Parenting U: Child Nutrition
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Parenting U: Child Nutrition



Providence Parenting U - Child Nutrition featuring Dr. Amy Belko of Olympia Pediatrics, May 2011

Providence Parenting U - Child Nutrition featuring Dr. Amy Belko of Olympia Pediatrics, May 2011



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Parenting U: Child Nutrition Parenting U: Child Nutrition Presentation Transcript

  • Toddler & Preschool Nutrition Tips for Picky Eaters, Grazers, and Chow Hounds Amy Belko, PhD, MD, FAAP Olympia Pediatrics May 24, 2011
  • Disclosures
    • Born in the 1950s with a stay- at-home mother who pressure cooked all vegetables until they were beyond recognition.
    • B.S. in Food and Dairy Science from the University of Wisconsin (Cheese and Beer capital of the USA).
    • M.S. and Ph.D in Human Nutrition from Cornell University.
    • M.D. from University of Vermont (more cheese).
    • Training in Pediatrics at Seattle Children’s/UW.
    • Pediatrician in Olympia since 1994 (Memorial Clinic and now Olympia Pediatrics).
    • Mother of two daughters, one who ate everything and one who ate like a hummingbird.
  • Outline
    • Review of Growth Charts
    • Nutrition for Toddlers, Preschoolers, and School Aged
      • Developmental milestones
      • How much/what to feed.
      • Tips
      • When to Worry, When to Cry, When to Laugh
    • Recipes/Taste Testing
    • Trickery
  • Great Resources
  • More Great Resources
  • Great Stories for Kids
  • Punchline
    • If left on their own, toddlers and preschoolers will eat a diet that allows them to grow and develop normally.
    • It is the parents/caregivers’ job to provide the food. It is the child’s job to eat the food.
    • Food battles are a child’s way of expressing independence. They are not intended to destroy the self-confidence, psyche, or emotional well being of the parent/caregiver.
  • Old Sayings Ring True
    • Babies double their birth weight in the first 6 months and triple it in a year (for babies 6-8#).
    • Growth slows in the second year of life with an average of 5-8 pounds gained.
    • Children ages 2-8 have the slowest growth rate.
  • Review of Growth Charts
  • How to Use a Growth Chart
  • Official USDA Recommendations
    • j
    Calorie, protein and nutrient needs vary with age, size, and activity level of the child…rough estimate is 1000-1200 calories per day for ages 2-3 and 1200-1600 for 4-6yr. New pyramid emphasizes importance of all nutrient groups with exercise. Great web resources for kids at
  • Toddler Fun
  • How Much to Feed a 2-3 year old (average guidelines)
    • Milk, cheese, yogurt: 4, ½ cup servings .
      • (1.5 oz cheese = ½ cup)
    • Veggies and fruit:
      • Vitamin C source (berries, citrus) ½ cup .
      • Vitamin A source (veggies, fruit) 3 Tablespoons .
      • Other veggie (potato): 3 Tablespoons .
      • Other fruit (apple, banana): 1/3 cup .
    • Protein (lean meat, chicken, fish, legumes):
      • 3, 3 Tablespoon portions .
    • Cereals (whole grain and non-added sugar):
      • 2, 1/3 cup portions.
    • Bread: 1 slice or 1 small muffin or ½ bagel.
  • Tips for Toddlers
    • Don’t worry appetites are SMALLER.
    • Don’t worry food choices avoidances are part of independence.
    • Strict schedule…3 meals, 3 snacks.
    • Calories come early in day not at supper.
    • No comments positive or negative. Buy, prepare, and present food. Do not “after feed”.
    • Water anytime. Juice and milk only at meals.
    • No soda.
  • Pre-School Fun
  • How Much to Feed ages 4-6 years
    • Milk, Cheese, Yogurt
      • 4 servings (1/2 cup milk or yogurt, 1.5 oz cheese)
    • Veggies and Fruit
      • Vitamin C source (berries, citrus) : ½ cup
      • Vitamin A source (green or yellow fruit/veggie): ¼-1/3 cup.
      • Other veggie (potato/legume): 1/2 cup.
      • Other fruit (apples, bananas) : 1/2cup .
    • Protein: 3, 6 Tablespoon portions .
    • Cereals (whole grained no added sugar): 2, 1/2 cup.
    • Bread: 1 slice or small muffin or ½ small bagel.
  • Tips for Ages 4-6
    • Expect dawdling (at meal times and anytime).
    • Meal-time atmosphere helps…TV off.
    • Encourage participation in food preparation.
    • Explain how food works in body.
      • Carrots for eyes, dairy for bones/teeth, fruit for gums, skin, pasta for energy, protein for strength, etc.
    • Limit screen time.
      • Decreased activity and eating while on the screen.
      • TV heavy on junk food advertising.
    • Silly foods as a treat.
      • Green Eggs and Ham, Pancakes for supper, Pizza for breakfast.
    • Ethnic food exposure.
  • School Lunches from Around the World
  • Tips for School Age
    • Breakfast and lunch become critical.
    • After school and evening activities put eating on the run. Avoid fast food every night. Microwave meals such as Lean Cuisine etc. will do in a pinch.
    • Provide fun lunches. Presentation matters.
    • Provide one food in the lunch which can be traded but only one food.
    • Encourage participation in shopping and planning menus and food preparation.
    • Dispute advertisements…laugh about how TV tries to sell and doesn’t always tell the truth.
    • More nutrition info…which foods are healthy and which aren’t.
  • Portion Size
  • Refusal
  • Hide, Disguise, Emphasize Ultimately Deceive
    • Is it OK to resort to trickery in order to promote health?
    • Don’t they need to learn to like healthy food on their own?
    • Who is the boss here?
    • Grandma says “Make her eat it!”
  • Disguise
  • Hide
  • Emphasize
  • General Tips for Hiding
    • Pureeing and blending work well: nutrient dense therefore have to consume less volume.
    • Beware of the color wheel. If you mix red and green you get brown! Try to combine similar colors whenever possible.
    • Start with small amounts and work up.
    • Be aware of texture…and after taste.
  • General Tips for Survival
    • Do your best. Try to provide healthy food 90% of the time. I try to surprise them 10% of the time.
    • Sometime, hopefully before graduation, they will be more adventurous. It will click. They won’t be eating macaroni and cheese at their wedding.
    • Pick your battles.
  • A Christmas Story: Mommy's little piggy
  • Questions?