During the first few years of life, a person develops diet preferences and feeding habits that can continue into adulthood. That’s why it is critical for parents and caregivers to be knowledgeable about good nutrition and healthy feeding behaviors. Mealtime can be challenging for both caregivers and the child even if a disability is not present. However, when a child does present with a disability that affects their feeding or swallowing ability, mealtime can be a very unpleasant experience. If this is the case, parents and caregivers should seek out proper therapy to resolve major issues.

Babies Ages 0 to 1 Year

To say babies need adequate nutrition during their first year of life is an understatement. Babies grow at such a rapid rate their first year that they need more nutrients per pound of body weight than at any other time in life. It has been estimated that a baby’s weight will double by 5 months of age and triple by their first birthday. They will also grow 30 percent longer by 5 months and 50 percent longer by 12 months. During this time, a baby will develop feeding skills that will allow for advances in food type and texture. If an infant is not progressing appropriately in his or her feeding ability, an occupational or speech therapist specializing in feeding disorders should be contacted.

Breast milk is the preferred nutrition for all infants because of its immune-boosting properties and other health benefits. Breastfeeding is also beneficial to the mother. A lower risk of postpartum depression and a quicker return to prepregnancy weight has been found in women who breastfeed. Research has also shown correlations between breastfeeding and decreased risk of developing diseases such as diabetes and breast cancer. The World Health Organization (WHO) and the American Academy of Pediatrics recommends that an infant be fed breast milk exclusively for the first six months followed by continued breastfeeding while complementary foods are introduced. These organizations encourage mothers to breastfeed through the first year and even longer, if desired by mother and baby.

Studies have shown that a large percentage of Americans continue to introduce their infants to complementary foods before 4 months of age even though the recommendations are to wait until at least the 4-month mark before starting solids. Unhealthy feeding behaviors and weight outcomes have been seen in babies who are introduced too early to complementary foods. Parents and caregivers should watch for developmental signs of readiness in the baby such as a tongue thrust reflex, movement of the gag reflex to the back of the mouth, ability to sit without support, and the desire to eat. Feeding guidelines recommend introducing one new food at a time and waiting three to five days before moving on to another new food. This gives the parent or caregiver time to observe any adverse reactions that may result. Avoid feeding a baby sugary or salty foods because they are not only lacking in nutrients but may also be enhancing a baby’s preference for these types of unhealthy foods. Appropriate beginner foods include pureed fruits, vegetables, beans, and lean meats. Research has shown that it can take up to 10 or 20 exposures before a baby will accept a certain food. Some great finger foods include bananas, avocados, sweet peas, whole grain Cheerios, cooked lentils, cooked carrot slices, cheese slices, and whole grain pasta noodles. By following these nutrition guidelines, a caregiver can provide a healthy food environment that can benefit the baby’s health not only now but also in the future.

Toddlers Ages 1 to 3 Years

After a baby’s first birthday, their growth rate begins to slow and their appetite decreases. Mealtime is now centered on the toddler’s expression of independence through self-feeding.  At this point, the main goal of a caregiver is to promote a pleasant and successful mealtime by providing quality foods, a calm eating environment, and developmentally appropriate feeding utensils and food textures. Some helpful tips that may lead to a more successful mealtime with a toddler include having quiet time prior to starting a meal to calm an excited child, setting a daily routine for snacks and meals, encouraging a child to take one bite of a new food, not forcing food, not using sweets as a reward for finishing a meal, and accepting that a toddler’s food preference can change from day to day. It is also a good idea to not overwhelm a child with too much food at mealtime. Just remember, one serving size for a toddler is one tablespoon per year of age.

By the time a baby has reached a year old, they no longer need infant formula and can drink whole cow’s milk. It is recommended that they transition from bottles to sippy cups or regular drinking cups. A typical amount of whole milk for a toddler is 24 ounces per day; however, if the child eats dairy products such as cheese or yogurt, the needed amount of milk is less than 24 ounces per day. When it comes to fruit juice, toddlers should not get more than six ounces per day.  It is important to only use 100 percent fruit juice and to dilute the juice with 50 percent water. Other sugar-containing beverages should be avoided to prevent unintended weight gain and dental problems.

Here are a few quick toddler meal ideas that will delight almost any tike:

• Spaghetti noodles, organic or homemade tomato sauce, lean ground beef
• Low sodium black beans with chopped veggies over whole grain rice
• Grilled salmon with green beans and mashed potatoes

Sources

1. Breastfeeding. World Health Organization, 2014. http://www.who.int/topics/breastfeeding/en/. Accessed February 11, 2014.
2. Breastfeeding & Lactation Support. Pediatric Nutrition Care Manual. Academy of Nutrition and Dietetics, 2014.
3. Eidelman A and Schanler R. Breastfeeding and the Use of Human Milk. Pediatrics, 2012; 129(3):600-603. http://www2.aap.org/breastfeeding/files/pdf/Breastfeeding2012ExecSum.pdf.
4. Full-Term Infants. Pediatric Nutrition Care Manual. Academy of Nutrition and Dietetics, 2014.
5. Grummer-Strawn L, Scanlon K, Fein S and et al. Infant Feeding and Feeding Transitions During the First Year of Life. Pediatrics, 2008; 122(2):s36-s42. http://pediatrics.aappublications.org/content/122/Supplement_2/S36.full.
6. Toddlers. Pediatric Nutrition Care Manual. Academy of Nutrition and Dietetics, 2014.