Toddlers expend an incredible amount of energy fueling their increased levels of activity as they develop new skills and investigate the world around them. Not only is it vital that they consume enough food to support this growth, it is the perfect opportunity to continue providing food in a way that creates a healthy relationship with food - one that honors each child's hunger and fullness cues, and supports their autonomy.
Toddler Feeding Practices - Creating A Positive Environment
Toddlerhood is an important stage for experimentation and food exposure. It is the foundation for a child's built relationship with foods and with eating. Each meal provides an opportunity to allow children the ability to make some decisions around eating, while simultaneously guiding them through household meal norms. Additionally, with each meal exists a chance, and a challenge, to offer different foods (prepared in different ways). THIS is truly the key.
[For the purposes of this series, ages 1 through 3 fall into this stage of life.]
Because it is likely a toddler is introduced to more "new" foods during this time of life than any other, understanding how exposure works is central to overall success. The exact number of times trying a food might need to be "attempted", before deciding it "tastes good", does vary. Anywhere from eight times, and upwards of thirty times, has been cited. So, it's important to keep in mind that just because a toddler/child gives the "no way" after eating a food for the first time, it does not mean they will always dislike that food. It's much easier to think that they are really saying "not this time, but maybe later" with their refusal in that moment.
In fact, unfortunately, it's often adult-formed opinions that actually create picky eaters. How many times have we heard a caregiver claim their child hates a certain food? All a statement like this really does is create a negative connotation around a specific food, further predicting a negative future relationship with that food.
The absolute best situation for encouraging a healthy relationship with foods, and with healthy eating behaviors, is to create a positive environment around meals and snacks. Here are 8 tips:
Develop consistent meal-time habits. Regularity and consistency eliminates the most critical question of "when will I eat again", which as an essential aspect of a positive eating environment also builds trust with caregivers.
Establish a designated eating area away from distractions. Because this stage of life is crucial for building healthy eating habits, it is important that toddlers continue connecting with the hunger and fullness cues they were born with, and most likely practiced during infant feeding. Avoid tablets, laptops, phone, TV's, etc., during meal time.
Be a role-model. Mimicry is HUGE at this stage. Toddlers are sponges and will pick up on your cues (stated or not). Eating meals together whenever possible is ideal. Separate feeding times for children and adults is NOT suggested, and neither is making different meal options for those participating.
Introduce new foods gradually. Encourage trying new foods (even if it’s a small bite) alongside familiar foods. Always praise for trying something new, even if they didn't enjoy the experience. Reintroduce the same foods again and again to allow tastes to develop - some tastes might not develop until adulthood. Don't consider the attempt a loss if the child is not into it.
Let your toddler help prepare meals and snacks. Toddlers are more likely to eat food they helped prepare. Some simple "jobs" can go a long way. Breaking up lettuce leaves, pulling the greens off of strawberries, stirring, adding ingredients, arranging the table or putting food on plates can provide children just enough "buy-in" to be invested (and feel proud) in the meal. This practice can lead to confidence in the kitchen and overall excitement around meal time.
Let go of old meal-time "requirements". We've all heard those old ideas of, "not leaving the table until you're finished eating" or "cleaning the plate". These types of requirements require children to ignore their hunger and satiety cues, and they reduce a child's "control" over their food choices.
Don't bribe with food. Avoid situations using food as the "carrot" or the consequence. Statements like "No dessert until..." and/or "eat blank and you can do blank" encourages food/meal time to be all about deals (and less about eating), and this can create an unhealthy relationship with food around reward and punishment.
Provide realistic proportions. Toddlers are not adults. Even though they have high energy needs, they do not need to eat the same portion sizes. Caregivers often mistake "growing needs" to equal large servings. The reality is that this age range is known for lacking regularity with meal sizes - some days they will amaze you with how much they eat and other days you will wonder if something is wrong with them due to how little they've consumed.
If you are interested in learning more about creating healthy eating behaviors for your child (or for yourself), the Ellyn Satter Institute (ESI) is an amazingly worthwhile resource. Additionally, ESI promotes the "Division of Responsibility In Feeding" (sDOR) which focuses on what food-related behaviors fall under the parent/guardian's responsibility and what food-related behaviors belong to the child. Feeding Littles is an equally worthwhile feeding education source that offers reliable, research-based information via courses and resources.
"sDOR encourages [the caregiver] to take leadership with the what, when, and where of feeding and let [the] child determine how much and whether to eat [...] what you provide. sDOR applies at every stage in [a] child’s growing-up years, from infancy through the early years and through adolescence."
Macronutrients
Macronutrients are the nutrients the body requires in large amounts. They are what makes up our total caloric intake.
Carbohydrates
NEEDED FOR: Carbohydrates are the brain’s primary choice for energy.
NOTE: Low-carb diets are NOT suggested for toddlers.
AMOUNT: 45 to 65% of total intake.
FOODS TO EAT: Complex carbs (whole grains, vegetables, lentils, peas and beans), but also nutrient-rich simple carbs like fruits and 100% fruit juice.
Fats
NEEDED FOR: Dietary fats are energy dense which supports the increased energy need at this stage of life and they also support normal brain development. Fat additionally helps to cushion and insulate the body, and support many body processes.
NOTE: Fats help the body absorb vitamins (A, D, E, K).
AMOUNT: 30 to 40% of total intake.
FOODS TO EAT: Unsaturated fats (avocados, peanut butter, almonds, walnuts, olive oils, peanut oils, canola oils, flax seed, and salmon).
Protein
NEEDED FOR: Protein is necessary for proper growth and development, especially during childhood.
NOTE: Milk-drinking toddlers have little difficulty meeting protein needs.
AMOUNT: 10 to 25% of total intake.
FOODS TO EAT: Lentils, nut butter, hummus, oatmeal, whole wheat products, salmon, fish sticks, eggs, turkey lunch meat, yogurt, mozzarella string cheese, and even veggies like peas, broccoli, and potatoes.
Calories
*Not a macronutrient, but worth including here.
NEEDED BECAUSE: Calories are the fuel our bodies require to survive.
NOTE: Just like adults, calorie needs for toddlers depends on their age, size, and activity level. On average, toddlers need approximately 1,000–1,400 calories a day.
Micronutrients
Micronutrients are the nutrients the body requires in small amounts. Although they are recommended in smaller amounts compared to macronutrients, they are equally essential.
Vitamin D
NEEDED FOR: Vitamin D is needed for bone growth, hormone production, calcium absorption, and nervous system function.
NOTE: Vitamin D needs are largely met by milk-drinking toddlers. Other fortified products, including milk alternatives, are just as effective. However, it is worth noting that children with dark skin pigmentation and limited sun exposure are susceptible to deficiency (and are often prescribed a Vitamin D supplement).
NUTRITION TIP: Vitamin D is a fat soluble vitamin which means fat is required to enable absorption of the vitamin through the diet.
Calcium
NEEDED FOR: Calcium promotes bone structure, which is essential at this age.
NOTE: Calcium-fortified orange juice, milk alternatives, supplements, etc. can replace dairy.
NUTRITION TIP: Although dark green veggies are a good source of calcium, toddlers typically do not consume enough of these vegetables to meet their calcium needs.
Iron
NEEDED FOR: Iron is needed for growth and development, and energy production (vital at this stage of life), and wound healing.
NOTE: Iron deficiency anemia is the most common nutrient deficiency in children in the U.S. (and around the world). An iron deficiency can impact attention, cognition and energy levels.
NUTRITION TIP: Good sources of heme iron (animal proteins) are lean meats, fish, and poultry. Non-heme iron sources are primarily plant based (peanuts, lentils, peas, and beans, greens and fortified foods), but also include some animal proteins like egg yolks.
NUTRITION TIP: Vitamin C is suggested at the same meals when consuming non-heme iron sources as this will help increase absorption.
Additional Nutrition Related Considerations
Allergens
What & Why
Allergen watch continues with the introduction of new foods.
"Allergic symptoms may begin within minutes to an hour after ingesting the food. The following are the most common symptoms of food allergy. Each child may experience symptoms differently. Symptoms may include: vomiting, diarrhea, cramps, hives, swelling, eczema, itching or swelling of the lips, tongue, or mouth, itching or tightness in the throat, difficulty breathing, and wheezing." (Johns Hopkins; 2019)
Eggs, milk, and peanuts are the most common causes of food allergies in children, with wheat, soy, and tree nuts also included.
"Nearly 5 percent of children under the age of five years have food allergies. From 1997 to 2007, the prevalence of reported food allergy increased 18 percent among children under age 18 years. Although most children "outgrow" their allergies, allergy to peanuts, tree nuts, fish, and shellfish may be lifelong." (Johns Hopkins; 2019)
Tips
Stagger the introduction of new foods to make it easier to monitor possible reactions and connect those reactions to individual foods.
Maintain a variety or rotations of already established "safe" foods.
Avoid foods that cause a reaction/symptom.
Vitamin/Mineral supplementation may be suggested.
Hydration
What & Why
Active toddlers experience a significant loss of fluids through sweat.
Dehydration can be easily be caused by vomiting and diarrhea.
Toddlers are inefficient at recognizing thirst cues.
Tips
Hydration Goal: Approximately 4 cups beverage/water (avoid added sugar beverages and anything less than 100% fruit juices).
Offer foods high in water content like veggies and fruits.
In instances of severe dehydration, contact a pediatrician to discuss rehydration options outsides of plain water.
Vegan Households
What & Why
Children of vegan households are susceptible to some nutrient deficiencies: Protein, Calcium, Iron , Zinc, Vitamin D and B12.
Fiber intake tends to be higher which can limit the absorption of iron and zinc. It can also provide a sense of satiety prior to actual fullness.
"Children [of vegan households] grow and develop normally but tend to be smaller in stature and lighter in weight than standards for the general population". (Sanders; 1988)
Energy intakes are often below the recommended amounts.
Tips
A good source of B12 is needed: supplement or alternative fortified sources is required.
Vitamin D supplementation or a consistent source of alternative, fortified milks is necessary.
Calcium-fortified foods and beverages or supplements may be necessary.
Alternative sources of iron consist of iron-fortified infant cereals, mashed tofu, and well-cooked pureed beans.
Alternative sources of zinc include: well-cooked mashed beans and fortified infant cereals.
Fiber
What & Why
Children (and adults) consume inadequate amounts of fiber.
Lots of fiber can fill up toddlers quickly.
Too much fiber can also decrease the absorption rates of some nutrients (iron and zinc).
Too much fiber can cause GI issues.
Tips
To increase fiber: add more whole grain cereals and breads, fresh fruits and veggies to diet.
To find a "happy" fiber amount: provide multiple and varied meals and snacks.
To decrease fiber: use some refined grains, such as fortified cereals, breads and pasta, and/or peel the skin on fruits and serve cooked instead of raw vegetables more often.
Watch Companion Video Here!
Other Nutrition Through The Ages Posts!
Nutrition Through The Ages: Special Edition - Lactation *Guest Author*
Nutrition Through The Ages: Special Edition - Child-Directed Marketing *Guest Author*
Nutrition Through The Ages: Special Edition - School Nutrition 101 *Guest Author*
Nutrition Through The Ages: Special Edition - Disordered Eating and Eating Disorders
Nutrition Through The Ages: Special Edition - Orthorexia (Clean Eating)
Nutrition Through The Ages: Special Edition - Drug/Nutrient Interactions *Guest Author*
Resources
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11. Interactive Nutrition Facts Label. https://www.accessdata.fda.gov/scripts/interactivenutritionfactslabel/vitamins.cfm. Accessed 29 Mar. 2022.
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13. Nutrition Guide for Toddlers (for Parents) - Nemours KidsHealth. https://kidshealth.org/en/parents/toddler-food.html. Accessed 14 May 2022.
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17. Samuel, Tinu Mary, et al. “A Narrative Review of Childhood Picky Eating and Its Relationship to Food Intakes, Nutritional Status, and Growth.” Nutrients, vol. 10, no. 12, Dec. 2018, p. 1992. www.mdpi.com, https://doi.org/10.3390/nu10121992.
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