$Unique_ID{PAR00221} $Pretitle{} $Title{1 Year to 2 1/2 Years: Nutrition and Feeding} $Subtitle{} $Author{ Editors of Consumer Guide Mendelson, Robert A Mendelson, Lottie M Meyerhoff, Michael K Ames, Louise Bates} $Subject{1 Year to 2 1/2 Years Nutrition Feeding nursing weaning transitional item nighttime bottle diet hot dogs choke growing weight gaining Eating picky eater meat meats protein eggs soda citrus fruits milk fast foods nutritious meal meals snack snacks snacking Discipline restaurant restaurants INAPPROPRIATE FOOD sugar salt choking hazard toddler toddlers} $Log{} The New Parents' Question & Answer Book 1 Year to 2 1/2 Years: Nutrition and Feeding My 13 month old is still nursing. Do you have any tips for weaning him from the breast? Some toddlers stop nursing on their own. Others stop when Mom weans them, and they never act like they miss it. A few stubborn toddlers don't want to give it up, especially if they are allowed to continue nursing much after 12 to 15 months of age. The easiest transition seems to be between ten and 15 months. The nursing should be diminished gradually for your sake and your toddler's. He should be drinking fairly well from a cup now and getting three meals and one or two snacks daily. His food and fluid requirements can be fulfilled without nursing. His sucking or comforting needs may not be so easily satisfied. If you haven't offered him a bottle previously, now is not the time to start. If you have been supplementing with a bottle, you should probably wait to take it away until he's totally weaned from the breast. First, reduce the nursing time at each feeding by two to three minutes for a couple of days, and then reduce it by a couple minutes more every few days. When you are ready, omit one feeding completely; the midday feeding will probably be the easiest to stop first. If stopping this feeding causes some soreness or breast engorgement, you can apply some ice for comfort and reduce your fluid intake. Keep reducing your nursing time during the other feedings, and offer your toddler a cup of two-percent milk after each reduced feeding. Within seven to ten days after you've eliminated one nursing period, eliminate another; a week later, one more. Soon, you should both be ready to stop the nursing completely; by that time, your breast milk production will probably have diminished or stopped completely. Throughout this weaning period, you'll probably need to offer a little extra support and comfort to your toddler. You may even find that your toddler substitutes a transitional item (like a blanket or stuffed toy) or starts sucking his thumb or a pacifier for comfort; either of these is fine if it helps make the transition easier for him. Congratulate yourself on providing the best start possible for your child and on helping him take this step toward independence. I give my two year old a bottle at night because he doesn't seem to be drinking milk from the cup. Is this okay? First of all, it's important to emphasize that your child should never be given his nighttime bottle in bed since taking a bottle to bed can promote tooth decay. Likewise, he should have his teeth brushed after the last meal (whether it's a bottle, a cup of milk, or a snack) before bedtime. What's more, at two years of age, your toddler doesn't need a bottle anymore. Your son will take more milk and other liquids from a cup if you remove the bottle. If you're worried about his intake of milk, you can offer milk in a cup more frequently. Two year olds should receive a minimum of 16 ounces of two-percent milk a day. To break the bottle habit, offer his nightly bottle with water only for a few nights or a week. Then offer only a cup of water after the bedtime ritual. To help make it easier for him, you can give him a new "big boy" plastic cup to take the place of the retired baby bottle. The cup can be a special nighttime cup and can be left at the bedside just for him. I've heard of a "prudent diet" for adults. Is there a similar diet for two year olds? A prudent or well balanced diet for a two year old should contain foods from the four basic food groups (dairy products, meats, grains, and vegetables and fruits). You should offer your toddler the appropriate number of servings (see sidebar below) from each of these groups every day. Don't be alarmed, however, if everything you serve doesn't get eaten every day. Children (and adults) have different needs and preferences daily. In the long run, enough of each type of food will be eaten to provide an appropriate balance. My 18 month old likes hot dogs and handles them well, but I've heard that they're dangerous for young children. Should I stop letting him eat them for now? Hot dogs are the known culprit in many serious choking incidents in this age group. For safety's sake, you should avoid giving them to your toddler until he's much older. Even four to five year olds have a tendency to bite off big pieces and not chew sufficiently. Feed your son small pieces of soft cooked meats, fish, and poultry instead. Teach him to chew slowly and enjoy mealtime. And whenever he's eating, keep him in his high chair, chewing and swallowing needs his undivided attention at this point. Are there other foods that I should not allow my toddler to have? You'll want to avoid salty and sugary foods; toddlers don't need them. They usually don't like very spicy foods either, although some may enjoy them later on. As before, avoid foods that toddlers can choke on or inhale into their windpipes. Offenders include carrots, popcorn, nuts, hot dogs, uncooked peas, raw apples, raisins, and the like; at this age, all of the foods you serve him should become liquid in his mouth. Although he can probably handle soft fruits now, you'll still need to be careful about giving him big chunks of raw fruits or vegetables. To encourage him to make healthier food choices in the future, start him off with healthy choices now. For example, serve him whole grain breads and crackers rather than white commercial bread. Cooked whole-wheat or high-protein pasta is a good choice as well. Remember, too, that your toddler needs 30 percent of his daily calories from fat. So if your diet is very low in fat, you'll need to make sure he's getting enough fat in the foods you offer him. For instance, even if you're drinking skim milk, he'll still need two-percent milk to help him get enough fat for healthy growth and development. Some days it seems like my two year old doesn't eat anything. He's no longer taking a bottle, and I'm worried he's not getting enough to eat and drink. What should I do? Your concern is a common one among parents of children in the second and third years of life. It sometimes seems like a two year old's intake is almost nothing. It is important to remember, however, that during the first year of life a child triples his weight, while during the second year his weight increases only by a third. After that, the rate of gain slows even more, and so does the need for increased calories. Continue to offer your toddler the variety mentioned in the "prudent diet" on the previous page, and be sure to follow his growth in height and weight through regular medical checkups. If he is growing and gaining weight normally, don't worry about how much food he eats. If he's not growing as expected, consult your pediatrician. How can I get my "picky" toddler to eat more? Eating needs to be your toddler's job, not yours. Your toddler will not starve himself. As long as you offer him a variety of nutritious foods every day, he'll eat what he needs. Offer him small servings, and give him choices whenever possible. Since toddlers dislike having to sit still for any length of time, you might try offering him small meals five to six times a day rather than larger meals two or three times a day. Keep in mind that he'll eat more when he's going through a growth spurt than when he's not, so he won't always eat the same amount of food every day. Above all, try not to make mealtime into a battle of wills, and try not to put too much emphasis on eating. Don't praise him or reward him for eating, and don't use food as a comfort or reward. You want your toddler to learn that he should eat when he's hungry and that eating more or less is neither a good thing or a bad thing. Encourage him to choose healthy foods and allow him to eat as much as he needs, even if it's less than you think he should be eating. As long as he's growing and developing normally, he's getting the nourishment he needs. My two and a half year old doesn't like meat. What substitutes should I give him? Good meat substitutes include poultry, fish, extra milk, yogurt, cottage cheese, hard cheeses, egg, tofu, peanut butter, high-protein pasta, and lentils. Eventually, your toddler may enjoy meat. Since we should all be reducing the amount of red meat we eat, however, he may be just as well off if he doesn't acquire a taste for it; just be sure he gets enough protein from these other sources. My two year old loves eggs and has them for breakfast nearly every day. Can they hurt him? Eggs are a good source of protein, although it's generally recommended that he eat no more than three a week. If you have a history of high cholesterol in your family, you may want to discuss this with your pediatrician. Try to serve him a variety of healthy foods to provide him with the nutrition he needs and to keep mealtime interesting. Try alternating the eggs with yogurt, fruit, pancakes, cereal, and bread. Remember, you want to get him into the habit of eating a variety of healthy foods. My toddler loves soda pop and prefers it to milk or juice. How much soda would be bad for him? Soda and other sweet beverages (including fruit juices) contain very little except sugar and water. Diet soda doesn't even contain sugar. There is very little food value in any of them. The ideal beverage for any child (or adult) who is thirsty is water. Water meets the thirst requirement but does not provide empty calories. It doesn't contain sugar, which can promote tooth decay, or artificial sweeteners, which your child doesn't need. If a child is given water as a thirst quencher starting in these early years, he will get used to choosing it as a primary beverage. Although milk is not an essential beverage, it is the most common liquid source of protein in the diet of most children. If your toddler is not allergic to dairy products, it's recommended that you give him 16 to 30 ounces daily of two-percent milk (including the milk that is added to foods). If your child does have an allergy to dairy products, consult your pediatrician about substitute sources of protein and other nutrients. Fruit juice is okay for occasional use. Soda can be given as a treat, but it should not be a part of his daily diet. My two year old doesn't like citrus fruits, but he is getting a multivitamin supplement. Will the supplement take care of his needs? Many children do not like citrus fruits when they are young but develop a taste for them later. In the meantime, the vitamin C contained in citrus fruits (including tomato) can also be found in many other foods, including berries, melons, leafy green vegetables, broccoli, peppers, cabbage, and potatoes. If you continue to offer your toddler a variety of foods, including citrus fruits and the other foods mentioned here, it is not necessary to supplement his diet with a multivitamin. My two and a half year old likes whole milk and refuses to drink skim milk. Is the extra fat a problem for him? Toddlers require more fat in their diet than adults in order for them to maintain normal growth and development. For that reason, serving skim milk to toddlers is not recommended. Two-percent milk is the better option. If you have a problem switching him to two percent milk, you can mix the whole milk and the two-percent milk for a while, gradually reducing the amount of whole milk, until he's drinking two-percent only. The baby-sitter flavored my toddler's milk with chocolate syrup, and now he prefers it that way. Should I let him continue to drink chocolate milk? Some professionals would advise you to get rid of the chocolate now. Children and adults alike enjoy sweets, but sweet treats should be a limited part of the diet. What's more, you don't want your toddler to expect that everything he eats or drinks will taste sweet. Don't let him have the chocolate milk at mealtime. Offer him plain milk, and explain to him that he can have chocolate milk occasionally as a special treat or snack. You might even want to reserve it only for times when the baby-sitter is taking care of him. By the way, you'll probably also want to have a talk with your baby-sitter and explain the types of foods and beverages that you want your toddler to be offered in the future. My family eats "fast foods" two to three times a week. My toddler really enjoys these meals. Can they be harmful to him? Your child will learn his eating habits from you. Fast foods can't really harm your toddler, but by making them frequent items in your diet, you may be teaching him inappropriate eating habits for later. Although the calorie and fat content of fast foods may not be a problem for your growing toddler, they are taking the place of more nutritious foods. Still, eating fast food two or three times a week is probably okay for your toddler as long as you're serving him a variety of nutritious foods for the rest of his weekly meals and snacks. The "prudent diet" suggested in this section, along with adequate fluids and any supplements prescribed by your pediatrician, should give him the calories, protein, and vitamins and minerals he needs. If you haven't been offering your toddler--and the rest of your family--a variety of nutritious foods at these other meals, now is the time to start. The whole family needs to start eating healthier. My toddler wants to snack all the time, but rarely finishes anything I give him. Should I restrict the number of times he's allowed to eat? Your toddler would probably snack all the time if you let him. Although his tummy doesn't hold very much at a time, constant snacking keeps him from ever being truly hungry. Cut him down to three meals and two snacks; depending on when he has his dinner, you might add a third snack before bedtime. Try to space snacking so it's far enough between meals for him to become hungry. When he is hungry, be sure to offer him nutritious meals and snacks. My 18 month old doesn't like to sit in his high chair for any length of time. Do you have any suggestions? Toddlers don't like to sit or remain still for any length of time. They like to move on to the next thing. Sitting and eating isn't particularly interesting to them. They'd prefer to eat on the run if they were allowed to. It's recommended, however, that your toddler be in his high chair whenever you offer him a meal or snack. He should be allowed to get down as soon as he's finished, within reason. You don't, however, want him to take a bite or two, get down out of his high chair, and then immediately ask to be put back in it. Before you let him down, ask him if he is finished and remind him that once he gets down, the meal is over. If he gets down, then comes running back for more, try not to get too upset. You can either give him one more chance or stand firm, depending on your parenting philosophy. If you try to act casually and not make a fuss, he'll eventually learn. While you can praise him for acting like a big boy when he's at the table, you don't want to put too much focus on what and how much he chooses to eat. While you want him to understand that eating is his job, you want him to learn that to sit and eat with the rest of the family, he'll need to behave appropriately. Discipline begins here, but only as positive reinforcement and praise for healthy choices, not as negative reactions from you. Let him know what's expected, but leave him room for autonomy. Whether he eats or not is his choice, but where he eats is yours. Don't worry; as long as you offer him a variety of nutritious foods, he won't starve himself. I like to go out to dinner, and I often take my two year old with me. If there's a wait, however, he wants to run around and "entertain" the other diners. Any tips for making restaurant outings easier? Have a little talk with your two year old about what is appropriate behavior for the restaurant. You'll probably need to repeat it over and over again for the next year or two. Keep in mind, however, that toddlers do not like to sit still or wait, and they shouldn't really be expected to. So when you go to the restaurant, bring along a book to read to him while waiting for seating or service. You might also try bringing along a snack or first course to satisfy him until the meal arrives. If these ploys don't help, seek restaurants that cater to little ones with immediate service and amusements. Save the more formal restaurants for times when he's not with you. PRUDENT DAILY DIET Meat or meat substitute (2-3 servings daily) Single serving suggestions: 1 oz cooked meat, fish, or poultry 1 whole egg (no more than 3 per week) or 2 egg whites 1/2 cup cooked beans or peas 2 tbsp peanut butter spread on bread or crackers 2 oz tofu 1 oz high-protein pasta Dairy products (3-4 servings daily) Single serving suggestions: 1 cup two-percent milk 1 cup yogurt 1 1/2 oz cheese 1/2 cup cottage cheese 1 to I 1/2 cups ice cream (occasionally) Grains (3-4 servings daily) Single serving suggestions: 1 slice bread 1/2 hamburger bun or roll 1/2 bagel or English muffin 3-4 crackers (whole grain preferred) 1/2 cup cooked cereal 1 oz cold cereal (not sugary type) 1/2 cup pasta or rice Fruits and vegetables (3-4 servings daily) Single serving suggestions: 1/2 cup raw or cooked vegetables (appropriate for age) 1 cup leafy cooked vegetables 1 whole fruit-soft and/or cooked (apricot, banana, pear, apple, plum, peach, fig, etc.) 1/2 grapefruit or other citrus fruit 1/2 cup soft cubed melon The lists above are only guidelines. What is offered and what is eaten is frequently very different. The most important way to evaluate a child's diet is by following his growth and development at routine health maintenance examinations. FOODS NOT APPROPRIATE FOR TODDLERS In addition to keeping foods that are high in sugar or salt off the menu, you should avoid serving your toddler foods which pose a choking hazard, including: - Carrots - Popcorn - Nuts (including peanuts) - Hot dogs - Raw apples or potatoes - Uncooked peas and beans - Raisins - Foods with seeds (sunflower, orange, melon, cherry, etc.) unless the seeds are removed - Chewing gum - Hard candy - Grapes - Caramels - Celery - Corn (on the cob or as kernels)