EDO STATE POLYTECHNIC, USEN

SEMINAR ON

Nutrition in Toddlers

BY

OGEDENGBE TITILAYO JOY

MAT NO. 12795

SUBMITEED TO THE DEPARTMENT OF FOOD SCIENCE AND

TECHNOLOGY, OF APPLIED SCIENCE, EDO STATE
POLYTECHNIC, USEN.

LEVEL: ND II

AUGUST, 2022

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Abstract
The establishment of eating practices that contribute to lifelong nutritional
habits and overall health begins in toddlerhood. During this time, children
acquire the motor skills needed to feed themselves and develop preferences that
affect their food selections. Classifications for faltering weight (also called
failure to thrive or growth faltering) and overweight are based on World Health
Organization child growth standards (for children younger than two years) and
Centers for Disease Control and Prevention growth charts (for children two
years and older). Breast milk or whole cow's milk should be offered as the
primary beverage between one and two years of age. Sugar-sweetened
beverages should be avoided in all toddlers, and water or milk should be offered
instead. Allergenic foods such as peanuts should be introduced early to infants
at higher risk of allergies. Vitamin D and iron supplementation may be
advisable in certain circumstances, but multivitamins and other micronutrient
supplements are usually unnecessary in healthy children who have a balanced
diet and normal growth. Optimal food choices for toddlers are fresh foods and
minimally processed foods with little or no added sugar, salt, or fat (e.g., fruits,
vegetables, lean protein, seeds, whole grains). Parents and caregivers are
responsible for modeling healthy food choices and dietary practices, which
shape children's food preferences and eating behaviors. Parents should avoid
practices that lead to overeating in toddlers (e.g., feeding to soothe or to get
children to sleep, providing excessive portions, pushing children to "clean their
plates," punishing with food, force-feeding, allowing frequent snacks or
grazing). In general, parents should use the approach of "the parent provides,
the child decides," in which the parent provides healthy food options, and the
child chooses which foods to eat and how much.

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INTRODUCTION

Your child can continue breastfeeding just as often during the second year, but

offer solid foods a few times a day. After 12 months, you can begin offering the

solids BEFORE baby nurses, if you wish, instead of after. Your milk is still an

important part of baby’s diet and will offer him many benefits (nutritionally,

immunilogically and emotionally). There is not any particular “recommended

number of times per day” that a toddler should be nursing. Some are only

nursing once or twice a day, while others continue to enjoy lots of time at their

mother’s breast. As baby slowly moves into eating more solids, your milk will

fill any nutritional gaps nicely. Once you do start to breastfeed less often,

remember that you must make a greater effort to ensure that your child eats

several meals of nutritious food each day. You’ll probably notice a sharp drop

in your toddler’s appetite after his first birthday. Suddenly he’s picky about

what he eats, turns his head away after just a few bites, or resists coming to the

table at mealtimes. It may seem as if he should be eating more now that he’s so

active, but there’s a good reason for the change. His growth rate has slowed,

and he really doesn’t require as much food now.

Good nutrition during the first 2 years of life is vital for healthy growth and

development. Starting good nutrition practices early can help children develop

healthy dietary patterns. This website brings together existing information and

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practical strategies on feeding healthy foods and drinks to infants and toddlers,

from birth to 24 months of age. Parents and caregivers can explore these pages

to find nutrition information to help give their children a healthy start in life.

Toddlers' nutritional requirements

Toddlers' nutritional requirements differ quite markedly from those of older

children and adults. Rapidly growing and extremely active,toddlers require

more calories and nutrients in each mouthful of food than adults. A toddler's

daily energy requirement is around three times that of an adult (95 Kcalories per

kilogramme (kg) of bodyweight compared to 30-35 Kcalories per kg of body

weight). Similarly toddlers need higher amounts of nutrients per kg of their

body weight than adults (see figure 1).

Calories

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(Energy) To consume these relatively large amounts of calories it is important

not to rely on the low-fat, high-fibre foods that are recommended for adults and

older children because toddlers’stomachs are only about one third the size of an

adult stomach (see figure 2) 1,2 . A toddler's diet should therefore include some

foods that are high in fat and low in fibre.

Nutrients

By making up meals and snacks with nutritious foods the high nutrient needs of

toddlers can easily be met. Three balanced meals a day of toddler-sized

portions, plus two or three nutritious snacks should be sufficient.

DRINKS

Toddlers should be offered around six to eight drinks per day from a beaker or

cup (more may be needed in very hot weather or when they are very

active).This will prevent dehydration and reduce the occurrence of constipation.

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Milk and water are the best drinks to give between meals and snacks as they do

not harm teeth when taken from a beaker or cup. Fruit juices should be diluted

one part juice to ten parts water and given with meals or snacks. They are acidic

and dissolve tooth enamel when given on their own. Squashes with sugar or

sweeteners are also acidic and should be well diluted. Bottles and reservoir

feeding cups should not be used because they bathe the gums and sensitive milk

teeth in acid for longer which increases the risk of dental caries and enamel

erosion. Tea and coffee reduce iron absorption and should not be given to

toddlers.

HOW MUCH SHOULD MY TODDLER BE EATING?

Between ages one and five, a child’s growth is in a decelerated stage; that is,

they have slowed down in growth. Since growth slows down, their need for

calories subsequently decreases, which in turn leads to a smaller quantity of

food ingested per day. Added to the decelerated growth is a burgeoning

independence which limits the variety of foods your child is willing to eat

(“finicky eater”). Rest assured that toddlers do not need as much food as you

might expect because of this slowing down of the growth rate. Three small

meals and two snacks a day (and some will eat a good bit less) will probably be

enough to fuel even the most active toddler. Please realize, too, that finicky

eaters are the rule rather than the exception.

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Some toddlers are eating very few solids, or even no solids, at 12 months. This

is not unusual and really depends on your child – there is quite a big variation.

We like to see breastmilk making up the majority (around 75%) of baby’s diet

at 12 months. Some babies will be taking more solids by 12 months, but others

will still be exclusively or almost-exclusively breastfed at this point. It is normal

for baby to keep breastmilk as the primary part of his diet up until 18 months or

even longer. An example of a nice gradual increase in solids would be 25%

solids at 12 months, 50% solids at 18 months, and 80% solids at 24 months.

Some children take a little longer to begin taking solids well. Some of them

have food sensitivities and this may be their body’s way of protecting them until

their digestive system can handle more. Others are late teethers or have a lot of

difficulty with teething pain. At this point there is NOTHING that your milk

lacks that your child needs, with the possible exception of enough iron. As long

as his iron levels are within acceptable levels and when he does eat you are

offering him foods naturally rich in iron, then you have plenty of time before

you need to worry about the amount of solids he’s getting.

All you need to do is to continue to offer foods. Don’t worry if he’s not

interested or takes very small amounts. Your only true responsibility

is what you offer, when you offer it and how you offer it, not whether or not he

eats it. That has to be up to him. Trying to force, coax, or cajole your child into

eating is never recommended. Continue to nurse on demand, day and night, and

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trust your child to increase the solids when he’s ready. As baby slowly moves

into eating more solids, your milk will fill any nutritional gaps nicely.

FEEDING SUGGESTIONS FOR TODDLERS

Finger foods are always great for toddlers, and your toddler will also begin to

learn how to feed himself with a spoon and fork. Many babies prefer to eat

foods which they can pick up and feed themselves, rather than foods that must

be spooned to them. A lot of babies would rather have food right off the table

than the blander-tasting baby foods.

After the age of twelve months, continue to be on the lookout for any allergic

reactions to new foods and keep in mind that the choking hazard is still very

real. Supervise your toddler’s meals in case of choking, and continue to avoid

foods such as popcorn, hard candies, hot dogs, jelly beans, chunks of carrots,

grapes, raisins, and nuts. Cut or finely chop such foods, or simply wait until

your baby gets older.

Toddlers should be offered a variety of foods. They can eat the same things as

the rest of the family. Foods rich in protein, calcium, and iron, along with fruits

and vegetables, breads, etc. should be made available on a routine basis. Serve

the most healthful foods possible, but don’t expect your toddler to eat a big

meal at each sitting. Most children, when offered nutritious meals and snacks

and allowed to eat what they wish, will meet their nutritional requirements over

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several days or even a week. Don’t let your child fill up on empty-calorie

snacks, but don’t force him to eat when he doesn’t want to.

Many toddlers eat better when they have food available throughout the day,

rather than just at a few set times (see grazing). Simply offer your toddler

nutrient-dense snacks throughout the day (cut-up vegetables, bite-sized pieces

of fruit, hard-boiled-egg slices, yogurt, whole wheat breads and cereals,

cheeses) and let him eat what he wants. Some parents have had good luck with

Dr. William Sears’ suggestion of a “nibble tray,” where you fill a tray (like an

ice cube tray, muffin tin, etc.) with several types of healthy foods and leave it

out for your toddler to nibble on throughout the day.

EATING IN SOCIAL GROUPS WITH PARENTS AND OTHER

CHILDREN

Toddlers learn by copying other children and adults, so eating in a social group

can be an important part of learning to like new foods. Families should eat

together as often as possible and parents should eat the foods that they want

their children to eat. Toddlers may also learn to eat new foods at nursery or in

extended family groups. Not only do toddlers copy other people's eating

behaviour, they also respond to others' reactions to them at a mealtime. Praising

toddlers when they eat well will encourage them to enjoy their food. Attending

to toddlers only when they are refusing food may increase problem eating

behaviour.

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REGULAR PATTERN OF MEALS & SNACKS

Toddlers benefit from a routine of regular meals and snacks around their

daytime sleeps. Toddlers do not eat well if they are tired or over-hungry. Snacks

evenly spaced between meals will help to avoid the frustrations of being over-

hungry. Toddlers should be given both a savoury and sweet course at meals.

This gives two opportunities for sufficient nutrients to be consumed and

increases the variety of foods the toddler is eating. Puddings are a valuable part

of the meal and should not be used only as a reward for eating the savoury

course.

TEXTURES AND FLAVOURS

Toddlers have individual tastes regarding the flavour and texture of foods. Some

like their food bathed in sauces while others prefer it dry. Some like each food

kept separate from the others on the plate. Many do not like stringy meat or

foods that are difficult to chew. It is important to respect a child's tastes and,

where necessary, to offer alternative foods from the same food group. Tastes

often change overtime, so it is important to keep offering a toddler all the foods

the family eats.

NUTRIENTS FOR HEALTH, GROWTH AND DEVELOPMENT

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A wide variety of nutrients ensures the body grows, develops normally and

continues to function well. Because toddlers are particularly prone to respiratory

infections it is important to provide the full range of nutrients, which will help

to maintain their immune system. These include:

• Water

• Protein

• Fat including omega 3 and 6 fatty acids

• Carbohydrates

• Fat soluble vitamins A,D, E and K

• Water soluble vitamin C and the B vitamins

• Minerals: calcium, copper, fluoride, iodine, iron,

 potassium, selenium, sodium, zinc

• Fibre including prebiotics

• Other phytochemicals which are also antioxidants.

explains the functions of these nutrients and which foods provide them. A diet

containing foods from each of the five food groups, in the correct combinations,

will automatically provide sufficient amounts of each nutrient. However there

are two exceptions to this: vitamins A and D - a supplement of these two

vitamins is recommended for children under five years to prevent rickets and

ensure normal growth and development 3 . This is especially important for

fussy eaters,toddlers of Asian,African and Middle Eastern origin and those

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living in the northern areas of the UK. Most vitamin drops include vitamin C

which helps with iron absorption.

FOODS THAT MAY HARM

Salt intake should be kept to a minimum. Limiting sodium, which is part of salt,

will help to minimise any health problems due to salt later in life, and may help

prevent a rise in blood pressure with age5 . It is better to flavour foods with

herbs and spices than with salt. Processed foods, which are high in sodium and

salt should also be avoided and salty snacks such as crisps should be given only

occasionally. Additives and sweeteners used in food are all tested for safety.

However large amounts of sweeteners, often found in drinks, should be avoided

if possible. Drinks containing sweeteners should be well diluted. Eggs and

shellfish should be well cooked as they can cause food poisoning in toddlers if

eaten raw or partially cooked. Large fish that live for many years, such as shark,

swordfish and marlin, may contain high levels of mercury and should be

avoided6 . Whole nuts should not be given to toddlers and young children under

five because of the risk of choking on them. Peanut allergy advice changed in

2009.The Department of Health and Food Standards Agency recommends that

toddlers with allergies (including eczema and asthma) which are thought to be

due to food or other allergens, OR who also have immediate members of family

(parents or siblings) with a food allergy or allergy (including eczema, asthma

and hayfever) may be at higher risk of developing peanut allergy. Such children

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should be reviewed by their GP, health visitor or a medical allergy specialist

before starting to eat peanuts or foods containing peanuts7 . Ground walnuts,

almonds, cashews and other tree nuts are acceptable and are a good source of

protein and nutrients especially for vegetarian toddlers.

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REFERENCES

1. 1.Janet MacGregor: Introduction to the Anatomy and Physiology of

Children. London: Routledge; 2000.

2. Richard S. Snell: Clinical Anatomy for Medical Students. 4th edition.

London: Little Brown; 1992.

3. 3.Department of Health: Weaning and The Weaning Diet. Report of the

Working Group On The Weaning Diet of the Committee on Medical

Aspects of Food Policy. Report on Health and Social Subjects 45.

London: HMSO; 1994.

4. 4.Department of Health: Birth to five.Your complete guide to parenthood

and the first five years of your child's life. London:Department of Health

Publications; 2004.

5. Consensus Action on Salt & Health (2005)

http://www.hyp.ac.uk/cash/information/salt_intake.htm

6. Food Standards Agency (2005)

http://www.eatwell.gov.uk/agesandstages/children/yrtoddler

7. 7. Food Standards Agency (2009)

http://www.food.gov.uk/safereating/allergyintol/peanutspregnancy

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