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Toddler - Food and Feeding

​​​​​​​​​​​​​​​​​​​​​​Information about the onset and patterns of risk behaviors associated with overweight and obesity during the toddler years are showcased in the link below. Visit the section titled Desired Behaviors to learn about how to promote healthy active living during the toddler years.

​​View Toddler ​​Timeline​



Desired Behaviors

Based upon eviden​ce, a number of desired behaviors were identified as critical to helping families foster healthy active living for their toddler. For each desired behavior you can explore the evidence, learn what parents told us about these behaviors, identify opportunities to promote healthy behaviors at the point of care, review how to start conversations and access messages and resources to support families. Also available to inform your counseling is the Onset and Patterns of Risk Behaviors for Toddlers Timeline located above this section. ​

Healthy Beve​​​rages: 

Choose milk or water for your child's beverage

    Evidence

    ​Juices contribute an average of 100 calories a day to a toddler’s diet.

    Strong evidence exists regarding the benefit from consuming a diet rich in low or nonfat milk and other dairy products.

    More than half of toddlers and preschoolers consume one or more sugar-sweetened beverages per day.

    Parent Feedback

    ​​Many parents supported the "no juice" message but found it difficult to set limits.

    Some parents viewed juice as a way to provide their toddler with fruit/vegetable servings.

    A subset did not know that juice was unhealthy.

    The oral health argument was most convincing.

    Parents were confused by the difference between juice and 100% juice.

    Opportunities for Care

    Explain the concerns around sugar sweetened beverages (SSBs) and juice, which include extra calories, diarrhea, flatulence, abdominal distention, and dental caries.

    Explain the benefits of water and low fat milk, which include better hydration, more nutrients, and reduced dental decay.

    Take this opportunity to educate parents about flavored milk and that it contains sugar and is not equal to plain lowfat milk.  Also explain the difference between juice drink and 100% juice.

    Offer strategies to increase water and milk consumption if needed. 

    Conversation Starters

    ​Tell me a little bit more about what your child ate and drank yesterday and the day before?

    What is your child’s favorite drink?

    What kind of beverages is your child drinking between and with meals?

    Can you tell me what happens when you try to set limits on sugared beverage consumption?

    What are your feelings about juice?

    Related Parent Resources

    Related HALF Messages:
    Milk and water are the healthiest choices, and water is the best option between meals.

    If you choose to offer other drinks, try to limit them to 4-6 ounces a day of 100% juice and/or low fat, low sugar flavored milk.

    HALF Resources:
    For realistic parent derived strategies to promote healthy beverages, refer parents to the following sections on healthychildren.org/growinghealthy:

         Food and Feeding for Toddlers

    Also take advantage of the HealthyGrowth app​​ to create personalized patient education for your patient.

​​Healthy Sn​​​acking: 

Offer 2-3 healthy and nutritious snacks as part of your daily routine

    Evidence

    Caregivers should provide their children with appropriate portions of healthy foods and maintain regular eating schedules while allowing the children to control the amount they eat.

    According to one comprehensive study, 86% of toddlers consume some type of sweetened beverage, dessert, sweet or salty snack in a day. Based upon the data, more children in this age range consumed sweetened beverages, desserts, and non-nutrient snack foods in a day than consumed distinct portions of fruits or vegetables (independently).

    Toddlers need 2-3 healthy snacks a day to meet nutritional requirements.

    Parent Feedback

    ​Parents strongly desired ideas for easy and healthy snacks.

    Some parents viewed snack time as treat time. They felt as though their child got all their nutrients at meal time, and that snacks were just for fun.

    Parents gravitated towards pre-packaged snacks because they were quick, portable, and perceived as safer in terms of choking hazards.

    Opportunities for Care

    Help families understand that snacks are an opportunity to provide nutrients for their child, not treat time, and that toddlers actually need more nutrients than they can get at meal time.

    Toddlers should be provided 2-3 healthy snacks per day. Snacks should be eaten at a planned time, while seated, and with adult supervision.

    Caution against all-day snacking/continuous snacking.

    Remind parents that healthy snacks can be easy, safe, and portable with just a little bit of planning.

    Conversation Starters

    Can you tell me about the snacks your child eats while at home and childcare?

    Can you tell me who decides what snacks your child eats?

    Can you tell me where your child usually has her snacks?

    Can you tell me what prompts you to give a snack or how you decide when to offer a snack?

    Can you tell me your child’s favorite snacks?

    Related Parent Resources

    HALF Message(s): 
    Healthy snacks can be fun and easy. Toddlers need 2-3 healthy snacks to get all their nutrients. Make healthy snacks a part of your daily routine.

    HALF Resources:
    For realistic parent derived strategies for establishing healthy snack time, refer parents to the following sections on healthychildren.org/growinghealthy

         Quick Tips: Keep Your Child Healthy widget. Simply select Snack Time to generate the results.

         Food and Feeding Toddlers

    Also take advantage of the HealthyGrowth app​ to create personalized patient education for your patient

​​Picky Eat​​ers: 

Introduce a variety foods multiple times and in multiple ways

    Evidence

    Preferences for one or two foods or refusal of certain foods (picky-eating) are normal behaviors in children in this age group.

    Best practice is to foster healthy eating by continuing to expose them to a variety of nutritious foods, with minimal deviation from these practices in response to children’s behaviors.

    Parent Feedback

    Parents were concerned about wasting food/money.

    Parents believed that if the child does not initially like a food, then she never will.

    Parents noted the feeling that they were forcing their child to eat.

    Most parents reported that they are tired and busy, and have no desire to turn meal time into a battle or listen to whining, so they give in and make what the kids like.

    Opportunities for Care

    Assess parent’s frustration and offer strategies to ensure peaceful and healthy meal times.

    Remind parents that it can take up to 15 times before a child actually accepts a new food.

    Also encourage them to try different presentations, cooking methods, and seasoning/dips. For example, try slivered carrots, waffle cut carrots, steamed carrots, shredded carrots, mashed carrots, and/or carrots with dips.

    Conversation Starters

    Tell me about dinner time at your house?

    What foods does your child like and dislike?

    What foods do you (parent) like and dislike?

    Can you tell me how you feel when you offer food that you have prepared and your child does not eat it?

    Can you tell me about what an ideal meal time would be for you?

    Are there any eating behaviors of your child that you are concerned about?

    Related Parent Resources

    HALF Message(s):
    Remember that you are in charge and that your child is going through a stage that will pass. In the meantime, don’t force your child to eat, and try to stay calm. Continue to offer a wide variety of foods and try not to cater too much to the child.

    HALF Resources:
    For realistic parent derived strategies for picky eaters, refer parents to the following sections on healthychildren.org/growinghealthy:

         Quick Tips: Keep Your Child Healthy widget. Simply select Picky Eaters to generate the results.

         Food and Feeding Toddler​s

    Also take advantage of the HealthyGrowth app​ to create personalized patient education for your patient.

​Parent Provides, Child D​ecides:

Offer healthy food in age-appropriate portions at meals and snacks
     Let child decide what and how much to eat. 

    Evidence

    Children have an innate ability to self-regulate their food intake.

    Three parenting practices have been shown to be associated with excess weight gain:

        feeding in response to emotional distress,
        using food as a reward, and
        excessive prompting or encouragement to eat.

    Among toddlers, there is variability of caloric intake from meal to meal, but total intake remains consistent over a 24-hour period.

    Parent Feedback

    Parents generally did not have a good sense of appropriate portion sizes.

    Opportunities for Care

    ​​If children eat less in one meal, they will make it up later. By offering regularly scheduled healthy meals, the child does not get over-hungry and learns how to self-regulate.

    Discuss the importance of

        regularly scheduled meals and snacks,
        taking time to pause while eating for conversation,
        model healthy eating, and
        show enjoyment of healthy food.

    Be patient with picky eaters and avoid dinner table negotiations and/or battles.

    Conversation Starters

    How do you feel when your child doesn’t eat all of his food?

    Related Parent Resources

    HALF Message(s):
    Toddlers are learning what they do and don’t like. It can take them a while to get used to new foods. A little patience and creativity can help you both get through this challenging stage. Parents need to provide a variety of choices and let the child decide when and how much to eat.

    HALF Resources:
    To support parents with this tactic, refer them to the HALF parent derived strategies for picky eaters in the following sections on healthychildren.org/growinghealthy:

        Quick Tips: Keep Your Child Healthy widget. Simply select Picky Eaters to generate the results.

        Food and Feeding Toddlers

    Also take advantage of the HealthyGrowth app​ to create personalized patient education for your patient.

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