What Growing Bodies Need
During the first three years, the rate of growth is more rapid than any other time in life. To support all this growth, kids need lots of nutrient-rich calories. The demand for vitamins and minerals is incredibly high, and some of these are easier to come by in the typical diet than others.
Dietary supplements may be an option for some children, but in general, food should always come first. Work with your pediatrician and a registered dietitian to determine your child’s specific needs. Either way, make sure there are more of these five nutrients in their diet.
• CALCIUM •
Function
Calcium is responsible for the proper growth and development of teeth and bones as well as muscle contraction and nerve conductivity.
Children ages newborn to three require between 200 and 700 milligrams of calcium per day.
Sources
Calcium can be found in dairy products like milk (300 milligrams in one cup), cheese, yogurt, and ice cream. It is also added to some brands of orange juice, tofu, and breakfast cereals. Other sources include almonds, broccoli, and leafy green vegetables like spinach and kale.
Deficiency in Children
In severe cases calcium deficiency can cause weakened teeth and bones. Poor intake of calcium during childhood can affect bone health later in life, and when kids grow older they may be at greater risk for bone fractures and osteoporosis.
• VITAMIN D •
Function
The body needs vitamin D to absorb calcium and mineralize bone. Vitamin D is also important for immunity and healthy muscles.
Needs
Vitamin D is measured in international units (IU). Children ages newborn to three require 400 to 600 IU per day.
Sources
Vitamin D is found in a relatively small number of foods, which may make it difficult for some kids to get enough. Mothers who exclusively breastfeed are encouraged to give babies vitamin D supplement drops during the first six to twelve months. From food it can be found in fatty fish (like salmon and tuna), egg yolks, and fortified foods like milk, orange juice, some cuts of pork, and some brands of yogurt. There are 40 IU in a glass of milk and about 20 IU in one egg yolk.
Humans are able to make some of their own vitamin D with the skin’s exposure to sunlight, but production varies on where you live and the time of year. Since there are plenty of other good reasons to keep the kids out of the sun (and slather on the sunblock), focusing on food should be a priority.
Deficiency in Children
In children, a lack of vitamin D can cause rickets, a rare but serious condition where the bones become weak and pliable. Children who suffer from rickets often have impaired growth, malformed teeth, and bowed legs.
• OMEGA-3 FATS •
Function
Omega-3 fatty acids are forms of healthy, polyunsaturated fats. They play an important role in circulation and neurological function. One form in particular, referred to as DHA, is beneficial for pregnant women, infants, and children, contributing to healthy skin, vision, neurological development, and cognitive function.
There are no established government recommendations for omega-3 intake for babies and children, but pediatricians recommend somewhere between 400 and 700 milligrams a day for infants and children ages newborn to three years.
Sources
In addition to prenatal vitamins, moms are encouraged to take omega-3 supplements from fish oil during pregnancy and for breastfeeding. As infants grow there are additional options to take in this important nutrient. Some brands of milk and many brands of infant formula have DHA added.
Fatty fish like salmon and tuna are wonderful sources of omega-3, but since these aren’t the most popular food choices for many children, flaxseeds, walnuts (barring a nut allergy), egg yolks, and fortified foods like cereals, milk and yogurt, and some varieties of jarred baby foods also have DHA added.
Deficiency in Children
Kids who don’t get enough omega-3 may be at a greater risk for learning deficits and possibly behavioral issues.
• IRON •
Function
Iron is one of the most important minerals for children and adults. It allows red blood cells to deliver oxygen to tissues and helps form enzymes that allow for all kinds of necessary body processes.
Requirements for iron shift with periods of growth. Children require 11 milligrams a day up to age twelve months, and then between ages one and three requirements decrease to 7 milligrams per day.
Sources
Iron can be found in plant-based foods like beans, raisins, lentils, spinach, tofu, and whole grain cereals as well as animal foods like red meat, poultry, tuna, and pork. Ideally it is best to eat a combination of both plant and animal sources of iron to maximize absorption.
Deficiency in Children
Not getting enough iron can lead to iron-deficiency anemia. Symptoms include headache, pale skin, fatigue, decreased appetite, shortness of breath, and decreased immunity. Deficiencies may also be accelerated by an excessive amount of calcium intake; kids who overconsume milk may be at greater risk.
• PROBIOTICS •
Function
Probiotics are healthy bacteria that keep the digestive system working properly. Getting enough can be very helpful for children with food intolerances or who are prone to other gastrointestinal conditions like diarrhea and reflux.
Needs
Like omega-3 fats, there are no established guidelines for probiotic intake. What is most important with probiotics is that intake is consistent and a regular fixture in the diet. Occasional consumption is not going to have the desired effects.
Sources
Children’s probiotic supplements exist, but in many cases, natural food sources should be parents’ first choice. You will find these healthy bacteria in yogurt and kefir (a cultured milk product) as well as sourdough bread and fermented foods like miso. There are also some naturally existing probiotics in breast milk, and infant formulas are often fortified.
Deficiency in Children
Bouts of diarrhea, illnesses, or taking antibiotics tend to wipe out much of the healthy bacteria along the digestive tract, making children deficient in what they need for normal digestion. Taking probiotics can help repopulate the digestive tract with what it needs to stay healthy.
• FEEDING KIDS •
The First Six Months: Life Before Solids
There are no meal plans for the first four to six months of a baby’s life. This is the time for an all-liquid diet. Nutrition comes from breast milk or formula, because an infant’s digestive tract is too immature to handle much else. But things get more exciting when they are in the four- to six-month-old range.
Introducing Solid Foods
Babies cannot say, “Hey, Mom, give me some of that!” When they are ready to try solids there are several cues parents can look out for. Look for these signs somewhere around four to six months:
How to Introduce New Foods
New foods should be introduced independently. It is the easiest way to know if your child has an adverse reaction to a particular food. When introducing a new food, give it four to seven days to rule out any adverse reactions before moving on to something else or mixing with another food. Once you start to incorporate mixed foods, like a combo of meats with vegetables, be sure only one new food (if any) is part of the mixture.
Rash, vomiting, skin changes, hives, diarrhea, even increased fussing and spitting up may be indications that the food is not being comfortably digested.
Don’t be deterred by a snarling face or unpleasantly puckered puss; a lot of time this is just a normal reaction to a foreign texture or flavor.
It has been well documented that it may take up to ten or more exposures to a new food before a child can truly determine if they like it or not. Parents often make the mistake of striking foods off the list of options, assuming their child does not like it, when they really just needed more of a chance to get used to it.
Age-Appropriate Foods from 6 Months to 3 Years
Rice and Other Grains
Dehydrated rice cereal is often the first solid food an infant will try. Rice-based foods are typically offered early on because they have a mild flavor, a soft texture, and a low risk of allergic reaction. Once rice is tolerated comfortably, move on to other grains like oatmeal and barley. Dry Cheerios (plain), breads, and pastas can start to be introduced around the seven- or eight-month mark. As children approach one year of age, they can tolerate more complex dishes such as grains pureed with fruits, vegetables, dairy, or protein.
Fruits and Vegetables
Some experts recommend starting with veggies instead of fruit out of concern that the sweetness of fruit may outshine the appeal of vegetables, but I always started with applesauce. Basic fruit and vegetable purees, thinned out to the proper consistency, are easy to make and loaded with nutrition. Switching back and forth between fruits and vegetables is a nice way to offer purees and diversify flavor offerings. After a few months, your little one will develop an impressive repertoire of produce to enjoy. Here is a suggested order for introduction:
Dairy
Cow’s milk is not recommended for babies until they reach one year of age, but some dairy products can be introduced sooner. Experiment with whole milk yogurt and cheese somewhere between eight and ten months. If the yogurt is fruit flavored, make sure your child has already been introduced to that type of fruit. As for cheese, mild flavors like American, Monterey Jack, mild cheddar, and ricotta are a good place to start.
Eggs
Egg whites pose a higher risk of allergic reaction, so try a cooked egg yolk first, somewhere around eight to ten months. As infants approach age one, give egg whites a try. Once any potential reactions have been ruled out, it’s a go for whole eggs.
Meat and Fish
Purees of meats like chicken, turkey, pork, lamb, and even beef and bison are typically well tolerated. Since at this stage your child’s teeth are limited (or nonexistent), puree well to prevent choking.
As their tiny palates advance, make coarsely pureed concoctions of meats, vegetables, and grains. Ground meat recipes like burgers, meatballs, and meat loaf are great options and can be cut into easier-to-eat finger food.
Fish like cod and salmon may be acceptable before a baby turns one year old, but the strong flavor often proves to be too much for most tiny palates. Allow your child to try it in small amounts as they grow. Shellfish like shrimp carry a higher risk of allergy, so proceed more cautiously; consider waiting until your child is older than one year or possibly longer if shellfish allergies or numerous other food allergies run in the family. If in doubt, consult your pediatrician.
As babies learn to navigate the kitchen table, they should also be getting their hands on a sippy cup. Try giving water (in the proper cup, of course). Babies are still getting plenty of fluid from their bottles, but it’s good to get some practice. Juice can be introduced at or after six months, but keep the portions modest (approximately four ounces a day). Serve in a cup (instead of a bottle) diluted with water. Children who take in excessive amounts of juice pile up the calories, and have less interest in table foods and a greater risk of cavities.
SUGGESTED AGES FOR INTRODUCTION OF FOODS
|
AGE |
GRAINS |
FRUITS & VEGETABLES |
EGGS |
DAIRY |
PROTEIN |
|
Six months |
Rice, oatmeal, barley |
Apples, pears, bananas |
|||
|
Eight to nine months |
Cheerios, pasta, bread |
Avocados, squash |
Yolk |
Yogurt, cheese |
Beef, pork, poultry |
|
Twelve months |
Toast |
Greens |
Whites |
Milk |
|
|
Twelve to eighteen months |
Pizza, baked goods |
Strawberries |
Whole eggs |
Ice cream |
Fish |
|
Eighteen to twenty-four months |
Bagels |
Omelets |
Smoothies and shakes |
||
|
Two to three years |
Sandwiches |
Quiche |
Shellfish, peanut butter* |
*Since peanut butter has a high risk of allergic reaction, work with your pediatrician to decide when it might be best to introduce to your child.
Common Food Allergies and Sensitivities
Food allergies and intolerances are not the same thing, and it is important to know the differences. Food allergies involve an adverse immune system reaction that affects numerous organ systems; in the worst cases they can be life threatening. Less severe symptoms may include upset stomach, nausea, vomiting, diarrhea, numbness, tingling, hives, and rash. A food intolerance involves compromised digestion and may have similar stomach symptoms but does not risk a life-threatening condition. In many cases, children with food intolerances may be able to eat small amounts of problem food comfortably. Children may outgrow these conditions with age as their digestive and immune systems mature. Children under three are most at risk for allergies and intolerances to milk, eggs, and peanuts. Allergies and intolerances to tree nuts (such as almonds, pistachios, and walnuts), fish, and shellfish are also possible. Always be on the lookout for out-of-the-ordinary reactions to foods. If you suspect your child has a food allergy or intolerance, get your pediatrician involved. They will help determine whether a referral to an allergist is needed.
If your child suffers from an allergy or intolerance, they obviously have to steer clear of certain foods. The great news is there are many alternative options readily available.
No-No Foods for Little Ones
In addition to potential allergens, there are a few other foods parents should be mindful of to help keep kids on a path to healthy eating. Some are serious choking hazards; others carry potentially harmful food-borne pathogens.
Choking hazards: hot dogs, sausages, raw carrots, whole nuts, popcorn, grapes, cherry tomatoes, large spoonfuls of peanut butter, tough/chewy meats*
Potentially contaminated foods: honey, agave, raw milk, and other unpasteurized dairy and eggs
A child’s immature immune system is not equipped to fight off potential pathogens. Honey may carry botulism spores, and unpasteurized (“raw”) dairy may be contaminated with food bugs like salmonella and listeria. Wait until children are one year old to have honey, and avoid raw dairy throughout childhood.
Picky Eaters
I’ve been interviewing experts about dealing with picky eaters for years, and there are times when all that I have learned goes out the window! Do your best, and when all else fails, take a deep breath and let it go. Don’t get up and make something different. Let your child take ownership and decide not to eat—they won’t starve to death if they skip dinner one night. Allow them to have some of the control; it will empower them. Believe it or not they will (almost always) come around.
TRY TO
• FOOD PREPARATION AND STORAGE TIPS •
Strategies for Meal Planning
A little planning can go a long way. Sit down for a few minutes over the weekend and map out the meals you want to make. Consider your schedule; when are you working late that week versus when you have time to cook more-involved meals. To make things easier on myself, I follow a simple framework for weeknight dinners. Specifics can change with the seasons, but using these tips helps take some of the guesswork out of the daily burning question—what do I make tonight?
Grocery Shopping: Saving Money and Getting It All Done
I prefer certain grocery stores for meat and fish and others for things like snacks and produce, but who has time to go to three stores each week? In the summer months I also like to get out to the farmers’ market to take advantage of all the locally grown offerings. You can make it easier. Use these strategies to help get it all done:
Stocking a Healthy Pantry
It is a lot easier to cook healthy meals if you’ve got the right ingredients on hand. Here are ten pantry staples to always have on hand:
Storage: Using the Freezer
I love my freezer (freezers—I have an extra in the garage). Storing food in the freezer allows me to have weeknight dinners at the ready and hold on to the flavors of summer during the winter months.
For best results, make sure your freezer is at the proper temperature and use specially designated freezer bags and containers to keep foods fresh. Save time and money by freezing the following items:
• NUTRITION POINTERS FOR PARENTS •
I know an amazing network of parents. Whether it’s about napping, footwear, potty training, or eating, we all share our experiences and work together to help. Here are just a few of the questions that have come up about feeding and nutrition.
Q: I follow a vegan diet, but my kids eat some meat. What is the truth about soy? Is there such a thing as too much? Does it affect adults and kids differently?
A: The soy issue is a buzzy topic, and I am asked about it frequently! I have researched it a lot and so far can’t find any reliable evidence to support that it would be dangerous for kids or adults in the amounts that they typically eat. Soy made the list of superfoods—twice—edamame and tofu. It’s an excellent protein source; it has all the same protein building blocks that animal protein does, without the cholesterol and unhealthy fats. I recommend choosing organic soy products the majority of the time.
Q: When you are transitioning to table food, what does a day of complete nutrition look like? How much should babies be eating table food?
A: Until babies are one year old, their primary source of nutrition is from breast milk or formula. But you start table foods early to help get them physically and behaviorally used to eating all the different types of solids. How much will vary for every child, but ideally by twelve months of age, they are comfortable with fruits, veggies, cheese, yogurt, cereals, bread, pasta, and meats. How much is really up to them—if the table foods seem to be satisfying them, you can back off on some of the bottle feedings.
As you know, once allergies have been ruled out, they can switch to cow’s milk around age one as well.
Somewhere around the one-year mark, they should be comfortable with enough table foods to have three meals a day in addition to two or three bottles (most likely in the morning and evening). One of those bottles may eventually turn into a table food snack. By age three, they are typically off the bottles and on a schedule of three meals and two(ish) snacks a day.
Some ideas for a one-year-old:
Breakfast: fruit, toast or pancake, maybe some yogurt
Lunch: pasta, or a cut-up sandwich and some soup (yogurt or fruit could go here too)
Dinner (similar to lunch): pasta, rice, protein, vegetables (whatever the family is having)
Q: What do I do if I can’t get my kids to drink milk—without chocolate in it?!
A: Such a popular question! We made a rule at my house—milk with dinner and two nights a week it can be chocolate. If it’s chocolate milk, then fruit for dessert (no other options)—this has seemed to create a nice balance. And if it’s been a sugar-filled day, I put the kibosh on it immediately. If they really don’t like it or have trouble digesting it, dairy-free alternatives like soy, almond, and coconut milk might be worth trying; they are fortified to have the same amount of calcium and vitamin D as cow’s milk. If all else fails, homemade chocolate milk allows you to control the amount of added sugar. Better it come from something with a lot of nutrients (like milk) than from candy and other junk food.
Q: My kids like to “snack” throughout the day and end up eating smaller meals—is this acceptable the way it is for grown-ups?
A: It is—as long as the snacks are healthy ones and they are still eating meals. Focus on superfoods like apples, berries, yogurt, cheese, peanut butter, and whole grains. Snacking is vital for keeping energy levels high (just like for adults). It’s just our job to keep an eye on their snacking. We’ve all been there when they snacked too much and don’t want an actual meal—as long as this doesn’t happen all the time, you’re in good shape.
Q: My kids are fairly thin and typically in the lower percentile for their height/weight at our checkups. What can I do to “fatten” them up? Milk shakes, etc.?
A: The occasional milk shake is totally fine, but if weight gain is warranted, you want them to gain the right kind of weight. High-calorie superfoods are the way to go—peanut butter, cheese, granola, smoothies with fruit and yogurt, even dishes like spaghetti and meatballs—all good!
Q: My kids always want juice! How much is too much?
A: Try to cap it at four ounces a day—tops! Always choose 100 percent fruit juice and dilute with water most of the time (juice boxes will happen, but dilute with water when using cups). If water isn’t cutting it for them, try flavoring it up by adding citrus, melon, berries, whatever they like—even a splash of plain seltzer water or adding an ice cube might add the excitement they want.
Q: Is organic really a better option and worth the extra cost?
A: There’s no need to buy all organic superfoods. Organic can be better, but it is not always worth the extra money. I get as much as I can at the farmers’ market (doesn’t have to be organic if it’s that local). When at the grocery store I rely on the Environmental Working Group’s Dirty Dozen and Clean Fifteen to help me decide what’s worth it. For example, apples tend to carry a high level of pesticide residues, so buying organic is a good choice. On the other hand, superfoods like avocados and sweet potatoes tend to be much less troublesome. Learn more at ewg.org/foodnews.
Q: Do I need to worry about sodium in my child’s diet?
A: Sodium is an important nutrient for a wide variety of body functions including fluid balance and muscle contraction. Little bodies need sodium but only about 1,000 milligrams per day; check labels to make sure your kids aren’t going overboard. As a general rule, the more whole foods (and less processed ones) in your child’s diet, the less you have to worry about all that added sodium.
Q: My son has an atrocious diet. He eats very few foods. No meats, no veggies, one fruit. I just go with it hoping that one day he will change; I don’t want to scar him when it comes to mealtime. Any advice to help?
A: I wish I had an easy answer, but there is none. But you are not alone! What I can say is don’t give up. Keep trying to introduce new things to him. It can take ten or more exposures to a food for a child to truly determine they aren’t a fan—and even after that, they may change their mind a few years down the road. Look at the foods he is currently choosing from and see where you can make small changes. Fighting about it certainly won’t help, but turning a blind eye and hoping he will change might not either. You can’t force him, but you can provide the tools. As you know, kids like to take ownership of things; see if you can channel that into the kitchen. Allow him to participate in the shopping and prep. Start with the foods he will eat, and then explore some new things together.
Q: My child has a peanut allergy; he refuses to try the almond or sun butter.
A: I’m a huge fan of soy nut butter; it has a better texture. Add some honey and cinnamon for extra flavor. Thankfully most schools are nut-free, so all parents are in the same boat for lunches. Cream cheese and jelly has been popular for my girls’ lunch boxes lately.