Healthy Eating FAQs

• My son is 19 mos. old and is starting to spit out his food at meal time. He used to be such a good eater and now I don't know what to feed him. NEW!
  
• In addition to "early and often" - any other advice on getting a 3 year old to not only try, but eat veggies AND a variety of foods? NEW!
  
• I have a 13 month old who has a milk allergy. She goes through about 10 or more fl oz of water a day. I am wondering if I should replace some of that water with soy-based formula to add more nutrition into her diet? NEW!
  
• What are some menu or recipe ideas for young children?
• I have a two year old. And I would like to ask how much sugar can she intake in her diet a day. She has been waking up at night, and I usually have to go into the room a put her back to sleep. Is sugar an issue? NEW!
  
• My granddaughter used to drink, in a bottle at bedtime, milk with a little Ovaltine. However, when she stopped using a bottle she stopped drinking milk altogether. I have tried it in a cup to no avail. I need some suggestions for getting her to eat vegetables and drinking milk again.
• My 19-month-old daughter is a VERY healthy eater. The problem is she has always been low on the weight side. Am I being overly concerned or are there other was of getting some fat into her?
• My three year-old daughter refuses to eat meat unless it is a chicken nugget. What can I do to encourage her to try meat?
• My three-year-old eats fairly well at breakfast and lunch. But when dinnertime comes I feel like a short-order cook. Am I doing something wrong?
• Ever since our son was a toddler, it was a habit of giving him a snack about an hour after dinner. Now that he's older, should we offer this snack as a reward for eating dinner?
• What is your opinion on feeding young toddlers fast food like McDonald's hamburgers and fries?

My son is 19 mos. old and is starting to spit out his food at meal time. He acts like he doesn't like the texture of meats, veggies or anything not in a mushy form. What do I do? I want him to eat with us as a family and all eat the same food for dinner and quit buying only toddler foods especially for him. He used to be such a good eater and now I don't know what to feed him.

Children at this age are famous for being "picky" eaters. They often have strong preferences for what they do and do not like to eat, and will refuse to eat anything they have decided they don't like. With this in mind, I suggest presenting your son with the foods he likes and with the textures he likes. There is no harm to giving him "mushy" foods from a nutritional point of view. Also offer some finger foods at meals in case he becomes interested in them. Be careful not to allow meal time to become a battle of wills. If a child realizes that you badly want him to eat a particular food or foods of a certain texture, he may refuse to eat just to "push one of your buttons" and remain in control. The best rule is to place foods he usually likes in front of him and don't do anything else. Don't encourage or cajole him to eat. If he doesn't eat much it is o.k. The meal is over when he plays with the food and is no longer eating.
 

In addition to "early and often" - any other advice on getting a 3 year old to not only try, but eat veggies AND a variety of foods? As a baby, he ate everything and anything. In his toddler years, he will not only refuse to eat most foods, he has stopped even trying foods.

Patience and persistence is helpful. Also, be a role model. Make sure your toddler is eating meals with you as often as possible and that he sees you eating a wide variety of foods. He will come to see that as normal and natural and will, eventually, come to enjoy a wider variety of foods. Keep up the >often' part of introducing foods he isn't currently eating. Don't pressure. Make sure they are in kid-friendly form and not in overwhelming amounts. A pea-sized bite of a new food is adequate. Let him know he can spit a new food out if he finds he really doesn't like it. Read stories that portray healthy foods in a positive light, or at least be aware of the way foods are portrayed in storybooks and talk about them. Have your toddler involved in food shopping and food preparation. Grow a garden. All of these are little ways to increase your child's experience with, and hopefully preference for, a wide variety of healthy food.
 

I have a 13 month old who has a milk allergy. I still breastfeed her once before she goes to bed, however I feel like she is not getting enough nutrition. I make her nutritious homemade foods and she has a very healthy diet. However throughout the day, she drinks only water (no juice). She goes through about 10 or more fl oz of water a day. I am wondering if I should replace some of that water with soy-based formula to add more nutrition into her diet? I don't want to stunt her growth because she isn't getting nutrition from her beverage.

Yes, you should absolutely replace some of that water with a fortified soymilk or formula. If she is already eating a nutritious diet with a good variety of foods from all the food groups, then an infant formula is most likely not necessary. However, she does need the calcium and protein. You may also want to discuss with your pediatrician giving your child a fortified soymilk.
 

I run a home day care and have to provide meals and snacks for the children. Although the state has provided me with some guidelines as far as the nutritional adequacy of the foods I should be serving, they didn't provide anything in the way of menu ideas or recipes. I would also like to include activities that help my kids learn about good eating habits.

Your charges are lucky to have a caregiver who is concerned about good nutrition. The nutritious foods you serve them will not only help to instill preferences for healthy foods, it will also help them learn better. More and more studies are showing the importance of adequate nutrition for optimal learning.

For learning about the basics of nutrition that you can apply to your cooking and child activities, you may find this on-line course helpful. This course was designed to help child care providers learn about the nutritional needs of young children, plus train them in teaching the ‘Food Pyramid for Kids' to children. The Extension Service of the University of Nebraska developed it. It is ‘A new Independent Study Course for Child Care Providers' and is found at http://ianrwww.unl.edu/ianr/nerec/childcare.htm Cost per Internet training hour is $5.

For simple, straightforward information on childhood nutrition, and nutritious recipes to use at your day care you can order this cookbook designed specifically for you: Meals Without Squeals. Child Care Feeding Guide and Cookbook by Christine Berman, M.P.H., R.D. There are sample menus in adherence with the USDA's Child Care Food Program http://www.healthpress.com/mealswoutsqueals.html

For a wonderful online resource for child care nutrition, go to this USDA Website http://www.nal.usda.gov/childcare/ There are links to food and nutrition activities for kids, recipes, and more.
 

I have a two year old. And I would like to ask how much sugar can she intake in her diet a day. She has been waking up at night, and I usually have to go into the room a put her back to sleep. Is sugar an issue?

A toddler has no nutritional need for added simple sugars in their diet. And, because simple sugars tend to be in foods without much other nutrition, you actually risk having sugar replace more important foods in her diet. SoY.the concern isn't how much sugar can she have, but is the sugar displacing other, more important foods? If her diet is otherwise healthy, then some sugar, such as in ice cream or a cookie, is fine. However, if you find your daughter is eating sugary foods at the expense of other foods, then she may be missing important nutrients. I doubt that too much sugar is causing her sleep problems. However a diet high in sugar but low in healthy proteins and fat may be causing her to get hungry in the night, which may contribute to her tendency to not sleep well. It may also be causing some blood sugar fluctuations that are also disturbing. What I would recommend is that you try and minimize any added sugars in her diet, and instead focus on natural foods such as fruits, vegetables, whole grains, dairy products, lean meats and fish. You may also want to offer her healthier treats such as Earth's Best Sesame Street Snacks which are specially fortified for toddlers with 8 or more essential vitamins and minerals including calcium, iron, zinc and B vitamins.
 

I adopted my granddaughter. She is 2 1/2 and is a very picky eater. She loves all fruit and chicken nuggets, pizza, mac and cheese, etc. She used to drink, in a bottle at bedtime, milk with a little Ovaltine. However, when she stopped using a bottle she stopped drinking milk altogether. I have tried it in a cup to no avail. I just started her on a daily vitamin, hoping this will help but I need some suggestions for getting her to eat vegetables and drinking milk again.

Have you tried the Ovaltine in her milk in the cup? Or perhaps some chocolate milk or strawberry flavored milk may entice her to drink more. While it does have the disadvantage of being high in sugar, the benefits of getting the calcium and protein outweigh it. If she still does not take her milk, find other ways for her to get calcium into her diet. I recommend trying yogurt, cheese (she is already getting some on pizza and in macaroni and cheese), calcium fortified juices and snack items, such as Earths Best Cereal Bars or Arrowroot Squares http://www.earthsbest.com/products/index_tots.php As for eating more vegetables, you may need to up the kid-value of how you present them. First of all, make the vegetables into toddler size servings. Then, enhance their flavor either by offering dips or putting a little peanut butter on them. It may be she'll like some fresh tender cooked beans with a little cheese sauce on them (cheese sauce similar to what is in the mac and cheese). You can also hide vegetables by pureeing them and adding them to meat loaf, spaghetti sauce, or muffins. Another way is to enhance their flavor with something as simple as brown sugar and a little butter. Try adding some to mashed sweet potatoes or winter squash to entice her to eat her vegetables. Finally, set a good example by eating and enjoying them yourself. Offer them but do not force them, and allow her to spit it out if she finds it disgusting. Many vegetables are an acquired taste. Some of the vegetables more popular with little children include potatoes, corn, sweet baby peas, and tender sweet baby carrots. Hopefully you'll find at least one or two she will like.
 

My 19-month-old daughter is a VERY healthy eater. She does not like sweets and loves all fruits, all beans, most veggies etc. The problem is she has always been low on the weight side. I feel like she needs more fat in her diet, but since she is such a healthy eater it is hard. She has cheese almost everyday, but sometimes that is the extent of her fat intake. She likes nuts and yogurt, but this is such a small amount of fat in total. Also, she does not like milk, so I give her calcium fortified orange juice once a day. Am I being overly concerned or are there other was of getting some fat into her?

Your daughter is at the age where she can transition to a low fat diet, so you don't need to be overly concerned. However, healthy fats will be important to include in her diet for the rest of her life because they provide essential fatty acids (those that her body cannot manufacture) and are necessary in order to absorb essential fat-soluble vitamins including vitamins E, D, and A. There are other ways you can get good fats into her diet. Foods that provide important fats include eggs that are high in Omega-3s (the carton will say the eggs contain this fat), fish - especially fatty fish like salmon, nuts and nut butters like she is getting now, and olive and canola oil. You can use these vegetable oils to cook her vegetables in or to serve over the lettuce or salad she eats. If she enjoys baked goods, such as whole grain breads or pancakes make them with some added fats. Being low on the weight end of the scale is not dangerous in and of itself. But if it is an indicator that she is not getting the nutrition she needs to develop and grow on schedule, then the low weight is a problem. Your best way to ensure that she is getting the nutrition she needs is to speak to her doctor, making sure she is meeting developmental targets, that blood lab levels are in normal ranges, and that she is a typical, energetic, curious almost-two-year-old. I'm guessing that she is!
 

My three year-old daughter refuses to eat meat unless it is a chicken nugget. This is very dismaying, as I don't consider chicken nuggets a very nutritious food. I always offer her small bit of whatever meat her 21 month-old little brother is eating or whatever my husband and I eat, but she flatly refuses. She is pretty open to eating broccoli, corn, carrots, peas and green beans, but won't eat "salad vegetables" or potatoes. She will not eat vegetarian "fake" meat either, such as veggie burgers or crumbles. I am concerned about her iron consumption especially. What can I do to encourage her to try meat?

I wouldn't worry about her reluctance to eat meat. Many children don't like meat, find it too hard to chew, dislike the‘yukky' mouth feel, or refuse for some other totally in-comprehensible reason. But, thank goodness vegetarian kids can be as healthy as their meat-eating counterparts. You just need to be sure she gets protein and iron from some other source. Iron is easily obtained from iron-fortified cereals and healthy snacks. Earth's Best offers iron fortified cookies, cereal bars and crackers http://www.earthsbest.com/sesame_street/products/index.php, http://www.earthsbest.com/products/index_tots.php as well as a wide variety of iron-fortified cereals that are appropriate for your three year old http://www.earthsbest.com/products/product.php?prod_id=969&cat_name= . Or, you could offer her a child's multi-vitamin and mineral supplement that contains iron. The protein she misses from not eating meat can come from a number of different sources including nut butters, cheese, milk, eggs, yogurt, beans, or tofu (have you tried tofu?). If you continue to offer meat to her in a kid-friendly form, in a non-pressured manner, I am predicting that she will eventually come to like it. However, if she doesn't, you can be sure she is getting the nutrition she needs without it if you simply follow the suggestions above.
 

My three-year-old eats fairly well at breakfast and lunch. But when dinnertime comes I feel like a short-order cook. She will not eat anything made with ground meat. She loves chicken but only when it's made certain ways. I've done what all the books tell you to do; only give her a couple tablespoons of each thing, tell her that is what is for supper and let her eat what she wants off the plate and have seconds, but it's not working. She just won't eat supper when I do that so I'll make her chicken nuggets or whatever because I feel bad if she doesn't eat. Am I doing something wrong?

Your overall approach sounds great. I do have a suggestion for you, though, and it is based on the fact that kids grow to like new foods the more they are exposed to them, and encouraged to try them. In fact, based on the findings of studies, it takes about 10 exposures to a new food before a picky toddler will even try something new. And even that doesn't guarantee he'll like it. Continue to offer her foods that you are serving for dinner. As much as possible, make foods that are kid-friendly. Make sure that there is at least one thing on the table she will like.

So, for example, if you are having meatloaf, serve her a small bit. Ask her to taste a little bite with the option of spitting it out if she doesn't like it. Also, have a basket of bread on the table if that is what you know she will eat, or a bowl of mashed potatoes or whatever food item is you know she will accept. It is fine that she won't like everything served! Since you know there is at least one item she will eat, you don't need to worry that she will go hungry, yet you are not short order cooking, and not giving the appearance of catering to food whims.

You can be confident she is getting the nutrition she needs because of the foods she is eating at other meals and snacks. It is only fair to recognize personal food likes and dislikes. Just as you respect your own and your husband's likes and dislikes, to a big extent you need to respect those of your children. However, with kids, it is a little different in that we also need to work on expanding their food repertoire. To do that we need to encourage the acceptance of new foods, but not the forced eating of disliked ones. There is a difference! To encourage acceptance of new foods, it's helpful to be aware of and sensitive to kids special food idiosyncrasies. For example, kids like colorful foods, they like foods to be separate from each other, they like food to be 'fun'. So, to help encourage eating healthy foods, include those healthy foods designed especially for children, such as Earth's Best Sesame Street Yummy Tummy Oatmeal (http://www.earthsbest.com/sesame_street/products/yummyyummy.php) (at breakfast or for a snack), or Crunchin Crackers (http://www.earthsbest.com/sesame_street/products/crunchincrackers.php) with that bowl of soup for dinner. Most importantly, maintain a relaxed attitude. Keeping mealtime a pleasant time, where the company is the focus is most important.
 

Ever since our son was a toddler, it was a habit of giving him a snack about an hour after dinner. Now that he's older he gets a snack if he eats all his dinner. I've read that you shouldn't require children to eat everything, but I'm afraid that if we didn't do this, he wouldn't eat anything. By the way, he is very picky. he eats fish sticks, chic nuggets, pizza, burgers, tater tots, mac and cheese, corn, carrots and that's about it. He also eats just about any type of fruit. Should we offer this snack as a reward for eating dinner?

Your son, despite being picky, has a nice variety of foods that he is willing to eat, and all the food groups are represented. I hope also that he is drinking milk each day. You should be pleased that he includes fruits and some vegetables in his repertoire. You are correct in feeling that perhaps the snack should not be offered as a reward. Your son can best stay tuned in to his internal eating cues without outside rewards and punishments. Offering food as a reward, for anything, be it good behavior, or finishing his vegetables, takes food out of the realm it is meant to be in and can set up attitudes and habits towards food that may be unhealthy in the long run. If your son is hungry he will eat his dinner. You want him to learn that food is to satisfy hunger. If he is not hungry, you don't want him to eat, or to eat more than his body is telling him he needs to eat for fear he may not get his evening snack. An evening snack is fine for a young child, even if they didn't eat all their dinner. The same is true for an adult. We should all learn to push the plate aside when we are full, not just when the plate is empty. Likewise, it is okay to have a healthy snack in the evening if we are hungry. So, I suggest you continue the evening snack, unattached to any other previous behavior, and perhaps you can even join him! Earth's Best has come out with some healthy snack foods you may want to consider as an option for snacking, late in the evening, or any time. They are fortified to help meet some of the nutritional deficiencies that are common amongst toddlers because of their pickiness. And, even consider the cereals a good late night snack, especially the oatmeal, which will be warm and calming. You can check out the snack foods here: http://www.earthsbest.com/sesame_street/products/index.php
 

What is your opinion on feeding young toddlers fast food like McDonald's hamburgers and fries?

McDonald's and other fast-food chains are easily avoided with very young toddlers. If you have no older children, who are sophisticated travelers on the Miracle Mile, and require a trip now and again to a fast food establishment, with the one-year-old in tow, then there is no need to even introduce your young one to those tastes. This gives you more time to develop more-healthful food preferences. Hamburgers and French fries at McDonald's provide no better nutrition than you can at home, plus you can do it with a fraction of the sodium and fat.

Babies have no need to consume foods that have been highly salted, nor eat fatty foods that come without other important nutrients. There is also a blatant lack of fruits and vegetables offered, leaving a nutritional void in the meal. If your one- or two-year-old knows nothing of fast food, don't introduce him to it unless you have to.

Once your child is older -- and peer pressure or the quest for a must-have Happy Meal toy -- takes over, an occasional visit for a burger and fries can be lots of fun. If it is only a once in a while event, then you have not increased its appeal by making it the "forbidden fruit," nor have you ruined the nutritional balance of your child's diet.

It is an important skill to learn to know how to fit fast foods into an otherwise wholesome diet. It can be viewed much like the birthday cupcakes that your kids will end up eating a few times a year at various friends' birthday parties. There is really no nutritional need for them, yet they are tasty and have a place in the diet, which is only on occasion -- not a regular event.
If you are in a situation now where you go to fast-food restaurants on occasion, for whatever reason, then there is certainly no harm in letting your one-year-old have a burger and fries. Opt for the milk or orange juice instead of the soda!

In sum, I think the best way to deal with fast-food restaurants is to avoid them as long as possible, and once they can't be avoided, don't go too often.