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Home > Nutrition for Mom & Baby Nutrition for Nursing ToddlersIt seems that all the the information I see regarding toddler nutrition assumes that your toddler is no longer nursing and is eating mainly solids. As a result, many moms of nursing toddlers (particularly those who are eating few solids) have lots of questions about how to adapt this information to their particular child.
Your child can continue breastfeeding just as often during the second year, but offer solid foods a few times a day. After 12 months, you can begin offering the solids BEFORE baby nurses, if you wish, instead of after. Your milk is still an important part of baby's diet and will offer him many benefits (nutritionally, immunilogically and emotionally). There is not any particular "recommended number of times per day" that a toddler should be nursing. Some are only nursing once or twice a day, while others continue to enjoy lots of time at their mother's breast. As baby slowly moves into eating more solids, your milk will fill any nutritional gaps nicely. Once you do start to breastfeed less often, remember that you must make a greater effort to ensure that your child eats several meals of nutritious food each day.
Many nursing moms are told that they must introduce cow's milk at a year. Your nursing toddler is already getting the best milk he can get - mother's milk! Breastmilk has a higher fat content than whole cow's milk (needed for baby's brain growth), and all the nutrients of human milk are significantly more bioavailable than those of cow's milk because it is species specific (not to mention all the components of mother's milk that are not present in cow's milk). There is no need for additional milk or (or the equivalent nutrients from other foods) as long as your baby is nursing 3-4 times per day. Cow's milk is really just a convenient source of calcium, protein, fats, vitamin D, etc. - it's not required. There are many people in many parts of the world who do not drink milk and still manage to get all the calcium, protein, fats, vitamin D, etc. that they need.
Pediatricians now recommend that any cow's milk be whole milk from a cup after the first year and until the child is at least 2 years of age. This ensures that your child receives enough fat, which is essential to proper brain development. After the age of two, if growth is good, you can switch to low-fat or nonfat milk. Note: If your child is nursing, then remember that mom's milk is "whole" milk - the more breastmilk your child gets, the less need to worry about your child getting additional fat from whole milk or other sources. It's best to limit the amount of cow's milk that your child receives to 2-3 cups (16-24 ounces) per day, since too much cow's milk in a child's diet can put him at risk for iron-deficiency anemia (because milk can interfere with the absorption of iron) and may decrease the child's desire for other foods.
Between ages one and five, a child's growth is in a decelerated stage; that is, they have slowed down in growth. Since growth slows down, their need for calories subsequently decreases, which in turn leads to a smaller quantity of food ingested per day. Added to the decelerated growth is a burgeoning independence which limits the variety of foods your child is willing to eat ("finicky eater"). Rest assured that toddlers do not need as much food as you might expect because of this slowing down of the growth rate. Three small meals and two snacks a day (and some will eat a good bit less) will probably be enough to fuel even the most active toddler. Please realize, too, that finicky eaters are the rule rather than the exception. Some toddlers are eating very few solids, or even no solids, at 12 months. This is not unusual and really depends on your child - there is quite a big variation. We like to see breastmilk making up the majority (around 75%) of baby's diet at 12 months. Some babies will be taking more solids by 12 months, but others will still be exclusively or almost-exclusively breastfed at this point. It is normal for baby to keep breastmilk as the primary part of his diet up until 18 months or even longer. An example of a nice gradual increase in solids would be 25% solids at 12 months, 50% solids at 18 months, and 80% solids at 24 months. Some children take a little longer to begin taking solids well. Some of them have food sensitivities and this may be their body's way of protecting them until their digestive system can handle more. Others are late teethers or have a lot of difficulty with teething pain. At this point there is NOTHING that your milk lacks that your child needs, with the possible exception of enough iron. As long as his iron levels are within acceptable levels and when he does eat you are offering him foods naturally rich in iron, then you have plenty of time before you need to worry about the amount of solids he's getting. All you need to do is to continue to offer foods. Don't worry if he's not interested or takes very small amounts. Your only true responsibility is what you offer, when you offer it and how you offer it, not whether or not he eats it. That has to be up to him. Trying to force, coax, or cajole your child into eating is never recommended. Continue to nurse on demand, day and night, and trust your child to increase the solids when he's ready. As baby slowly moves into eating more solids, your milk will fill any nutritional gaps nicely.
Some things to look at to determine that your child is getting appropriate nutrition:
I have always had a hard time finding information on average toddler growth, so I took a look at the standard CDC growth charts to get these numbers. (Note: these numbers are not for breastfed babies specifically; they come from the growth charts for all children.) This link on checking your child's growth has some great information on how to monitor your child's growth using growth charts.
Finger foods are always great for toddlers, and your toddler will also begin to learn how to feed himself with a spoon and fork. Many babies prefer to eat foods which they can pick up and feed themselves, rather than foods that must be spooned to them. A lot of babies would rather have food right off the table than the blander-tasting baby foods. After the age of twelve months, you can offer foods you've been withholding (cow's milk, citrus fruits, egg whites), but continue to be on the lookout for any allergic reactions. Even though you can offer more foods at this point, the choking hazard is still very real. Supervise your toddler's meals in case of choking, and continue to avoid foods such as popcorn, hard candies, hot dogs, jelly beans, chunks of carrots, grapes, raisins, and nuts. Cut or finely chop such foods, or simply wait until your baby gets older. Toddlers should be offered a variety of foods. They can eat the same things as the rest of the family. Foods rich in protein, calcium, and iron, along with fruits and vegetables, breads, etc. should be made available on a routine basis. Serve the most healthful foods possible, but don't expect your toddler to eat a big meal at each sitting. Most children, when offered nutritious meals and snacks and allowed to eat what they wish, will meet their nutritional requirements over several days or even a week. Don't let your child fill up on empty-calorie snacks, but don't force him to eat when he doesn't want to. Many toddlers eat better when they have food available throughout the day, rather than just at a few set times (see grazing). Simply offer your toddler nutrient-dense snacks throughout the day (cut-up vegetables, bite-sized pieces of fruit, hard-boiled-egg slices, yogurt, whole wheat breads and cereals, cheeses) and let him eat what he wants. Some parents have had good luck with Dr. William Sears' suggestion of a "nibble tray," where you fill a tray (like an ice cube tray, muffin tin, etc.) with several types of healthy foods and leave it out for your toddler to nibble on throughout the day. Below are the current USDA food
pyramid guidelines (
Feeding Infants and Toddlers by William Sears, MD Feeding the Picky Eater by William Sears, MD Is your child getting enough to eat? How to tell by William Sears, MD Nutritional guidelines for toddlers by Sue Gilbert, Consulting Nutritionist RDA for toddlers? by Sue Gilbert, Consulting Nutritionist Calorie Boosters for Kids by Kelly Vieira, MS, RD The Food Guide Pyramid for Young Children from the US Department of Agriculture (including the booklet, Tips for Using the FGP for Young Children) How do the Daily Values found on food labels compare to the nutritional recommendations for children? from the USDA/ARS Children's Nutrition Research Center at Baylor College of Medicine Dietary Reference Intakes (DRI) and Recommended Dietary Allowances (RDA) from the USDA Food & Nutrition Center Latham MC. Human nutrition in the developing world, (FAO Food and Nutrition Series No. 29). Rome: Food and Agriculture Organization of the United Nations, 1997.
DairyCow's milk: Necessary for nursing toddler? by Debbi Donovan, IBCLC Calcium and nursing toddlers by William Sears, MD Does putting chocolate in milk decrease calcium absorption? by Sue Gilbert, MS, consulting nutritionist
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