Encouraging lifelong healthy eating habits
Toddlerhood is an important developmental stage that provides health-care professionals with an opportunity to monitor the growth, weight, and development of these young patients and to guide parents on the essentials of healthy eating habits and behaviors.3
This is especially important given that 25% to 35% of parents and caregivers of preschoolers report feeding problems among those children, such as refusal to eat or slow eating, which causes concerns about providing a healthy and nutritious diet.3,33
Parents should be reassured that young children adjust their energy intake to their needs and usually demonstrate a normal growth pattern despite their eating preferences and behaviors.3What is important is the availability of healthful food choices for toddler meals and snacks, repeated exposure to new foods, and positive parent or caregiver modeling to foster good nutritional habits (see box at left).3An example of a daily recommended meal pattern for an 18-month-old child is presented inTable 3.
Table 3. Sample recommended daily meals for a typical 18-month-old child*.3
|Breakfast||1 slice whole-wheat bread
1 soft-boiled egg
2 oz orange juice
|Snack||1 medium apple, sliced
2 oz whole milk
|Lunch||1 slice whole wheat bread with ½ tablespoon peanut butter
2 oz whole milk
4 raw baby carrots
|Snack||¼ cup dry cereal
½ oz cheddar cheese cubes
|Dinner||½ cup cooked pasta,
¼ cup spaghetti sauce with 1 oz lean ground beef
3 broccoli spears 4 oz water
|Snack||¼ cup canned fruit cocktail in juice
¼ cup low-fat fruit yogurt
| 825.4 (estimated energy requirement: 783.3)
25.5 g (28% of calories)
39.5 g (4.1g/kg body weight)
*Child is 29.5 inches tall and weighs 21 lb, 5 oz.
Clinicians who manage the care of children aged 1 to 3 years play a critical role in ensuring that the nutritional needs of these young patients are met. Identification of CMPA and management of the condition with extensively hydrolyzed formula, even into toddlerhood, are essential to avoid GI and dermatologic complications and provide necessary protein, fat, vitamins, and minerals.
The transition from a milk-based diet in infancy to a more omnivorous diet in toddlerhood provides an opportunity for health-care professionals to make recommendations for establishing healthful food choices and behaviors that will meet the energy and nutritional requirements of children during this period of rapid growth and development. Iron and vitamin D deficiencies, suboptimal intake of DHA, and excessive consumption of saturated fat, sodium, and sugar are nutritional problems often encountered in the toddler years.
Good nutrition from birth not only has a profound impact on physical growth and on cognitive, motor, and social development, it also provides the foundation for good health into adulthood.
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- Metsälä J, Lundqvist A, Kaila M, et al. Maternal and perinatal characteristics and the risk of cow’s milk allergy in infants up to 2 years of age: a case-control study nested in the Finnish population. Am J Epidemiol . 2010;171(12):1310-1316. Available at http://aje.oxfordjournals.org/content/171/12/1310.full.pdf
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- Warren CM, Jhaveri S, Warrier MR, et al. The epidemiology of milk allergy in US children. Ann Allergy Asthma Immunol . 2013;110(5):370-374.
- Fleischer DM, Spergel JM, Assa’ad AH, Pongracic JA. Primary prevention of allergic disease through nutritional interventions. J Allergy Clin Immunol Pract . 2013;1(1):29-36.
- Jin YY, Cao RM, Chen J, et al. Partially hydrolyzed cow’s milk formula has a therapeutic effect on the infants with mild to moderate atopic dermatitis: a randomized, double-blind study. Pediatr Allergy Immunol. 2011;22(7):688-694.
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- Briefel RR, Kalb LM, Condon E, et al. The Feeding Infants and Toddlers Study 2008: study design and methods. J Am Diet Assoc . 2010;110(12 Suppl):S16-S26.
- Briefel RR, Reidy K, Karwe V, Devaney B. Feeding infants and toddlers study: improvements needed in meeting infant feeding recommendations. J Am Diet Assoc . 2004;104(1 Suppl 1):s31-s37.
- Siega-Riz AM, Deming DM, Reidy KC, et al. Food consumption patterns of infants and toddlers: where are we now? J Am Diet Assoc . 2010;110(12 Suppl): S38-S51.
- Carter RC, Jacobson JL, Burden MJ, et al. Iron deficiency anemia and cognitive function in infancy. Pediatrics. 2010;126(2):e427-e434.
- Baker RD, Greer FR, The Committee on Nutrition. Clinical Report—Diagnosis and Prevention of Iron Deficiency and Iron-Deficiency Anemia in Infants and Young Children (0-3 Years of Age). Pediatrics . 2010;126(5):1040-1050. Available at pediatrics.aappublications.org/content/early/2010/10/05/peds.2010-2576.full.pdf+html.
- Lozoff B, Clark KM, Jing Y. Dose-response relationships between iron deficiency with or without anemia and infant social-emotional behavior. J Pediatr . 2008;152(5):696-702.
- Butte NF, Fox MK, Briefel RR, et al. Nutrient intakes of US infants, toddlers, and preschoolers meet or exceed dietary reference intakes. J Am Diet Assoc . 2010;110(12 Suppl):S27-S37.
- Kuratko CN, Barrett EC, Nelson EB, Salem N Jr. The relationship of docosahexaenoic acid (DHA) with learning and behavior in healthy children: a review. Nutrients . 2013;5:2777-2810. Available at www.mdpi.com/2072-6643/5/7/2777.
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- Leung AKC, Marchand V, Sauve RS; Canadian Paediatric Society, Nutrition and Gastroenterology Committee. The “picky eater”: the toddler or preschooler who does not eat. Paediatr Child Health . 2012;17(8):455-457. Available at europepmc.org/articles/PMC3474391/.
All electronic documents accessed July 7, 2014.