- When can my baby start drinking cow's milk?
- Does my child need fruit juice?
- How often should my child have a snack?
- I'm concerned that my child weighs too much — what should I do?
- My family is vegetarian. How can I provide foods to meet my child's growth needs?
- I'm concerned my child doesn't eat enough — what should I do?
Your baby can start drinking cow's milk at 1 year of age. Breast milk or formula is best for your baby's first year because they provide the most complete nutrition for your growing child. In addition, the protein found in cow's milk is hard for your baby to digest.
When your baby starts drinking cow's milk, whole milk is best because it provides the fat needed for development of the nervous system and immune system. After age 2, you can change to 2 percent, 1 percent or nonfat milk. By this age, children's diets are more varied and they aren't as dependent on milk to provide the fat their bodies need.
There is no nutritional reason that your child needs fruit juice. Juice is a concentrated source of calories. If you do give juice, make sure it is 100 percent pasteurized juice and offer no more than 4 ounces a day to children age 1 to 6 years. For ages 7 to 18 years, limit juice to 8 to 12 ounces per day.
Juice can be given as two 2-ounce servings of straight juice or two 4-ounce servings of 2 ounces of juice mixed with 2 ounces of water. Juice should be given after the child has eaten a meal or snack so juice doesn't become a replacement for food. Allowing only two small servings of juice a day limits the amount of empty calories your child receives. Excessive juice intake can contribute to excessive weight gain and obesity. It is important to encourage the consumption of whole fruits.
Diluted juices can be introduced at about 6 months of age, when the child can begin drinking from a cup. Juices should never be offered in a bottle. Babies who drink juice from bottles are more likely to develop cavities and to have seriously damaged teeth due to constant exposure to sugar.
It's normal for young children to want food every three or four hours. Experts suggest offering snacks midway between meals. Providing snacks at regular intervals helps prevent overeating at meals or refusing meals.
If there will be more than four hours before the next meal, the snack should contain fat, protein and carbohydrate. The following examples provide all three:
- Crackers with ham or turkey slices and cheese
- Cottage cheese, cooked vegetables and crackers
- Fruit slices and yogurt for dipping
- Milk and toast or crackers with peanut butter
If it will just be one or two hours until the next meal, fruit, vegetables or crackers should be enough to curb your child's hunger.
If you think your child is overweight, first speak with your child's doctor. Your child's doctor will monitor your child's weight and height on growth charts to decide if his or her growth is appropriate.
If the doctor is concerned about your child's weight, you can start with the following guidelines:
Using the food guide pyramid, be sure that your child is offered foods from all food groups so that he or she gets the necessary nutrients. Consider the following when you plan meals for your child:
- Maintain a balanced diet with a variety of food choices
- Include more fruits, vegetables and whole grain foods
- Limit fried foods and high-fat meats
- Limit juice intake to less than four ounces per day
Physical activity is important for children. Children can be physically active during the day by playing sports, riding bikes, playing outside or just moving around rather than sitting and watching television or playing video games. An active child is more likely to maintain healthy activity through adolescence and into adulthood. Try to limit TV time to one hour or less per day.
Meal times are a great opportunity to establish positive attitudes about food. It is important to avoid conflict.
For more help with your child's weight and diet, you can contact a registered dietitian. Ask your child's doctor for a referral.
A lacto-ovo vegetarian diet that includes milk and eggs can meet a child's needs for growth and development. For strict vegetarians (vegans), care must be taken in meal planning because the diet does not include milk or other animal products. Alternative food sources of some nutrients like protein, iron, calcium and vitamin B-12 must be used. In addition, the diet may consist of mainly low-calorie, high-fiber foods such as fruits, vegetables and grains. These foods are healthy, but can fill up the stomach before the child has eaten enough protein-rich foods.
A registered dietitian can provide helpful information about vitamin and mineral supplements, meal planning and the amount of calories and protein needed for growth and development.
The UCSF Medical Center Nutrition Department recommends that vegetarian children see a registered dietitian. Ask your child's doctor for a referral.
It is important to realize that a child's portion is generally much smaller than an adult's. Your child may be getting enough food to be healthy and grow normally. Appetite and food intake are different at different ages and can be affected if your child is sick or has a chronic disease.
If your child is growing normally, she or he is probably eating enough. No matter how much your child eats, it is important to provide healthy foods, a calm and supportive eating environment and to allow your child to decide how much to eat.