Nutrition needs and developmental skills change as a child grows. An age-appropriate diet is one that provides the nutrients a child needs to grow and to develop. It also includes foods that a child likes and can eat easily.
From birth until four to six months of age, infants rely on the sucking ability with which they are born. They obtain all their nutrition either from a bottle or from breast-feeding. Newborn infants feed every two to four hours up to eight times a day or more. Breast milk provides all the nutrition a newborn infant needs. Man-made infant formulas are designed to be as much like breast milk as they can be.
Between four and six months of age, an infant begins to take larger amounts of breast milk or formula at one time. This means that they may not want to feed as often. Their digestive systems have developed more fully, so they can eat new foods. An infant who has doubled in weight since birth may be ready to begin solid foods. The baby should also be able to sit up and have good head support.
Eating from a spoon is a new skill a baby must learn. Until about the age of 12 months, an infant can manage only small amounts of food with a spoon or fingers. This eating method does not provide a major source of nutrition. An infant continues to depend on breast-feeding or bottle feeding for most nutritional needs.
Rice cereal is usually the first solid food to be given to an infant. It is thought to be the least likely to cause a food allergy. Infant barley and oatmeal are other choices. Either strained fruits or strained vegetables can be offered next.
By the time the infant is six to eight months old, strained meats, egg yolks, and small amounts of dairy foods can be started. At seven to nine months, an infant begins teething and can accept textures in foods. Once an infant reaches eight to ten months of age, he or she can often tolerate more foods. These may include wheat products, whole eggs, and larger amounts of dairy products.
Babies begin to use their hands to feed themselves crackers and soft foods. These include pieces of fruits, vegetables, and tender meats. Crunchy or stringy foods such as nuts, popcorn, or less tender meats may cause choking. As the ability to eat finger foods and to use a spoon improves, an infant will eat more solid foods. That means the baby can rely less on breast milk or formula for daily nutrition.
Learning to drink from a cup is a hard and often messy process. By the time they are one year old, most infants have mastered this skill well enough to wean from a bottle. They may also lose interest in breast-feeding at this point. New foods should be started one at a time and at least two or three days apart. This allows the parent to watch the baby's response to each food.
Providing a toddler with the right diet can be challenging. Children this age want to practice their new skills by eating with their fingers or trying to use a spoon. Appetite varies widely due to a slower growth rate. Toddlers are also more aware of their surroundings and often become distracted. All these things affect what the child is willing to eat at any given meal. There is no longer one single food that will provide all or most of the child's nutritional needs. A variety of foods is needed for good health and steady growth.
The right portion size changes with age. One rule of thumb for feeding toddlers is to offer one tablespoon of each food for every year of age. A child may choose to eat more or less than this amount. Children should be given whole milk until they are two years old. This is because their developing nervous systems need the extra fat. From age 2 to 5, 2% milk is acceptable.
Toddlers often go on what are called food jags. This means they will eat only one or two foods for several meals or several days at a time. Studies show that most children still meet their nutritional needs over time. The challenge for parents is to be patient. It's crucial to offer a variety of healthy foods. It is not a good idea to try to force a child to eat a food. This approach will only ensure that the food is never a favorite. Parents do not have to give a favorite food when a child refuses what is first offered. Food refusal at one meal will likely result in an improved appetite at the next meal or snack time.
Three meals and two to three snacks per day is ideal. Children cannot eat enough in just three meals to sustain their energy needs so they need between meal snacks. Many parents think that fruit juice is a good source of nutrition. However, the fact is, children who drink juice or soda between meals are often less hungry at mealtime. Sweetened juices bring a much higher risk of developing childhood obesity.
Choking can be a problem for children under the age of 4. At this age, chewing and swallowing skills are still developing. Choking is also more likely if a child eats while running and playing. Eating and drinking should be allowed only when a child is sitting. Common foods that toddlers tend to choke on include: hot dogsgrapesraw vegetablespopcornnutshard candy
Pieces of food offered to a toddler should be small enough not to lodge in the throat. Grapes and weiners, in particular, must be cut into small pieces.
School-age children need the same types and number of servings of foods in their diet as preschool children. However, they are able to eat bigger amounts at one time and may eat less often. Most youngsters who are age 5 and older can safely drink skim milk and still grow well. If they continue to have high energy needs for growth, they may still need the extra calories that are found in 2% milk.
Food choices are more influenced by peers at school and by what they see on television. Children are bombarded with commercials for processed foods, such as sweetened breakfast cereals, fast food, candy, and soda. This gives rise to new concerns. Poor eating habits can lead to obesity and iron deficiency anemia. Anemia is a shortage of red blood cells. Children who have developed healthy eating habits are likely to continue to eat well, despite these influences.
[hyperLink url="http://www.Alzheimers.org/" linkTitle="Alzheimer's"]Alzheimer's[/hyperLink] website (from the National Institutes on Aging, a division of NIH)
Tang et al., The Lancet, 1996; 348:429-432.