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The Art of Feeding a Toddler

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Suzanne Dixon
By Suzanne Dixon M.D., M.P.H.
"There is nothing so amazing as the development of a child," says Suzanne Dixon, M.D., a behavioral and developmental pediatrician who was one of the founding members of the Pampers Parenting Network. "Every day is a new adventure when you have a child around you. I never get tired of learning from the children who have been a part of my life, professionally and personally."Suzanne Dixon, M.D., M.P.H., was born and raised in Minnesota and graduated from the University of Minnesota, School of Medicine. She did her pediatric training at Massachusetts General Hospital in Boston and then completed a fellowship in Child Development at Boston's Children's Hospital. Dr. Dixon joined the faculty at the University of California, San Diego, and did patient care, teaching, and research for 20 years. She ran a large newborn service, performed research in early child development, and was involved in many community outreach activities in maternal child health. Throughout her entire professional life she has maintained an interest in cross-cultural activities, living and working in many parts of the world, including Mexico, India, Kenya, Indonesia, and several countries from the former U.S.S.R. Dr. Dixon is the author of numerous research articles, review articles, and textbook chapters in pediatrics, child and family development, and public health. Her textbook, written with Dr. Martin Stein, Encounters With Children: Pediatric Behavior and Development, has become a classic in child health education and is in its fourth edition. She is Editor in Chief of the Journal of Developmental and Behavioral Pediatrics, an international journal of high standing in the professional world. She also has served as an associate editor for Infant Mental Health and currently reviews for several major pediatric journals. Dr. Dixon is a fellow of the American Academy of Pediatrics and served in national positions in that organization. She is a member of the Society for Pediatric Research, the Society for Research in Child Development, the American Public Health Association, and the Executive Council of the Society for Developmental and Behavioral Pediatrics. She serves as consultant to several national and international organizations and has received an award from Healthy Mothers, Healthy Babies.Dr. Dixon continues to lecture and consult worldwide on aspects of maternal, child, and family health. She practices behavioral and developmental pediatrics in Montana and works with local advocacy groups on education and women''s health. Dr. Dixon has been married for over 30 years and has three sons. She and her husband travel frequently, are outdoor enthusiasts, and enjoy being amateur anthropologists.
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Toddlers and preschoolers are notoriously picky eaters. Starting at the 1-year mark, even previously voracious eaters suddenly seem to lose interest. As they get older, toddlers develop strong opinions about what goes on their plate (and where it is on their plate). Because feeding is at the heart of nurturing, a child's rejection of our carefully prepared food cuts to the core. At such times, it's important to see the big picture. You're teaching your child healthy eating so she can take care of herself over a lifetime. Seeing things from her perspective helps you in this task.

This picky fussiness is normal behavior for 1- to 3-year-olds. Your child is trying to establish her independence and let you know that she wants to take charge of herself. She's also settling into a growth pattern that will lead her toward her genetic body type. The roly-poly baby of slender parents will begin to look more like the rest of the family in these years.

Here's what you can expect at the table during these picky eating years and how to deal with it.

 1 Year

 18 Months

 2 Years

 3 Years





1 Year

At his first birthday, your child is probably more fascinated with learning to walk than with eating. As such, his interest in food plummets: He's just too busy to spend any time eating. But this is normal: Your child grows more slowly in the second year, and his appetite will decrease appropriately. The extra fat he stored in the first year will help fuel this exciting movement. Don't expect any long meals right now.

Still, tots this age need energy to keep going. A 1-year-old can run out of gas quickly and may get frantic or irritable. It's best for him to have five or six small meals throughout the day, including two or three healthy snacks. Give him food in very small portions, adding more if he finishes. A lot of food overwhelms a toddler and just invites him to swipe it all overboard from the high chair or table.

No Time to Eat

Because it's so hard to pin him down, every bite counts for a busy toddler. Empty calories in cookies, sweets, or juice are a waste of your child's time and appetite. Click here for tips on healthy snacks for toddlers. If you or your health care provider thinks your toddler needs to consume more calories, you'll need to look at increasing the nutritional value of every bite rather than increasing the amount he eats. Think about putting an extra spread of butter or cream cheese on toast or a thicker slice of cheese on a muffin, for example.

Offer your child nutritious food at your regular mealtimes as well, but don't force him to eat. Young children who are allowed to decide for themselves when to stop eating grow up to have much healthier eating habits. Your job is to be sure that healthy, appealing foods are offered regularly and in the same eating place. Your child is in charge of whether or not to eat at that time. If he passes once, he'll be hungrier at the next scheduled time.

Having your child sit down with you at regular mealtimes,— no matter how little he eats, will eventually teach him to eat when meals are served. Toddlers and preschoolers love to eat at the table with the family, and it's the perfect opportunity for them to learn about socializing and table manners. If your child resists or throws food, he's letting you know he's done. Set him down or give him a book to read, but don't coax him to eat more food. It sets up a battle that you can never win.

The Big Mess

Your child learns a lot from "playing" with his food. Dropping food on the floor, squeezing it, and smearing it are all ways he learns about food and how to enjoy eating it. He probably can't use a spoon well, but he should have one anyway, for practice. Toddlers want to feed themselves, and you should encourage it by letting them, no matter how messy they are. Your may also be learning how to use a cup —— again, this means a lot of spills. Your best option is to learn to live with the mess by using (and wearing)— easy-to-clean materials.

Meal Tip

If your child decides he'll only eat pasta bows, for example, talk to your health care provider about whether you should give him a baby vitamin. In general, children don't need extra vitamins, but if your child is really putting up a fight about food, it may help you feel better. Don't give him adult vitamins — they can be toxic to children.

No Meals on the Go

Setting up good eating habits means eating in a regular eating place, such as in a high chair or chair in the kitchen or dining room. It does not mean in front of the TV, in the bedroom, or walking around the house. Toddlers who walk and eat are at risk for choking, as well as long-term bad habits.


18 Months

Your child needs less food now than she did during her first year. Surprised? Don't be. She's just not growing quite as fast, and so many other exciting developments are competing for her time.

Children this age are very picky about what they'll eat. Don't force-feed your toddler or require a clean plate before she leaves the table. She knows how much she needs, and she'll eat appropriately if not pressured. Forcing her will only result in a food battle —— one you won't win! It can also lead to eating problems when she's older.

Binges and Refusals

Your child can eat many of the same dishes the whole family eats. Just take out her serving before you add salt and strong spices. Of course, she may not necessarily agree to eat what you're eating. Toddlers this age tend to fixate on one beloved food and eat only that for days. These "binges" are normal, however, so don't worry. If what your child is eating is nutritious, it doesn't matter how often she eats it. Offer her a variety of foods anyway, a little at a time, to get her used to the sight and texture of new foods. Generally, you have to offer a food about 10 times before a child this age will accept it, so don't be upset or daunted by the first or second refusal.

    • Try not to use food as a reward. If your child starts to eat to please you, she isn't eating for the right reasons.
 
    • Don't bribe a child to eat. It sets up a silly game that escalates to unreasonable levels. And it doesn't lead to good, self-directed, healthy eating. Studies show that a child will eat less, not more, if this is how you interact.
 

Make sure you give your child plenty of opportunities to feed herself — she's ready to practice using a spoon and a cup. Avoid foods she could choke on, however, such as whole grapes, nuts, or raw carrots. Hot dogs are the most-choked-on food! Cut them into small pieces lengthwise and also across so she won't choke if you're going to serve them.

Fluid Facts

How much should your toddler drink? In general your child shouldn't have more than 4 to 6 ounces of juice each day, and all of that should be from a cup. Juice is mostly just sugar and water, and fruit is better for her. Juice addicts have poor growth patterns and are at risk for "toddler diarrhea," tooth decay, and nutritional imbalance. Your toddler doesn't need more than 24 ounces of milk, either.

If your child is still sucking on a bottle, you should start trying to wean her now. A "sippy" cup is a good alternative to a regular cup if you can't stand the constant spills. Don't let your child take her bottle to bed. It's not good for her sleep or her nutrition and could rot her teeth and make her more prone to ear aches.

Meal Tip

Learn to love a mess! Your 18-month-old needs to try feeding herself to bolster her emerging sense of independence, as well as learn how to use utensils and cups. A big bib will help protect her clothes from the worst of it, and you might put a plastic mat under her high chair. Get used to messy mealtimes. And don't forget to change out of your nice clothes when it's feeding time.

At the same time, don't tolerate airborne food. If your toddler starts to fling food all about and has stopped eating, it means she's done. Put her down, and don't try to coax more food into her.


2 Years

Your 2-year-old is still a picky eater, but he's watching you like a hawk so he can be just like you. Providing him with nutritious foods and eating well yourself are two of the best ways to get him to eat right. Be aware that he's picking up your bad habits as well as your good ones.

Your child is growing much more slowly than last year, so he really doesn't need as much food as you might think he does. He's also extremely opinionated about what he'll eat (and where he'll eat it and when he'll eat it, as well as in what bowl he'll eat it). He may continue to "binge" on favored foods for a while, only to suddenly reject them later.

Pick Your Battles

If you give in to these picky habits quietly, your child won't fight for them as hard. Insisting on your way will only make the battle that much more important to him. You can't win. Just be sure all the foods you give her are nutritious, and it won't matter if he only eats one of them every night for a while. Don't ask him what he wants to eat —— that choice gives too much power for a very small person to handle. You make the selection from reasonable, kid-friendly foods.

Make sure your child eats at the table. People who eat at a set time and place usually get the best nutrition and are in the best physical shape. Establish this good habit early. Keep meals out of the car or bed and away from the TV. If your child won't drink much milk, give him calcium in the form of cheese or yogurt. He should be weaned off the bottle entirely now.

Food Fight!

If your 2-year-old refuses to eat anything you put in front of him, you've gotten yourself into a feeding war that you can't win through confrontation. Try these methods:

    • Remove him from the table and try again in a couple of hours, at the next regular mealtime.
 
    • Start with a nutritious snack, such as cheese and crackers or fruit. Put it on a tray and join him. But don't stare at him and wait for him to eat.
 
    • If he still refuses, put him down again and stop worrying. No healthy child, even a 2-year-old, has ever starved himself. He'll be ready to eat at the next regular mealtime.
 

Ask your day care provider when and what your child is eating during the day. If his diet isn't ideal, discuss the matter with your day care provider. If your provider can't supply what you want your child to eat, offer to send a lunch pail for your child. But don't be too fussy; children learn from different care environments, and there is a lot of leeway in children's diets. If possible, stop in for lunch with your child from time to time.


3 Years

Although your 3-year-old still has very definite ideas about what she wants to eat, she's more willing to try new foods than she was last year. She'll probably like certain foods because of their colors or shapes, and she may still insist on food being arranged "just so." She'll also enjoy helping out in the kitchen, as long as you're patient with her limited assistant skills.

The reluctant eater of this age may accept foods that are presented in a new or interesting way, on a special dish or in an unexpected shape. So it's time to get clever and have fun together.

Three-year-olds learn so much about eating and socialization at the dinner table with their families. Studies show that children who eat at least one meal a day with their families have better vocabularies, as well as better diets. Now is the time to get your child in the habit of sitting at the table with you, not in front of the TV. Turn the tube off during mealtimes and talk instead. And have meals at regular times, at a regular place, such as the kitchen or dining room table.

Your 3-year-old is really ready to learn table manners. Teach her to say "please," "thank you," and "may I." She should only spill a little and not throw at all. She can and should help set the table. She's likely to enjoy the habits and rituals of family meals.

That is, she will if you can get her to the table at all. Preschoolers are often so busy playing that they can hardly be bothered to stop. Don't let your child get into the habit of eating on the go, however. Easy-to-eat, easy-to-carry foods are often high in salt, fat, and sugar. And don't ask your child to decide what's for dinner. It gives her too much power and sets you up to be a short-order cook. Your job is to decide what's for dinner; her job is to eat it. Don't set yourself up for long-term haggling with a 3-year-old.

Here are a few important things to remember about feeding your 3-year-old:

    • Constipation can be a problem at this age. It's usually caused by eating too many dairy products and not enough fruits, vegetables, and water. If your preschooler is having painful, hard stools or doesn't have a BM for a day or two, change her diet right away. If the problem isn't corrected in a day or two, call your health care provider for advice. Your child may become reluctant to use the toilet if this goes on too long.
 
    • Take steps to wean your child from her bottle, if you haven't already. Drinking from a bottle at this age could hurt her teeth or cause her to drink too much milk or juice, which can make it difficult for her to learn proper eating habits at home and at school.
 
    • Don't use food as a reward or bribe for good behavior. Studies show that this pattern leads to short-term decreases in eating and long-term battles.
 
    • It's still a good idea to avoid small, hard foods such as hard candy, chewing gum, peanuts, and corn nuts. These foods could lodge in your preschooler's windpipe and choke her.
 
    • TV and meals don't mix. Your 3-year-old will develop bad eating habits and miss out on the social activity of family interaction if she eats in front of the TV, and she'll start being influenced by commercials pushing foods that may not be the best choices for her.
 
    • Keep bread, crackers, or a bowl of pasta available at each meal so your child can make a choice between these, if all else fails.
 

Meal Tips

Make mini pizzas with your 3-year-old! You can pack a lot of nutritious vegetables and meats (even leftovers) under melted cheese. Use an English muffin or half a bagel, well-minced or pureed vegetables, chopped up chicken, or even a minced hard-boiled egg. A red sauce will make them stick, and the cheese will glue it all together. Your child will love this pizza even more if she gets to help make it.

Use cookie cutters to make shapely sandwiches! Great fillings include smooth peanut butter, cream cheese and jam, and finely minced tuna, meats, or eggs. Allowing your 3-year-old to cut out her own shape will make it more fun for her.

 

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Member comments

LOVED this article. Great information, and even helped explain why my toddler does certain behavior..

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