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Nutrition FAQs - Providers Choice

Child Nutrition FAQs

pic_of_kid_eating We all want to help our children become happy and healthy eaters. However, we often have questions about how to make that happen. In this part of our website you'll find answers to some of those questions.

Our answers reflect the opinions and recommendations of noted health and nutrition experts such as the American Academy of Pediatrics and Ellyn Satter, author of several child feeding books.

How much should I feed my infant?

Babies drinking formula usually want to be fed every 3 - 4 hours. The amount of formula consumed can vary day to day as well as from meal to meal. When your baby stops nursing and turns her head away or closes her mouth tightly, she is signaling that she has had enough. Babies may want to eat less if they are teething or not feeling well and more if they are going through a growth spurt. Breast fed babies may eat more frequently.

How do I know when my baby should start to eat certain foods?

Most babies are developmentally ready to begin solid foods sometime between 4 and 7 months of age. Each baby develops at a different rate. They should be able to; sit unsupported, close their mouth around the spoon, and move semisolid food to the back of their tongue. Generally the first food offered is infant rice cereal because it is easy to digest.

How should I introduce new foods to an infant?

It's important to start new foods one at a time, waiting 5-7 days before starting another new food. Introduce a small amount (1 to 2 teaspoons) of a new food at first to give the baby time to adapt to a food's flavor and texture. If a reaction occurs, discontinue the food. Wheezing, rash, vomiting or diarrhea should be reported to your baby's doctor.

When should I introduce fruits or vegetables to my infant?

Fruits and vegetables may be introduced when your baby is readily accepting 2-3 tablespoons of infant cereal at each meal. Offer pureed fruits and vegetables or home-prepared foods that have been blended or mashed. Give him time to accept the new taste and texture.

What fruits and vegetables should I avoid?

Avoid foods such as corn, raw unpeeled apples, raw carrots, celery, lettuce, raisins and grapes because they may cause choking. Raw fruits (except ripe bananas) should also be avoided as they may be difficult for the baby to digest.

When can I offer meat and meat alternates to my infant?

Meat and meat alternates can be offered to babies starting at 8 months of age. Some physicians recommend introducing them between 6 and 8 months of age. By that time most babies will be ready to replace some of the protein and iron from formula or breastmilk with meat. Egg yolks and pureed lean meats or poultry are good first choices.

What table foods are appropriate for my infant?

Appropriate table foods to offer include well-cooked strained or pureed meats and poultry, boneless fish (other than shellfish, shark, swordfish, mackerel, or tilefish), egg yolk, pureed dry beans and dry peas, diced or grated cheese, or cottage cheese. If you are using commercial baby food, choose plain meats rather than the mixed meat and vegetables or noodle combination dinners. You may mix the plain meats with vegetables after measuring to encourage meat acceptance by your baby.

Are there additional foods I can serve to my infant?

Additional foods may be offered to your baby as they grow older and continue to learn the skills of eating. Fruit juice may be served to babies when they are ready to drink from a cup. Choose a juice that is fortified with Vitamin C and limit amount to 4 ounces per day or less. Citrus juices (oranges and grapefruit) should be avoided as they are more likely to cause an allergic reaction. Enriched crackers, bread, dry cereal, rice and macaroni are examples of additional foods which may be served to infants. These foods are appropriate finger foods which can help the baby to develop the muscles and hand/eye coordination necessary for self-feeding.

My child is 10 months old, can I switch from formula to milk?

The American Academy of Pediatrics recommends that infants continue on breastmilk or formula until one year of age. Formula and breastmilk include just the right balance of nutrients which help your child to grow and develop properly. You may begin introducing small amounts of whole cow's milk in a cup at meal time when your child is around 11 months of age. Offer formula or breastmilk for between meal snacks so children get the nutrients needed for growth.

Last week my toddler loved peaches. This week she turns up her nose at them. What's that all about?

Your toddler is beginning to test her wings with regard to eating. She's learning that she has control over some things and whether she eats or not is one of them. As the parent of a toddler your job is to select and prepare the food for meals and leave the eating up to her. Trust her to eat what she needs. That means some days she may eat very little and on other days she will eat more.

My child seems to eat very small amounts of food and I'm concerned that she isn't eating enough to grow properly. How much should a young child eat at each meal?

Young children's appetites vary tremendously from meal to meal and day to day. That's normal eating for a young child. Because children in this age group aren't growing as much as before their energy needs won't be as high. A general guide to the amount of food to offer is one tablespoon for each year of age of each of the foods served at that meal. (A two year old serving would be two tablespoons). The key word here is offer, it's the child's job to decide how much and even if they will eat what's offered.

How do I get my kids to eat vegetables?

How you approach the serving of vegetables has a lot to do with how well children will eat. Offer a variety of vegetables and let your children see you eating and enjoying them. Keep offering them even if they are initially rejected. Many vegetables contain stronger tasting compounds that are initially rejected. Children may be encouraged to taste, but shouldn't be forced or bribed into eating. Eventually they will learn to enjoy vegetables.

How do I get my kids to try new foods?

It's natural for children to be wary of new foods. Sometimes it takes as many as 10 - 15 exposures to a food before a child is willing to taste it. Try offering the new food in different ways, making sure to offer the new food with familiar foods so the entire meal isn't foreign to your child. Lastly, make sure your child sees you enjoying the new food. Children are great imitators and will eventually want to try some of this new food they see you enjoying.

What if my child refuses to eat?

Follow the Division of Responsibility in Feeding recommended by feeding expert, Ellyn Satter, RD, ACSW. As a parent your job is to determine "what, when and where" with regard to meals. It's the child's job to decide how much to eat at each meal. When planning meals take into consideration your child's likes and dislikes. Try to offer one familiar food that is liked at each meal. Then let your child decide what and how much to eat. If they leave the table without eating anything do not offer a substitute, have them wait until the next meal or snack to eat. The consequence of not eating (hunger) will help them to know that they need to eat something at meals to curb their hunger.

Is it okay to "bribe" kids with candy or dessert?

Using a bribe is really just another form of pressuring a child to eat. It adds to mealtime tension and won't help them to like spinach. In fact, according to Dr. Leann Birch, (a Penn State University professor doing research on children's food acceptance), children learn to value the foods that are offered as a reward more than the food they are being bribed to eat.

What about the "clean plate club"?

Children are born with an internal ability to regulate how much they eat based on their hunger level. They will eat a balanced diet if they are offered healthful, balanced choices over time. Forcing a child to eat leads to a power struggle and teaches the child to ignore their internal cues for hunger and satiety.

What if my kids are just plain "picky eaters"? How do I handle that?

Do not become a short order cook. Have structured meals and snacks where you offer a variety of food - a main dish, milk, fruit or vegetable, bread to all family members and let your child pick and choose from what's available. Include one food that your know your child usually likes. Involving children in the preparation and selection of meal components also helps them feel more comfortable trying new foods and they benefit by learning new skills at the same time.

Should I put my child on a diet?

No. The impact of diets and their affect on children's growth has not been well studied so pediatric nutrition and feeding experts such as Joanne Ikeda, MA, RD., University of California at Berkeley advise against it. Children and adolescents are not "little adults". Their bodies are growing and developing. Dieting generally deprives the body of the nutrients needed to support growth and development. Continue to offer a variety of nutritious foods at meals and snacks, letting the children decide how much to eat at any given meal. Further information is available in a book by Ellyn Satter, RD, ACSW titled How to Get Your Kid to Eat...But Not Too Much. If your child is significantly overweight talk to your pediatrician and ask for advice and referral to a dietician who can help your family with food selection and structuring meals and snacks to meet the needs of all family members.

I always thought fruit juice was a nutritious beverage, however I've recently heard reports to the contrary. What's the scoop on juice?

Fruit juice can be a part of a nutritious diet as long as you choose products that are 100% juice and limit the amount you serve. The controversy over juice centers around the quantities that are consumed. Children who consume larger amounts tend to fill up on the juice, leaving little room for more nutritious foods and beverages such as milk. Children between the ages of 1 and 6 should consume no more than 4 - 6 ounces per day. Two servings for a total of 8 - 12 ounces should be the limit for children age 6 - 12 years.

My child is allergic to milk so I'm looking for ideas on how to boost his calcium intake. Is calcium-fortified juice as good as milk?

The calcium in calcium-fortified juices appears to be readily absorbed by the body so it is an acceptable alternative to milk. However there are other key nutrients found in milk such as magnesium and vitamin D which are also needed for bone development. For this reason it's important to discuss additional food supplements with your child's health care professional and/or registered dietician, if your child is unable to drink milk.

Additional Child Nutrition Resources

We've compiled information from a host of health and nutrition professionals including Ellyn Satter and the American Academy of Pediatrics. Of course, you will want to check with a child's parent before making any dietary changes.

"American Academy of Pediatrics Guide to Your Child's Nutrition: Feeding Children of All Ages" by William Dietz, M.D. and Loraine Stern, M.D. Editors. Villard Books, 1999

"Child of Mine: Feeding with Love and Good Sense" by Ellyn Satter. Bull Publishing, 2000.

"First Meals Revised: Fast, Healthy, and Fun Foods To Tempt Infants and Toddlers" by Annabel Karmel. DK Publishing, 2004.

"How to Get Your Kid to Eat... But Not Too Much" by Ellen Satter. Bull Publishing, 1987.