Parenting U: Child Nutrition


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

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Parenting U: Child Nutrition

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