Healthy tips from a Registered Dietitian
If you are a parent of an infant or toddler, you may wonder if you are giving your child the best nutrition possible. You hear about food allergies, sensitivities and weight concerns. The, you go to the drugstore and see shelves of vitamins, minerals and other dietary supplements promoted for children’s well-being. So, with so much information out there (and much of it given out without thorough research to support it), what is a parent to do?
As a mother of two young children, and as a dietitian, I have researched the various opinions and recommendations when it comes to children’s nutrition. Once a child is 4 years old, the www.MyPyramid.gov can be used for food guidance. However, if a child is younger than four years old, you may find the following information beneficial in order to help nourish him or her healthfully:
The first 6 months:
I fully recommend solely breastfeeding until a child is 6 months old. Breastmilk is the optimal source of nutrition for infants. A nursing mother should eat a balanced diet and usually take certain dietary supplements. I often recommend the mother continue to take a prenatal multivitamin, a calcium/vitamin D3 supplement and an omega-3 fatty acid supplement. Specific supplement recommendations should be discussed on an individual basis. However, infants should take 400IU of vitamin D3 drops daily (Carlson for Kids makes a natural version with no artificial ingredients and has been verified for safety/potency/purity by Consumer Lab). If breastfeeding is not possible, an infant should be solely formula fed until 6 months old. No rice cereal in the bottle, either!
Solids can be introduced, starting with iron-fortified rice cereal and followed by other iron-fortified single grains (like infant oatmeal cereal) and various fruits and vegetables, waiting 3-7 days in between introducing new foods to ensure no allergies occur. Continue with breastmilk (or, formula if not breastfeeding) until the child is one year old, at which time cow’s milk or fortified soymilk/ricemilk can be introduced.
Parents of children with food allergies should consult with a dietitian to get specific recommendations on what foods to introduce when and which to avoid. Good first foods include pureed bananas, peas, unsweetened applesauce, pears, avocado, sweet potatoes, mango and green beans. Choose organic versions if possible and avoid additives, artificial ingredients and trans fats. Children can then move on to pureed meats and lentils/beans. Finger foods like puffs (such as Happy Baby Organic Puffs), Cheerios or Barbara’s Bakery Organic O’s and small cut up pieces of soft bread (such as Arnold 100% Natural whole grain white sandwich bread) may come next. If no dairy sensitivities exist (see the post on Food Allergies, 5/2/09), yogurt may be given after 9 months old. If no fish allergies exist in your family, you can consider providing your child with certain fish (such as flounder or organic farm raised salmon) closer to the time he or she will turn one year old. As a child gets older, you will be able to give him or her more table foods or small portions of safer foods the family is eating. Continue with 400IU of vitamin D3 daily, either in a poly-vitamin or tri-vitamin formula (like Poly-Vi-Sol by Enfamil) or the basic vitamin D3 drops.
1-3 years old:
Children in this age category need about 1000-1300 calories per day. A balanced plan could include: 2-3 cups milk (from breast/cow/soy/rice) in a straw cup (not a bottle), 2oz grains, ½ – ¾ cup vegetables, ¾ -1 cup fruit, 1.5oz meat/protein and water if desired (more as a child gets older). The Dietary Reference Intake for omega-3 fatty acids (from ALA, a plant source) for children in this age category is 700mg per day. I recommend 100-200mg of omega-3’s coming from DHA (in fish and algal oil). DHA can be obtained by choosing fish like wild (or organic farm-raised) salmon or fortified foods such as cow’s milk (i.e. Horizon Organic with DHA), soymilk (i.e. Silk Soy Plus DHA) and certain yogurts. ALA can be obtained from soybeans, soymilk, flaxseed, canola oil and some grains (certain frozen waffles, cereals, granola bars). Two good brands of chewable DHA supplements for children I have found are Carlson for Kids and Nordic Naturals.
An example of 1oz grains is 1 slice bread, ½ cup of pasta or ¾ cup Cheerios. One ounce of meat/fish/poultry is equivalent to 1 egg or ¼ cup beans.
Encourage children to develop a healthy eating pattern, using internal hunger and satiety cues. Don’t force a child to finish what is on his/her plate if he/she says she is full. However, don’t let them have desserts or snacks instead of finishing a meal. You provide the food choices and positively encourage the child to eat appropriately. Limit candy and artificial foods. No child in this age category needs soda or habitual fried food.
Continue with 400IU of vitamin D3 daily, either in a poly-vitamin or tri-vitamin formula or the basic vitamin D3 drops. By the time a child is 2 years old, he/she can try a chewable multivitamin designed for a 2-year-old if your pediatrician recommends it. Experts disagree on whether to give children multivitamins. I think it depends on how balanced your child’s diet is. Natural versions of multivitamins exist, though none has thoroughly impressed me. Flinstones are fine, though they do contain artificial ingredients.
Before starting any dietary supplements for children (vitamins, minerals or omega-3 fatty acids), consult your child’s pediatrician.