Toddler Nutrition Questions

[extendedforecast]

I took my son to his two year check up earlier this week. I brought up some concerns about his eating habits, among other things. I explained how this child used to be a good eater. He would eat whatever I served him in the amounts he chose, which was usually everything. He often ate off of my plate after finishing his food, which usually was the same food I would serve him, but with more spices. This would include foods, like blackened salmon, tacos, spicy pork chops, etc. Now, in the past few months, he often refuses to eat what we are eating. Or he only eats one part of the meal, often choosing the carbs and leaving the protein and veggies. Also, he will taste something he has liked in the past, make a face and refuse to eat any more of that item. The doctor said it was typical behavior for kids of that age, and that if I was truly concerned, I could offer him a carnation instant breakfast or pediasure. She also said that as long as I provide the quality of food, to let him choose the quantity. So later on in the visit, she refers to his growth chart and becomes concerned with his stats. He was in the 10th percentile for height and 25th for weight. His head was in the 73rd percentile. The doctor's concern is that he appears to have fallen off his growth curve, and she wants him to come back in two months to get weighed and measured again. He is also getting a cbc test done this afternoon.

My question to you all is what can I do to encourage my son to eat? DH and I serve the whole family the same food. Should I find toddler friendly alternatives? I want him to grow to his full potential, and if I am doing something to prohibit that, I will feel awful. More importantly, I know how important proper nutrition is for the brain. I don't want his intelligence to be affected either. I didn't mention that his speech is lagging too, though he seems to have learned a handful of new words in the past few days. He is being referred to a speech therapist for an evaluation just in case.

[Amy in TX]

Hi Cindy,

 

Your doctor will have the ultimate say in what actions you take, of course, but I just want to reassure you a bit. It sounds scary to be told he's "fallen off" the growth chart, but really this is not unusual in itself. Kids' rates of change in height and weight can fluctuate wildly, as can their eating habits.

 

When my dd was 1 or so, she experienced something like what your son is doing now (sudden onset of pickiness after being a "good" eater, suddenly in the low percentiles for weight). If I were you, I'd just make sure that he only has access to high-quality food--organic if possible, no white flour, very occasional sugar, etc.

 

Dd at that time seemed to want only bread and cheese. Go figure. I let her have a lot of bread and cheese, but only 100% whole wheat, and only "real" cheese (no Velveeta, American, etc.). Full-fat organic milk only, and whatever fruits/veggies I could tempt her with or slip into other things.

 

If you can get him to take a multivitamin in some form or if he likes the Pediasure that's good also.

 

If you google you can find recipes for healthy baked foods that have hidden fruits/veggies. I have recipes for delicious waffles and zucchini/banana bread that use only whole wheat flour and honey for sweetening. I'd be glad to post them or pm them if you want.

 

HTH!

[extendedforecast]

Hi Cindy,

 

Your doctor will have the ultimate say in what actions you take, of course, but I just want to reassure you a bit. It sounds scary to be told he's "fallen off" the growth chart, but really this is not unusual in itself. Kids' rates of change in height and weight can fluctuate wildly, as can their eating habits.

 

When my dd was 1 or so, she experienced something like what your son is doing now (sudden onset of pickiness after being a "good" eater, suddenly in the low percentiles for weight). If I were you, I'd just make sure that he only has access to high-quality food--organic if possible, no white flour, very occasional sugar, etc.

 

Dd at that time seemed to want only bread and cheese. Go figure. I let her have a lot of bread and cheese, but only 100% whole wheat, and only "real" cheese (no Velveeta, American, etc.). Full-fat organic milk only, and whatever fruits/veggies I could tempt her with or slip into other things.

 

If you can get him to take a multivitamin in some form or if he likes the Pediasure that's good also.

 

If you google you can find recipes for healthy baked foods that have hidden fruits/veggies. I have recipes for delicious waffles and zucchini/banana bread that use only whole wheat flour and honey for sweetening. I'd be glad to post them or pm them if you want.

 

HTH!

 

Thanks for the reassurance. It looks like I'm already on the right track. I was just unsure of anything else I should be doing. My son would live on cheese and bread too. His favorites are cheddar and monterey jack. He's given up cow's milk, but still nurses frequently. Everything else he eats with less consistency. Again, thank you.

[Rivka]

Ah, yes. When my daughter was a toddler she dropped several lines on the growth chart. I was frantic. I am calmer with my second, who is also a very skinny kid, but I still feed him carefully.

 

It is normal for toddlers to get pickier as they get older, and to refuse foods they previously ate. Don't bang your head against the wall on this one. Keep offering a wide variety of foods, including refused ones, and don't make a power struggle over what he tries.

 

Toddlers have tiny stomachs. Instead of trying to get him to eat more than he is now, concentrate on trying to make sure that the foods he does eat are nutritionally dense. It is very easy for a toddler to fill up on low-calorie, low-nutrition foods. I used to give my daughter a rice cake to nibble on while I made her lunch. She'd fill up her stomach with, essentially, puffed air that contained virtually no calories. Then she didn't eat much of her actual meal. I didn't mean to be giving her "diet" food, but I was - accidentally.

 

So make sure that the foods you give him have as much nutrition and calories per ounce as possible. Put butter on his bread or rice. Saute veggies in olive oil instead of steaming them. Use spreads and dips to add calories to low-calorie foods. Try high-calorie treats with some nutritional value, like banana bread, zucchini muffins, puddings, custards.

 

Keep in mind that "healthy" for an adult and "healthy" for a two-year-old are very different. It is fully appropriate for a newly-two to get 50% or more of his calories from fat. He needs plenty of fat for proper growth and brain development. You don't want to load him up with pure sugar and junk food, but don't hesitate to offer him plenty of high-fat foods like eggs, cheese, butter, oil, peanut butter, etc. Those are "danger foods" for adults (and only some adults, at that) - not for little kids.

[Chris in VA]

The little one I babysit went thru a similar growing problem. Her ped told her mom and dad to give her 4 meals during the day, and no snacks (technically, 3 squares and a snack, but...).

She gets fed pretty regularly, at 8ish, noonish, 3ish, and 6ish--LOL--give or take 30 minutes or so. She put on the pounds after that, and is growing well, tho she's still a bit small.

Maybe a regular time schedule and 4 meals would help your child.

[Paige]

I had toddlers with a true food aversion and were crazy picky eaters and below the third percentile. The Dr is right- it is very normal behavior to become picky and eat less around 2yrs old. Kids can't maintain that huge growth pattern they had as infants forever so their caloric needs may be much less than you'd expect. Also, it is normal for kids to fall off their growth pattern but then reestablish a new growth pattern. Lots of babies start out well above the 50th percentile but then become quite average or even small for their age as children and adults. The only way for this to happen is for your child to fall off that curve for a while. If your child is truly malnourished, the pediatrician would tell you to give him pediasure or something similar, and if your child is not malnourished, it won't hurt him although it may end up causing him to eat less food to balance it out. My kids were on 2 pediasures a day for a while to help them gain weight because they were so picky and small.

 

If you really think he has more than a normal picky toddler problem, however, there are things you can do to help and working on it now while he is young and it's better to start early. Does he seem to have problems physically chewing or swallowing any foods? Does he seem to have problems tolerating certain textures on his hands and mouth? Does he gag, choke, and spit up a lot, have irregular BMs, complain of tummy aches, or anything similar? Will he refuse to eat anything for so long that he is physically sick? By physically sick, I mean throwing up and unable to stand or sit up. Does he consistently only eat an extremely narrow range of foods and would- seriously- let himself starve before eating anything else and no bribing or threats make a difference? If the answer is yes to many of these, then you may want to get him evaluated. If the answer to most of these is no, then he is probably just being a normal 2yr old.

[extendedforecast]

Ah, yes. When my daughter was a toddler she dropped several lines on the growth chart. I was frantic. I am calmer with my second, who is also a very skinny kid, but I still feed him carefully.

 

It is normal for toddlers to get pickier as they get older, and to refuse foods they previously ate. Don't bang your head against the wall on this one. Keep offering a wide variety of foods, including refused ones, and don't make a power struggle over what he tries.

 

Toddlers have tiny stomachs. Instead of trying to get him to eat more than he is now, concentrate on trying to make sure that the foods he does eat are nutritionally dense. It is very easy for a toddler to fill up on low-calorie, low-nutrition foods. I used to give my daughter a rice cake to nibble on while I made her lunch. She'd fill up her stomach with, essentially, puffed air that contained virtually no calories. Then she didn't eat much of her actual meal. I didn't mean to be giving her "diet" food, but I was - accidentally.

 

So make sure that the foods you give him have as much nutrition and calories per ounce as possible. Put butter on his bread or rice. Saute veggies in olive oil instead of steaming them. Use spreads and dips to add calories to low-calorie foods. Try high-calorie treats with some nutritional value, like banana bread, zucchini muffins, puddings, custards.

 

Keep in mind that "healthy" for an adult and "healthy" for a two-year-old are very different. It is fully appropriate for a newly-two to get 50% or more of his calories from fat. He needs plenty of fat for proper growth and brain development. You don't want to load him up with pure sugar and junk food, but don't hesitate to offer him plenty of high-fat foods like eggs, cheese, butter, oil, peanut butter, etc. Those are "danger foods" for adults (and only some adults, at that) - not for little kids.

 

I bolded the things I especially need to remember. I feel much more calm about it now. It's so easy to panic over the ones you love. Thank you for your reassurance that his pickiness is normal. Today I made him an egg over medium and toast with butter. He picked at the egg, ate half the toast, and ate some of my scrambled egg omelet. PB&J was his lunch meal, and for dinner he ate about 2-3 tablespoons of homemade cream of chicken soup. He didn't touch any of his snacks today.

 

The little one I babysit went thru a similar growing problem. Her ped told her mom and dad to give her 4 meals during the day, and no snacks (technically, 3 squares and a snack, but...).

She gets fed pretty regularly, at 8ish, noonish, 3ish, and 6ish--LOL--give or take 30 minutes or so. She put on the pounds after that, and is growing well, tho she's still a bit small.

Maybe a regular time schedule and 4 meals would help your child.

 

I agree that a regular schedule would be beneficial. This weekend, I happened to plan out mealtimes after I saw the daily schedules posted outside the rooms of a church daycare I was visiting. It clicked that I needed to be more consistent with mealtimes. Implementing it has been a lot harder than I thought with five children, unfortunately. Thank you for sharing your experience.

 

I had toddlers with a true food aversion and were crazy picky eaters and below the third percentile. The Dr is right- it is very normal behavior to become picky and eat less around 2yrs old. Kids can't maintain that huge growth pattern they had as infants forever so their caloric needs may be much less than you'd expect. Also, it is normal for kids to fall off their growth pattern but then reestablish a new growth pattern. Lots of babies start out well above the 50th percentile but then become quite average or even small for their age as children and adults. The only way for this to happen is for your child to fall off that curve for a while. If your child is truly malnourished, the pediatrician would tell you to give him pediasure or something similar, and if your child is not malnourished, it won't hurt him although it may end up causing him to eat less food to balance it out. My kids were on 2 pediasures a day for a while to help them gain weight because they were so picky and small.

 

If you really think he has more than a normal picky toddler problem, however, there are things you can do to help and working on it now while he is young and it's better to start early. Does he seem to have problems physically chewing or swallowing any foods? Does he seem to have problems tolerating certain textures on his hands and mouth? Does he gag, choke, and spit up a lot, have irregular BMs, complain of tummy aches, or anything similar? Will he refuse to eat anything for so long that he is physically sick? By physically sick, I mean throwing up and unable to stand or sit up. Does he consistently only eat an extremely narrow range of foods and would- seriously- let himself starve before eating anything else and no bribing or threats make a difference? If the answer is yes to many of these, then you may want to get him evaluated. If the answer to most of these is no, then he is probably just being a normal 2yr old.

 

Thankfully I answered no to almost all of the questions you listed. I hope the cbc comes back normal, and that my DS goes through a growth spurt soon. Until then I just need to keep offering healthy foods. Thanks for your advice.