Nutrition do's |and don'ts

 Parents of young children spend hours ensuring their child eats meals that are nutritious and guarantee healthy growth and development. But what exactly is nutritious and at what age should the child be eating it?

The following are some age appropriate milestones where nutrition and childhood development meet that will help keep a parent on track.

- Four to six months

Babies are ready for solid food between the ages of four and six months. Children who are ready for solids have good head control, sit well with support, swallow their food instead of spitting it out using their tongue, and are hungry despite having six to eight feedings of breast milk or formula. 

Iron fortified baby cereals are a good solid food to try first. Breast-fed babies in particular need to start with iron fortified cereal as breast milk does not include iron, and a baby’s iron stores are beginning to dwindle by this time. Once the cereal is going down well, begin to introduce a new pureed food every three days. Pureed food can then become increasingly chunky with time.

- Eight to 10 Months

Babies need to develop fine motor skills and one of the ways they do this is by feeding themselves finger foods. Learning to pick up pieces of soft pasta, chunks of soft fruit, ground meat, and small pieces of cheese with their forefinger and thumb is therefore important. Also, it is time to drop the bottle at mealtimes in exchange for a sippy cup. 

- Twelve to 15 Months

Fine motor hands movements should be developed enough to enable children to begin drinking from a regular cup or cup with a straw attachment. Start introducing a spoon and fork but keep in mind they will be far from proficient at using them for a while. Be prepared for many spills along the way.

Eighteen Months to two years

Children at this age should be able to feed themselves with a spoon and drink from a regular cup. 

Many parents fall into the traps of poor feeding habits, especially if their child is a picky eater. However, most will discover that in the long term it would have been better to avoid the traps. Therefore:

- Have children eat their meals in a chair either at a table or a highchair. Don’t run after a child trying to scoop extra bits of dinner in their mouth.

l Meals should a time to focus on and enjoy food. This means no TV or toys at the table. 

- Be careful about power struggles involving food. Children will be hungry one day and not as hungry the next. As long as a child is following their growth curve don’t worry about how much food a child eats day to day. Around the age of two, children are looking for ways to express their independence and can sometimes refuse food as a way to make their level of independence known. If there is concern that a child is falling below their growth curve, consulting a paediatrician is advised. 

- Limit juice and the use of sippy cups. Juice is not a nutritional necessity and bottles and sippy cups often lead to liquid to remaining in the mouth resulting in dental caries. Also, if a bottle is placed in the bed with a child it should be only filled with water for the same reason.

l Watch the amount of milk a child drinks. A two year old needs approximately 480 ml per day. Once a child is drinking 9609 ml or more it begins to fill them up and they will refuse solid food. Excessive milk also interferes with iron absorption.

 

Dr Pikul Arsirawech is a specialist in paediatric behaviour and |development at Samitivej Sukhumvit Hospital’s Child Health Institute. Call (02) 711 8236-7.