In this session we are finally getting to the topic of nutrition. We felt it made the most sense to first talk to you about feeding strategies in the early sessions. Here is why: a positive feeding relationship between you and your child is more important than the most nutritious meals. Just because in the long term, your child’s relationship with food will determine his or her food choices. And we as parents are responsible for helping them have positive experiences with food and eating from the first days of life so that later on they have the tools to make good choices and enjoy eating. The ultimate goal of good feeding is to raise competent eaters, defined here as healthy children who are a joy to feed. Such children:

* Feel good about eating, enjoying food and joining in with family meals and snacks.
* Enjoy meals and behave nicely at mealtime and uses manners.
* Are able to pick and choose from food you make available, eventually learning to eat almost everything you do.
* Eat as much or as little as they need.

“When the joy goes out of eating, nutrition suffers” – Ellyn Satter

Of course we believe that nutrition is important. We became Registered Dietitians for a reason :). But we also know that if we make nutrition a chore, it is not going to benefit anyone.

And although counting grams may become necessary if your child is deficient in certain nutrients or you are switching to another diet like vegan or dairy free, we prefer to focus on food group balance and variety.

Adina, as a semi-vegetarian, knows it is easy to rely heavily on cheese, so she makes an effort to make sure she varies protein sources.

Natalia rarely serves fried food but she always serves an additional source of fat like olive oil, butter or sour cream on the table so every family member could add as much as they see fit.

Let the following nutrition details guide you insofar as ideas hit you, ideas about where you might need to tweak this or that a bit. If any of these nutrients concern you then evaluating what you serve may help you make needed improvements. For example, if you realize that you aren’t serving much in terms of high fiber foods or there’s constipation or iron deficiency amongst your children, then focusing on those areas and what is served would be helpful. Otherwise, think of the big picture: balance and variety.

That is why, in this session, instead of strict rules you will find suggestions on nutritious foods you can serve to your child to help her meet nutrient needs, information on planning balanced and nutritious meals that are also satisfying and suggestions on how to choose supplements for your toddler.

Basics of a balanced diet for toddlers

Here is a picture by Natalia’s 5 year old that represents her ideal meal. Translation: pizza, mushrooms, octopus and lollipop. Pretty balanced, don’t you think?

But jokes aside, kids need to be served a balanced diet in order to learn to eat a balanced diet. Even if all they choose to eat is just one food.

Here are the food groups and amounts an average toddler needs to be served daily:

– 2-4 oz meat or beans

– 1-1.5 cup vegetables

– 1-1.5 cup of fruit

– 3-5 oz of grains

– 2-3 servings of dairy (including all milk products and formula)

Does it mean that you should pressure your child to eat these exact amounts? Not really – your job stays the same – serve the food and allow your child decide how much to eat. Will your child eat a balanced diet if you let him pick and choose from what you serve? Most likely, yes. If you are in doubt, try recording everything he eats over a few days, or even better, a week. Most toddlers will manage to eat in a very sensible way if we look at a longer period of time, not just 1 day.

Here is a sample meal plan with ‘starter’ portions: Sample_Meal_Plan — 1_to_3.  Remember your child may need more or less at any given meal, let his appetite lead him.

As far as serving sizes are concerned, you toddler will need only about a tablespoon of food from each food group at a meal. But it does not mean that he will not want more of something and will not touch other foods. See the Before and After Meal Photos and What the Kids Ate (in the subsections below) of what Adina’s kids eat – it is a pretty typical toddler eating behavior. They eat a lot of something one day, do not touch it another day, pile lots of things on the plate and do not touch them, eat their mini dessert first etc. While it is frustrating, it is hard to expect them to eat 3 square balanced meals a day plus snacks. Meal skipping and one-ingredient meals are pretty common at this age.

What is a balanced meal?

To **serve** a balanced meal, you will need 3-5 foods from at least 3 food groups. Include some kind of protein, one or two starches, a vegetable, fruit or milk.

Kids learn best by serving food on their own plates. Of course your 18 months old may need your help or even pre-plating but kids 2 and older enjoy being more independent at mealtimes. You do not need elaborate dinnerware to serve a meal family style. To make her job easier, Adina may serve food family style in pots and pans. Natalia often does this too or she transfer the food into small serving bowls after cooking and uses them as storage containers by covering the leftovers with foil or plates before putting away in refrigerator.

Include **high fat and low fat food** in each meal. Kids need lots of energy and fat is a great source. By adding a good source of fat on the table you will allow kids easily adjust the amount of calories they need on a particular day. Besides, fat makes food taste good! So make sure to combine foods with different fat content or simply put a fat like butter or olive oil on the table. For more on fats, see the section below.

When choosing **starches**, serve whole grain about 50% of the time. While fiber is very beneficial for both kids and adults, as you will see in the following sections, it is easy to go overboard if your child eats lots of whole grains plus fruits and vegetables. Too much fiber may interfere with nutrient absorption and make kids feel full without eating a sufficient number of calories.

Do not worry if your child skips **vegetables**. Vegetables are harder for kids to learn to like. By seasoning them well and using different cooking methods you will help your child find his favorites sooner.

Your can also try serving vegetables to your child when he is at his hungriest – right before a meal. Natalia puts a tray of veggies with a simple dip for the kids and her husband to nibble on while she is finishing preparing dinner.

Review our Session 10: “Increasing Variety” for more ideas on how to serve new foods, including vegetables, to your child.

But above all, do not stress if your toddler consistently refuses veggies. If he likes fruit, serve them more often and enjoy vegetables yourself often, while putting no pressure on your child and you will see positive results sooner!

We have many parents coming to our practices because they are concerned that their child is not getting enough **protein**. But as we proceed through the counseling session, it often becomes obvious that while the child’s diet may not be optimal, protein is often not an issue.

Just 2 cups of milk or other servings of dairy provide most of protein needs for an average 2 year old which are only 19 grams per day. So if your child drinks a cup of milk in the morning and eats some cheese at lunch he will meet his protein needs without any problems even if he ignores the chicken you serve for dinner. In fact, most of us in the US eat 2 to 3 times more protein than we need.

When brainstorming protein option for a meal, do not forget that beans and lentils also pack a good amount of protein. Beans and lentils are very nutritious and easy to like for little kids because of their mild flavor. Need ideas on how to prepare them? Check this lentil and white bean soup recipes from Natalia’s blog.

And it is not a big deal if you don’t include protein rich foods in every meal. Even common carbohydrate rich foods like grains provide 2 to 4 grams of protein per serving. So you do not have to worry if your child does not eat meat, fish or beans at each meal.

Important foods and nutrients

Some of the food and nutrients are more important than others for toddlers because of toddler’s unique needs and also because they are more likely to fall short on them. Read more about the most important nutrients here: Important nutrients_1to3yrs — It may be a useful resource for you if your feel like you need to serve more of food providing certain nutrient/s.  Below we will address common nutrients in more detail.

Before & After Meal Photos

Just for fun Adina has kept track of her kids’ eating for the sake of sharing on her FB page to help other parents see variants of normal. Here are a few photos for your perusal. Keep in mind her 4.5 y.o. daughter is the “pickier” one and her 3 y.o. son has had the heartier appetite and has generally been more adventurous with eating.  The photos start off from a year ago so the “3.5 y.o” refers to her daughter who is almost 5 now.

 

 

— 3 y.o. ate her chocolate first. Then she ate one egg and asked for a second and ate that too. The polenta you see was actually her second serving which I spread out thinly because it is very hot. She maybe had a bite of spinach.
— 21 mo old ate his chocolate first. Then he ate his egg and asked for about 4ths of the polenta and 3rds of the spinach. This kid LOVES his polenta, but although I’ve served this meal many times, this is the first time he gobbled up the spinach, let alone asked for more! He is now 2.5 and has only recently tried it again.

3 y.o.: tasted everything. Finished her first half patty, had a second ‘chicken’ patty half and ate at least half of it.
21 m.o.: tasted everything. Finished nothing but his juice.

 

Above was the 4 y.o.’s plate with leftovers served for lunch with the addition of asparagus. Notice how she piled on the asparagus but didn’t eat any but she did eat tofu (which she hadn’t touched the night before). A new day, a new appetite. Meanwhile 2 y.o. ate GIGANTIC portion of baked sweet potatoes & yams followed by some beans and rice. No tofu. No asparagus.

What the Kids Ate

In addition to the Before/After meal photos Adina does for her FB page, she also shared these meal records to show how her kids eat from time to time. Notice the wide variation in amounts eaten, both between the two of them and from meal to meal.

This was year ago, sometimes my 4 y.o. can eat 5-6 fish sticks in one sitting.

Worth noting is that typically Adina’s daughter loves salmon. The above are two occasions when she ate very little of it.

Looking at the selections this was most likely a “get rid of leftovers” lunch or dinner, hence the combo of foods.

This next food record comes from Adina’s blog and the topic is worth reading: Why it’s Okay to Relax About Your Child’s Eating http://healthylittleeaters.com/why-its-okay-to-relax-about-your-childs-eating/ — Note that in the record below the 4 y.o.’s intake is listed first.

What we hope you can tell from the food photos and food records above is that it’s normal for kids to pick at food and eat very little some meals.  Even in families where kids are fed the same foods in the same way, there will be variation between each child.  Some of your children may eat more than Adina’s kids or more variety.  Others of you have children who eat less or a much narrower variety.  Picky eating is normal in the toddler years.  It is your response to this picky phase with a firm commitment to focusing on your feeding jobs that will yield the best long term results.

Coming Up Next: Your Child’s Growth & Dealing with Unsolicited Feeding Advice

Assignment: Use this worksheet to analyze your child’s food record for balance: BalancedNutritionChecklist

Discussion: What did this lesson get you thinking about?  What do you want to focus on in terms of serving ‘balanced’ meals?  What is your reaction to the food records and before/after photos Adina kept of her kids’ eating?