for one may not be best for all. At each visit, your GPAM provider will consider your child's individual needs when making nutrition recommendations.
The toddler years encompass children from age 1 to 3 years. Toddlers are energetic, curious, impulsive, and very independent! Their favorite word is "no" and they are always on the move. Toddlers are not interested in sitting down for a long meal. Toddlers are typically very picky eaters. For example they may love strawberries one day and dislike them the next. Your children's capacity to eat at any one time is limited. This can all make for frustrating meal times! But, do not dismay, we have some helpful tips that will help you during this wonderful, crazy toddler stage.
To eat or not to eat and how often?
It best to start with the wisdom of Ellyn Satter, a registered dietitian, whose Division of Responsibility in feeding has become a cornerstone for pediatric nutrition. In her book, 'How to get your child to eat ... but not too much', she explains that "parents are responsible for what is presented to eat and the manner in which it is presented" and the child is responsible for what and how much he/she eats. So, your "job" as the parent is to buy, prepare, and serve the food. Your toddler's "job" is to choose whether to eat, what to eat, and how much to eat. Most parents want to do both their job and their toddler's job! Do not try to do your toddler's job. Do not let your toddler do your job. Your toddler may try to take over your job of meal planning by refusing to eat certain foods. You prepare the meal and your toddler eats it, eats some of it, eats none of it. You are not a "short order cook" making endless food substitutions.
Most providers recommend offering your toddler 3 meals with 2-3 "snacks" a day. Meal and snack times should be planned or scheduled into your daily routine and eaten while seated at the table. Snacks should be appropriately spaced between meals to allow your child to be hungry at meals. In general, feeding intervals of 2-3 hours are appropriate for most toddlers. A meal should provide protein (meat, fish, poultry, egg, beans), a fruit and/or vegetable, bread and/or cereal (bread, noodles, rice), and milk. Remember, it does not have to be fancy. The quality of food served for snacks should be the same as a meal but you do not have to include all the components listed above. Snacks can be a good time to go ahead and give in to some of your child's food preferences. But, avoid "junk food" snacks.
Recommendations for healthy snacks
- Fresh fruits and vegetables-- serve with peanut butter, hummus, cheese, yogurt as toddlers love to "dip".
- Fruit cup (rinse off sugary syrup)
- Cheese sticks
- Rye crisps or whole grain crackers with cheese or peanut butter
Although your active toddler may prefer to "multi task" by grazing while playing, it is best that he/she sit down in a high chair or booster seat for all meals and snacks. Encourage your toddler to self-feed by offering spoons and dishes with steep sides. But, your toddler will likely prefer to use his/her fingers! Expect messes and spills.
Toddlers: the definition of picky eaters
It is quite normal for toddlers to be picky eaters. Rejection does not mean dislike. They can love a food one day and dislike it the next. Offer your toddler a variety of different foods. Continue to offer a variety of foods even if they have been rejected in the past. It can take 10-15 exposures to a new food before a child is even willing to even consider it. If your child does love a particular fruit or vegetable, it is ok to serve it often. Try to keep your focus "on the big picture" rather than on exactly how much is eaten at one particular meal/snack.
Struggles over vegetables seem to be universal between parents and children. It is important for parents to serve as good nutrition role models. If you want your toddler to eat veggies, you need to eat yours as well! Out of frustration, we are often tempted to "hide" vegetables in other foods. This strategy may work but can often backfire and cause your toddler to be even more suspicious of the foods you are serving. But creative preparation of vegetables, such pureed cauliflower, zucchini bread and vegetable lasagna may help your toddler accept these foods. For example, if you serve your toddler zucchini bread and he/she loves it, he/she may be more willing to try grilled zucchini or zucchini casserole.
Food is food. It is not a reward or a bribe.
This is a good concept to try and remember but can be difficult to implement when faced with toddler in a tantrum! When your toddler is having a tantrum, it is very tempting to use a piece of chocolate candy to coax him back into compliance. There is nothing wrong with an occasional sweet treat. But, it is best to avoid using the sweet treat as a bribe or a reward.
Milk: So many choices
One would think that buying milk would be a simple thing. But, these days, with so many choices in the dairy case, it can be quite confusing. So, we want to try and simplify things a bit.
Unless your child has an allergy or an intolerance, most GPAM providers recommend cow's milk. Cows' milk contains a wide array of key nutrients that help support human health. It is an excellent source of protein, calcium, potassium and phosphorus.
The fat content of milk is the proportion of milk, by weight, that is made up by butterfat. The fat content of cow's milk is modified to make a variety of products: whole milk (3.25%), reduced fat (2%), low fat (1%), skim/nonfat (0-0.2%). Most GPAM providers recommend whole milk from 1 to 2 years of age. After 2 years of age, most GPAM providers recommend low fat or preferably skim milk.
Organic milk is defined by the USDA as milk from cows that have been exclusively fed organic feed, have not been treated with synthetic hormones, are not given certain medications to treat sickness, and are held in pens with adequate space. Most GPAM providers recommend, if possible, offering organic milk.
Most GPAM providers strongly recommend NO flavored milk (chocolate, strawberry) due to the added sugar.
In general, most toddlers should be drinking no more than 24 oz. of milk per day. Many will drink less and the amount will likely vary from day to day.
Juice: an unnecessary sweet
For most healthy children, fruit juices are not a necessary part of their diet. Juice has no nutritional benefits over whole fruits. Whole fruits provide fiber and other nutrients often lacking in fruit juice. So, encourage your child to eat an orange or grapes rather than drink orange or grape juice. The AAP recommends limiting your child's juice intake to no more than 4-6 oz. per day for children aged 1- 6 years. Juice contains sugar and can fill your child up without providing good nutrition. Too much juice consumption has also been linked to obesity and tooth decay. Water or milk are good alternatives.
Sippy cups can be a helpful way to transition from the bottle and avoid spills. Toddlers love their sippy cup and if they had their way, would carry it with them at all times. So, discourage "roaming" with the sippy cup by allowing your child to drink only when seated at the table for a meal or snack. This will help prevent your child from filling up on fluids between meals and snacks. You may find that as soon as your toddler sits down for a meal, he/she guzzles that 4 oz. sippy cup before even looking at the food being served. So, you may want to only fill it half way at the start of the meal so as to try and encourage him/her to eat the food also being served. By age 2, most providers recommend use of a traditional cup rather than a sippy cup.
We live in a "supersize" world and so it is no wonder that portion size is a confusing issue for most parents. Most parents overestimate the amount of food that their children need to eat. Most toddlers do not eat very much. But, most toddlers get what they need.
A toddler portion size is roughly about 1/4 of an adult portion size. But when toddlers are distracted by something other than food, do not like what is on their plate, or are not hungry, they will eat less. So, the amount they eat will vary from day to day and meal to meal. Just remember, if you offer your toddler a variety of different foods, he will eat what he needs.
Respect your child's signs of fullness. Young children are typically very good at responding to their internal cues for hunger.
Some general guidelines on toddler portion size:
- Milk and dairy: 1/2 cup or 4 oz.
- Meat, fish, poultry: 1-2 oz.
- Vegetables: 2-3 tbsp. (cooked), a few pieces (raw)
- Fruits: 2-4 tbsp. (canned), 1/2- 1 small (raw)
- Bread: 1/2- 1 slice
- Rice/pasta: 1/4-1/2 cup
A warning about choking. Never leave your toddler unattended during feeding. Your toddler should always eat seated in a high chair or booster chair. Offer table foods in small amounts so that your toddler does not put too much food in his/her mouth at a time. Foods that are small, round, and firm, those that are stringy or sticky, and those that swell when moist are the most dangerous. Examples of choking hazards: whole grapes, cherries with pits, hard candy, caramel, raisins, popcorn, nuts, seeds (sunflower, watermelon, etc), hot dogs, chunks of meat, sausages, hard cheese, raw veggies (celery, carrots) hard fruits (apples), peanut butter.
The American Academy of Pediatrics believes that healthy children receiving a normal, well-balanced diet do not need vitamin supplementation over and above the recommended dietary allowances. Consult your GPAM provider on specific recommendations for your child.
Tips on dealing with a picky eater
- Remember the wisdom of Ellyn Satter: parents are responsible for the what, when, and where while children are responsible for the if and how much.
- No reward for eating. No punishment for not eating.
- Limit juice and milk intake between meals and snacks.
- Do not force. If you try to force children to eat a particular food, most will do the exact opposite and refuse to eat it.
- Try to incorporate a food the child likes into each meal.
- Visit a local farmers market. Let your kids can pick out the food and meet the farmer.
- Begin a family garden. This can range from a simple tomato plant on your deck to herbs to a full garden.
Promote positive family mealtimes
We encourage you and your family to come together at the table for meal time. Family meal times are especially important for toddlers. Toddlers learn a lot from watching their parents and siblings. Family meal time allows you to model healthy eating habits, table manners, and enjoy quality time together.
Allow children to help in the meal preparation with age appropriate tasks. Even toddlers can help by carrying placemats to the table or passing out the napkins.
Sit together at the table, serve the food "family style", and offer 3-5 different foods. Allow each family member to choose from what is on the table. Serve familiar foods with unfamiliar foods and favorite foods with not so favorite foods. Do not nag, prompt, or bribe your child to eat. Do not cheer and clap when you toddler tries a new or previously rejected food. Simply remain neutral and do not interfere. Your child should sit with the family even if he/she chooses not to eat.
Steer discussions away from the food and instead share stories about the day or upcoming plans. Enjoy the meal and the time together. Be present with one another. This means no television, no video games, and no phone.
If you are interested in more nutrition information, we have included a list of books recommended by GPAM providers. Check out the GPAM bookstore on our website for a more extensive list.
- How to Get Your Kid to Eat... But Not Too Much by Ellyn Satter
- Child of Mine: Feeding with Love and Good Sense by Ellyn Satter
- Secrets of Feeding a Healthy Family by Ellyn Satter