$Unique_ID{PAR00229} $Pretitle{} $Title{2 1/2 Years to 5 Years: Nutrition and Feeding} $Subtitle{} $Author{ Editors of Consumer Guide Mendelson, Robert A Mendelson, Lottie M Meyerhoff, Michael K Ames, Louise Bates} $Subject{2 1/2 Years to 5 Years Nutrition Feeding water fluoride tablet juice juices milk yogurt cottage cheese ice cream allergic allergy calcium baby bottle choking hazard mealtime mealtimes meal meals nutritious food nutrients breakfast protein sugars vitamin vitamins vegetarian diet cholesterol Eating foods salt salty Cookies sweets artificial sweetener sweeteners aspartame barbecue PAH polycyclic aroma hydrocarbons SUGAR tooth decay preschooler preschoolers} $Log{ Your preschooler should be drinking 16-32 oz. of milk each day*0051401.tif Have your child sit while eating, as any food is a possible choking hazard*0053701.tif} The New Parents' Question & Answer Book 2 1/2 Years to 5 Years: Nutrition and Feeding Our water supply does not contain fluoride. Does my preschooler still need to take a fluoride tablet daily? Your preschooler has probably been taking a fluoride supplement since the first months of her life, and she should continue to take it now. During this time, her primary (deciduous) teeth have been erupting and her secondary teeth have been forming. In the next year or so, the deciduous teeth will loosen and fall out and behind them will be the permanent teeth. This process will continue until the late teens, when the permanent third molars make their appearance. Throughout this process, the teeth are made stronger and more resistant to decay by fluoride. Therefore, if your water supply does not contain fluoride, your preschooler should continue to take one chewable fluoride tablet per day until your pediatrician or dentist recommends stopping (usually sometime during the teen years). My child gets juice twice a day at school and three times a day at home. Is this okay? Most juices contain very little except sugar and water and occasionally vitamin C. It is recommended, therefore, that juice be reserved for special treats and snacks. Many preschoolers will drink whatever liquid is given to them when they are thirsty, although what their bodies really need is water. At this age, it is a good idea to get your preschooler used to drinking water when she's thirsty. Try to encourage water as her first choice, and keep the juice intake to a minimum. How much milk should my preschooler be drinking each day? Ideally, children should consume about four servings of dairy products daily. These servings can include milk, yogurt, cheese, or cottage cheese. Ice milk and ice cream can also be served occasionally. Your preschooler should be drinking a minimum of 16 ounces of milk each day and a maximum of 32 ounces. If she's drinking more than a quart of milk daily, she's getting more milk than she requires; try offering her water or other liquids more often when she's thirsty to keep her milk intake within this range. Is homogenized whole milk (3.8 percent) better for my preschooler than two-percent or skim milk? There's more butterfat in the whole milk than your preschooler needs. Two-percent milk is the preferred milk to offer your child, although some pediatricians may advise one-percent milk or skim milk under certain circumstances, such as when a child has an elevated cholesterol level or is significantly obese. Consult your pediatrician, and follow his recommendations. My preschooler is allergic to milk. How can I be sure she's getting enough calcium in other foods? Foods high in calcium include fortified juices, tofu, broccoli, canned salmon, and sardines. Collard and mustard greens are high in calcium too, but they're not always favorite foods with preschoolers. Other foods with calcium content are soybeans, garbanzo beans, oranges, corn, and wheat bread. If you feel she won't eat enough of these foods to fulfill her calcium requirement, consult your pediatrician. He may advise you to give your preschooler a daily calcium supplement. My three year old has been picking up the baby's bottle and drinking from it. What should I do about this? After they are weaned, most children do not like the taste of formula, so chances are your preschooler is feeling a bit jealous of the attention the baby is getting from you. Explain to her that the baby's bottle is not for her. She's beginning to know what is hers and what isn't and can understand this. Point out to her that she's a big girl now and can drink from a cup while her baby brother can't. Let her know that the baby will want to be just like his big sister and drink from the cup as soon as he is able. Don't give her a big reaction, but offer her something to drink in a cup and/or divert her attention to something else. Reassure her about all of her big girl accomplishments and privileges. Make certain to praise and reward her positive behavior and to reserve some special time when you can give her all of your attention. What foods should I avoid offering my preschooler to prevent choking? Until your child is at least four years of age, you should continue to avoid offering her hot dogs, chunky pieces of raw vegetables and fruits, hard candy, raisins, nuts, and popcorn. Although the molars are usually in by two or three years of age, your preschooler still won't be able to grind foods well, so meat and poultry should still be cut into small pieces for her. And, as before, be sure your child is sitting when she eats meals or snacks, since running around while eating can turn almost any food into a choking hazard. How many times a day should my preschooler eat or be offered food? Ideally, a preschooler should be offered three meals and two to three snacks each day. Remember, your child's stomach is smaller than yours, so she'll need to eat more frequently than you will. In addition, most children do not comfortably sit at the table for a lengthy meal. So offer small portions at mealtime, and try to make it a relaxing and pleasant time by not coaxing your preschooler to eat. While you should offer snacks, you should avoid allowing your child to snack all day long; otherwise, she won't want even a small meal. Snacks should be small but nutritious and should be offered far enough away from mealtime to allow the child to become hungry. Snacks and meals should be offered at the table, with your preschooler in her chair or high chair. While your preschooler shouldn't be expected to sit through long meals, she shouldn't be allowed to run around while eating either. My child really only eats one meal per day. How can I get her to be a better eater? Children eat when they are hungry, and if they're growing and developing normally on one meal a day, it's probably adequate. Remember, children eat more on certain days than others, and they increase their intake during a growth spurt. Continue to offer your child three meals and two to three snacks a day. Make certain that what you offer is nutritious so that when she does eat, she'll get important nutrients. Offer her small amounts of a variety of foods, and then leave it up to her as to the quantity she consumes. Anytime you are concerned about your child's weight, consult your pediatrician. How important is breakfast, and how do I get my preschooler to eat it? Breakfast is a very important meal because your child has gone for eight to ten hours or more without food. Her tummy is empty, and she should be hungry. Many studies have shown that a child's level of energy and functioning throughout the morning is affected by whether or not she had a healthy breakfast. Milk is the preferred beverage at breakfast because it contains protein. The energy boost provided by protein lasts longer than the boost provided by sugar. If your child doesn't like cooked cereal or other traditional--and healthy--breakfast foods, you can offer her a variety of other nonbreakfast foods instead. Whole grain bread or toast with peanut butter or chicken or tuna is nutritious breakfast fare. Bananas and other fruits and fruit juices are wise choices; you might even offer yogurt with fresh fruit. Even leftovers from dinner will do. Allow your child choices, and give her an interesting variety from which to choose. Some preschoolers prefer to have some "wake up" time to run around and play before sitting down to eat. Schedules permitting, breakfast doesn't have to be offered immediately after waking. She can have a choice here, too, such as eating before or after she gets dressed. My mother insists that children need to take vitamins daily. What kind do you recommend? There is no reason for a child to take daily vitamins if she's eating a well-rounded diet. However, if there is no fluoride in your water supply, you will need to give her a fluoride supplement. Some of the vitamins on the market appeal to children because of their colors, shapes, and flavors. Keep in mind, however, that vitamin supplements, like drugs, can be dangerous if used improperly. Your child should not learn to think of them as candy or a treat. Therefore, if you feel that you need to offer your child a vitamin supplement, try to choose a plain brand that has been recommended by your pediatrician. Store it as you would any medication--out of your child's reach. I'm a vegetarian, and I eat a very healthy diet. Is this type of diet healthy for my preschooler, too? Some very conscientious and health-minded parents have gotten into serious trouble by offering their diets to their growing children. Preschoolers need more fat in their diet (30 percent of their caloric intake) than adults do to maintain normal growth. It's much easier for children to get some of their protein from animal sources, such as meat, fish, poultry, and dairy products. However, if you are careful about the amounts of protein in your vegetarian meals, they may be adequate for your growing and developing child. Since certain grains are poor in protein, you may have to add wheat germ when you serve them as a meal. In general, children shouldn't be on special diets, so for safety's sake, you'll want to discuss your menus with your pediatrician to make certain they are fulfilling your preschooler's nutritional needs. When should I have my child's cholesterol level checked? Cholesterol screening is advised at different ages depending upon the judgment of the pediatrician. In some pediatric clinics, routine cholesterol screening is not performed until the child is ten years old. If there is a history of high cholesterol levels and/or cardiovascular disease in your family, however, your pediatrician may want to screen your child at a much earlier age. While growing children require more fat in their diets than adults do, your physician may want to suggest some modifications in your child's daily intake of cholesterol and saturated fat if her cholesterol level is high and the family is considered high risk. The main part of my preschooler's diet has become macaroni and cheese and bread and margarine. I'm worried about this, but isn't it better than eating nothing? This intake of macaroni and cheese is much better than starving, but children do not starve themselves. Offer your child an interesting variety of nutritious foods daily. She can choose to eat or not, but she should only be allowed to choose from what you offer. Let her choose her favorite macaroni-and-cheese meal occasionally, but don't let her dictate her menu to you. When you offer bread and margarine, serve whole grain bread. Try to be matter-of-fact about meal and snack time. Don't ever plead with your child to eat. If you focus on the amount she eats, eating can become a tug of war between you. Remember, a child isn't good because she eats or bad because she doesn't. Eating isn't good or bad. Your child should choose from the variety of nutritious foods you offer and should eat only when she's hungry. Do you recommend that I cook all of my preschooler's foods without salt? While you don't have to completely avoid salt when cooking your preschooler's food, you certainly should reduce the amount you add and keep the salt shaker off the table. Likewise, it's a good idea to avoid offering your preschooler salty snacks and salty commercially prepared foods. Once again, you are educating your preschooler's tastes; if she doesn't get used to eating salty foods now, she's not likely to choose them frequently later on. I have the original cookies-and-ice-cream kid. I know I shouldn't have started this, but how do I get it to stop? Cookies and ice cream taste very sweet and very good, so of course your preschooler would prefer them to other foods. The point is that parents should determine what food is offered to their child. Children enjoy making choices about meals, and this should be encouraged; however, they should be allowed to choose from the variety of healthy foods offered to them by their parents. You want to help educate your child's tastes toward healthy food choices now and for the future. Limit the cookies and ice cream to special days or special treats. Instead of saying "No cookies today," say "This is what we're having for lunch today." Simply avoid bringing up the cookies and ice cream all together. Try to be "out of cookies" most of the time. I've heard some confusing statements about the artificial sweetener aspartame. Is it safe for my preschooler? Aspartame has been extensively tested. So far, the studies have not proven that moderate use of this artificial sweetener is harmful to healthy human beings. As compared to sugar, aspartame is healthier for teeth. However, keep in mind that you want to teach your preschooler to make healthy, nutritious food choices now and in the future. She shouldn't get into the habit of thinking that everything she eats and drinks should taste sweet. In addition, you want to encourage her to choose nutritious foods, regardless of whether they taste sweet or not. So while consuming a limited amount of aspartame in foods is not a problem, you should avoid serving her sweet-tasting but nutritionally poor foods--no matter where the sweet taste comes from. Should I avoid giving my preschooler barbecued food? A major concern here is the possibility of food poisoning from improper handling of the food before it is cooked. If you're picnicking or barbecuing, make certain that the meat (or poultry or fish) is properly refrigerated until it's cooked, and then cook it thoroughly on the barbecue. Clean your barbecue grill well each time you use it to remove particles of food that may spoil and chemicals that can become a part of your next cookout. In addition, there's some worry about the amount of PAH (polycyclic aroma hydrocarbons) and other possible cancer-causing agents that are produced when food is barbecued. These agents are formed when fat drips onto flame, hot charcoal, lava rocks, and heating elements. The smoke then picks up these agents and deposits them on the food. Some of these agents are also formed on the food itself when the flame touches it. Currently, there is no hard scientific evidence that PAH is harmful to humans in reasonable amounts. As long as you don't barbecue every day, your little one can probably enjoy some barbecued foods. To minimize any potential danger, choose leaner meats; this will cut down on fat drippings. Avoid soft woods as fuel for your barbecue; although they may add a little extra flavor, they also burn at a higher temperature than charcoal, thus producing more PAH. And cover your grill with foil that has holes poked in it to let the fat drip out and keep charring of food to a minimum. The final worry involves the risk of burns from a hot grill, hot utensils, and hot food. Be sure to keep your preschooler away when you're grilling, keep hot utensils out of her reach, and be sure her food is sufficiently cooled to avoid burns. 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 1 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 her growth and development at routine health maintenance examinations. A WORD ABOUT SUGAR As many as 20 to 30 percent of school-age children in the United States are overweight. While the quantity of food consumed plays a role in overweight, the caloric content is just as important. Sugar provides empty calories. Preschoolers generally prefer sugary foods and, given the chance, would probably fill up on sweets and leave no room or appetite for nutritious foods. In addition to providing empty calories, sugar plays a role in promoting tooth decay, even in the deciduous (baby) teeth. Therefore, it's best to limit the amount of sugar in your preschooler's diet. While you can use sweets as a special treat, try to avoid using them specifically as a reward; you want to encourage a healthy view of eating and food. Although there are theories linking hyperactivity in children to sugar content in the diet, there has been absolutely no documentation or scientific proof that this is the case. Hyperactive children, like all children and adults, need a healthy, varied diet.