Jennifer Caryn Brand Nutrition

Jennifer Brand, MPH, MS, CNS Clinical Nutritionist

Preschooler Nutrition (3-5 Years of Age)

Preschool aged children are between 3-5 years old and during this developmental stage there is increased autonomy, broader engagement in social circumstances (attending preschool, playing with friends, and staying with friends or relatives), increased language skills, and a better ability to control behavior.(1)

 

For preschoolers 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)

 

Children of this age continue to refine their gross and fine motor skills. A sense of egocentrism begins where the child may not be able to accept the views of others. They begin to learn to limit behaviors internally rather than relying on demands of parents and caregivers to do so. Control becomes a central theme. Preschool aged children will test their parents’ limits, and may resort to temper tantrums to get their way. Tantrums tend to peak around age 2-4 years. The child wants to become independent, and parents must balance this desire by setting appropriate limits while also letting go (a parallel to adolescence).(1)

 

At this age, children can use a cup, fork and spoon. Using a knife to cut foods may need refinement. Children should be seated at the table for all meals and snacks. Eating may not be as messy as it was during the toddler years, however spills are normal and will occur. Choking may still be a risk, so cutting grapes and meat into smaller bites for example is advised. Adult supervision at mealtime is also important.(1)

 

The child’s rate of growth at this stage remains slow as it is during toddler years, therefore appetite may be small. Growth occurs in spurts and there will be an increase in appetite and food intake before a growth spurt, causing children to gain weight that will be used for the soon to occur growth in height. Thus, the appetite of children at this age can be variable.(1)

 

This is a good age to involve children in food selection and preparation, in that they want to be helpful and please their parents. Taking them to the supermarket, and better yet a farmer’s market, to have them ‘help’ with food selection can provide an opportunity to introduce your child to a variety of fruits and vegetables. Children also can help prepare foods for meals. For example tearing lettuce, rinsing fruit and vegetables, squeezing citrus fruits, stirring batter, peeling eggs, bananas and oranges, or even measuring liquids as they are able are ways they can become involved in meal preparation.(1)

 

A very important cornerstone of nutrition is that young children have the ability to self-regulate food intake. If they are allowed to decide when to eat and when to stop eating without external interference, they will eat as much as they need. Children also have an innate ability to adjust their caloric intake to meet their energy needs.(2) Intake may fluctuate day to day, however it will remain relatively stable over the course of a week. Interfering with a child’s self-regulation of eating by asking them to clean their plate or by using food as a reward is asking the child to over or under eat. While they can self regulate caloric intake, they do need to be guided to select and eat foods that are part of a well balanced diet. This is a time when their food habits and preferences are established. Modeling healthy eating behaviors, and providing your child with healthy foods to select from is important for helping her learn to enjoy a variety of foods that are rich in nutrients to promote overall health and development. Keep in mind that children and their eating behaviors can be influenced by other children and adults, siblings and family members, and by the media.(1,3)

 

Preschool aged children may be described as picky eaters.(4) This can be because eating familiar foods is comforting, or your child may be trying to exert control over this part of her life.  To avoid having the dinning table become a battleground, serve child sized portions in an attractive way. Young children may not like their foods to touch on the plate, or to be mixed together like in salads or casseroles, and they may not enjoy strong tastes (sour or bitter) or spicy foods. It is important not to allow snacking or grazing indiscriminately between meals because this can blunt appetite at mealtime. Children should not be forced to stay at the table until they have eaten a certain amount of food determined by the parent.(1)

 

Children naturally prefer sweet and slightly salty tastes.(1,5)  Children eat foods familiar to them, and this emphasizes the importance of environment in their food choices. Familiarize them with healthy and varied food choices and they will learn to gravitate towards them. With repeated exposure, children will learn to like new foods that are unfamiliar to them. It can take 10-20 or more tries of a new food before a child will take to it. Be patient and persistent, and remember that modeling the behavior you want your child to learn plays an important role in the process. If you eat a variety of foods, you child is more likely to do so as well.(1)

 

Children tend to prefer foods that are energy dense and therefore those higher in sugar and fat.(3) This may be because they have pleasant feelings from eating these foods, such as satiety, or because these foods are associated with special occasions like birthday parties. Keep in mind that foods served on a limited basis or used as rewards become more desirable.  Restricting access to certain foods may increase the desire for them and lead to disordered eating behaviors, and obesity later in life. Remember that children can innately regulate their food and caloric intake, and studies have shown that allowing children this flexibility results in healthier eating behaviors long-term.(1,2)

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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References:

  1. Brown J. Nutrition through the Life cycle 4th ed. Belmont, CA: Wadsworth; 2011.
  2. 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.
  3. McNally J, Hugh‐Jones S, Caton S, Vereijken C, Weenen H, Hetherington M. Communicating hunger and satiation in the first 2 years of life: a systematic review. Maternal & Child Nutrition. 2016;12(2):205-228. doi:10.1111/mcn.12230.
  4. van der Horst K, Reidy K. Picky eating: Associations with child eating characteristics and food intake. Appetite. 2016;103(1):286-293. doi.org/10.1016/j.appet.2016.04.027.
  5. Mennella JA, Bobowski NK, Reed DR. The Development of Sweet Taste: From Biology to Hedonics. Reviews in endocrine & metabolic disorders. 2016;17(2):171-178. doi:10.1007/s11154-016-9360-5.