Boosting Calories in Children

To begin planning your toddler's diet, it can help to begin with the idea that toddlers need a lot less to eat than you think. Remember that children aren't growing as fast as they were during their first year of life and so have lower energy needs (the amount of calories per pound of their body weight) and smaller appetites. So if your child is active, healthy, and growing and developing normally, then he is likely getting plenty to eat.

Feeding toddlers and preschoolers can sometimes be a problem for parents. Food and eating is often something toddlers want to be in control of. Toddler’s appetites naturally decrease during the second year of life. They are not growing as much and they don’t need as much to eat.

At the same time they are learning to try different foods, some of which they might not like. Toddlers can be worried by too many changes and like to keep to the few things they know well. It is important for them to show that they are starting to learn to think for themselves by saying “No.” The world is becoming a very exciting place and there are lots more interesting things to do than eat! Getting into battles with toddlers about food and eating can only make life miserable for everyone.

It is important that toddlers see parents eating and enjoying healthy food - are you a good role model for your child? It is normal for children to be wary about eating a food they have not eaten before and there are ways to help them. Offer the food in a happy environment. Children tend to like foods that they associate with fun. (This is why fast food outlets can become so popular.)

A baby in the home is an opportunity to look at the dietary rules for the whole family. Some of these recipes are so delicious you can serve them when entertaining. Babies' nutrition in their first year probably has a greater influence than at any other time of life. This reinforces the need to start early with a good balanced diet. When your child opts for the raw fruits and vegetables (which adults imagine kids hate) over sugary sweets, you will recognize your success.

How Do I Know If 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. A child who is growing well is getting enough to eat.

To check your child’s eating pattern, pay attention to his or her food choices.

• Make sure no one food group is completely left out. If this happens for a few days, don’t worry. But prolonged neglect of a food group could keep your child from getting enough nutrients.

• Encourage your child to be adventurous and eat a variety of foods within the food groups too. Even within a food group, different foods provide different nutrients. If the family is adventurous, then the child will likely join in.

• For children, adult-sized servings can be overwhelming. Offering child-sized servings encourages food acceptance.

It can also help to avoid common mistakes, such as:

1. Drinking more than 16-24 ounces of milk each day. 

2. Drinking more than 4-6 ounces of juice each day. 

3. Letting your child fill up on sweets and snacks. 

4. Forcing your child to eat when he isn't hungry. 

5. Giving servings that are too big. 

The average toddler serving is going to be about 1/4 of an adult serving size. Don't go by the serving size listed on nutrition labels, as these are mainly for older children and adults. 

The average toddler needs about 1300 calories each day. Larger toddlers will need a little more and smaller toddlers a little less.

The average toddler will need 40 calories each day for each inch of height.

Guide to Child-Sized Servings

• Serve one-fourth to one-third of the adult portion size, or one measuring tablespoon of each food for each year of the child’s age.

• Give less than you think the child will eat. Let the child ask for more if still hungry. 

1. Keep offering the food on several occasions. It can take 8 to 15 tries before the food becomes familiar and a child accepts it.

2. Children are more likely to try a food when they see the rest of the family or other children enjoy it.

3. Don’t insist that the food is eaten and don’t offer a reward for eating it. Both of these measures have been shown to make children dislike that food.

4. Children are more likely to want a food if they are told they can’t have it or if it is used as a reward.

5. Children have the natural ability to know how much food they need and they do not usually overeat. However they can easily lose this skill.

6. If children are pushed to eat more than they want or encouraged to finish everything on the plate, they may learn not to stop when they have had enough. This can lead to weight problems later.

Suggestions to Get Your Toddler To Eat:

1. We usually recommend adding dry milk when cooking foods such as yogurt, casseroles, milk shakes, muffins, cookies, sauces, gravies and cream soups.  

2. If drinking fruit juice, don't dilute it but don't offer more than 1 serving per day.

3. Add butter or margarine to breads, hot cereals, pancakes, casseroles and vegetables

4. Add cheese to meat, potatoes, vegetables, pasta, rice and cream sauces. 

5. Use peanut butter on breads, crackers, fruits and vegetables and you can also blend into ice cream or yogurt. Make Jell-O with juice instead of water

6. Add mashed fruit to milk, yogurt, shakes, ice cream and pudding.

7. Add honey to fruit.

How Much Table Food Should My Baby Be Eating?

When introducing table foods (around 5 months), don't worry too much about the amount or variety your baby accepts, or how much gets into his/her mouth. Your baby is still getting most nutrition from breast milk or formula. 

Once your baby is adept at eating finger foods or using a spoon, offer small portions (about one fourth of an adult's portion) and add more if interested. Watch for cues that your baby is finished: disinterested, turning head away, or pushing food away -- don't force your baby to eat more.

Expect your toddler to go through periods when she wants only a "favored food of the moment." It's not uncommon for a child this age to want peanut butter and jelly sandwiches for every meal or insist on the same breakfast for a month. Toddlers may also change their minds about what's good to eat in an instant: one day your child loves applesauce, and the next day she views it as poison.

Remain relaxed, continue to offer other healthful choices, and remember that these behaviors will one day come to an end. Again, your toddler might not eat what you would call a balanced meal at each sitting, but over the course of time she should get what she needs for good health.

You'll probably notice a sharp drop in your toddler's appetite after his first birthday. Suddenly he's picky about what he eats, turns his head away after just a few bites, or resists coming to the table at mealtimes. It may seem as if he should be eating more now that he's so active, but there's a good reason for the change. His growth rate has slowed, and he really doesn't require as much food now. About 1,000 calories a day, broken down between three meals and two snacks, should be sufficient to meet needs for growth, energy, and good nutrition. Most babies this age are switched from formula to cow's milk (1 year old), and many (but not all) nursing babies are weaned from the breast. This means it's even more important to offer your toddler a variety of healthy foods at this stage. Not only is regular table food forming the basis of his diet now, your baby is learning eating habits that will last a lifetime. Good choices now will increase the odds that better choices will be made later on.

Toddlers are notorious for not wanting to eat and giving their parents endless headaches by suddenly refusing their favorite food or demanding only one type of food all the time. Let’s first consider loss of appetite. It's important to remember that toddlers have very small stomachs and, unlike adults, they are physically unable to eat large quantities of food at main meals. Refusal to eat what adults may regard as a “normal portion” may just be that the portions are too big and that the meals are spaced too far apart for a small child.

Don't count on your child always eating the same way because the eating habits of toddlers are erratic and unpredictable from one day to the next. Your child may eat everything in sight at breakfast but almost nothing else for the rest of the day, or your child may eat only a favorite food for three days in a row, and then reject it entirely.

An emotionally upset toddler will generally not eat, so always explore reasons such as fear or anger when your child refuses to eat

When planning your child's menu, remember that cholesterol and other fats are very important for his normal growth and development, so they should not be restricted during this period.

By the first birthday, your child should be able to handle most of the foods you serve the rest of the family but with a few precautions. Be sure the food is cool enough so that it won't burn his mouth. Test the temperature yourself, because he'll dig in without considering the heat. Try to avoid foods that are heavily spiced, salted, buttered, or sweetened. These additions prevent your child from experiencing the natural taste of foods, and they may be harmful to his long-term good health. Young children seem to be more sensitive than adults to these flavorings, and may reject heavily spiced foods.

A 1 year-old can eat at the table with the rest of the family and join in. Take whatever you're eating and mash it or mince it. Avoid foods that are salty or very spicy. As they get older you can introduce finger foods and more texture, and by the age of two they can eat the same type of food as you.

To get the nutrients he needs, a toddler should have a diet that contains all the main food groups - protein, fat, carbohydrates, vitamins and minerals. If you eat a mixed diet with plenty of fresh fruit and vegetables, and your child eats the same, you'll have no need to worry. Avoid cutting out any whole category of foodstuffs - fat-free diets aren't good for toddlers.

It's hard to make a toddler overweight. They need plenty of food to fuel growth. Don't ever restrict their diet for fear of making them fat. Let your child eat what he/she wants and that way they will keep in touch with their appetite. When your child has had enough, don't force more or say 'just one extra spoonful'. A healthy and growing child is a good indication they are getting enough calories.

Avoid sweetened drinks. They are very bad for your baby's teeth and create a taste for overly sweet things. Even those labeled “no added sugar” contain enough fruit-sugar to harm the teeth. If thirsty, cool water is best. If hungry between meals, your child can still have some milk.

The recommended dose of calcium for children ages 1 - 3 years is 500 mg of calcium daily and for ages 4 - 6-years, it is 800 mg daily. The best sources of calcium include milk, yogurt and cheese, but you can boost daily calcium with calcium-fortified juices, broccoli and dark leafy vegetables. (ask to see our “Calcium Requirement” Handout). Children ages 1 - 6 years need 10 mg of iron each day.

Your child should want to feed himself with his fingers and a spoon or fork and should be able to drink out of a cup. He should have given up the bottle by now. Remember that your baby's appetite may decrease and become pickier over the next few years as his growth rate slows. Your baby should also have given up middle of the night feedings by this age.

Feeding practices to avoid are giving large amounts of sweet desserts, soft drinks, fruit-flavored drinks, sugarcoated cereals, chips or candy, as they have little nutritional value. Also avoid giving foods that your child can choke on, such as raw carrots, peanuts, whole grapes, tough meats, popcorn, chewing gum or hard candy.

Suggestions to Boost Calories

A Pediatric nutritionist can suggest ways that you can provide your child with more calories by offering high calorie foods that are high in protein with lots of nutrients, especially since your child will need additional calories to help catch-up with growth.

1. Avoid junk foods, such as candy, which may have calories, but are usually low in protein.

2. For younger children, under the direction of your Pediatrician or a nutritionist, your infant's formula can be concentrated to provide more than the regular 20 calories/ounce. 

3. For older children, over 12 months of age, instead of milk, you can offer 2-3 times a day Pediasure (30 calories/ounce vs 20 calories/ounce for whole milk).

4. Mix whole milk with a packet of instant breakfast powder (adds 130 calories) or dry milk powder (adds 33 calories per tablespoon) to increase calories.

5. When baking and cooking, substitute whole milk, half and half, evaporated milk or condensed milk mixed with dry milk powder for water or milk.

6. For high calorie snacks, offer milk shakes made with a cup of whole milk, a packet of instant breakfast powder and a cup of ice cream blended together (can provide over 400 calories).

7. Pudding can also provide a lot of calories if you add 1/2 cup of dry milk powder to the milk and instant pudding mix.

8. Cheese as a topping for sandwiches, vegetables, etc.

9. Use peanut butter (about 100 calories/tablespoon) as a snack and as a topping for vegetables, crackers, and fruits or blended with milk, ice cream or yogurt.

10. Make a high calorie fruit snack using fruits canned in heavy syrup, add sugar or yogurt to fresh fruit or add a packet of instant breakfast powder to strained fruits.

11. Make high calorie Jello by substituting fruit juice for water in its preparation.

12. Serve meats and breads with added butter, margarine, gravy or sauces.

13. Serve fried foods, such as fish and chicken and add breading or flour before cooking.

14. Spread a couple of tablespoons of smooth, salted peanut butter on bread gives you 192 calories.

15. A 2-ounce serving of cooked pasta contains only 75 calories. It’s the rest of the ingredients, such as the meatballs on the spaghetti which contribute to this being a high-calorie dish.

16. One serving of cheddar cheese packs a good 69 calories.

17. Cheese is basically concentrated milk, so its nutrition value is similar. This means high in protein and calcium but also high in fat, cholesterol and cheese calories.

18. Depending on the type of dressing and the amount that you will pour on to your favorite salad dish, it can add 50 to 85 calories for each 1-tablespoon serving. Salted butter has 36 calories for each 5-gram serving.

19. One mini-chocolate or candy bar can contain 37 calories.

20. Whole wheat bread contains 69 calories, more than overly processed white bread. 

21. A 261-gram serving of guacamole contains as much as 360 calories.

22. The fruit-flavored, non-fat yogurt can give you as much as 118 calories for a 125-gram serving.

23. Aside from giving your body the vitamins and nutrients that it needs, pure fruit juices also pack a lot of calories. One ounce of the commercially-packaged fruit juice contains 57 calories.

24. One large banana contains 20 calories. Slice it up with your peanut butter sandwich or breakfast cereal to increase calories. They are very high in simple carbohydrates.

25. Nuts are good for the heart, and are high in calories. Salted, roasted cashew nuts, for example, has 165 calories for each serving.

26. One tablespoon of the olive oils that you use at home contains 40 calories and it’s healthier than the regular cooking oil that you use for frying. Olive oil, which is pure fat, contains 1920 calories per cup. Any food that has a lot of fat in it will have a high calorie density.

27. Chicken breast, which is supposed to be the healthiest and fat-less part of this type of white meat has 78 calories for each serving which contains about 70 grams.

28. One thick slice of bacon contains 174 calories, which is perfect for those who are trying to gain weight fast.

29. A 3-ounce serving of salmon contains 152 calories. The richest dietary source of Omega 3 fatty acids are cold-water fatty fishes such as Salmon, Tuna, Mackerel, Sardines. Fish are a rich source of EPA and DHA fats, the two most essential Omega 3 fatty acids.

30. 3 slices of beef strips for breakfast will provide153 calories.

31. A typical mushroom omelet contains 560 calories. Omelet recipes differ, but they are easy and fast to prepare, and you can add whatever you want!

32. Macaroni Cheese: Make sure that you use high fat cheese and pasta, and your serving will top 450 calories

Meal Suggestions That Are Tasty, Convenient, and Nutritious

This menu is planned for a one-year-old child who weighs approximately 21 pounds. 

Common measurements to learn:

• 1 tablespoon = 1/2 ounce (15 cc)

• 1 teaspoon = 1/3 tablespoon (5 cc)

• 1 cup = 8 ounces (240 cc)

Cereal with low-fat milk is a favorite, but sweetened cereal can have a lot of added sugar. Check the nutrition facts label before buying. Although the percent daily values on food labels are based on calorie levels for adults, they can still be used to select more nutrient-rich cereals (and other foods). Choose cereals with less than 10 grams of sugar and at least 2 grams of fiber per serving. If your child prefers a sweet taste, jazz up unsweetened cereal with sliced peaches or bananas, strawberries, or blueberries.

Breakfast

Breakfast gives children energy to carry through an active morning. Children who skip breakfast may not concentrate well at school or may lack energy to play. They also tend to eat unhealthy foods as snacks.

1. 1/2 cup (4 ounces) of cereal, 1/4 cup of milk and 4 ounces of orange juice would give about 230 calories.

2. A slice of bread with 1 tablespoon of peanut butter and jelly and 4 ounces of orange juice, would give about over 250 calories 

3. 1/2 cup iron-fortified breakfast cereal or 1 cooked egg (not more than 3 eggs per week)

Add to cereal one of the following:

1. 1/2 banana, sliced

2. 2-3 large sliced strawberries

For children who don’t like traditional breakfast foods, like cereal or toast, try one of the following recipes:

1. Breakfast shake: Combine milk, fruit, and ice in a blender. 

2. Frozen banana: Dip a banana in yogurt, roll it in crushed cereal and then freeze.

3. Leftovers: Serve whole-wheat spaghetti or chicken hot or cold.

4. Peanut butter snack: Spread peanut butter on whole-wheat crackers, a tortilla or apple slices.

5. Cheerios topped with yogurt or teething toast dipped in yogurt

6. Whole milk yogurt

7. Add 1 tablespoon of dry infant cereal to each 4 ounce jar of strained fruit

Lunch

Children who help make their own lunches are more likely to eat them. The following are ideas to make lunches fun!

1. 1/2 sandwich-tuna, egg salad, peanut butter, or cold cuts. Top peanut butter with raisins, bananas, or apple slices. 1/2 sandwich (one slice of bread), with 1 slice of lean luncheon meat (90 calories) and cheese (45 calories). 

2. Tuna fish sandwich (add 1/2 tablespoon of mayo to the tuna to get 50 extra calories).

3. Sliced and quartered hot dog

4. 1/2 cup cooked green vegetables

5. 1/2 cup juice

6. Use cookie cutters to cut sandwiches into fun, interesting shapes.

7. Decorate lunch bags with colorful stickers.

8. For color and crunch, use a variety of veggies as “sandwich toppers”: cucumber slices, grated carrots, or zucchini.

Dinner

1. 1-2 ounces of chicken (75-100 calories) or beef (120-165 calories)

2. 1/2 cup cooked yellow or orange vegetables. 2-3 tablespoons of vegetables (50-75 calories)

3. 1/2 cup pasta, rice, or potato

4. Whole wheat bread (40 calories)

5. 1/2 cup of milk (76 calories).

6. Add 1 tablespoon of melted butter, margarine or oil to each 4 ounce jar of strained vegetables or mixed dinner

7. Use higher calorie fruits and vegetables, such as squash, sweet potato, peas, mashed avocado or bananas rather than lower calorie fruits and vegetables, such as green beans, carrots, pears and peaches. Avoid fruit desserts, since these have empty calories from added sugars.

Snacks Count

Snacks make up an important part of childhood nutrition. 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.

Type: Offer a variety of snacks. Choose mostly healthy snack foods that are a good source of nutrients (protein, vitamins, and minerals) as well as calories. One hundred percent fruit juices (unsweetened) are an alternative to soda and fruit drinks but should be limited to 4 to 6 ounces per day.

Timing: Plan snacks. 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. If your schedule is hectic, pack a snack. This helps prevent a cranky, hungry child with no options besides fast food.

Your child will likely need a couple of small snacks mid-morning and in the early afternoon.

These might include: 

1. 1/2 -1 cup of milk (76-152 calories)

2. 2-3 tablespoons of fruit (50-75 calories)

3. A slice of cheese (45 calories)

4. Jello, pudding, or yogurt

5. A slice of toast or whole wheat muffin

6. 1-2 tablespoons cream cheese or peanut butter

7. Raw vegetables

8. Fresh or dried fruits 

• Try to balance your child's request for a snack with the family's need to enjoy a regular meal together. If the meal is several hours away, you can offer a bigger snack. If the meal is in the next hour, you may want to offer a small snack. If you give your child only a small snack, explain to your child that the family will be eating soon.

• If your child doesn't eat at one mealtime, you can offer a nutritious snack, such as fresh fruit, vegetables or whole-grain crackers, a few hours later.

• If your child doesn't eat the snack, offer food again at the next mealtime. A child will usually eat at the second meal. 

• With this approach, you can be sure that your child won't starve or have other problems that come from a poor diet

Picky Eaters

Even the most nutritious meal won’t do any good if a child won’t eat it. Many children are picky eaters. Others eat only certain foods - or refuse food - as a way to show their independence. If your child refuses one food from a food group, try another from the same food group. Try these ideas to make your family meals pleasant. 

If Your Child Refuses Instead Try

Green vegetables Deep-yellow or orange vegetables 

Milk Low-fat flavored milk, cheese, or yogurt

Lean beef Chicken, turkey, fish, or pork

• Boost the nutritional value of prepared dishes with extra ingredients. Add nonfat dry milk to cream soups, milkshakes, and puddings. Mix grated zucchini and carrots into quick breads, muffins, meatloaf, lasagna, and soups.

• Serve a food your child enjoys along with a food that he or she has refused to eat in the past.

• Try serving a food again if it was refused before. It may take many tries before a child likes it.

• Invite children to help with food preparation. It can make eating a food more fun.

• Add eye appeal. Cut foods into interesting shapes. Create a smiling face on top of a casserole with cheese, vegetables, or fruit strips.

• Set a good example by eating well yourself. Ideally, eat at least one meal together as a family every day or try for 3 to 4 times per week.

Food Groups

Foods from all these groups work together to supply energy and nutrients necessary for health and growth. No one food group is more important than another. For good health, you and your child should choose foods from all 5 food groups.

• Grain group: Whole-grain products such as breads, crackers, cereal, pasta, brown rice, bagels, tortillas, corn bread, pita bread, bran muffins, English muffins, matzo crackers, pancakes, breadsticks, and pretzels.

• Vegetable group: Asparagus, beets, bok choy, broccoli, carrots, cauliflower, collard greens, corn, cucumbers, green and red peppers, kale, okra, peas, potatoes, pumpkin, snow peas, squash, spinach, string beans, sweet potatoes, tomatoes, vegetable juices, and zucchini. Some raw vegetables can be choking hazards for young children.

• Fruit group: Apples, applesauce, apricots, bananas, berries, cantaloupe, figs, 100% fruit juices (unsweetened), grapefruit, kiwi, mangoes, nectarines, oranges, papayas, peaches, pears, plums, pineapple, raisins, prunes, starfruit, strawberries, tangerines, and watermelon. Many of these can be offered as dried fruits as well. Some fresh and dried fruits can be choking hazards for young children.

• Meat, poultry, fish, dry beans, eggs, and nuts group: Lean cuts of beef, veal, pork, ham, and lamb; skinless chicken and turkey; fish; shellfish; cooked beans (kidney beans, black-eyed peas, pinto beans, lentils, black beans); refried beans (made without lard); peanut butter; eggs; reduced-fat deli meats; tofu; nuts; and peanuts.

• Milk, yogurt, and cheese group: Low-fat milk, yogurt, cheese, string cheese, cottage cheese, pudding, custard, frozen yogurt, and ice milk. 

“Food Pyramid For Kids”

www.mypyramid.gov/kids/

See our Web Site Home Page (bottom right box) for a direct link to this site:

www.AndorraPediatrics.com

At the government’s updated food pyramid, MyPyramid, parent’s can plan meals for their toddler. Kids can go online for games, posters, tips, and worksheets, while learning more about healthy food choices.

See the handout on our web site called “Picky Eaters” for more information.

Other Resource: http://www.earthsbest.com/organic-baby-food/toddler-food