Q&A about nutrition for toddlers with Dr Frankie Phillips

Dr Frankie PhillipsDr Frankie Phillips answered your questions about food and nutrition for toddlers in July 2013. This Q&A is sponsored by Organix

As a registered dietitian and leading child nutritionist, Dr Phillips has experience in advising patients about their diets and has appeared on a range of TV and radio programmes. She answered your questions on dealing with fussy eaters, balanced diets and toddler friendly snacks.

 

Fussy eaters

Q. mandmsmummy: I have two fussy children who will not eat food mixed up, but they love potatoes and pasta. Any tips on how to win them over?

A. Dr Frankie Phillips: It's always good to hear when children love their food! I'm guessing that your children would eat the pasta with a bolognese sauce, or potatoes with mince separate but just not when they are in a dish together. In that case, have you tried getting them to help you make the food? Yes, it will be a messy event, but if they can see for themselves that the foods that they love are just going on top of one another, that might be all that's needed. If you can, perhaps get some child-sized pots to serve the shepherd's pie in and get them to layer the foods and add in any extra foods they fancy eg some grated cheese on top.

"Getting children involved in making their own food is a really helpful way of encouraging good eating habits and it's teaching them a life skill too. It's something that is seeing a bit of a comeback now as we realise how important it is to teach children about food and cooking."

Getting children involved in making their own food is a really helpful way of encouraging good eating habits and it's teaching them a life skill too. It's something that is seeing a bit of a comeback now as we realise how important it is to teach children about food and cooking. Try to stay calm, get all of the things you need together on the kitchen table and let them make up some child friendly recipes. You may be able to pick up recipes to try at your local children's centre, or try the Change 4 Life kids cookbook.  

Q. Xiaoxiong: My son is 18 months old and drinking between 400 and 500ml whole milk a day in addition to three meals which we attempt to make balanced, but it's often futile when he rejects the healthy stuff. Luckily he eats loads of fruit and any carbohydrate we put in front of him but vegetables, like broccoli and spinach, are a no go even though we've been offering them to him since he was six months.

We've tried reducing his milk, diluting it, offering water/diluted juice and nothing works. He gets to the end of the smaller amount we offer and has a meltdown demanding more. I want to go with the flow and trust that he knows what he needs but he's having so much milk, more than any of the other kids his age we know, that I am starting to doubt myself. He's getting 1/3 of his calories through milk daily, in addition to guzzling any cheese or yoghurt we offer.

Am I overthinking this? Do toddlers still just regulate themselves? If they do, how come we keep reading about obese toddlers?

A. Dr Frankie Phillips: It sounds like you've been struggling with the start of your son's need to have more control over what he eats. People will say it's just a phase, and as you put it 'go with the flow', which in many cases is true but in the mean time, I can see you want help to deal with it now! 

Research shows that infants and toddlers under two can self-regulate their appetite. If they don't eat much at one mealtime, they make up for it at another, or vice versa. It's important to look at what they're eating over say, a week, rather than looking at one day in isolation. Also, if he's growing and developing well, then that tells you he's eating enough.

Regarding milk, we recommend at least 300ml of whole milk per day but this can be used on cereal, for example, as well as in drinks. At 18 months it's important to move onto a cup or a lidded beaker with free-flowing or no valve. Perhaps giving him a new drink beaker or a cup, or let him choose one, with only water during the day or with meals might be worth a try. You could use the milk as a drink at a specific time of day, eg having a bedtime story and on breakfast cereal to show that there is a time for drinking milk and he can come to expect it then, but not all the time. Dealing with a tantrum is awful, I know, but you need to keep yourself calm and have a plan to deal with it. I find that having a good distraction is the best thing at this age.

Regarding meals, it's fantastic to hear that you are aiming for balanced meals, and as a family eating a balanced diet is so important. It's always good to eat together, so if you can do this he can see you enjoying the meal too. If some foods are rejected do keep putting them on the plate even if it's just the tiniest amount as we know that number of exposures to a new or unliked food can increase later preference for a range of tastes. Snacks are another good way of introducing a new food too, but stick to just a couple of snack times rather than grazing as you may find he's not hungry at mealtimes.

"And don't doubt yourself. If you're giving a good example, staying calm and in control, you'll get there!"

And don't doubt yourself. If you're giving a good example, staying calm and in control, you'll get there!

Q. JacqueslePeacock: My son is 21 months old and is becoming fussier and fussier. He won't eat any vegetables unless they are seriously disguised. He loves fruit but even there he is becoming faddy, insisting that the skin is taken off etc. We are vegetarian so he doesn't eat meat but he's also started refusing eggs and yoghurt (unless it's very sugary). Even houmous, which he previously loved, is often rejected now. Despite our best efforts to limit sweet stuff he is demanding cake, biscuits and other sweet things. Do you have tips on how to limit sweet food while still getting enough calories into him? Also, how do I make sure he's having enough protein?

A. Dr Frankie Phillips: It's a recurring theme that once children hit the toddler age they can become seriously opinionated and need to show off their new skill of choosing for themselves. This is an important part of development but can be really frustrating, especially when it comes to eating well. Try to look at your sons diet over a few days, be quite strict about snacks and make them planned snacks rather than grazing. Even if he is demanding cake, biscuits and other sweet things, it's down to you to set out the ground rules and to stick to them. This might be tough at first but try to introduce non-food treats, limiting the sweet treats to specific times. That way he can learn to enjoy the sweet treats occasionally as part of a healthy balance.

As for getting enough protein, there are lots of easy ways to add more protein through healthy snacks. Try some soft cheese or a nut butter eg peanut or brazil nut butter, with breadsticks and sticks of cucumber or pepper to dip in, slices of French toast (eggy bread) or sliced hard boiled egg on top of a mini rice cake, or maybe get some frozen peas in a little pot and let him eat these (yes, cold, straight out of the freezer, they do taste good!).

Q. AimForTheMoon: My four-year-old son is a very fussy eater, he has never been particularly interested in food. We tried baby led weaning but he would never bother to put anything in his mouth. He would eat pretty much anything we gave him when he was little but we always had to spoon feed him. After a bout of toddler diarrhoea at about two and a half, he lost his appetite and has gradually cut down what he will eat to meaty pasta, porridge with brown sugar, toast with honey, crackers with butter, plain pasta with cheese on the side, cheese sandwich, apple, mango, fish fingers and waffles, hula hoops, bourbon biscuits and ice cream. He eats a variety of sweets if he is allowed and only drinks water or lemonade. He has been referred to a child psychologist and had blood tests to check there are no physical problems. He takes an iron supplement and daily multi vitamin. Is there anything else I can do to keep him healthy? I am concerned that such a limited and crappy diet will have a long term effect on his development. He says he only wants to eat food the same colour as us. In his case, pasty!

A. Dr Frankie Phillips: Yes, you're right that his diet is quite limited but from the list you give I can see that he is still having some food from each of the food groups, protein (meat, fish, egg, beans), dairy, starchy carbohydrates and fruit/vegetables. However, tricky as it may seem you need to limit the number of occasions where he's eating the sweet sugary foods and the lemonade. His teeth will be at risk of decay if sugary foods are eaten frequently so for now I'd suggest leaving out the lemonade and just stick to water, and keep the sweets and sweet biscuits to just a couple of times a week at the most.

You mentioned about the iron supplement and the multivitamin. Not all of these are suitable for a four-year-old so check with the pharmacist that you're using a brand that includes the right balance of nutrients for under five's.

I'm glad you mentioned about the referral to a child psychologist as it sounds like you are struggling. His growth and development are a good indicator of how he is doing more than his eating behaviours. Rest assured that if there are no physical problems and he's growing and developing well otherwise then his diet is something that you can work on over time. The psychologist will be able to work with you to gradually introduce new foods and support you through this time.

Q. NatashaBee: What are your thoughts and opinions on fruit? It's the one thing my son will consistently eat, even when he rejects his normal meals. But, I'm worried that it's still sugary and bad for his teeth. If he eats fruit for every meal for a few days, is that better than him eating nothing?

A. Dr Frankie Phillips: Fruit is a fantastically versatile food to include in a child's diet. It works well as a snack, in puddings, in savoury dishes and salads and the bright colours and sweet tastes really appeal to children. However, as you point out, sugar is naturally sweet and the juices are slightly acidic so it can cause damage to teeth if too much fruit is eaten frequently or grazed on over a long period of time. Combined with poor teeth-brushing it can lead to tooth decay. If your son enjoys eating fruit that is good news, make sure you give him lots of variety. But, fruit isn't a substitute for meals and should not be used as a fall-back option if meals are refused.

The nutrients found in fruit are fine but it doesn't contain all of the nutrients that children need, so protein, essential fats and a range of vitamins and minerals must come from other foods in the diet. There is a lot of advice around fussy eating and how to ensure your child gets through faddy eating times and you need to take control over mealtimes so that things do not escalate. Before you know it, he might even only eat one or two fruits, severely limiting the foods eaten as it becomes an area he knows he can control. It's important to set boundaries with children and eating at mealtimes is part of that. Have a look through the answers I've given to other Mumsnetters who are concerned about fussy and faddy eaters, and download some of the Change 4 life resources to give some more ideas.

If you can take control and put up with some tantrums in the short term, it is far better than having to deal with a permanently picky eater, mealtimes will be calmer and more enjoyable for everyone, and more than anything, children will get a good balance of foods and all of the essential nutrients needed for growth and development. 

 

Balanced diet

Q. Thereonthestair: I have a three-year-old ex-premature child with cerebral palsy. I know he has additional nutritional needs as he uses more energy to walk etc. That's fine, but I am getting nowhere with a balanced diet. He loves bread, pasta etc but eats no fruit except bananas and raisins, and only peas, sweetcorn, broccoli and spinach (and baked beans if they count) by way of veg. He can sometimes be persuaded to try things with food hidden such as pizza, fishcakes etc. He also dislikes milk and drinks only water. He is not keen on it in things but will tolerate it occasionally, but not cream and nothing sweet. He even dislikes chocolate and cake so bribery is out. He's quite adventurous with hot tastes and chillies etc and will usually try things before he decides he doesn't like them.

How much does balance in a conventional sense matter for a three year old? I spent months watching his weight, diet and growth when he was first born and as such, always care that he eats enough and care less that it is balanced but maybe that should change.

A. Dr Frankie Phillips: It sounds like your little one is doing quite well and his diet is not that severely limited from what you have said. You might want to ask your GP to refer you to a registered dietitian for specific help and to make sure that his diet is along the right lines by doing a thorough food diary with you.

You say he is quite adventurous with new tastes, which is a brilliant starting point! With milk, yes, it is a great drink for children but it isn't essential. If he eats cheese then this is just as good for calcium and you can always try adding milk to other foods eg in sauces or mashed potato, otherwise, it's fine to just drink water.

If he's not keen on fruit per se have you tried offering fruit in different ways? Maybe put apple or pineapple with chunks of cheese or try making a smoothie together using banana (and maybe even some plain yogurt). You could also put some fruit into a spicy stir. If he likes raisins have you tried other dried fruit such as dried apple and dried apricot?

The thing about balance is that it doesn't have to be achieved every single day. Provided that over, say a week, there is a general balance of a variety of foods, that is fine. The main thing is that he is growing and developing well and you can discuss this with the health visitor and your GP. Oh, and yes baked beans do count as a portion of your 5 a day!

"The thing about balance is that it doesn't have to be achieved every single day. Provided that over, say a week, there is a general balance of a variety of foods, that is fine."

Q. GlaikitFizzog: My two-year-old son loves fruit, will eat anything I put I front of him if it's fruit. Savoury is where we fail miserably. He will eat mash (sometimes with hidden veg through it, sometimes he is wise to my trickery) and fresh bought pasta such as tortellini, ravioli and the like. Breakfast is Weetabix or porridge or toast, sometimes all three. He eats a huge breakfast so I don't really worry if he just picks for the rest of the day, but I can't help worrying that he just avoids savoury stuff. He does like toddler meals and will usually wolf those down at the childminders and knows if I try to mimic them, even if I put them in the same tubs.

A. Dr Frankie Phillips: It sounds like you've discovered the hard truth that toddlers are really quick to wise up to things, hence him being suspicious if you try to disguise the foods you're trying to give to him. Honesty is the best policy with toddlers. The hidden veg might work for some but you need to build his confidence that you are not going to try to trick him. It can take a long time to get used to the taste of a new food but don't give up if he refuses it at first. I'd suggest trying to eat together where possible and show him that you are enjoying the same meals as you are giving to him. Families who eat together have been shown to have better eating habits, eating more vegetables for example, so if that's not something you do at the moment perhaps you could try it a couple of times a week.

If vegetables are not a favourite if they are cooked, then you might want to try them as dipping sticks of raw or salad vegetables. You could also try introducing some more savoury foods in a different way. Try a picnic with some pasta or rice salad, slices of quiche or cold pizza. Another thing that I'm always encouraging is to cook food together so that he can see what's going into it. Get him to try tasting the food as you go along and you taste it too. Go shopping together and find some new interesting foods to try and perhaps get him to choose a colour and try a new food in that colour every day for a week (okay, blue might not work too well…). Together you can explore new foods, it doesn't have to be anything complicated, and expand his taste repertoire.

Q. Jojay: My nearly two-year-old twins are allergic to dairy and egg. I'm still breastfeeding at the moment but plan to phase it out soon. How can I ensure they get enough calcium in their diets? Are there any other nutrients I should be concerned about? They have soya milk in their cereal but aren't keen on any of the substitute milks as a drink. Like most toddlers they aren't wildly keen on dark green leafy veg, which is often spouted as a good source of calcium. Any toddler friendly ideas? 

A. Dr Frankie Phillips: Allergies can be tough to manage but thankfully, many children do grow out of them so be sure that you speak to your GP about being referred to a paediatrician who specialises in allergy and will be able to establish how to best manage the allergy. In the meantime, if you are concerned about calcium do look for a soya milk that has added calcium, even if they do only have this on cereal. You could also use it in cooking and can make desserts such as rice pudding which can be served with a fruit puree.

Other foods that contain useful amount of calcium include some vegetables as you say, and notably broccoli. Maybe try it raw chopped into 'trees' as a change from cooked. You could also try including some tofu (check it is enriched with calcium, most types are) to replace chicken in some dishes or introduce them to canned salmon and sardines, the soft bones can be mashed up and provide a great source of calcium, as well as vitamin D and they can be made into a toast or sandwich filling.

Q. Cindy34: What would a typical meal for a two-year-old consist of in terms of protein, carbohydrates, vegetables, sugar, fat etc and how do you get the balance right?  What would be a typical daily amount for a two-year-old to consume and should it be looked at daily or over a longer period of time, as some children certainly seem to have days when they do not eat much at all? A toddler who has not eaten much during the day requests cereal, such as Weetabix, for supper or a before bed snack. Is cereal before bed something to permit or to be discouraged?

A. Dr Frankie Phillips: Just like adults, there is no prescription as to what a specific meal should look like but the balance over a whole day or even a few days is what is really important. As I've mentioned in some other answers, the amount a two-year-old eats can vary a lot from day to day, but it's a good idea to have plans for what foods you can offer them. Not all of it is likely to be eaten every time, but this is fine. If it's not a hungry day, just offer a smaller portion and if possible you might be able to freeze another portion or even keep it in the fridge to have tomorrow (being sure it's reheated properly).

There are guidelines for adults in the Eatwell plate model, it's not based on a single meal or even a single day, but an overall balance. The Eatwell plate can also be a guide for children aged two to five years, gradually moving towards the proportions needed for the rest of the family. If you aim as a family to eat roughly following the proportions in the Eatwell plate it will help to make the whole family have a balanced diet, obviously larger portions for adults and small portions with healthy snacks added for under fives.

"Mealtimes should roughly consist of some starchy carbohydrate, some protein and vegetables or salad, followed by some nutrient-rich pudding eg yoghurt and fruit or rice pudding and fruit puree."

Mealtimes should roughly consist of some starchy carbohydrate, some protein and vegetables or salad, followed by some nutrient-rich pudding eg yoghurt and fruit or rice pudding and fruit puree. There are some good meal planners and activities for toddlers online if you need some more ideas. As for salty, fatty and sugary foods, these should be kept to a minimum, it's all about getting into good habits from an early age. You mentioned about cereal for supper. If he's hungry at this time maybe think about what time tea was given. Did he have a snack that meant he wasn't ready for tea? It's okay to have supper and cereal with milk would be fine provided it wasn't exactly before bedtime, and make sure teeth are brushed properly.

 

Snacks 

Q. TotallyEggFlipped: Is it ok for a two year old to still have a mid-morning and mid-afternoon snack, or should they just be having three meals a day? What sort of snacks would you recommend?

A. Dr Frankie Phillips: At two years of age, children need plenty of energy to play and to grow, develop and thrive. The only tricky thing is getting the balance right so that they are having just the right amount of energy to do all of these things. The best guide is to go with your child's appetite and be aware that this can fluctuate from day to day and meal to meal and to keep a check on growth.

"The best guide is to go with your child's appetite and be aware that this can fluctuate from day to day and meal to meal and to keep a check on growth."

Toddlers have smaller stomachs than adults but relatively greater energy needs and so they need to eat more frequently. Added to that, they are often still having a nap during the day and with all of their busy times it's a job to fit in the mealtimes!

Having planned snack times and mealtimes is an important part of ensuring a balanced diet, but there are no hard and fast rules about how many snacks are appropriate at each age. Some people find that having a mid-morning and mid-afternoon snack is a good idea, but make sure these are organised eating occasions rather than grazing over a long period of time. Don't withhold a snack if they are hungry and it's a while to wait for the next mealtime. Likewise, some days they may not be hungry and so the snack might not be eaten – this is fine, and you shouldn't insist they eat if they are simply not hungry at that time. Snack time can also be a good opportunity to introduce new foods, tastes and textures to increase variety.

As for the type of snacks to include, it's a good idea to aim for something from the four main food groups, and occasionally a sweet treat. Snacks can be a useful way of boosting nutrition and a range of vitamins and minerals can be gained from a variety of snacks. You can see some examples of snacks in the other answers I've given, but here are a few more to try:

  • Slices of apple spread with cream cheese or peanut butter
  • Whole milk yogurt or fromage frais with fruit slices or dried apricot
  • Rice or corn cakes topped with chopped fruit or grated cheese
  • Mixed raw vegetable sticks (red peppers, baby sweetcorn and carrot) with houmous or guacamole
  • Bread sticks or crackers with cubes of cheese
  • Fruit smoothie made with milk or yogurt and fruit
  • Broccoli and cauliflower florets with salsa dip

Q. RobinBedRest: My daughter is allergic to dairy and egg. She eats as much fruit as I give her but I have to be careful to avoid toddler diarhea, so keep it to mealtimes. Can you suggest quick and easy food for her afternoon snack as it has to keep her going two to three hours before dinner. I use Organix snacks out and about (she loves the mini gingerbread men) but I need other ideas for at home, currently stuck in a peanut butter on toast rut!

A. Dr Frankie Phillips: Toddlers need bags of energy if they're out and about exploring the world and having a healthy snack plan can be just what they need to boost nutrition until it's mealtime. Snacks not only provide energy but, chosen wisely, they can boost a whole host of other nutrients. You can get stuck in a rut by relying on the same snacks, and a few ideas can help get over that. Fruit is an easy choice, but try savoury snacks as well for a change. Having a dairy and egg allergy can make it a bit more tricky, but try these ideas at home and see how you get on:

  • Mini sandwiches with lean meat or houmous
  • Vegetable sticks (try cucumber, peppers and mini broccoli florets) with a dip (nut butter, hummous or guacamole)
  • Homemade popcorn (no salt)
  • Slices of banana or other fruit on mini rice cakes or oatcakes

 

Portion sizes

Q. TeWiSavesTheDay: What's the best way to work out portion sizes for individual toddlers?

A. Dr Frankie Phillips: The amounts that a toddler needs to eat really does vary from day to day and meal to meal, so the best thing to remember is to be led by their appetite. Remember, some toddlers can be put off by having large amounts on their plate, so try putting out a smaller portion or a 'me-sized' meal first and if they need more, you can put extra on their plate later. If it's not eaten, provided you store it properly and it's not been previously cooked and re-heated, you can save some for tomorrow. Some people suggest hand or fist-sized portions as a guide, so you might want to try that too.

The Change4Life campaign has a useful poster to remind you of key tips about portion size, and reinforces the message of 'me-sized' meals rather than being too strict about clearing the plate. Hard as it is to accept, when you've lovingly prepared a meal, your little one might simply not be that hungry today, barely having a couple of mouthfuls, and then tomorrow might be ravenous and need 2 platefuls!

Q. 50shadesofbrown: Is it possible to overfeed a toddler? My daughter is 13 and a half months, she has no major health issues and is around the 75th - 91st centile for height and weight. She walks confidently. At meal times she will easily eat around 2oz (dry weight) cooked rice or pasta or half a dozen new potatoes or 2 full slices of bread and butter. She will also have a small portion of protein, some fruit and/or veg, a yoghurt and maybe some more fruit. She isn't fussy and will eat mild curry, seafood, salad - anything really. She can basically eat a small adult portion. She doesn't often want a snack between meals (she has fruit or occasionally a baby biscuit) but she will still eat the same amount at her next meal. She drinks full fat cows milk, water and occasionally watered down pure fruit juice.

Is this normal? She's not fat, not skinny, just nicely toddler chubby. She wears 12-18 month clothes at present but we are going to put her into the next size as they are getting too tight and too short. Obviously I'm not going to limit how much she eats, but should we be steering her away from certain foods? She has very little refined sugar, but does eat quite a lot of fruit. My husband's family in particular have all got significant weight issues and it's not something I want to see her struggle with as she gets older, I'd rather set up good eating habits as early as possible. Alternatively, should I just chill out and trust that she'll be ok? She does have (almost) all homemade food anyway, is that good enough at this stage?

A. Dr Frankie Phillips: In the first years, children are very good at using their internal cues to tell them when they are hungry, and to communicate when they need feeding. They can also communicate when they are full, but we need to recognise these cues and to respond to them. Many infants when faced with extra food when they feel full react by turning away, pushing the food away and generally fussing. This is a sign that they've had enough and if you leave it a minute before offering some more and they still turn away, then it's a very strong sign. However, even at this age, these internal cues to stop eating can be overridden if you keep pushing them to 'finish the dish'. That's why we think it is so important to take notice of the cues saying 'I've had enough'. If you do go along with a child's appetite guiding how much they eat, it really is a good way to regulate food intake.

Regarding your daughter, the size of meals you mention does sound quite a lot but if you are going with her appetite, not insisting that she finishes a meal, then it's probably just that she does have a big appetite at times. Toddlers' appetites do vary a lot and sometimes they might only have a couple of mouthfuls whilst eating a lot at other times. I'm sure the health visitor can help you to check whether her weight is tracking nicely along the centiles, or if it's started to creep over too many lines so that her weight and height are out of sync. It is quite possible that she started off on a higher centile and so long as this is being more or less followed, she is just growing normally. The age/size of clothes is not a good indicator of appropriate growth, so it's best to go along with what the growth charts show. Toddlers can often look chubby and as they become more active they start to lose some of the 'chubbiness', but if you are concerned about her weight it is good to chat through things with the health visitor. Just because your husband's family struggle with weight issues, it doesn't necessarily follow that she will too, especially if you set a good example, eating a balance of food and keeping active.

 

Drinks

Q. AmIGoingMad: How much should a toddler, mine is two years and five months, be drinking? Our son drinks an awful lot. We always have a glass of water at hand and sip throughout the day so we're in the habit of him having some majorly diluted squash at hand most of the time. Should we only really be offering drinks at mealtimes and when he asks or is it ok for him to have the amount that he is?

He is also in a very picky food stage. Do we just give in to him having a limited range of food for now or if not, how can we get the veg into him? Fruit isn't a problem.

A. Dr Frankie Phillips: The first thing to check is that there's no physical reason for your son drinking a lot. In rare cases this might be a sign of diabetes, which can start in early childhood, so just check with your GP that there is no underlying cause. It may be useful to keep a jug of water just for him so that you can get an accurate picture of exactly how much he is having to drink through the day. The example that you are setting by drinking water is great but you mentioned that your son drinks very diluted squash. I'd suggest avoiding the squash and just sticking to water or milk between meals, and if he likes it, have diluted unsweetened fruit juice with meals. Even sugar-free squash can cause damage to teeth as it is still acidic.

Toddlers do need to drink regularly to keep them hydrated and that's especially true if they are busy being active on hot days. For most children, aiming for around 6-8 cups of fluid per day is about right, that includes water, milk and any diluted juice. If he is thirsty, by all means make sure he has a drink, but perhaps get him to sit down with a drink and have a few mouthfuls rather than having sips here and there.

"Toddlers do need to drink regularly to keep them hydrated and that's especially true if they are busy being active on hot days. For most children, aiming for around 6-8 cups of fluid per day is about right, that includes water, milk and any diluted juice."

As for your point about being picky, you'll see from the other answers that there are a few things you can try to get over this stage, which is really common among one to two-year-olds. Remind yourself that practically all fussy eating stops with time. In the mean time, remember that you are in control and don't make the fussiness a central part of mealtimes, the attention can start to fuel greater amounts of fussiness. Have a look at the Change4life booklet, Ready Steady Go, for more tips.

Q. Honeymoonmummy: Is carbonated or sparkling water bad for children? Should we avoid all types of sliced ham and processed meat? How much fruit and veg should a two-year-old have per day? My daughter is four and a half and my son is two.

A. Dr Frankie Phillips: Carbonated or sparkling water is acidic, and as such, it has the potential to damage tooth enamel by eroding it. Flavoured sparkling waters have been shown in studies to be worse than unflavoured varieties. Also, some mineral waters have high levels of sodium (labelled Na) and are not suitable for children. The best advice regarding drinks is to choose plain still or tap water, or milk, and occasionally diluted unsweetened fruit juice.

Regarding ham and processed meats, there has been some strong evidence linking high consumption of processed and cured meats with certain types of cancer, and current advice is that intake should be no more than an average of 70g per day, with some meat-free days. There isn't any specific advice for children, but including a small amount of ham, eg in a sandwich, in the diet is fine provided it is balanced with other foods. Processed meats also tend to be high in salt, and so although it is fine to include them sometimes, other unsalted meats or fish are good choices.

Similarly, there is no hard prescriptive advice regarding how much fruit and veg a two-year-old should have per day. As a guide, it's a good idea to aim for a variety of fruit and vegetables every day, but in child-sized portions, which as a guide is around the size of the child's fist. Aiming for at least 5 a day can be introduced as a family so that eating a variety of fruit and vegetables is seen as just a normal part of the whole family's eating pattern.

 

 

Last updated: 12-Feb-2014 at 3:33 PM