Feeding Toddlers

Pediatrics for Parents, June, 2001 by Harry Pellman

My parental instructions for feeding toddlers begin with frequently repeating the following mantra: "Don't worry, be happy."

Since I do not ever remember parents of a toddler telling me that their child eats well (read - sufficient quantities and quality of food), perhaps our perspective of "normal" diet and appetite in children this age is incorrect.

To be sure, toddlers are very finicky eaters, impatient at meal time, and lacking the adventurous trait of trying different foods and textures (although they have no problems putting every variety of dirt and other non-nutritious objects into their oral cavities). Despite all of this, other than iron deficiency, serious nutritional problems are infrequent in toddlers offered a varied diet. The following commandments should help optimize nutrition in this difficult-to-feed age group.

Power Struggle

Do not get into a power struggle at meal time - you will lose! You may cause relationship and feeding problems. You should control the foods made available to your child. Allow your child to control the quantity eaten.

Breast-Feeding

Continue breast-feeding or iron-containing formula feeding your child. This is a good insurance policy for better nutrition in the one- to two-year-old child. Both formula and breast feeding are far superior to cow's milk in nutritional quality, iron availability, calcium-phosphorus ratio, zinc content, etc. Of course, the type of milk used (formula vs. cow milk) has nothing to do with the vehicle used to feed the child (bottle vs. cup). To improve the taste of formula, chill it. Do not expect toddlers to like unchilled beverages any more than you.

Bottle-Feeding

Stop bottle-feeding as soon as possible! Bottle feeding is associated with more colds and ear infections, bad teeth, slower speech development, and poor self esteem (the latter two, my opinion). It has no redeeming value other than facilitating the act of feeding. Bottle-fed toddlers frequently become milk-grazers as they run around, a bottle dangling out of their mouth, sipping liquids periodically. This suppresses appetite and promotes dental caries, obesity, a reluctance to eat solid foods, and -- if the beverage is fruit juice -- diarrhea.

Quality Not Quantity

Be more concerned with the quality, not quantity, of food eaten by children. Studies going back to 1928 suggest that children will pick out the foods that they need when offered dietary variety. Do not let them fill their tummies with empty calories. One or two cookies or crackers could be half of their caloric intake for lunch.

Snacking

Keep children from snacking within two hours of mealtime. If they have a snack 30 minutes before dinner, it is not reasonable to expect them to sit and eat a nutritious meal. Keep snacks healthy. If they do not eat the ones offered, they will have a better appetite for the following meal. You have lost nothing.

Family Meal

Try to eat as a family. A family eating together provides entertainment and role models for behavior during mealtime. I am sure that some of the toddler's impatience at mealtime comes from watching other family members sit for a very short time, "wolf down" some food, and leave. Avoid distractions such as the telephone, television, reading material, and loud music.

Proper Portions

Place very small portions of food on the plate for a toddler. Larger portions overwhelm them. They eat so little anyway, and you can always add more. As a bonus, when they are messy, there is less to clean off the floor and high chairs!

Thin or Not

Respect mother nature. If you and your spouse were thin as children, you are more likely to have thin children. Do not expect otherwise. If you both were overweight, do not be surprised if your children are the same. Your approach to mealtimes in both circumstances is the same. Feed the children healthy diets.

Food As A Reward

Refrain from using food as reward or punishment. The old cliche goes something like, "If you are good (or bad), you will get (or not get) candy."

Salt, Sugar & Fat

As much as possible, restrict heavily salted, excessively sweetened, and high-fat foods. In other words, avoid fast-food restaurants.

Television and Meals

Restrict television viewing time. TV is loaded with food commercials. The food advertised is almost always unhealthy (when was the last time broccoli and squash were advertised on children's programs?). The commercials were tested prior to being aired and were proven to be appealing to children. The result is that children ask for these foods. Actually, ask for these foods is an understatement. They sometimes howl and scream for parents to buy these products. Another power struggle ensues. Avoid these problems by limiting television-viewing and muting commercials. Or watch noncommerical stations.

Role Model

Be good role models. The hypocrisy of telling your children to eat a healthy diet while you gorge on Twinkles, chips, and Diet Coke is not lost on them. They pay more attention to what you do than what you say.