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Expert Q and A

Each month, you'll be able to get answers directly from experts covering a wide range of parenting topics. You'll also have a chance to share your own expert tips with other parents. Join the conversation!

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Inspire Curiosity and Independence in Girls with Nature

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Good Nutrition, Right from the Start

by Connie Evers, MS, RD


Connie Evers, MS, RD

Connie Evers is a registered dietitian, consultant and author who specializes in the health of children and adolescents. Read more »

As parents, we know that good nutrition is essential  for our children's growth and development. We read all the latest nutrition news, have dozens of healthful cookbooks on our shelf and can readily list all five food groups. Unfortunately, though, there is a disconnect between nutrition knowledge and the actual eating behavior of many of today's families and children.

Too busy for meal planning or perhaps even meals at all, as a nation we rely on drive-through dining and convenient options which contribute plenty of fat, sugar and calories but little in the way of fiber and nutrients.

As a working mom with three children, I fully understand the pressures facing today's busy families. Sometimes it seems like nothing short of a miraculous feat to get everyone around the table eating the same meal at the same time.  Family meals are well worth the planning and effort, though. Eating together on a routine basis contributes to good nutrition, improved communication and stronger family bonds. Research shows that children who eat frequent family meals have better health, perform better academically and even engage in fewer high-risk behaviors as teens.

In addition to committing to shared family meals, here are a few additional "food rules" that promote the development of healthy eating habits in children:

  • Disband the Clean Plate Club
    When presented with a variety of healthful foods, children have an innate ability to regulate their food intake. Don't push or negotiate for "one more bite" once your child indicates he is full.
  • Begin with Breakfast
    Start each day with a balanced breakfast that includes at least three food groups. Studies confirm that kids can think, focus and concentrate better when they eat a morning meal.
  • Be a Smart Snacker
    Children need snacks to refuel and squeeze in important nutrients. Just make sure after-school and bedtime snacks contain at least two food groups. Snacks should not be confused with "treats" such as soft drinks, fried chips, cookies or candy.
  • Practice Persistence
    For some kids, it may take 10 or more exposures to a new food before they will take the first taste. Continue to serve and offer your child a variety of foods but don't force the issue. Fortunately, tastes tend to change as children mature.
  • Set limits on Fun Foods and Fast Foods
    Limit, but don't forbid occasional fast food meals and treats. Increasingly, fast food restaurants are featuring more healthful choices. When dining out, encourage your child to choose milk over soda pop and salads or apples instead of fries.

The odds are good that your child  will learn to love a variety of nutritious foods if you continue to emphasize fun over force. Most important of all, show your child how much you enjoy eating healthful foods. Children learn more by watching what we do rather than what we say!

The information contained in this Expert Q&A is not intended as a substitute for medical and/or nutrition advice. See your physician and/or registered dietitian for individual health and/or dietary concerns.

Connie Evers is no longer taking questions. But please share your own experiences and ideas by leaving a comment.


Comments

Simon writes...

I have a 5 year old and a three year old, and there seems to be no rhyme or reason to what they'll eat, if anything. We give them fresh vegetables and pasta one night and they eat lots, but the next time they have it, they won't touch it. Foods seem to go in and out of fashion frequently and inexplicably. It's incredibly frustrating and a lot of food gets wasted! Any advice?

Connie? writes...

Hi Simon. While your situation sounds frustrating, it is certainly not unusual. Preschoolers are at a stage of development where eating habits are completely unpredictable. While one child will go on a "jag" and only request one or two foods for weeks, another child may label foods "yucky" one day and "yummy" the next. Part of this pertains to biological development. From day to day, both growth and energy requirements vary in a growing young child. Because children are much better at responding to their body's needs, they will adjust food intake accordingly (adults, unfortunately, often eat based on external factors such as time of day, emotions, social expectations, etc).

The other factor in play here relates to social development. Preschool aged children are developing a sense of autonomy and want to make choices. If they sense that adults want them to eat certain foods or certain amounts of foods, they may counter by saying "no." I often counsel parents that in a power struggle over food, the child will always win.

It sounds as if you are doing a great job when it comes to offering nutritious family meals. My advice is to continue to offer a variety of healthful choices at the dinner table but not to make an issue if the kids are not eating much. Encourage them to self-serve and to start with small amounts. They can always ask for more and you will feel better about the reduced food waste. Trust your children to decide when they are full. I don't believe you should push for "one more bite." It teaches children to eat more in order to receive approval.

It is also very important for young children to have a regular meal and snack schedule. Children who are alowed to graze throughout the day often have little appetite for meals.

Finally, preschool children love to be involved in food activities. Take them to the grocery store or farmer's markets and let them pick out a few new and unusual foods. Allow them to help "cook" with you, even if it is simply slicing a banana with a dull knife or tearing up lettuce leaves for the salad. When they have a hand in preparing food, they will be more likely to eat it. It's also a great way to get them interested in food and nutrition.

Gary writes...

looking to calculate ideal weight for 12 year old girl, struggling with anorexia ?

Connie? writes...

Hi Gary. First of all, I hope that your 12 year-old is seeking treatment with a qualified professional. A good resource for finding eating disorder specialists as well as a lot of great information is the ANAD National Association of Anorexia Nervosa and Associated Eating Disorders.

As far as calculating ideal weight, many factors enter into one's so-called ideal weight. With children, it's more important that they are following a pattern of growth, development and weight gain. When weight fluctuates suddenly (either up or down) in a child, there is often cause for concern. The Children's BMI Calculator from the Children's Nutrition Research Center can be a helpful tool for monitoring a child's progress in achieving a healthy body weight.

While the BMI may be a helpful tool, I can't emphasize enough the importance of seeking individualized professional assessment and treatment for this very serious disorder.

Dahema writes...

Hi,
I have a 17 month old son and I'm finding it difficult to get him off the bottle. Do you have any suggestions on how I could ease this process for my son and I. I am also finding it hard to get to eat actual food.

Connie? writes...

Dahema,

Actually, both of your concerns are directly related. When a toddler depends on too many of his calories from milk, he will not be as likely to eat enough solid food. Thus, your task will be to gradually cut down on the amount and frequency of the bottle and increase his exposure to solid food. This should be done gradually and you should not force him to eat or this could compound the problem. As you cut down on his bottles, he should be experiencing an increase in hunger. Make sure that you have a regular schedule of 3 meals and 2-3 snacks and that the mealtime atmosphere is pleasant.

It is important from a nutritional standpoint that he transitions to a diet of more solids. He should not be getting more than 16 ounces of whole milk at this point (1% milk is fine, once he is 2 years old). While milk is a nutritious beverage, it is not a complete source of nutrition. Notably, it is low in iron and toddlers who continue to get the majority of their nutrition from milk run the risk of anemia. In addition, the bottle contributes to dental problems since both milk and 100% fruit juice contain carbohydrates. Your son will be at a higher risk of early dental decay if he continues to rely on the bottle, particularly if it is offered frequently throughout the day. If you have not tried already, offer his fluids in a toddler cup.

The Florida Department of Health has published Feeding Your Toddler, which is a helpful, concise guide that will help you in making this feeding transition.

I would also encourage you to discuss your concerns with your pediatrician or family physician. It may also be helpful to seek counsel from a pediatric registered dietitian if you continue to have feeding issues.

Minnie writes...

Hi,
I have a three and a half year old son. He just does not want to leave his high chair and sit with others on the table and eat his meal. The only way for us to make him eat his meal is in his high chair and while he watches some TV, that is the only time he gets to view the TV. I have tried a number of times to make him break this habit but he barely eats if i do not let him view his cartoons. While watching the tv he eats a good amount of food and has a good percentile weight too. I just dont know how to break this habit of his.

Connie? writes...

Hi Minnie,

This may not be fun or easy but it is a habit that needs to be broken. Here's why: Family meals are so very important for a child's nutrition, growth and development. A good deal of research has pointed to family meals as a major predictor in the well-being of children. Preschoolers who eat meals with their family even have better language skills. Kids who learn to eat in front of the television often have poor eating habits, particularly as they get into the school-age years.

I think the key here is to allow your son his TV time but to separate it from mealtime. Perhaps you will even need to change mealtime a bit if there are particular children's programs he loves to watch.

You can turn this into a positive by praising him for being a "big boy" who gets to sit at the big table with the family. If he is small, you may want to put a cushion or booster in his chair so he is up at the same level as other family members.

Don't be surprised if he doesn't eat well at first. But he will eventually become hungry and adjust to the new change. It sounds as if he is a good eater and his growth is on track. If he is upset, remind him that he still has his TV time every day.

I think if you stick this out, you will be very pleased within a week or so.

GT writes...

Hello Connie,

I have a 2 and a half yr old son.
He was born pre-mature -7 weeks early with a birth weight of 3lbs.He was in NICU for 14 days.He is perfectly normal in Health and all other activities except Weight.His present weight is 23lbs.His Weight Percentile was always below the line.I am trying to give him all the High -calorie foods I can but ,he takes everything in Moderation and does not eat much at a time.I have been continuing giving him small meals every 2 hours.I am very much worried aboout this.Could you please advise me on any foods which might help him grow his weight.

Connie? writes...

Hello GT,

I'm glad to hear that your son is healthy and growing. It is not unusual for premies to lag behind a bit in growth.

I do feel like this is outside my area of expertise, though, and I think it would be helpful to discuss this with a pediatric registered dietitian in conjunction with a pediatrician. You may also want to research and see if your community has a hospital or facility with a feeding team. Professionals who are used to working with children with growth concerns are better able to provide individualized suggestions and possibly supplemental sources of nutrition.

One place to start in finding a registered dietitian is to visit the American Dietetic Association and click on "Find a Nutrition Professional." It will take you to a screen where you can search by area and specialty (in your case, pediatrics).

I think if you talk to a professional, you will find it very helpful and reassuring.

Charlene writes...

My child sometimes tells me he is full when I know he isn't.

I usually tell him he can leave the table but there will be nothing else to eat until the next meal.

Is there any harm in doing this?

He is at a normal weight for his height & eats healthy on a regular basis.

Connie? writes...

Hi Charlene,

You are right on track here. As long as you are following though and not allowing him to eat until the next scheduled time (snack or meal), this is very good. You are honoring and trusting his ability to determine when he has had enough to eat and not forcing the issue. That is probably one reason he "eats healthy on a regular basis." What you are doing is exactly what I encourage all parents to do.

Also, he truly may not be that hungry at times. Kids often have amazing swings in appetite. I'm sure at times he seems to eat a lot more than you would expect, too.


Margie Tompson writes...

I have a 2-year old grandson. He is a good drinker - loves water, assorted juices, gatorade, regular milk, soy milk, that vitamin water.

When visiting I will have a diet beverage - diet cola, diet Splash, etc. and my grandson always wants a taste. If his parents have a beer or coffee he wants to taste whatever they are drinking & then comes back for more.

What is the consensus on children drinking diet beverages & taking sips of a beer, coffee, etc.

Regards,
Margie Thompson

Connie? writes...

Dear Margie,

I have to take a hard line on this issue. The ONLY beverages that a 2 year-old should be consuming are water, milk (around 16 oz. daily) and 100% fruit juice (around 4-6 ounces daily). Period. In the early years, an incredible amount of growth and brain development are taking place and nutrients should be maximized through both food and beverages. Children are also forming taste impressions and habits that will last a lifetime.

I caution parents to start early equating thirst with water. When children are constantly given sweet-tasting beverages, they learn that thirst is equated with a sweet beverage. In addition, beverages such as soda pop, sports drinks and other sweetened beverages contribute nothing but sugar and empty calories to a child's diet. Because of their small stomach size, they can fill up on sweet beverages and then refuse more nutritious foods. As they grow up, the "liquid calories" from sweetened beverages become extra calories added to the diet. I firmly believe that part of today's obesity epidemic stems from the incredible increase in sweetened beverage intake over the past 30 years.

Now, on to the alchohol and coffee issue. This is absolutely inappropriate for a 2 year-old. Most toddlers will reject beer, coffee and other bitter substances. They are defiinitely acquired tastes. It is a concern that your grandson has developed a taste for these beverages and "comes back for more." This early imprinting could leave your grandson vulnerable to alcohol abuse in later years.

Alcohol poisoning and caffeine overload are very real and dangerous possibilities in a young child with a very small body size. Suppose for a moment that someone left an unsupervised beer on the table while they left the room. It would take just a few swallows for a child this young to reach a high blood alcohol concentration. This can actually be fatal. Caffeine overdose could also pose a serious health risk for a child this young.

I would encourage you to have a conversation with the parents of your grandson. While it may seem harmless and "no big deal," this behavior can pose a real danger to a young child.

Mubashir writes...

I have a boy who is almost three years old. He is a very picky eater and sometimes refuses to eat three meals a day. How do I get him to eat regularly? Also, after watching some programs on PBS where he saw baby birds and turtles coming out of eggs, he refuses to eat eggs for breakfast. Can you advise me on how I can cope with this situation? Thanks and best regards!

Note: edited for clarification by Jean (PBS Parents)

Connie? writes...

Dear Mubashir,

Let me address the issue with the eggs first. It's very natural for children to eventually discover the origins of their food. This is an encouraging developmental step and I'm impressed that your son made that connection at such an early age. He is obviously very observant and compassionate. Because he is only three, he will most likely not continue to reject eggs based on his observation. If eggs are a food he previously enjoyed, he most likely will enjoy them again. In the meantime, you can invite him to watch you crack the eggs and cook them. You can simply explain that the eggs you are using will never turn into birds or turtles or any other animal. If he still doesn't want to eat them now, I would not force the issue.

In regards to picky eating behavior, this is very common among young children. Over the years, the question I have been asked most frequently pertains to picky eaters. I completely share this frustration as the parent of a formerly picky eater. The good news is that she has grown into a wonderful young lady who enjoys a variety of foods!

Here are my abbreviated guidelines for coping with a picky eater:

• Relax. Picky eating behavior is often a perfectly normal phase at certain ages and stages in your child's development.
• Understand parent-child boundaries in regards to eating. Offer your child a varied and well-balanced diet but don't force him to eat a specified amount or produce a "clean plate." Respect your child's ability to determine when he's had enough to eat.
• Realize that it's normal for many kids to react with disgust when they see a new food. Don't give up though -- kids sometimes need 10 or more exposures to a food before they will take their first bite.
• Recognize the importance of a regular meal and snack schedule and make it a priority to include a shared family meal each day. Eating together on a routine basis contributes to good nutrition, improved communication and stronger family bonds.
• Be a positive model for healthy eating and physical activity. Children learn more by watching what we do rather than what we say.
• Prepare foods in a variety of ways. For instance, if your child picks at his salad every night, try serving a steamed vegetable such as petite peas or baby carrots seasoned with a dab of trans-fat free margarine. For more ideas, check out sneaky ways to add nutrients , an article I posted on my website (nutritionforkids.com).
• Involve kids in food-related activities such as shopping, menu planning, cooking and gardening.
• Catch kids when they are hungry. After school and before bed are times when kids often have the biggest appetite. Make sure there are plenty of healthy snack choices available for these times.
• Encourage your child to drink water when thirsty. When kids fill up on sweetened beverages such as soda pop or other sweetened drinks, they can lose their appetite for more nutritious choices.
• Be sure to take your child to the pediatrician for regular growth check-ups. Most often, you will be reassured to see that your picky eater is managing to get enough food to grow on. Regular check-ups can also alert you to any problems before they become serious.
• For many kids, a daily children's multivitamin/mineral supplement is a good idea. Supplements are especially appropriate for children who refuse to eat entire categories of foods such as vegetables or dairy products.

Sue writes...

Hi.

I'm concerned because my 2 year old daughter will only drink milk (and lots of it). She refuses to drink water and is not interested in juice. Is it harmful in any way? Thank you.

Connie? writes...

Hi Sue,

I've discussed general beverage needs of a 2 year-old in the reply to Margie.

As far as your daughter is concerned, if she is drinking a lot of milk, eating a variety of foods and growing appropriately, there is little cause for concern. I would be worried if she seems to be drinking milk to the exclusion of eating solid foods. By age 2, she needs a variety of nutrients and milk will not supply all of them. Fruit juice is not required as long as she is eating whole fruit every day. As far as the water goes, it is important to try to encourage her to drink water when she is thirsty. Perhaps you could let her pick out a cute cup or small water bottle. Tell her the cup is only for water, though. Also, when she sees you drinking water, it may encourage her to try it. Parents are powerful role models for healthy behaviors.

Jennifer writes...

Dear Connie,

My 5-year-old daughter is usually a very good eater--has a good appetite and eats a decent range of foods. Sometimes, though, she'll say she's had enough dinner, even though she has only had a bite or two--and then she'll ask for cereal to eat before bed. Is it a bad idea to give in to this request?

Also, if we're serving something for dinner that she doesn't want, she really lets us know that she's not happy about the menu. ("I hate that!") We try to cook kid-friendly dishes, but we don't cook separate things for her, no matter how much she objects--everybody gets the same meal. The house rule is: Try a bite of everything, but you don't have to finish it.

Any advice on how to encourage her to be less judgmental about meals? We've had some luck getting her to help with the cooking--she's more likely to eat something she helps make--but it would be nice to reduce the mealtime drama a bit.

Thanks!

Connie? writes...

Hi Jennifer,

I've been in your situation before and feel your pain. I guess we will never have to ask our child, "What do you really think about the food?" (smile)

It sounds as if your daughter is eating well most of the time. I think you are right to avoid the "short-order cook" syndrome. One thing I did do when my daughter was going through this phase is that I always set several easy side dishes on the table such as whole grain rolls or bread, a bowl of baby carrots, cut-up fruit and salad. There were evenings when her supper consisted of whole wheat bread, milk and a few baby carrots, which is not really too bad from a nutritional point of view. I think the bedtime cereal snack is OK, as long as a bedtime snack is always an option. I just wouldn't allow her to eat cereal at suppertime or immediately following. You can remind her that the next time food will be offered is at snacktime.

As far as the negative comments, it is important to remind her to use good manners. "No thank you," works much better than "I hate that!" Tell her you understand what she's saying when she says "no thank you." Remind her that she can choose foods from the table but you will not be making special things just for her.

She will most likely outgrow this behavior. I would advise you to be relaxed and don't argue with her once you have reminded her of your rules. Over time, mealtime should be less dramatic and more enjoyable.

Shirley Orio writes...

Do you have any suggestions, expirence with celiac disease? My 6 year old has been diagnoised and she is a very picky eater. I need ideas for breakfast, she doesn't like eggs, cereal (gf) I have to get her to gai weight so I'm told to give her milkshakes but I really would like to give her something to EAT! Please help if you can.

Connie? writes...

Dear Shirley,

Since this is a diet your daughter will be following for life, it is important for you to learn as much as possible. Below, I've included a brief article that I wrote about Celiac disease. I thought it might be helpful for other readers to learn more about this common digestive disease as well. I once had to make a gluten-free Thanksgiving dinner (for my sister-in-law) and also had to feed an entire basketball team a gluten free dinner because one of the players has Celiac. It does force you to be more creative in your cooking!

I would recommend you get a copy of Shelley Case's book (info below). It is a great resource for dealing with the dietary restrictions of Celiac.

**************************************
Celiac Disease, sometimes referred to as gluten intolerance, is an immune system disease that affects the digestive system. Gluten, a protein found in rye, wheat and barley, triggers an allergic-type immune reaction in those with the disease. It is estimated that 1 out of every 133 people in the U.S. has Celiac Disease.

In children, symptoms include failure to grow or develop appropriately, diarrhea and enlarged stomach. Both kids and adults with Celiac Disease may also have weaker bones than normal.

The good news about Celiac disease is that it is very manageable as long as a special diet is followed. Because the symptoms are so unpleasant, most people with the disease learn to avoid all foods with gluten.

All foods made from wheat, rye and barley must be eliminated from the diet. Grains that are allowed include corn, rice, quinoa and flours made from potato, soy or rice. Oats are also tolerated by some people with Celiac disease (though experts disagree on whether oats should be used or not). There are many gluten-free foods on the market and most natural food stores carry a wide selection of gluten-free products. Careful label reading is also required to detect foods which may contain trace amounts of wheat, rye or barley.

A book that is a great resource for planning and following a gluten-free diet is Gluten-Free Diet: A Comprehensive Resource Guide, by Shelley Case (©2006, Case Nutrition Consulting).

The Kidshealth.org site has a thorough, yet simplified overview of Celiac disease that may be helpful.

JoAnn writes...

My 8 year old daughter is overweight and average height. Her pediatrician has advised us that this is too young to worry about losing weight, as she should be gaining height. We still have concerns that she doesn't seem to have an understanding of when she is full. Are there any metabolic disorders that may account for her lack of sense of having had enought to eat?

Connie? writes...

Dear JoAnn,

I'm not sure how overweight your daughter is but it is not too young to be making positive changes in activity and nutrition. As your pediatrician stated, your daughter is growing and developing and needs adequate nutrition to support this. She does also need to learn healthy habits and the meaning of fullness and hunger. In my work with children, I have used the hunger scale as an awareness activity. I find that children really respond well to this activity and will even tell me their "number" when they see me later. We also talk about the reasons we eat and why it's important to find other activities besides eating when we are bored, sad or frustrated.

In only very rare cases does a metabolic disorder impact the sense of fullness and satiety.

Many Americans of all ages are unable to regulate their food intake appropriately. A big contributor is our current culture of food. Food is readily available at all hours of the day in very large portions. Food marketers also inundate us with messages about food and the "value" of getting the larger size. Much of the food heavily marketed to us is high in fat, sugar and calories and low in nutrients.

If your daughter is used to eating large portions, one technique is to substitute the type of foods she is offered. Salads with reduced fat dressing, broth-based vegetable soups and fresh fruits and vegetables are all foods that she can eat larger portions of without adding a lot of calories. I would also encourage her to slow down when eating. It takes the brain about 20 minutes to send the signal to the stomach that we are full. Because so many of us are in a rush, we tend to overeat before we even realize it.

You may also want to see if your community has any family based healthy weight programs for children. The most successful programs involve the family and include nutrition, activity and behavorial components.

Sandra Flores writes...

I have done all your suggestions for feeding my kids since they where babies, but what can I do fos an extreme picky eater, with whom any tactik doesn't work I am a consistent parent and at one point I get tired and I end up giving him the crapp that he eats.

Any suggestions ?

Norma writes...

My 3-year old son seems to prefer fruits and some vegetables to beef, chicken or fish. At his last checkup, the pediatrician said that my son's weight was a few pounds too low but countered that by saying that my daughter was also thin when she was about the same age and now at 5 she falls in the average weight range for her age group. My son is very active. We offer him a variety of foods including dairy, vegetables, fruits, grains and some sweets. Should we be concerned that he may not be getting enough calories? If so, how can we increase his calorie intake in a healthy way?

Connie? writes...

Hi Norma,

From your description, it seems that your son is not getting enough protein and possibly iron. If he dislikes meat, try offering him protein foods such as eggs, beans, peanut or other nut butters and dairy foods such as cheese, yogurt and milk. If he likes fruit, perhaps a fruit smoothie made with frozen fruit and yogurt would work. I would skip the ice and just use the frozen fruit such as a banana or berries instead to make it higher in calories. You may also find that sneaking meat, chicken and fish into other foods such as burritos, soups and casseroles are better accepted by your son.

Beans are great because you can toss them in to a lot of other foods such as tuna salad, soups, stews, and Mexican dishes. You can even puree white beans and mix with the pasta sauce. Beans provide a powerhouse of nutrients so any "sneaking" will benefit the entire family.

I would also make sure that he is offered three meals and three snacks daily. A children's multivitamin/mineral supplement is also a good idea when children are not consuming all the food groups.

Maggie writes...

Dear Connie,

I have two questions about kids and nutrition:

1. What do you think about hiding healthy foods in kid's favorite meals, as Jessica Seinfeld suggests in her new book "Deceptively Delicious: Simple Secrets to Get Your Kids Eating Good Food"? I'm eager to get my boys to eat more vegetables but hesitant about tricking them.

2. Any ideas for healthy snacks I can give to trick-or-treaters? I want a candy alternative that kids will be really excited about. Please don't suggest baby carrots; I don't want my house rolled in toilet paper.

Thanks,
Maggie

Connie? writes...

Hi Maggie,

I was hoping someone would ask me your first question. I definitely have an opinion!

Hiding vegetables in kid-favorite foods is one technique to improve nutrition. I think most moms have done this to one degree or another for generations (yes, mom, I know you hid mushrooms in my lasagna). My own children have probably unknowingly eaten buckets and buckets of spinach. Because chopped spinach cooks down so much, it is hardly noticeable in soups, stews, and pasta sauce. I have never denied putting the spinach in, though.

But I have to say I am bothered by the philosophy of the new book you reference. I would say it is almost completely counter to my views on getting kids to eat better. My philosophy for over 20 years has been to INVOLVE children at an early age with food selection, cooking, gardening, etc. I'm all for TEACHING kids about whole foods which also fits very nicely with personal health as well as environmental awareness.

The problem too, is that pureeing vegetables and hiding them in favorite foods will be a fairly short-lived solution to getting kids to eat better. As they get older, more of their meals will be at daycare, school, friend and family homes, restaurants, etc. It's pretty much a slam-dunk guarantee that the macaroni served at their friend's house won't be packed with butternut squash. So, the children are not really learning to accept a wide variety of foods when they are unknowingly given a "vegetable" version of brownies or macaroni. Remember too, kids are smart and will eventually figure this out anyway. (unless you maintain a secret, stealth kitchen)

If you do hide some healthful ingredients, be sure to still include the whole, original form of the food on the table. As I've written a few times here already, it is the exposure to healthful foods and the role modeling of other family members that most influences a picky eater.

On to Halloween....

Maggie, I agree that baby carrots won't cut it for trick-or-treating. I do have some ideas though that will appeal to kids. Also, I was quoted in this article from Reader's Digest that provides a perspective on the Halloween/candy issue.

- Packets of cocoa
- Kashi TLC chewy granola bars
- small bags of corn nuts
- small 100% juice boxes
- individually packaged crackers with peanut butter
- small bags of trail mix
- individual bags of baked chips or pretzels
- non-food items such as pencils, stickers, colorful erasers

You may want to have two bowls -- a traditional candy bowl with SMALL pieces of candy or mini-candy bars and a bowl with the better choices listed above. Invite each child to select one item from each bowl.

The other thing I always like to mention for your own children is to:
- make sure they eat a balanced dinner prior to trick-or-treating
- Don't send them out trick-or-treating with a pillowcase! Limit them to a smaller bag or bucket. If they can't lift their bag at the end of the night, they probably have too much candy.

Terrie writes...

I have a 5 year old son who is a very picky eater. He just started school in August and I have been sending his lunch. The only thing that I can get him to eat in his lunch is a PB & J sandwich. He had been eating it just fine but the last week or two he has not been eating but a bite or two out of it & most days he hasn't even touched it. I send chips and a desert (usually cookies or applesauce) with it too but he doesn't eat them either. I can't get him to eat breakfast before school so when he doesn't eat lunch, he doesn't get anything to eat until he gets home. I am just worried since he isn't hardly eating anything during the day and doesn't really seem to be any more hungry than he was when he was eating his lunch. Also, they are supposed to have an afternoon snack at school but when I ask him what he had for his snack he usually says he didn't have one ( I figure it was something he didn't like). I don't know what to do. Is something wrong with him?

Connie? writes...

Dear Terrie,

I have covered picky eating quite a bit here so I do encourage you to read the previous posts. It sounds as if your son is going through an adjustment to his new schedule. I would recommend you speak with the teacher and find out how he is doing generally during the school day. It may take a while for him to feel comfortable at school and able to eat. I would encourage you to get him up a few minutes earlier on school mornings and try to get in a little breakfast. Even if it's a small bowl of cereal, a banana, some yogurt or a piece of peanut butter toast, it will help him to get through the morning. If you have concerns about his growth or health, you should talk to your pediatrician and have him evaluated.

I would also talk to your son about any food preferences he has and whether he would like to try eating the hot school lunch. If his friends are all eating hot lunch, he may want to join in as well.

kelly writes...

I have a 12month old son who I just took to his first year check up. The doctor said that he is a little below his required weight and recommened that i give him a pedisure? Do you think that this could be helpful? Also I am trying to introduce new table foods everyday so he can start to taste new things so it wont effect him being a picky eater. I also am trying to ween him off of formula and start whole milk,except he wont drink it from the bottle? I have been putting it in cereal and giving it to him that way. Does that sound like he is getting enough milk?

Connie? writes...

Hi Kelly,

I think it is very important that you follow your doctor's recommendations. A medical professional who is seeing, measuring and evaluating your child in person is who you should look to for advice. A forum such as this can't substitute for the medical or nutritional advice given by your personal physician or dietitian. I do think it would be a good idea to ask your physician for a referral to a pediatric registered dietitian if you still have feeding questions. For one thing, it is hard to know how much milk your child should be getting if a portion of his calories will be coming from Pediasure.

I talk about general guidelines for toddler feeding in Dahema's response above, including a link to a brochure from the Florida Dept. of Health.

amy writes...

my2yearold want eat any table food at all expect of couse french fries.we use sunflower oil she also eats fried oraka fried pork chops just the crust fried chicken just the crust.all fried things .she will eat bannas .but the rest of the table food that it .all the rest baby food im reaaly getting disgoured.thak u for your help.

Connie? writes...

Dear Amy,

A toddler learns to eat the foods she is most often exposed to. You may want to cut back on the amount of fried foods that you serve your family. Everyone will benefit from a diet lower in fat and calories. Even healthy oils such as sunflower or canola contribute a lot of calories to the diet.

By age 2, a child should be eating mostly table foods. I would eliminate the baby foods and start by offering soft foods such as avocado, banana, applesauce, winter squash, oatmeal, yogurt and scrambled eggs. Gradually increase the texture of the food so that she is eventually eating the same foods the family is eating. If she refuses to eat or eats very little, don't worry but do make sure she is offered a meal or snack every 2 to 3 hours.

I have two articles posted on my website that may be helpful to you and other readers. The articles are Finger Foods for Toddlers and
Can a toddler survive on air?.

Aida writes...

Greetings,
I am having an on going problem w/my 9mth old. 3mths now he has been constipated from mild to worst. If I give him baby food he gets binded and now he refuses milk. He likes water and a varity of juices. He is still a happy baby but is always hungry. I have tried many different methods thru the doctor and nothing is working but she perscribed Polyethylene Glycol but he have become dependent on it which was my fear. What can I do?
Can you tell me which baby foods work as laxatives besides Prune food or juice?
Thank You Much........Aidine

Connie? writes...

Dear Aida,

I think it is very important that you talk to a pediatric health professional as soon as possible about your baby's feeding and nutrition. I am quite concerned that he is not getting proper overall nutrition. A 9 month old baby needs to have around 24-32 ounces of breast milk or infant formula daily as well as a variety of baby foods. Water and juice are NOT nutritional equivalents and your baby runs the risk of malnutrition if he is not receiving the nutrients in infant formula or breast milk. Whole cow's milk should not be given until a baby is one year of age.

A great deal of brain development occurs the first year of life and this takes the protein and fat found in breast milk or infant formula. Water and juice have virtually no protein.

It is also not a good sign that your baby is always hungry. For general infant feeding guidelines, you can download How to Feed Your Baby Step by Step
from the Oregon Dairy Council.

Please make an appointment soon and talk to a pediatrician or pediatric nurse practitioner about your child's nutrition and feeding. They may also want you to talk with a pediatric registered dietitian. You will also get ideas on managing constipation, but you need to focus on the bigger nutritional picture first. The constipation may ease once your child is getting proper nutrition.

BEN writes...

Is there a standard ratio of protein to body weight an active child should have per day?

Connie? writes...

Hi Ben,

The following values reflect the 2002 Dietary Reference Intakes (DRIs) updates from the Food and Nutrition Board of the National Academy of Sciences.

Age ----------- Recommended Protein Intake(grams/kg body weight/day)

1 to 3 ---------------------1.1 grams
4 to 13 --------------------0.95 grams
14 to 18 ------------------0.85 grams

Source: Dietary Reference Intakes: Macronutrients, Institutes of Medicine, 2002

To convert a child's weight to kilograms (kg), divide weight in pounds by 2.2. For instance, a 79 pound 10 year-old would need around 34 grams of protein per day (79 divided by 2.2, multiplied times .95)

For an active child, the values may be slightly higher than the chart above (perhaps as much as 1.5 times the requirement above if the child is involved in one or more hours of daily training) . What's interesting is that most children (and Americans in general) far exceed these minimum requirements. For reference, a cup of milk or yogurt has about 8 grams of protein, 1 egg provides 6 grams, 2 ounces of lean deli meat provides 20 grams and 2 tablespoons of peanut butter has 7 grams of protein. Protein is also found in plant-based foods including beans, grains, nuts, seeds and many vegetables.

Another point to consider is that these protein requirements assume that the child is getting adequate calories. If a child is not getting enough calories in general, protein will be converted to energy instead of used for building cells and tissue. Also, calories in excess of body needs, whether from protein, carbohydrate or fat, will be converted to fat in the body.

Jean (PBS Parents)? writes...

Looking for healthy, kid-friendly recipes? Check out these sites and blogs:
In her blog, A Veggie Venture, Alanna Kellogg leaves no vegetable unprepared. There are so many variations on vegetable recipes that you’re bound to find at least one that even the most anti-veggie kid will love! And what kid wouldn’t like Garbage Pasta Salad and Wacky Wafflewich, found on the site Kidnetic. Then, Whole Foods Market has devoted an entire section of its website to kid-friendly recipes, focusing on some of the more challenging – breakfast, snacks, and lunch-box meals. The food site, Relish, also has a section on cooking with kids. Finally, Clotilde Dusoulier uses her food blog Chocolate & Zucchini to share healthy recipes and food experiences from her home in France. While her recipes are not specifically aimed at kids, they sound yummy and would certainly expand a child's horizons!

Connie? writes...

Since a lot of the participants on this forum have asked questions regarding infants and toddlers, I wanted to share a few select resources that you may find particularly useful for feeding children ages birth to three.

What Everyone feeding a baby should know is an issue of the FOOD reflections newsletter that emphasizes safety when feeding an infant.

Breastfeeding Basics is an article available on the nutritionforkids.com website.

While Feeding Infants: A Guide for Use in the Child Nutrition Programs is technically designed for USDA child care centers and day care homes, parents and other caregivers will also find a wealth of information in this resource. The guide includes information on topics such as infant development, nutrition for infants, breastfeeding and formula feeding, preventing tooth decay, feeding solid foods, drinking from a cup, choking prevention and sanitary food preparation and safe food handling.

WIC provides supplemental foods, health care referrals, and nutrition education for low-income pregnant, breastfeeding, and non-breastfeeding postpartum women, and to infants and children up to age five who are found to be at nutritional risk.

MyPyramid for Moms was just released this month. Nutrition guidelines and meal patterns are tailored for pregnant and breastfeeding moms.

Nutrition Guide for Toddlers from KidsHealth for parents provides a nice overview of toddler feeding.

Connie? writes...

Before the month draws to a close, I wanted to share a link to the Produce for Kids site. There are some fun fruit and vegetable recipes for kids and other great resources for families. I have had the opportunity to work with Produce for Kids for the past two years. It is a great program that brings together families, grocery stores and produce suppliers. Best of all, the fall campaign benefits PBS Kids and the great work that they do.

If any of you need to find me after this month, my home on the web is at Nutritionforkids.com.

Finally, a big THANK YOU to all of the parents and grandparents that wrote in with questions this month. I really enjoyed hearing from all of you. It's always great for me to hear about issues important to today's families.

Best to all of you!
Connie

Bhawna Goswami writes...

I have a 19-month-old boy and my biggest concern these days is that he's not just picky, he has completely stopped eating everything that I try to feed him. Also, because we have recently moved to a different city, we are presently putting up in a hotel room. His activities have become too limited . I am really very concerned about his health and, of course, his development too . Even at home or in day care he does not happily eat anything . So kindly suggest me some really effective way which can help me here .

Note: edited for clarification by Mark (PBS Parents)

Connie? writes...

Dear Bhawna,

Sometimes when a child's routine is turned upside down, he will react with changes in eating, sleeping or behavior. It sounds as if you are adjusting to a new city and are not situated in a home as of yet. This could explain why he is refusing food, particularly if he is a picky eater to begin with. (picky eating has been discussed on this page, so I would encourage you to scroll up and read prior posts)

The most immediate concern is that he is maintaining his fluid intake. Hopefully, he is still drinking milk on a daily basis. Dehydration can happen more quickly in young children.

You may want to try establishing some family routines. Even though you are in an unfamiliar setting, perhaps you could try to reconnect to some of your traditions or daily events such as family meals, reading before bed, playing familiar games or with familiar toys, etc.

If he continues to refuse food after a few days, I would find a local family physician or pediatrician and have him evaluated.

Julie writes...

Another rule should be DO NOT BUY JUNK. So many families don't get the idea that if you just don't buy that stuff then the kids won't have an unhealthy option. I think ALL preschools should be required to only provide healthy snakcs. Unfortunately that is NOT the case!

Debbie writes...

I think that's great advice. I just wish some of those things would work for my son who is 4, but he is strictly a by sight and smell child. If it doesn't look right or smell right he won't go near it. I've quit pushing most foods only because I'm sick of the battles with him. He basically lives on grapes, noodles, turkey, string cheese and chicken fingers. My husband and I are very concerned that he is not getting the proper nutrition he needs. If you have any helpful advice I would gladly appreciate it.
Thanks,

Connie? writes...

Hi Debbie,

Your message really struck home because I recall a "grapes and noodles" stage with my daughter when she was about this age. Your son is actually including two more food groups -- cheese and meat. I think you are wise not to battle with him and take a a more hands-off, yet positive approach. He may be the type of child who responds to choosing foods at the store and helping in the kitchen. He may be more willing to try foods if he is involved in the selection and preparation. I would also give him a children's multivitamin/mineral supplement (look for one of the "complete" formulations).

An important book for parents of picky eaters is the classic "How to Get Your Kid to Eat... But not Too much," by Ellyn Satter. Satter is a well-known expert in this field and although she has written several books, this one from 1987 is still my favorite. She talks a lot about establishing positive feeding relationships and also the division of responsibility in feeding, i.e. parents provide a variety of foods and a regular meal/snack schedule, but children have the responsibility of choosing what and how much to eat (or even, whether to eat). I think you will gain a lot from her wisdom.

LAURA writes...

Hi everybody, my youngest child is 15 months old. I am learning that he loves fresh fruits and all vegatables. I cook daily and consume more meat than veggies, except for baby, he gets his favorite veggies from the soups and side dishes. Juan-Miguel will start day care soon and the school suggested I provide snacks to keep him content if he disagrees with their food. He is not too fond of bread, canned spaghetti, or packaged foods that my family eats. I limit his sugar and "junk" food that we eat (Oreos, cheetos, jumbo pak cereals) by offering him a fruit (banana) or yogurt raisins. I realize that baby eats healthier than we do and that I have to make better choices for the rest of our family. Baby has been teaching us a few things about our food choices, but I don't have ideas on what to cook instead of meat everyday or chicken soup or how to cook other than in a soup or fry in a pan. Because of baby, we do all eat more fruits and veggies, but I feel that I have been cooking the same things over again. Please help, I do want his day care to continue to provide him with healthy foods. Are yogurt raisins (17g sugar), dried fruit (33g sugar), Teddy Grahams (8g sugar), the only non perishable snacks? What do you suggest for packaged/boxed juice drinks, Hi-C (26g sugar)? WOW I did not realize how mouch sugar I was giving baby. I really need your help!!!!!

Connie? writes...

Dear Laura,

I'm glad that your baby enjoys fruits and vegetables. It sounds as if he is motivating you to make some family changes. That's great! In Jean's post above, she mentions some great websites that have good kid-friendly recipes. Also, I would go ahead and invest in a basic cookbook or two. I still refer to my basic "Better Homes & Garden" cookbook for many ideas and recipes. Almost every family gets into a "food rut" now and then and needs new ideas.

As far as snacks go, a few ideas include low-sugar dry cereals in baggies (e.g. cheerios, crispix, chex, etc), zwieback toast, toddler biscuits, 100% fruit juice boxes (4 oz. size), bananas or individual packs of applesauce (with no sugar added). I would also discuss the snack choices available at daycare. It may not be necessary for you to pack snacks if they have a good variety. It sounds as if your son is accepting of new foods.

I would not give a 15 month old dried fruit or yogurt raisins because they are potential choking hazards and also they contribute to poor dental health.

Kandy writes...

Hi,
I have 20 month old son. He is good at everything except for eating. he dont like the solids at all. he always want milk milk milk. if i disguss this problem with his doc he says not to give him milk he will come for the food. I have even tried that too but he was still crying for milk rather than the food. can u please suggest some solution to this problem. he dont even want to open his mouth for the solid foods. this is really worrying me a lot.
thanks

Connie? writes...

Dear Kandy,

Your question is very similar to the one posed by Dahema. If you scroll up the page, you will be able to read her question and my response.

The only thing I would add is that it does pay to be patient. As you cut back his milk intake, he will eventually become more hungry and willing to try more foods. It may take several days but I would start limiting him to a total of 16 ounces of milk each day.

Lisa writes...

I have read your response on picky eaters. My 3 year old son has got to be the pickiest eater ever. He has had tonsil and adnoids removed this year and astma difficulties which I am sure have played a role in his eating issues. When he was on baby food he never made it to the 3rd stage foods. He would spit it out if it had lumps in it. I have offered varieties of foods to him consistantly without luck. He has NEVER eaten a fresh fruit or vegitable. Nor has he eaten any of the kids favorites-birthday cake, pizza or hot dog. He will drink soy milk (due to allergy) and a few things that are dry like crackers. I have tried to discuss this with every doctor he has seen from the ENT to the allergist and they always say if he gets hungry enough he will eat. Is there some magical way that I am missing? Is he old enough to understand "If you don't eat your dinner you will not have another option". My other child eats anything I put infront of her without any problems. Thank you for any advice you share.

Connie? writes...

Hi Lisa,

Because of the medical nature of your son's feeding issues, I would strongly encourage you to look for a hospital or medical center in your area that has a feeding team. I really think he would benefit from evaluation by an occupational therapist (who specializes in feeding issues) as well as a speech therapist, pediatric dietitian and child psychologist. I was fortunate to work as a member of a feeding team in my early career (at the Univ. of Iowa pediatrics dept) so I appreciate the usefulness of a coordinated approach to feeding difficulties. When a child such as yours misses out on certain phases of feeding development (i.e. texture progression), it can set the stage for years of feeding difficulties.

jean coles writes...

2 year old toddler will not eat .only french fries/milk with vagetable mixes only choice.mother has made effort with other food. what can we do next. cocern ggrandmther

Jean (PBS Parents)? writes...

Hi Jean,
Connie Evers is no longer taking questions, but I think you'll find lots of useful information in the answers she has already provided. One of her answers specifically addresses feeding infants and toddlers. So scroll up the page to read through her answers, and hopefully you'll find what you are looking for.

Nobuhle writes...

Can you please help me?
I have a three year old boy, he does not enjoy food instead he likes water and juice or Hot chocolate. What can i give him?

Jean (PBS Parents)? writes...

Hi Nobuhle,
Connie Evers is no longer taking questions, but I think you'll find the answer to your question in the answers she has already posted. Scroll up the page to see her other answers. In particular, look at her answer to Mubashir's question about his almost three-year-old son who is a very picky eater. She provided him with lots of great advice!

Donna writes...

my daughter is 13 and has had a weight problem in the past. She has lost 35 lbs and is very happy with the way she looks. My only concern is that she may be taking it too far. She is constantly concerned with how many calories she is eating. How many calories a day should a 13 year old girl who weighs 90 lbs and is 57 1/2 inches have a day to keep a normal body weight or not to gain weight.

Hi Donna. Connie Evers isn't taking questions anymore. An earlier poster, Gary, asked Connie a similar question regarding his 12 year-old daughter. Her response was very thorough. Just scroll up toward the beginning of the posts, and you'll find it. Hope it helps. Good luck!

jean coles writes...

have a grand son will not eat .frech fries /chips ,some juice .milk still main diet .what can we do .trying new food will not eat. thanks jean

Hi Jean. You may have missed the response to your November 6 post, but Connie Evers is no longer taking questions. She did give lots of suggestions to other posters who were also concerned about picky eaters. Scroll up the page for those comments. Hope this helps.

Cyndi writes...

My 16 month old is always hungry. he eats large volumes of food and always wants to snack. he is in the 20th percentile for weight and the 70th for height for his age. His belly is extremely large, but his legs and arms are thin. I feel I need to restrict his volume because his stomach gets so large with eating but don't want to cause he is so slow to gain weight. Whatt should I do?

liz writes...

My granddaughter is the same...she cries for food all day long and will not stop eating...we can not take her to parties ..all she wants to do is eat and will continue to cry throughout the party..we are beside ourselves. It is a full-time job.

sara writes...

I have an 18 month old little boy who will only eat baby food. Do you know of any food specialists in the Houston area that could help me out? I really appreciate your help!

shannon writes...

my sister has a 3 year old son who is still mostly bottle feed. she uses pedisure to make sure he gets the nutriants he needs. He refuses to eat real food, except for few things, like the occassional mac & cheese, gold fish, and few other things. They have tried to take the bottle away and he starves himself going a day with out eating. Being concerned, my sister always gives in and gives him the bottle again. He had refulx when he was an infant not sure if that has anything to do with anything. He also has some speech delays. He can say some words and some small sentences, but mostly babbling, like he has his own language. Her last trip to the ped said they have to do some testing to see if he might have autism? Could his delayed speech development be blaimed on the bottle feeding?

curcina writes...

my son is 4 years 8 months old and weighs 17 kgs 117 height goes to kindergarten school and has a very bad appetite how do i plan his food for the day and what is good for his growth?

Thank you for keeping an update on your journey. I feel encouraged. I hope you continue to post such fabulous ideas.Its really a good idea to help children to keep their diet balanced and attaining a better lifestyle because nutritious diet is very much important to keep us healthy and completely fit.Healthy eating begins with learning how to “eat smart”. It's not just what you eat, but how you eat. Paying attention to what you eat and choosing foods that are both nourishing and enjoyable helps support an overall healthy diet.Despite what certain fad diets would have you believe, we all need to provide to kids a balance of carbohydrates, protein, fat, fiber, vitamins, and minerals to sustain a healthy body.A vegetarian "ape-diet", based on the foods, is as effective in lowering cholesterol as an established cholesterol-lowering drug. .Of course you need to give a balanced healthy diet consisting of 7-8 servings
of fruits and vegetables

Ramandeep singh writes...

Good nutrition is very very important for one. It maintains balance and the life become very comfortable. We can get rid of all the hypertension by safe and best nutrition diets. Each good and fresh. All the Best.

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Oscar Sanchez writes...

Hi Connie Evers,


My 6 years old daugther has become a vegetarian and don't want to eat any meat . The problem I am facing is that in the school meals there is not many alternatives specially on the lunch time.

What is the best way to go, so she can eat better meals.Thank you

I really appreciate your work to this site.So continue this kind of stuff in future also.

Bookmark writes...

Good nutrition is very very important for one. It maintains balance and the life become very comfortable. We can get rid of all the hypertension by safe and best nutrition diets. Each good and fresh. All the Best.

yangdi sherpa writes...

i have 30months old daughter.she is very active.she eats everything and the problem is that she never comedown and if we say her to wait than she cann't wait till she get the things she wants.sometimes she makes me crazy any suggestion how to handle
this conditiuon
thankyou

jackie writes...

my five year old is very ppicky he won't eat potatoes but hell eat french fries i don't know what to do should i stop feeding him fries or pushing potatoes on period?

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Karelyn writes...

I have a 3 yr.old daughter and I have 2 issues. The 1st is, she will only eat a few things(hot dogs,noodles,ham,chicken nuggets and sausage) I try fruits and veggies but she won't eat anything but apples or sometimes bananas(not all the time) but when she has to poop it's so hard-she cries to try and push it out. That's why I think she won't eat. She's afraid when it comes out. It hurts her. 2nd is, she mostly drinks milk 2%. I give her apple juice but that only works sometimes.I tried water and that doesn't work at all.But the best part is,she won't give up the bottles.She has 12 different style cups but refuses to use them- to a point she won't drink anything at all for hours at a time if I don't use the bottle.She's even picked out most of them.I know she needs the cup but I can't leave her not drinking,especially since she won't eat.And I'm sure it affects her poop too-but what can I do to make it easier for her? Can I try and give her something to soften them up? or do you have any suggestions how to get her to use the cup and drink water? Any advise will help,I can't see her suffer like this anymore.Thank-you!!

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