Infant and Toddler Nutrition

Starting solid food is a major milestone in development

infant at breastThere are many milestones in the first year that mark significant changes in the way your child interacts with the world. One of the most radical and elemental of these changes is the introduction of solid food and the transition away from breastmilk (or formula) as the only source of nutrition.

As energy and nutrient requirements change with growth, and as toddlers develop new feeding capabilities, they are introduced to a new variety of foods, which in turn exposes them to new smells, textures, and flavors. Learning to feed oneself is another important milestone related to food during this period. So is the social learning that takes place during mealtime routines and communal eating.

Optimal nutrition in early childhood not only supports physical and cognitive growth and development, but modeling healthy behaviors around food, and exposing your child to a variety of food choices, can help to initiate and reinforce healthy eating habits that will set the direction for future development.

When To Introduce Solid Food

Parents often wonder how and when to begin introducing solid food, and this seems to be an area where research has yet to influence real-world practice. The World Health Organization (WHO) recommends exclusive breastfeeding for 6 months, and continued breastfeeding up to age 2. The American Association of Pediatrics (AAP) recommends introducing solid foods no sooner than 6 months of age.

However, a 2007 report from the CDC showed that while 3 out of every 4 new mothers in the United States initiate breastfeeding, only 33% are exclusively breastfeeding by 3 months. A 2011 study, that received widespread news coverage, showed that formula-fed babies are at higher risk of obesity at age 3. Among those that were formula-fed and started on solid foods before 4 months of age, the risk of obesity at age 3 was even greater. Another study published in Pediatrics showed that starting solid foods before 6 months of age might have effects on weight and health that extend into childhood.

Breast milk helps kids develop their taste for food!

While the health benefits of breastmilk are well known, new research suggests that flavor alsoasian child eating nodles plays a role in the link between breastfeeding and health. Breastmilk transmits most of the flavors from mom’s diet, while formula carries a standardized and unchanging flavor profile. This seems to influence developing food preferences. There is a developmental “flavor window,” which is open roughly between 4 and 7 months.

For example, one study demonstrated that breastfed infants whose mothers ate a concentrated amount of carrots, showed a preference for carrots as toddlers. It has long been known that both amniotic fluid and breastmilk have their own person-specific smell and taste that are influenced very much by mom’s diet. Newer research suggests that there might be real benefit in extending breastfeeding throughout the flavor window to prime toddlers to be more accepting of a varied diet.

Based on the AAP guidelines, infants under one year should be primarily breastfed, with small amounts of pureed whole foods introduced slowly around 6 months of age. By 12 months, an infant’s milk intake should be tapered down from around 24 to 16 ounces a day, to make room for solid foods.

As children are weaned and transition to a diet more similar to that of adults, it is important to keep in mind that the foods they eat must supply all the essential nutrients required to support their important developmental needs. In other words, there really is no room in a child’s diet for foods with low nutritional value. In reality this is true for all of us, but especially so for young children.

How much food do toddlers and young children need?

father feeding toddlerAccording to the AAP, a one-year old needs about 900 calories, 30-40% of which should be from fat. Their diet should also include at least 2 ounces of whole grains, 1.5 ounces of lean protein, 16 ounces of dairy (preferably breastmilk) and 8 ounces of fruit. Two- and three- year olds need 1000-1200 calories a day and an additional ounce of both protein and grains, with about 30% of those calories coming from fat.

By the time they are four and five years old, children need around 1200-1400 calories a day (20-25% from fat), 5 ounces of grains, and 4 ounces of protein. More active children may require more calories. In addition to the macronutrients like fat and protein, all children need to eat micronutrients (i.e., vitamins and minerals) to support organ and immune health.

Fat is especially important for younger children. This is because their brains are building important white-matter tracts that help speed up the way messages are transmitted between brain cells. This white matter, called myelin, is primarily made from fat. Protein and complex carbohydrates are important for physical growth and cognitive development, and micronutrients (vitamins and minerals) support the development of all our major organs, plus the health and function of nerves, blood vessels and the immune system.

The best way to ensure optimal nutrition for your child is to provide a varied diet of whole and unprocessed foods. However, that sometimes feels easier said than done, as young children can be sensitive to unfamiliar smells, textures, and flavors. Also, toddlers are in a developmental stage that involves testing boundaries and asserting individuality, two tendencies that can result in defiance and willful pickiness around food. If you offer only healthy choices and stay calm, your toddler will be fine.

If you have any questions or concerns about your child’s eating, it is important to discuss them with your physician or health care provider.

Written by Emily Owen, Ph.D., BSN

Dr. Owen is a developmental psychologist who also holds a degree in nursing and is a certified postpartum doula. She is a developmental science writer for Insights for Parents. You can read more about her work here or visit her website.

Watch for our upcoming article on how to encourage the development of healthy attitudes and behavior about food. It will appear soon in the Early Childhood section.