Tips and Tricks on Diet
and Nutrition
Tammy Cooper, RD
CHEO Connects!
February 6, 2012
Objectives
• Explore reasons that may contribute to feeding
difficulties
• Review appropriate nutrition for Toddlers and
Preschoolers
• How it relates to their developmental stages
• Demonstrate portion sizes
• Discuss challenges and strategies for picky eaters
• Offer resources and ideas
How Do I Get My Kid to Eat ?
What should our kids be eating, how much,
how often?
What to do about picky eaters?
How do I get my child to stop talking and
eat?
Does it really matter if we sit down at the
table and eat?
Feeding Conflict
Parental
pressure
to eat
Feeding resistance
Chatoor I. Diagnosis and Treatment of Feeding Disorders in Infants, Toddlers, and Young Children. Washington, DC: Zero to Three; 2009.
Medical Reasons for feeding problems
• Reflux
• Undiagnosed Food Allergies
• Constipation
• Dental Problems
• Excessive Juice or milk intake
• Autism
If you suspect that your child has any of these, contact
your family physician
5. Excessive Juice or Milk Intake
- Recommended drink for children is water
- Recommendations are no more than 250mL (1 cup of
juice) per day
- Recommendations for milk are 2 cups (500mL) per
day
- Liquids (except water) should only be offered with
meals and snacks after the food has been eaten.
Picky vs. Problem Feeders
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PICKY
Eat fewer than 30 foods
Eat at least one food from
almost all textures
Eat the same food every day
(food jag)
Tolerate new foods on their
plate
Adventurous to taste new foods
Willing to eat new foods after
repeated exposure 15-25 times
•
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PROBLEM
Eat fewer than 20 different
foods
Restricted range or variety of
foods and textures
Foods lost to food jags are NOT
re-acquired
Cries and “falls apart” when
presented with new foods
Adds new foods in more than 25
times
Selective Eating
• Extreme picky eating can cause growth problems,
nutritional deficiencies, severe dental decay,
dehydration, and constipation.
• Keep a food diary
• Is your child’s diet varied enough?
• Try to understand what, where, and how your child
prefers to eat
• Don’t label your child as “picky” “problem” or “fussy”
eaters in front of them
1 Year of Age – begins to eat more independently
• Family foods encouraged
(may need to be softer in texture depending
on the food)
• Encourage small frequent feedings
• Food jags/dislikes: try again later
• Supervise during meals and snacks for safety
• Promote Healthy Eating Habits
.... 2 Years of Age + - definite likes & dislikes,
wants to eat only one food, conflict at mealtime
• Develop a sense of taste and an acceptance and enjoyment of
different foods
• Give small quantities of new foods
• Portion sizes appropriate for age
• Energy dense, nutrient-rich foods
• Comfortable setting without distractions
Ages 2 Years +
• Appetite is variable with growth
• Increase independence & experimentation with foods
(colour, texture, taste)
• Avoid pressuring child to eat – be a good role model
• Child will determine how much food is enough - listen to cues
e.g. turning head away, refusing to eat.
How do I get my kid to eat? Tips and tricks on diet
and nutrition.
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Be a good Role Model
Get your child to participate in cooking, baking,
shopping etc.
•
Give appropriate serving sizes
(many parents give too much)
How do you as a parent ensure your child is getting
what they need?
Follow Canada’s food guide recommendations for all
food groups. Smaller children need small portions.
Talk to a health professional if your child:
Is missing out on a specific food group (a food diary
helps).
Regular visits with your family doctor to check growth.
How to get your fussy eater to eat?
• Same as getting any kid to eat, ignore negative
behaviours at mealtimes and reinforce positive ones.
• Have the same food on your plate
• Make sure they come to the table hungry
(it has been 2 hours since their last meal/snack)
How to get a child to eat more variety?
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Offer a “nibble tray”
Let children cook or help prepare food
Serve new foods over and over again
Prepare new foods in ways your child prefers (same
shape, color, texture)
• Set a good example
• Ignore “food jags”
....Setting the Stage
New foods are introduced one
at a time every 3 to 7 days
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Start with 1 Tbsp of a new food
Introduce it first with foods the child likes
Be positive
Be sure the child has not eaten too close to the
meal
Feeding Strategies
• Feed foods your child likes
• Don't force your child to eat foods he/she cannot
tolerate
• If a new food causes distress, remove it and try
something more closely resembling a preferred food
• Do not push your child to try new foods
• Always respect your child's aversions
Mealtime Routines
• Set a schedule (3 meals and 2-3 snacks spaced 2
hours apart)
• Offer solid foods first
• Give 30 minutes to complete a meal (including drink)
• Give 15 minutes to complete a snack
• Ensure child is seated during meal or snack
Nutritional Requirements
• Nutrients are required for maintenance, growth and
development
• Amount needed depends on the individual.
• Most reliable guide to energy requirements is regular,
frequent measurements of body weight, and monthly
measurements of length/height
Macronutrients
• Energy – Needs vary based on age, size, activity,
rate of growth, and overall health
• Fat – No need for low fat before age 2
• Fluids – 4-5 cups per day
• Protein -Required for growth, tissue repair, enzymes
& antibodies, hormones, etc.
Multivitamins
• Most children who are selective eaters require a daily
multivitamin
• Aim for a children’s complete multivitamin with iron,
calcium, vitamin D
• If children are getting 3-4 of each food group at a
meal and 2-3 of each food group at a snack from
Canada’s Food Guide for Healthy Eating they should
be meeting their needs
Meat and Alternatives:
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1 serving
Cooked fish, shellfish, chicken, turkey, meat (2.5 ounces or ½
cup)
Cooked legumes (lentils, chickpeas, beans) (3/4 cup)
Tofu (3/4 cup)
Eggs (2 eggs)
Peanut or nut butters (2 Tbsp)
Nuts and seeds (1/4 cup)
Milk and Alternatives
2 servings per day
- Milk or Powdered Milk (1 cup)
- Canned milk (1/2 cup)
- Fortified Soy or Rice beverage
(1 cup)
- Yogurt (3/4 cup)
- Cheese (1.5 ounces)
Vegetables and Fruit
-
4-5 servings per day
Fresh, frozen, or canned vegetables (1/2 cup)
Leafy vegetables (1/2 cup cooked; 1 cup raw)
Fresh, frozen or canned fruit (1 fruit or ½ cup)
100% real juice (1/2 cup)
Grain Products
3-4 servings per day
- Bread (1 slice)
- Bagel (1/2 bagel)
- Flat breads (1/2 pita or ½ tortilla)
- Cooked rice, bulgur, quinoa (1/2 cup)
- Cereal (3/4 cup)
- Cooked pasta (1/2 cup)
Simple Steps to a Lifetime of Healthy Eating
• Serve and eat a variety of healthy foods
• Make smaller portions
• What, when and where is Parent’s responsibility
• How much or whether to eat is Kid’s responsibility
Recommended websites
Eat Right Ontario - www.eatrightontario.ca
or call 1-877-510-510-2 to speak to a dietitian
Dietitians of Canada-Healthy Start for Life
www.dietitians.ca/healthystart
Health Canada –Eating Well with Canada’s Food Guide
www.healthcanada.gc.ca/foodguide
Resources
• Nutrition resource centre (www.nutritionrc.ca)
• Ottawa Public Health – Nutrition - Ottawa.ca/nutrition
• Ottawa Public Health (613) 580-6744
• Ottawa.ca/health
Recommended Books
• A SMART START for Feeding Your Toddler: A guide
for moms, dads and caregivers of families with
children aged 1-6 years. (Ottawa Public Health 2008)
• Secrets of Feeding a Healthy Family. (Ellyn Satter. Kelcy
Press, 1999).
• Child of Mine (Ellyn Satter, Bull Publishing Company, 2000).
• Better Food for Kids. (Joanne Saab & DainaKalnins. Robert
Rose Inc. 2001)
Thank You !
Questions?