Nutrition dos and don’ts: ages birth through three years

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This is an article from our “Doctor’s Corner” series, brought to you by Samitivej Hospital. Make sure to read the entire series!

It is amazing how much time a parent will spend determining, preparing, and then ensuring their child eats meals that are nutritious and sufficient in amounts that guarantee healthy growth and development. Every visit to the pediatrician that includes a weight and height measurement can feel like a test to a parent of a child considered a “fussy eater.” Parents commonly ask “has my child gained the appropriate amount of weight since the last visit?” or “how does my child compare to where he or she should be on the growth curve?” Breastfeeding, bottles, introducing foods one at a time, puréeing food and then not puréeing food, and making sure a child eats can be time consuming and stressful.

Nutrition dos and don'ts

The following are some age appropriate milestones where nutrition and childhood development meet that will help keep a parent on track.

Four to Six Months
Babies are ready for solid food between the ages of four and six months. Children who are ready for solids have good head control, sit well with support, swallow their food instead of spitting it out using their tongue, and are hungry despite having six to eight feedings of breast milk or formula.

Iron fortified baby cereals are a good solid food to try first. In particular breast fed babies need to start with iron fortified cereal as breast milk does not include iron, and a baby’s iron stores are beginning to dwindle by this time. After the cereal is going down well, begin to introduce a new puréed food every three days. Puréed food can then become increasingly chunky over time.

Looking for a doctor for your child development questions? We recommend:
Pikul ArsirawechPikul Arsirawech, M.D.
Behavior Counseling Pediatrics, Developmental and Behavioral Pediatrics, Samitivej Hospital
Questions about your pregnancy, child birth or life with an infant? Ask the Doctor!

 

Eight to Ten Months
Babies need to develop fine motor skills (small exact movements) and one of the ways they do this is by feeding themselves finger foods. Learning to pick up pieces of soft pasta, chunks of soft fruit, ground meat, and small pieces of cheese with their forefinger and thumb is therefore important. Also, it is time to drop the bottle at mealtimes in exchange for a sippy cup. This is a messy and time consuming process but keep at it!

Twelve to Fifteen Months
Fine motor hands movements should be developed enough to enable children to begin drinking from a regular cup or cup with a straw attachment. Start introducing a spoon and fork but keep in mind they will be far from proficient at using them for a while. Be prepared for many spills along the way.

Eighteen Months to Two Years
Children at this age should be able to feed themselves with a spoon and drink from a regular cup. However, continue to expect spills and mess.

Many parents fall into the trap of creating poor feeding habits, especially if their child is considered a picky eater. However, most will discover that in the long term it would have been better to avoid the traps. Therefore:

  1. Have children eat their meals in a chair either at a table or a high chair. Don’t run after a child trying to scoop extra bits of dinner in their mouth.
  2. Meals should a time to focus on and enjoy food. This means no T.V. or toys at the table. These should be a reward when the meal is done.
  3. Be careful about power struggles involving food. Children will be hungry one day and not as hungry the next. As long as a child is following their growth curve don’t worry about how much food a child eats day to day. Find ways to put more calories into small frequent meals but when a child signals he or she is done continue to take the food away. Around the age of two children are looking for ways to express their independence and children can sometimes choose to refuse food as a way to make their level of independence known. If there is concern that a child is falling below their growth curve consulting a pediatrician is advised.
  4. Limit juice and the use of sippy cups. Juice is not a nutritional necessity and bottles and sippy cups often lead to liquid to remaining in the mouth resulting in dental carries. Also, if a bottle is placed in the bed with a child it should be only filled with water for the same reason.
  5. Watch the amount of milk a child drinks. A two year old needs approximately 16 ounces (480 mls.) per day. Once a child is drinking 32 ounces or more it begins to fill them up and they will refuse solid food. Excessive milk also interferes with iron absorption.

Good Luck!

Samitivej, We Care!

Pikul Arsirawech, M.D.
Behavior Counseling Pediatrics, Developmental and Behavioral Pediatrics
Samitivej Sukhumvit Hospital

For further information, please contact:

Child Health Institute
Samitivej Sukhumvit Hospital
2st Floor, Building 2
Tel: 66 (0) 2711-8236-7
Call Center: 66 (0) 2711-8181
E-mail: info@samitivej.co.th
Facebook: www.facebook.com/samitivej

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