What Toddlers Should Eat

Table of contents 

 

By Nicole Silber, RD, CSP, CLC

nicole silber

Nicole Silber, RD, CSP, CLC & mom is a registered dietitian, board certified specialist in Pediatric nutrition, and certified lactation counselor, Nicole has worked with hundreds of children and families with chronic medical conditions, food allergies, and picky eating. She is the creator of Tiny Tasters on-demand feeding classes. Prior to her current roles she was a clinical nutritionist at the Morgan Stanley Children’s Hospital at NewYork-Presbyterian/Columbia.  

A busy one to three year old has many interests that take priority over mealtime. These curious kids are exploring the world, and finding ways to get into whatever is in their reach. For parents, mealtime can be a source of both happiness and anxiety. They wonder, “Is my child eating enough of the right foods?” By the age of 12 months, most toddlers have graduated from “first foods” to mashed table ones. Infant formula is discontinued and some infants are weaned from breastfeeding. Infant food restrictions no longer apply, but there are food safety concerns unique to this age group. In addition, parents often notice changes in their toddler’s eating habits and preferences. The nutritional needs of toddlers pose the challenge of finding the right balance of nutrients while giving age appropriate foods.

Clinical Scenarios

In practice, I have witnessed a variety of temperamental toddler behaviors in regards to eating. Some toddlers will drink as much milk throughout the day as a parent or grandparent will offer. In extreme cases, some drink over 40 oz of milk per day! These toddlers are so “full” from milk that they refuse food at mealtimes. There are other situations where the toddler prefers select foods. For example, a two year old may “love fruit, pasta, and pizza,” but cry or have a tantrum at the sight of a vegetable on the plate. Other toddlers are “grazers, snacking throughout the day instead of eating set meals. And then, there are the lucky parents whose toddlers eat all varieties of foods without protest. With so many barriers to consuming a balanced diet, it is important to be aware of what toddlers need for overall health.

Several medical authorities have presented guidelines for toddler nutrition in an effort to promote optimal growth and development. The American Academy of Pediatrics (AAP) recommends 1000 calories per day for one to three year olds (source). The World Health Organization (WHO) gives the additional guidance of dividing these calories into three to four meals, and one to two snacks daily (source). For a balanced diet, components of the five major food groups should be offered:

Fruits
2-3 servings


1/4 cup cooked, frozen, canned
1/2 piece fresh

Vegetables
2-3 servings

 
1/4 cup cooked

Grains
6-11 servings


1/2 slice bread
1/4 cup cooked cereal, rice, pasta
1/2 cup dry cereal
2-3 crackers

Proteins
2 servings

 
1 oz meat, fish, tofu, chicken 
1/4 cup beans
1/2 egg

Dairy
2-3 servings


1/2 cup milk 
1/2 oz cheese
1/2 cup yogurt

 

For children with a milk allergy or who have celiac disease, authorities recommend soy milk and gluten-free grains (source). Soy milk is their preferred alternative until the age of two because of the higher fat and protein content compared to other non-dairy options. Busy parents who view these guidelines may cringe at the idea of measuring food for each meal; it is just too daunting a task. Stanford Children’s Hospital offers an easier way: a toddler meal should be 1/4 the size of an adult portion (source). Parents should also keep in mind that it is perfectly normal for toddlers to eat large amounts of food some days, and less on others. The average food consumed, however, should be consistent.

The mechanics of eating can be difficult for toddlers, so modifications are necessary to make foods easier and safer for them. By the age of 12 months, most toddlers have at least two front teeth (source). This allows for biting of foods, but not much help with chewing. Molars begin to erupt around 14 months old, and teething continues until after the second birthday. Sore gums can make eating uncomfortable. For these reasons, most foods offered to young toddlers should have a soft texture, and be cut into bite-sized pieces. The chewy textures of meats and poultry are more difficult, causing some toddlers to reject these foods. I frequently hear parent stories of toddlers who try to chew such a food, ball it into their cheek, then, ultimately, spit it out. Ground or pureed versions of meats are better tolerated.

In addition to this, some foods are choking hazards for toddlers. Smooth-surfaced foods like small round fruits and hard candies can easily lodge into a toddler’s airway (source). To avoid this, any fruit the size of or smaller than a cherry should be cut into quarters before serving. Hotdogs and similar foods with skins or casings are equally hazardous. The casings should be removed, and the meat should be cut into bite-sized pieces. “Gummies” have become very popular foods items among children, and are used for fruit snacks, candies, and even vitamins. Unbeknownst to many parents, their sticky texture is both a choking hazard and dental cavity risk. Prior to 12 months, certain foods are considered unsafe for infants due to the risk of certain infections. Honey, in particular, is a risk for botulism. Over the age of 12 months, however, most medical authorities feel that the digestive system has matured enough to handle any possible exposure (source). Unpasteurized foods should still be avoided, however, and food should be prepared and stored at proper temperatures (source).

Despite a parent’s best efforts, many toddlers fail to consume enough of the proper nutrients. The temperamental nature of many toddlers influences how they eat. In a report published by The Journal of Nutrition, the study participants ate only small portions of healthy foods, but larger amounts of foods high in salt and saturated fat. Their diets were also deficient in fiber, vitamin D, and potassium. White potatoes were the preferred vegetable, and fruit intake was minimal (source).

Foods to Offer and to Avoid

The nutritional needs of toddlers differ from those of older children. It is especially important for them to obtain adequate vitamin D and calcium for optimal growth. Iron and healthy fats are important for brain development until the age of two. Although the WHO recommends breastfeeding at least until the age of two, this is not practical for every family (source). Fortified milk and soy can provide calcium and vitamin D. Care should be taken, however, not to exceed more than 20 oz of milk per day which can cause constipation and anemia. Full fat dairy, nuts, coconut oil, salmon, and avocados are great sources of healthy fats. Food iron sources include beans, lentils, meats, eggs, tofu, and spinach (source). After age two, the AAP recommends low fat, low cholesterol foods (source). Processed foods should be avoided due to their high salt and sugar content. Kids don’t need this extra salt, and sugary foods and drinks contribute to obesity and tooth decay (source).

So, What ELSE?

To assist parents in providing their toddler with the recommended nutrients, the developers of ELSE have created a novel product: ELSE Toddler Drink. ELSE is a plant-based beverage made from almonds and buckwheat. It contains a variety of vitamins and minerals, especially the calcium, vitamin D, and iron that toddlers need and may fail to get regular in their diets. Consistent with the AAP recommendations, ELSE is low in sugar and salt. It is a “clean ingredient” product that is less processed than other options on the market, and contains no hormones or preservatives. For all of these reasons, ELSE is a product that can be beneficial for many toddlers.

The content and advice provided in this article is for informational purposes only and is not a substitute for medical diagnosis, treatment, advice for specific medical conditions. Always consult a pediatrician to understand the individual needs of your child.


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