Amanda Ursell, TV nutritionist, author and mum, provides toddler nutrition advice.
What’s unique about a toddler’s growth?
Believe it or not, between the ages of one and three, toddlers grow faster than at any other time since they’ve been born. On average, they gain an astonishing 40 per cent in height and weight over these three short years.
What’s more, toddlers have very active brains and bodies. They need lots of energy and the right amount of nutrients to fuel their daily exploring, discovering and tearing around. Unfortunately, it appears from studies by the Department of Health that many toddlers are not getting all the right nutrients in the right quantities so their needs are not being met.
What can I do to help my toddler?
Start early and lay down a solid foundation with good eating habits during the toddler years. Establish regular mealtimes and stick to them. A good pattern is breakfast-snack-lunch-snack-dinner with an extra snack before bedtime if you think it’s necessary.
Choose water and milk as your toddler’s main drinks but be careful about giving them too much milk because it can leave your toddler too full to eat.
Sit and enjoy eating with your toddler and other children at every opportunity, and encourage people caring for them to do the same. This can help them to feel safe, secure and more adventurous about trying new foods, textures and tastes.
What’s your advice for mums of fussy eaters?
Firstly, I know that this can be worrying for mums because I’ve been through it myself. The key is to be patient and hold your nerve – most toddlers do grow out of this phase. So try hard to stay calm and ride out the storm, with a business-as-usual attitude to meal-times, and you should both come out of the other end unscathed. I will say though, it may need a bit of acting on your part, pretending that you aren’t bothered when you actually feel anxious and stressed inside!
Secondly, keep offering breakfast, lunch and dinner at regular times with two nutritious snacks in-between. This stable routine will mean that you can relax in the knowledge that if your toddler has not eaten much at one meal, he will be offered a nutritious snack within a few hours. Remember, if your toddler is hungry, he almost certainly will eat.
Are supplements important when my toddler’s not eating well?
Toddlers often regulate their dietary intakes over several days and so may naturally just eat more one day than another. Bear this in mind before you worry that your toddler isn’t eating well and remember that the UK Departments of Health recommend that children aged between one and five years be given supplements containing vitamins A, C and D even if they are enjoying a healthy, balanced diet.
Do toddlers need extra iron?
Newborns arrive with enough iron in their bodies to last for around six months. After these initial stores run out, they need to get iron from the food they eat.
How can I get iron into my toddler’s diet?
Foods such as lean red meat, green vegetables like broccoli and pulses like peas and beans are great for iron. Fortified foods like bread and some breakfast cereals also give us this crucial mineral.
Vitamin C boosts all of our bodies’ – toddlers included – ability to absorb iron from the food we eat. It is therefore well worth trying to combine iron-rich foods with vitamin C in, for example, a piece of red pepper when having baked beans.
What is Vitamin D?
Vitamin D is an essential vitamin and is needed for normal growth and development of bone in children. Ensuring your toddler gets enough vitamin D*** is very important.
Can you tell me how to increase my toddler’s vitamin D intake?
Remember to expose your toddler to appropriate amounts of time in the sun. This is the primary way for them to get vitamin D and works by the action of ultraviolet rays on their skin. Just fifteen minutes of sun on the hands, face and arms two to three times a week (without high factor sunscreen), from April through to September, is believed to be enough to keep vitamin D levels up while keeping the risk of sun damage low.
* Little People’s Plates. Toddler Feeding Time. Poll of 1,000 mothers with children aged between 9 months and 3 years, 2009. Available from: www.littlepeoplesplates.co.uk/toddlerfeeding-time.html
** The Reference Nutrient Intake of iron for a toddler 1-3 years is 6.9µg per day (DH, 1991)
*** The Reference Nutrient Intake of vitamin D for toddlers is 7µg per day
Johanna, nutritionist and mum of two, has appeared on Radio 4 Today Programme, BBC News, Channel 4 News and BBC Breakfast. Here Johanna provides toddler nutrition advice.
What do you think of toddler diets in the UK?
Nutrition is so critical at this young age; toddlerhood is a period when children are growing and developing rapidly and they need plenty of energy and other nutrients to support this. They are also learning to walk and talk and beginning to assert their own independence, which can often spill over into food and mealtimes and manifest as fussy eating. Having said that, many toddlers are well-nourished and grow well; of concern are those who are not encouraged to develop good eating habits. They may be fussy eaters and not encouraged to try new foods so often or who follow very restricted diets for health or cultural reasons. The more you limit variety in the diet the more you limit the variety of nutrients in the diet. So children who have a restricted range of foods in the diet, who eat only tiny portions of a limited range of foods often struggle to meet their energy or nutrient requirements.
Do enough mums know about the need for fortification, as advised by the DoH?
The Department of Health recommends that all children aged between one and five years be given supplements containing vitamins A, C and D. Remember, babies aged six months plus need these vitamins as well however, babies drinking more than 500ml of formula milk per day won’t need additional vitamin supplements. These vitamins are important for development and are often low in toddler’s diets.
Vitamin D is a particularly important vitamin as it is essential for the absorption of calcium in the body, thus playing a role in the formation of healthy bones and teeth in toddlers. The awareness of the need for vitamin drops is low. In fact, when my children were that age, vitamin drops were the last thing on my mind! I don’t recall being reminded about them by the health professionals I came into contact with.
Do enough mums know what a healthy balanced diet should look like for toddlers or is it all a bit confusing?
I think it’s confusing! Toddlers are not simply little adults, they have unique requirements and the healthy eating advice for adults (to choose foods low in fat and high in fibre) is simply not appropriate for toddlers. Toddlers need energy and nutrient dense food. They have small tummies so the smaller portions they do eat need to provide all the energy and nutrients they need. So skimmed milk, low fat yogurts, high fibre mueslis and low calorie drinks are all fine for mum but not for a toddler!
I think mums and dads often struggle with giving enough variety in a toddler’s diet. It’s all too easy to give the foods a toddler likes rather than persevere with new foods that they may reject a few times before becoming accustomed to them. Choosing the right portions for a child is a challenge too and information on typical toddler portion sizes is available but I suspect many parents are not aware of it.
Why should we be bothered about toddler’s diets and fortification? Does it really matter that much?
Research by the Department of Health investigating the quality of toddlers diets has shown that they are often low in iron, zinc and vitamins including A, C and D.
What would you say to someone who says ‘But we didn’t need all those extra vitamins and stuff in my day and we grew up fine’?
I hear that frequently, but as our knowledge develops we learn more and more about the nutritional needs of toddlers and how important this subject is. Times change and dietary habits change. For instance, the breastfeeding rates today are significantly higher than they were in the 70s or 80s, yet our toddlers are eating more fast food and snacks than years ago. Many toddlers are well-nourished but it’s the pockets where we see these deficiencies that are concerning. None of us want to see our children grow up suffering because a poor diet during the early years has affected growth and development. The Department of Health’s recommendation for use of vitamin drops is based on scientific evidence showing that these nutrients are commonly lacking in toddlers’ diets.
What are your five top tips for ensuring a toddler gets as good a diet as possible?
- Encourage them to eat a wide variety of foods. The wider the variety of foods the wider the variety of nutrients in the diet. Fussy eaters who eat only a handful of different foods are likely to struggle to get all the nutrients they need.
- Eat family meals together. Eating is a social occasion and encouraging your toddler to eat with the family helps them learn to enjoy food as you do. Equally your toddler will learn to enjoy the type of foods you and your family eat, making your food preparation easier!
- Try new foods regularly. It can often take a few attempts before a toddler learns to accept and then enjoy new foods so persevere and you will hopefully be rewarded by the fact that your toddler will eat a wide variety of different foods.
- Try to keep calm. Encouraging kids to eat and try new foods is a gentle process, aided by a little peace and calm, without too much pressure.
- A treat every now and then is fine. And brings a smile to their faces! As long as they are eating a good variety of healthy foods a treat at the end of a meal occasionally is fine.
Why are Vitamins A, C, and D important for toddlers?
These vitamins play an important role in the growth and development of young children and are essential for everyone. The British Nutrition Foundation has excellent information on the role of these nutrients in the diet www.nutrition.org.uk.
Why is Omega 3 important for toddlers?
Omega 3s are found in oily fish, rapeseed oil and some nuts.
An essential fatty acid, alpha-linoloeic (omega 3) is important for health, including growth and development, as the body cannot make them. Other types of omega 3′s are long chain polyunsaturates (LCPs) and are important for the development of key organs including the brain and the eye. Research is ongoing in this area looking at the key roles for these important nutrients in toddlers.
Why is calcium important for toddlers?
Calcium is needed for the normal growth and development of bone in children. Getting adequate calcium during toddler years is essential to help build a strong skeleton that forms the foundation of the bone structure right through to adulthood. A lack of calcium can cause problems such as osteoporosis or fragile bones much later in life.
Calcium is found in dairy products such as milk, cheese, yogurts and fromage frais. It is also found in fish such as sardines, whitebait and canned salmon where the bones are soft enough to eat. Finally some green leafy vegetables, nuts and pulses also contain calcium though this is not as well absorbed as dairy calcium. Toddlers should be having three portions of dairy a day (such as milk, cheese, yogurt) to ensure they have an adequate intake. Don’t forget that vitamin D is important for the absorption of calcium in the body.
*Based on an average of the vitamin D content of growing up milks and toddler milks from Cow and Gate, Aptamil, HiPP and SMA