AN EVIDENCE-BASED GUIDE TO TODDLER NUTRITION FOR HEALTHCARE PROFESSIONALS
Healthcare Professionals are vital in helping parents of toddlers (1-3 years) create positive mealtime routines and experiences
- Healthy eating is as much about ‘how’ as ‘what’. To promote the physical and mental development of a toddler, it is important to create a positive eating environment in which wholesome food is offered.
- Family meals are comforting for any person of any age. Parents should aim to eat with their toddler as a family on most days of the week.
- Toddlers aged two and up should contribute to meal preparation. A toddler’s help in the kitchen might add time, but encourage parents to think of it as bonding time rather than mealtime ‘chores’.
CHARACTERISTICS OF A POSITIVE EATING ENVIRONMENT
- It has routine.
- Suitable family foods are provided.
- Self-feeding is encouraged.
- Brings the whole family together.
- Has few distractions.
- Is inclusive.
- ROUTINE: ESTABLISH A POSITIVE ROUTINE FOR FOOD, FLUIDS, REST
Toddlers thrive on routine. It’s important to establish regular meals and snacks around the same time each day1. To help establish a regular routine of meals and snacks:
- Provide 3 main meals and 2-3 snacks each day. Have three main meals and two or three snacks at similar times each day of the week. This primes toddlers to feel hunger in time for their meal or snack and reduces grazing. Discourage grazing between meals and snacks. If a toddler is eating three main meals and two or three snacks, they are eating roughly every two hours and should not be hungry between these times. Only water should be consumed between feeding times.2
- Avoid excessive fluid intake. Avoid excessive fluid intakes throughout the day, as this will reduce the amount of food consumed. Toddlers should consume between 1200-1500mls of fluid, including milk, each day.3
- Establish a good sleeping routine. Promote enough sleep during the day and at night4. Toddlers do not eat well if they are tired and unsettled.
- PROVIDE SIMILAR AND SUITABLE FOODS TO THE WHOLE FAMILY
- Eat what they eat. When parents and toddlers eat the same foods, this normalises and positively reinforces the healthy foods provided1.
- Keep an eye on salt. Meals suitable for adults and toddlers should be lower in salt; avoid stock cubes, packet soups, and other processed seasonings as much as possible.
- Try new foods together. Parents should remember to try new foods with their toddler, and to remember that a new food may need to be offered in excess of 15 times before a toddler will be willing to taste it5.
- ENCOURAGE SELF-FEEDING
Toddlers eat better if they are allowed to feed themselves3. Toddlers who are permitted to explore their food are more likely to eat enough and to eat a greater variety of foods. A messy meal is, more often than not, a sign that a toddler is positively engaging with their food3. Self-feeding should be encouraged, and to facilitate this, parents can:
- Use toddler-specific tableware. Use unbreakable plates and bowls to make meals and snacks much safer. Plates with raised edges should be used, especially when toddlers are learning to use cutlery. The raised edge helps prevent food from sliding off the plate and makes eating less frustrating.
- Introduce appropriate cutlery at suitable ages. Toddler-specific cutlery should be introduced when a toddler shows an interest in using cutlery with their meal6. An easy-grip plastic spoon should be introduced first, usually at some point between 9 and 14 months of age. Once a toddler is comfortable with using a spoon and with picking up finger foods, a toddler-specific fork can be introduced, usually at about 18 months of age. Toddlers will continue to use their fingers alongside the cutlery at this time. A toddler-specific knife can be introduced from 30 months. At the beginning, toddlers should be encouraged to practise with it when soft foods, like scrambled egg, and to slowly progress from there.
QUICK TIP FOR PARENTS
Help your toddler cut difficult foods, especially meat,up to and beyond age 5. It takes several years to master the use of cutlery, especially a knife and fork together.
Cut foods into appropriate segments. Finger foods and small slices of food which can be easily held or speared with a fork should be provided.
Allow toddlers to serve themselves. Consider allowing toddlers, especially those over 2 years of age, decide their own portion sizes. Parents can help put food on plates, but toddlers should dictate the amount of food put on their plate.
- BRING THE WHOLE FAMILY TOGETHER
Mealtimes should be times when a whole family sits together to converse, exchange ideas, share thoughts, and of course, eat. Family meals have been shown to improve nutrient intakes, academic success, vocabulary, self-esteem and sleeping habits1. They have also been shown to decrease behavioural issues and the risk of obesity and disordered eating1. To encourage sociable family meals:
- Set the tone3. A light-hearted and relaxed atmosphere should be promoted. Meals should not be times of argument or reprimand.
- Emphasise good manners. Meals are a great opportunity to teach toddlers to say please, thank you and excuse me.
- Serve everyone at the same time3,7. Food can be provided in bowls or on platters in the centre of the table, to encourage family members to serve themselves.
- Adults set the example3,7. The toddler should not be the focus of attention during a meal. This means that once a parent has prepared a meal and provided it to their toddler on schedule at a table, their job is done. They should then sit down, serve themselves and focus on creating a relaxed family meal in which a toddler will naturally want to participate. Where parents lead, their toddler will follow.
- Prioritise family meals8. Family meals don’t have to be dinner. It may be easier for everyone to have breakfast or lunch together. But whatever meal is chosen, it’s important that each family member is encouraged to make it a priority. Suggest that parents prioritise family meals as often as possible when making work, leisure or extra-curricular commitments.
- Be realistic. Happy and relaxed family meals won’t happen every day, and this is to be expected in a busy family. The important thing is to try to prioritise family meals as often as family life allows.
QUICK TIP FOR PARENTS
Your job at mealtimes is to decide on the what, when, and where of eating. Let your toddler decide on the whether and how much.
- MINIMISE DISTRACTIONS
All meals and snacks should be consumed sitting down at a table with minimal distractions. To minimise distractions and encourage a more relaxing eating environment:4,9
- Switch off. Remove screens at mealtimes. Turn off all televisions and laptops. Turn off, or put on silent, all phones for the duration of a meal. The more time a toddler spends watching screens (such as televisions, laptops, and smart phones), the more likely they are to consume unhealthy meals and snacks9. Watching a screen whilst eating also affects the quantity of food consumed. If a toddler is distracted by screens whilst eating, they are less attuned to their satiety signals, and are more likely to overeat.
- Get the environment right. This means removing distracting toys, closing doors and using softer lighting.
- BE INCLUSIVE
Toddlers should be encouraged to contribute to some aspect of meal preparation and cooking from two years of age10. Focusing on some simple and healthy family recipes can facilitate the involvement of toddlers in cooking3. Meal preparation and cooking may take longer, but parents should be encouraged to think of these activities as productive bonding time with their toddler, which is time well spent. Suitable tasks for toddlers when preparing meals vary by age, but can include10:
Suitable articles for parents on this topic are available at www.toddlebox.ie/nutrition