Children between the ages of 1-3 years are considered toddlers. During this stage of development there is a quick increase in gross and fine motor skills, along with an increased desire for independence, exploration of the environment, and development of language skills.(1)
For toddlers to reach their full growth and developmental potential, adequate intake of energy (calories from food) and nutrients is important. Nutritional deficiency, or under-nutrition, during this time can hinder cognitive development. Providing adequate nutrition in a supportive environment can prevent long-term effects of under-nutrition, like failure to thrive and cognitive impairment.(1,2)
Toddlers have an increased need to express their own will and this expression may come in the form of negativism and temper tantrums.(1,3) This is where the term “terrible twos” comes from. With increased motor development and an increased desire for independence, toddlers may try to do more than they are able, and this can lead to frustration for them, therefore some of the ‘difficult’ behaviors parents identify at this age.(1,3)
Weaning from breast or bottle-feedings typically occurs around 9-10 months of age, and the intake of solid foods increases. Drinking from a cup also tends to begin at this time. It is important for parents to pay attention to cues of readiness for weaning. For example, there may be a lack of interest in breast or bottle feedings. Weaning is a sign that the toddler is becoming more independent and is typically complete by age 12-14 months. Depending on the toddler this age can vary.(1)
Toddlers are able to chew different textured foods, and to feed themselves. By 12-18 months of age, they gain more tongue mobility and therefore can eat a wider variety of chopped or soft table foods. By 12 months of age they can pick up small objects and put them in their mouths, like cooked peas and carrots. They may also begin using a spoon. Between 18-24 months they should be able to handle meats, raw fruit and vegetables, and foods of a variety of textures.(1)
Due to the strong need for independence with self feeding, toddlers may start to use the phrases like “I do it!” and “no!”. This type of response is normal as they reduce their dependency on parents and caretakers.(3) Self-feeding can be messy as fine motor skills continue to develop. Parents should let children practice self-feeding, while minimizing environmental distractions during mealtime, like television. Adult supervision is important because there is a high risk for choking on foods. The toddler should eat seated with the family, and not be allowed to eat on the run, as we tend to do as busy adults.(1)
Toddlers have a need for rituals, and they may develop food jags (strong food preferences and dislikes).(4) They may go through periods of refusing foods they previously liked. To mitigate this, serve new foods along with familiar ones. New foods are better accepted if they are introduced when the child is hungry and if she sees other family members eating the same foods. Toddlers are curious and they are great imitators, including imitating eating behaviors of others.(1)
Mealtime is not the time for battling over food and forced feedings. This is a time for toddlers to practice language and social skills and to develop a positive self-image. Eating breakfast is an important habit to establish for your toddler, and is a healthy eating behavior to continue throughout life. Also, mealtime with the family is important for modeling healthy eating behaviors for children.(1)
Toddlers naturally have a decreased interest in food because there is a slowed rate of growth at this age, along with which comes a decreased appetite. With their newfound gross and fine motor skills, they have interests in their environments beyond food and eating, and this is normal.(1)
Portion size for toddlers follows the rule of thumb. One rule of thumb for serving size is 1 tablespoon of food per year of age. That means that a serving for a 2 year old would be about 2 tablespoons. It is preferred to give toddlers smaller portions and have them ask for more rather than to serve larger portions. Overestimating and over serving children can lead to the child being labeled as a picky eater because toddlers can’t eat large amounts of food at one time.(3) Snacks therefore are important, however allowing your child to graze on unhealthy snacks like chips, cookies and sweetened beverages should be avoided because they can blunt the toddler’s appetite for healthy foods at mealtime. Toddlers can control the amount of food they eat by hunger, so allow your child to ‘voice’ their hunger and satiety cues without pressuring them to eat more, otherwise over or underfeeding can occur.(1,5)
PRACTICAL APPLICATIONS OF CHILD FEEDING RESEARCH FOR TODDLERS AND PRESCHOOLERS(1)
Respond appropriately to the child’s hunger and satiety cues
Focus on long-term goals of developing healthy self-controls of eating
Look beyond concerns regarding the composition and quantity of foods consumed or fears that your child may eat too much and become overweight
Trying to control food intake by attaching punishment or reward to eating is not recommended
Severely restrict treats is not recommended because this may make such foods even more desirable
Model positive eating behaviors, like eating a variety of fruits and vegetables, and help your child develop preferences for a wide variety of foods consistent with a healthy diet and lifestyle
It may take repeated exposure to a new food before your child takes to it, this is normal, be patient and persistent
Serving appropriate portion sizes is important, and it’s better to keep them smaller and have your child ask for more if she wants it
Mealtimes should take place in a positive, secure and happy environment with the family, and with adult supervision
Children should not be forced to eat
If your child has low interest in eating, long mealtimes (more than 30 minutes), prefers liquids over solids, refuses foods, or needs to be offered foods as if she is younger than her chronological age, feeding problems may be indicated and further evaluation can be helpful
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Brown J. Nutrition through the Life cycle 4th ed. Belmont, CA: Wadsworth; 2011.
Goh LH, How CH, Ng KH. Failure to thrive in babies and toddlers. Singapore Medical Journal. 2016;57(6):287-291. doi:10.11622/smedj.2016102.
Hoecker JL. Mayo Clinic. Infant and toddler health. April 21, 2016. Available from: https://www.mayoclinic.org/healthy-lifestyle/infant-and-toddler-health/expert-answers/terrible-twos/faq-20058314. Accessed January 2, 2018.
Pitman T. What to do when your picky eater goes on a food jag. Today’s Parent. September 29, 2015. Available from: https://www.todaysparent.com/toddler/what-to-do-when-your-picky-eater-goes-on-a-food-jag/. Accessed January 2, 2018.
Fox MK, Devaney B, Reidy K, Razafindrakoto C, Ziegler P. Relationship between portion size and energy intake among infants and toddlers: evidence of self-regulation. J Am Diet Assoc. 2006;106(1 Suppl 1):S77-83. Available from: https://www.ncbi.nlm.nih.gov/pubmed/16376632.