Nutrition in Toddlers

The establishment of eating practices that contribute to lifelong nutritional habits and overall health begins in toddlerhood. During this time, children acquire the motor skills needed to feed themselves and develop preferences that affect their food selections. Classifications for faltering weight (also called failure to thrive or growth faltering) and overweight are based on World Health Organization child growth standards (for children younger than two years) and Centers for Disease Control and Prevention growth charts (for children two years and older). Breast milk or whole cow's milk should be offered as the primary beverage between one and two years of age. Sugar-sweetened beverages should be avoided in all toddlers, and water or milk should be offered instead. Allergenic foods such as peanuts should be introduced early to infants at higher risk of allergies. Vitamin D and iron supplementation may be advisable in certain circumstances, but multivitamins and other micronutrient supplements are usually unnecessary in healthy children who have a balanced diet and normal growth. Optimal food choices for toddlers are fresh foods and minimally processed foods with little or no added sugar, salt, or fat (e.g., fruits, vegetables, lean protein, seeds, whole grains). Parents and caregivers are responsible for modeling healthy food choices and dietary practices, which shape children's food preferences and eating behaviors. Parents should avoid practices that lead to overeating in toddlers (e.g., feeding to soothe or to get children to sleep, providing excessive portions, pushing children to "clean their plates," punishing with food, force-feeding, allowing frequent snacks or grazing). In general, parents should use the approach of "the parent provides, the child decides," in which the parent provides healthy food options, and the child chooses which foods to eat and how much.