Young children between the ages of 12 months and three to four years grow and develop quickly. Parents need to make sure that children at this age are eating well and that they are getting all the energy and nutrients they need.

This phase in a young child’s life is also an important time for him/her to learn about food and eating so that good habits are fostered and they learn to consume a healthy, varied diet that can be enjoyed with the rest of the family.

However, at times, it can be hard for parents to know exactly what toddlers should be eating and in what amounts.

Eating a healthy, varied diet

One of the most common complaints among parents of toddlers is that they refuse to eat certain foods. Some children will be reluctant to try out new tastes and others will not accept foods with which they were previously familiar. This ongoing ‘battle’ between parent and child lasts till the child turns about six, after which most children will generally accept a wider variety of foods. Although fairly normal, this period cannot be ignored because it is very important that young children get used to eating a healthy, varied diet that includes food from the four main food groups. These include:

• fruits and vegetables (five times a day);

• starchy foods (five times a day);

• protein foods (two times a day);

• dairy foods (three times a day).

Fruit and vegetables

Fruit and vegetables are essential in a child’s diet because they contain several vitamins and minerals which are crucial for healthy development. Try to include as many coloured fruits and vegetables as possible. Children often initially reject vegetables but do not give up on offering them over and over again.

Toddler-sized portions of fruits and vegetables per day should include:

• ½ to 1 small banana;

• 4 to 8 grapes;

• ¼ to ½ medium apple;

• 1 to 3 cherry tomatoes;

• 2 to 6 carrot sticks;

• 1 to 2 tablespoons broccoli/pumpkin;

• 1 to 2 tablespoons peas.

Starchy foods

Foods such as bread, rice, pasta, cereals and potatoes provide your toddler with energy, B vitamins and calcium. Several fortified breakfast cereals intended for young children can also provide iron, folic acid and, in some cases, vitamin D. In using these latter products, be wary of the nutritional information on the pack and stay away from cereals with a high sugar content. It is recommended that a young child’s portion (20-30g) of breakfast cereal does not contain more than 5g of sugar. Other suitable portions of starchy foods are the following:

•  1 to 3 tablespoons mashed potato/sweet potato;

• 2 to 4 tablespoons cooked rice/pasta;

• 2 to 4 potato wedges;

• 1 to 2 oat/rice cakes;

• ½ to 1 slice of bread.

At this young age, whole- meal cereals are not highly recommended, and, if given to children, they should be offered gradually. Young childrens’ stomachs are still small and they can fill up very easily on products with a high level of fibre. This could make them stop eating before they get enough energy from food to satisfy their needs.

Protein foods

These foods include meat, fish, eggs and pulses (beans, lentils, chickpeas). They provide protein and iron, both very essential for a growing child. Oily fish like salmon and fresh tuna is a very rich source of omega-3 fatty acids which are very important for proper brain maturation. Offering these foods with vitamin C-rich foods/drinks will also help enhance their iron absorption.

At two portions of protein per day, some suggestions for suitable choices include:

• 2 to 4 tablespoons chicken/ veal/beef;

• 2 to 4 tablespoons fish;

• 2 to 3 tablespoons baked beans;

• 1 poached/hard-boiled egg;

• peanut butter on bread/toast.

Dairy foods

Milk, cheese, yoghurt and ricotta are very good sources of protein, fat and vitamins B2 and B12. Full fat varieties are best for toddlers and skimmed milk products are not suitable for children under five years.

At three servings of dairy foods per day, here are some suggestions in toddler-sized portions.

• 1 pot of yoghurt (125g);

• 1 cheese triangle;

• 2 to 3 tablespoons ricotta;

• 100ml milk.

It is recommended that the amount of milk offered to a young child does not exceed 300ml daily. This is particularly important because higher volumes could make the child feel full and consequently reject food from other food groups which are equally important for optimal growth and development. 

As for the choice of milk, this could be either fresh cow’s milk or young child (toddler) formula. This latter choice provides the child with a higher level of iron and vitamin D and a lower level of protein which has been researched and found to be of benefit in reducing the chance of obesity later on in life.

It is worth emphasising that at this age a child formula forms part of a balanced diet and should not be thought of as a solution to replace other food groups.

Drinks

It is imperative to ensure that a young child is well hydrated with at least 800ml of fluid daily. Water should be the main drink and milk is the next preference. If fruit juices or sweetened drinks/milk are given, these should only be offered at the main mealtimes. This reduces the chances of tooth decay and helps to discourage developing a preference for sweet drinks. For the same reason, after the age of 12 months, milk should be offered from a cup/beaker and not from a bottle.

Malta has the highest rate of child-hood obesity in children with more than one in four of all two- to four-year-olds estimated to be overweight or obese. Such children are more likely to suffer from emotional and psychological problems and tend to grow up to become overweight or obese adults which can lead to very serious health problems like type 2 diabetes and certain cancers.

It is recommended that physical activity should be encouraged at an early age since being active on a daily basis improves children’s bone health, develops movement and coordination and contributes to a healthy weight. Screen time (TV, iPads, smartphones) should be limited and physical activity encouraged to take up as much as three hours per day.

Sometimes it is difficult to recognise that a child is overweight, so one should consult regularly with a doctor who will able to assist you with your concerns about your child’s diet and activity levels.

Regular annual visits to a dentist are also very highly recommended from this young age and it is a must to supervise brushing of teeth twice daily with fluoride toothpaste.

It is also recommended that children under the age of five should take a daily supplement of vitamins A, C and D in the form of drops/syrup; ask your doctor or pharmacist for advice.

It might sound obvious but the key to overcoming fussy eating is to help your child learn to like the foods you offer. Children are born with very few likes and dislikes – they acquire these through experience.

Aim to create a healthy home environment that is conducive to healthy eating. Stock up on a wide array of healthy foods and try to avoid having foods high in fats and sugars on display or within easy reach.

‘Model’ behaviour from parents has been shown to be an effective way to en-courage children to accept new foods, so lead by example and eat the foods that you would like your child to eat. 

Maria Gatt is a nutritionist. This article first appeared in Child magazine.