Right From the Start: ABCs of Good Nutrition for Young Children

As a parent, you are interested in your child's health. Your role is to provide healthy food in appropriate portions, and your child's role is to decide how much to eat. That is why it is important to understand how to provide healthy choices for your child.

Read on for information from the American Academy of Pediatrics about making healthful choices. If you have specific questions about your child's nutrition, talk with your child's doctor or a registered dietitian.

For starters

Child-sized portions help children accept new foods. Two tips for parents include

Serve one-fourth to one-third of the adult portion size, or 1 measuring tablespoon of each food for each year of your child's age.
Give less than you think your child will eat. Let your child ask for more if she is still hungry.

Sample List of Food Choices
Food Group	Types of Foods
Fruit: Whole fruits provide many essential vitamins and minerals, together with a variety of disease-fighting substances, like those in vegetables, and fiber. Fruits are the most important source of vitamin C. Vitamin C is needed to produce collagen, the connective substance that holds cells together and helps maintain blood vessels, bones and cartilage, and teeth.	Apples, apricots, bananas, berries (blueberries, raspberries, or strawberries), grapefruit, grapes, kiwifruit, mangoes, melons (cantaloupe, honeydew, or watermelon), nectarines, oranges, papayas, peaches, pears, pineapple, plums, prunes, raisins, tangerines, or 100% unsweetened fruit juice. Fruits may be fresh, canned, frozen, or dried. Fruits may also be whole, cut up, or pureed. (The American Academy of Pediatrics recommends that juice be limited to 4 ounces per day for children 1 to 3 years of age, 4 to 6 ounces per day for children 4 to 6 years of age, and 8 ounces per day for children 7 to 18 years of age.)
Vegetables: Vegetables are the most important source of beta-carotene and many other vitamins and phytochemicals. Vegetables also provide plenty of fiber. Our bodies convert beta-carotene to vitamin A for healthy skin, glands, immune system, and eye function. Phytochemicals are naturally occurring plant compounds believed to fight cancer and other diseases. Vegetables may be fresh, canned, or frozen.	Dark-green vegetables: bok choy, broccoli, collard greens, kale, or spinach Red and orange vegetables: acorn, squash, butternut squash, carrots, pumpkin, red peppers, sweet potatoes, tomatoes, or tomato juice Starchy vegetables: corn, green peas, lima beans, or potatoes Other vegetables: artichokes, asparagus, avocado, bean sprouts, beets, brussels sprouts, cabbage, cauliflower, celery, cucumbers, eggplant, green beans, green peppers, jicama, mushrooms, okra, onions, snow peas, tomatoes, or zucchini
Grains: Foods from grains are packed with starches (complex carbohydrates). Carbohydrates are the best source of energy for active, growing bodies. However, consuming too many carbohydrates, especially sugars and processed starches, can be unhealthy.	Whole grains: brown rice; buckwheat; bulgur (cracked wheat); oatmeal; popcorn; whole-grain barley or cornmeal; whole rye; whole-wheat bread, cereal flakes, crackers, pasta, or tortillas; or wild rice Other products, mostly made from refined grains: cornbread, corn tortillas, couscous, crackers, flour tortillas, pasta, pitas, pretzels, or ready-to-eat cereals (However, some of these may be made from whole grains; check the ingredients for whole grain or whole wheat. )
Protein foods: Protein is needed for growth as well as to maintain muscle, bone and cartilage, teeth, and every system in the body.	Meats: lean cuts of beef, ham, lamb, pork, or veal Poultry: skinless or ground chicken or turkey Seafood: fish such as catfish, cod, herring, salmon, trout, or tuna, or shellfish such as clams, crab, lobster, mussels, oysters, scallops, squid (calamari), or shrimp Beans and peas: black beans, black-eyed peas, chickpeas (garbanzo beans), kidney beans, lentils, or pinto beans Processed soy products: tofu (bean curd made from soybeans), veggie "burgers," tempeh, or texturized vegetable protein (TVP for short) Nuts and seeds: almonds, cashews, peanuts, almond or peanut butter, sunflower seeds, or walnuts Eggs: chicken or duck eggs
Dairy: Milk is children's best source of calcium and an important source of protein, riboflavin (vitamin B2), and many other nutrients.	Nonfat (skim) or low-fat (1%) milk; yogurt; cheese such as cheddar, mozzarella, Swiss, parmesan, or cottage cheese; pudding; frozen yogurt; or ice milk. Calcium-fortified soy milk (soy beverage) is also part of the dairy group.

Adapted from US Department of Agriculture.http://ChooseMyPlate.gov. Accessed April 26, 2016.

How do I know when my child is eating enough?

Children eat when they are hungry and usually stop when they are full. Some parents worry because young children appear to eat very small amounts of food, especially when compared with adult portions. To check your child's eating pattern, pay attention to his food choices.

Offer all food groups at every meal. Make sure no one food group is completely left out. If this happens for a few days, don't worry. However, missing out on a food group for a long time could keep your child from getting enough nutrients.
Encourage your child to eat a variety of foods within the food groups by modeling good eating yourself. Even within a food group, different foods provide different nutrients.
A child who is growing well is getting enough to eat.

Building a healthy plate

Over the years, various tools have been created to provide guidance on the type and amount of food Americans should eat. MyPlate recommends

Balancing calories. Enjoy your food, but eat less. Avoid oversized portions.
Foods to increase. Make half your plate fruits and vegetables. Switch to nonfat (skim) or low-fat (1%) milk (see Milk choices).
Foods to reduce. Limit foods that contain saturated fats and sodium. Check the Nutrition Facts label. Drink water instead of sugary drinks.

Food groups

There is a variety of foods from each food group (see Sample List of Food Choices). The next time you shop for groceries, try something new.

Keep in mind, do not feed children younger than 4 years round, firm food unless it is chopped completely. The following foods are choking hazards: nuts and seeds; chunks of meat; chunks of cheese or string cheese; hot dogs; whole grapes; fruit chunks such as apples; popcorn; raw vegetables; hard, gooey, or sticky candy; and chewing gum. Peanut butter or other nut butters can be a choking hazard for children younger than 2.

If your child has food allergies or is diagnosed as having peanut or tree nut allergies, avoid nuts and any food that contains or is made with nut products.

Snacks count too

Snacks make up an important part of childhood nutrition and are an opportunity to encourage healthy eating. Children must eat frequently. With their small stomachs, they cannot eat enough at meals alone for their high-energy needs. Three meals and 2 or 3 healthy snacks a day help children to meet their daily nutrition needs.

To make the most of snacks, parents and caregivers should offer healthy snack choices and be consistent with the time snacks are served. Schedule snacks around normal daily events, and space them at least 2 hours before meals. Children should not feel full all the time. A feeling of hunger between meals and snacks encourages children to eat well when healthy foods are offered.

Milk choices

Here are guidelines about what type of milk to give your child.

Children younger than 12 months — Breast milk is best. Give iron-fortified formula if breast milk is not available.
Children 12 to 24 months — Whole milk. Your child's doctor may recommend reduced-fat (2%) or low-fat (1%) milk if your child is obese or overweight, or if there is a family history of high cholesterol or heart disease. Check with your child's doctor or a registered dietitian before switching from whole to reduced-fat milk. (Breastfeeding can continue after 12 months of age as long as is desired by mom and baby.)
Children older than 24 months — Low-fat or nonfat (skim) milk.

Don't forget active play!

Physical activity, along with proper nutrition, promotes lifelong health. Active play is the best exercise for kids! Parents can join their children and have fun while being active too. Some fun activities for parents and kids to do together include playing on swings, riding tricycles or bicycles, jumping rope, flying a kite, making a snowman, swimming, or dancing. The daily recommendation for exercise for children (adults also) is at least 1 hour per day. This takes commitment from parents, but the rewards are time together and better health.

For more information

American Academy of Pediatrics

www.aap.organdwww.HealthyChildren.org

Academy of Nutrition and Dietetics

www.eatright.organdwww.kidseatright.org

US Department of Agriculture Food and Nutrition Service

www.fns.usda.gov(includes information on SNAP [Supplemental Nutrition Assistance Program] and WIC [Women, Infants and Children] benefits)

Listing of resources does not imply an endorsement by the American Academy of Pediatrics (AAP). The AAP is not responsible for the content of external resources. Information was current at the time of publication.

The information contained in this publication should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

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