Early Childhood Nutrition: How to Get Feeding Off to a Positive + Healthy Start
Early Childhood Nutrition: How to Get Feeding Off to a Positive + Healthy Start

In May 2013, we sponsored a webinar for health professionals that highlighted the best practices for childhood feeding. The content focused on feeding toddlers, that challenging time when young children are advancing from breast milk or formula and baby food to regular milk and table food. We had two terrific speakers, Katja Rowell, MD known as the feeding doctor and Mary Mullen a pediatric dietitian specializing in healthy eating for families. 

While originally designed for health professionals, the topic area is of interest to parents as well. The following are some take away messages from the webinar that parents of young children need to know:

  • Trust is the foundation of feeding. My favorite line from the webinar is the quote from Mr. Rogers, "Knowing deep within us that someone is going to feed us when we are hungry is how trust and love begin..."
  • We are in a feeding crisis, eating disorders and obesity are on the rise. One third of all parents of preschoolers ask a doctor about feeding problems.
  • Parents can easily fall into a "worry cycle" that leads to more problems. The cycle begins with worry, lack of information or support and poor advice and can rapidly begin spinning out of control.
  • Worried parents can fall into a trap of pressuring their children to eat, yet research shows that if parents pressure their child to eat more they will actually eat less! And the opposite is also true; if you restrict or limit what children are allowed to eat, they will eat more. 
  • The solution to this worry cycle is the division of responsibility. Parents are responsible for the what, when and where of feeding and the child is responsible for how much they will eat and whether they will eat.

In the second portion of the webinar, Mary Mullen discussed what parents should be feeding their children. Specifically she recommended feeding children from all five food groups. Here is a handout that describes how much food children ages 2 - 5 should be eating from each food group.

She also discussed what beverages young children should be drinking. Many children are consuming sugar sweetened beverages that replace nutrient-rich beverages such as milk. In a nutshell here are her recommendations:

  • Whole milk is recommended by the American Academy of Pediatrics for children from age 1 - 2. They need the extra fat and calories for their growth and development; low and fat-free alternatives are not appropriate. At age two and older, parents can transition children to low-fat and fat-free milk.
  • She advises caution when using alternate beverage choices (soy, rice, almond, coconut), as they have a different nutrient profile than milk. 
  • Limit juice to 4 - 6 ounces per day. Also, parents should be watchful that many sippy cups are now larger than 6 ounces! Make sure you serve fruit juice, not fruit punch, drink or cocktail. It is okay to dilute the juice by adding extra water to fill up the sippy cup.
  • Say "so long" to sugary drinks such as sodas and sports drinks. Young children fill up quickly so you want to be sure the foods provided contain nutrients for growth and development.
  • Get your child used to drinking water! It is important for children to get used to quenching their thirst with water.

Finally, it is very important if you are concerned about allergies and intolerances to have your health care professional run the proper tests before removing foods from your child's diet. Your child could be missing out on important nutrients if you assume a food allergy exists when in fact something else is going on.

Children sometimes reject food one day and love it the next. Be patient. Keep serving healthy foods from all five food groups and your children will eventually follow your lead. Take the pressure off yourself and your kids to eat perfectly. What you are really trying to do is help your child develop a healthy relationship with food and build family love and trust through shared meals. Mr. Rogers was really on to something. 

 

1. Carnell S, Benson L, Driggin E, Kolbe L. Parent feeding behavior and child appetite: Associations depend on feeding style. Int J Eat Disord. 2014 Nov;47(7):705-9. 

2. Ellyn Satter Institute Website. Division of Responsibility in Feeding. Madison, WI  http://ellynsatterinstitute.org/dor/divisionofresponsibilityinfeeding.php Accessed March 29, 2015

3. American Academy of Pediatrics. Healthy Children Web site. Elk Grove Village, IL. http://www.healthychildren.org/English/healthy-living/nutrition/Pages/What-About-Fat-And-Cholesterol.aspx Accessed March 30, 2015.