Introducing foods to our children can be tricky! Many parents end up feeling overwhelmed and confused by the varying and often conflicting information they find on Google. As a registered dietician, I believe it is very important to use science-based recommendations when deciding how, what, when, and how much to feed our children. One question I get a lot is how to approach adding sugar, salt, dairy, and meat to babies and toddlers. Here is how I approach introducing these foods:
According to the US Dietary Guidelines, children under 2 years old should avoid foods and beverages with added sugar. In order to determine if a food has added sugar, look at the Nutrition Facts label on the package for a line that says “Added Sugars.” This will tell you how many grams of sugar is in the food item. Added sugar is not the same as natural sugar, like that found in fruit! Fruit is healthy and great for children once they have been introduced to solids. Of course, it may not be realistic for your family to avoid added sugar all together, but do the best you can and keep this guideline in mind.
For children between 2 and 18 years old, the recommendation is to consume less than 10 percent of calories per day from added sugar. But what does this mean? On average, this equates to less than 25 grams (or 6 teaspoons) of added sugar each day. There is no specific recommended way to introduce sugar. It sneaks into our children’s diets pretty easily so ideally you would try to avoid it until at least 2 years old according to the Dietary Guidelines. Once your child turns 2-years-old, if you see there is added sugar on packaged foods your child is eating or if you are using it in cooking, try to keep this recommendation in mind.
Wondering how and where to start cutting back on added sugars? Interestingly, the main source of added sugar in our diets is not actually dessert. Rather, it’s sugar-sweetened beverages!
There are so many different opinions about whether or not to expose infants to salt once they start eating solids. The truth is that the research is constantly evolving (as with all areas of nutrition). Currently, the USDA infant feeding guidance recommends not to add salt to foods for infants under 12 months old. This is generally due to the concern that a baby’s kidneys are unable to handle high levels of sodium. In practice, after 6 months of age, but not before, a small amount of added salt used in cooking should not be an issue. Families who prepare a large portion of food with a small amount of salt used in cooking, do not tend to have salt intake issues when giving their children some of this food. With that said, I would not recommend offering processed or canned foods with high levels of sodium to infants.
But as infants approach 12 months old, research shows that their kidney function gets better and is more similar to that of an adult, meaning they are able to handle more salt.
For children ages 2 through 4, the maximum recommended sodium intake is 1,200 mg/day. For children ages 5 through 8, the maximum recommended sodium intake is 1,500 mg/day. Not surprisingly, children are exceeding these recommendations. The average intake of sodium for both males and females 2-4 years old is above 2,000 mg, and for ages 5-8 years old, it is above 2500 mg/day.
Packaged and processed foods are the main source of sodium in our diets. Remember to look at the Nutrition Facts label on the package for a line that says “sodium” to determine how much is in that food item. After your child turns 1 years old, definitely feel free to use salt in cooking and remember to check the package label to determine how much sodium it contains.
There are 8 foods that account for about 90% of all food allergies – these foods are egg, dairy, peanuts, tree nuts, fish, shellfish, wheat and soy. As a result, when introducing dairy, it is recommended to start with a small amount first. I suggest trying it in the morning so that in case there is a reaction, it will likely not happen overnight. It will take a few experiences with dairy, eating increasing amounts each time, to rule out an allergy. If any symptoms of an allergic reaction occur, contact your pediatrician. It is also important to note that the CDC does not recommend that infants under 12 months of age drink cow’s milk. However, after approximately 6 months of age, yogurt or cheese that is pasteurized is appropriate to offer.
Sometimes parents are scared to introduce meat to their infants, but there really is no reason to
wait. After introducing solids, your baby can happily enjoy meat right from the start. This is great news because meat is an excellent source of nutrients, such as protein, fat, zinc, iron and selenium. In fact, iron is a nutrient that is very important for proper neurological development during infancy, and iron deficiency is the most common nutritional deficiency in children. So, definitely feel comfortable offering meat right away! Of course, please make sure to prepare meat safely according to the age of your child. That means that for infants you’d want to either puree meat or soften it for a baby-led weaning style approach.
In terms of portion sizes for foods, I generally leave it up to the child to determine his or her own hunger levels. This helps to create a lifelong pattern of eating when hungry and stopping when full. All children are different. Some children are naturally larger and therefore will eat more food and others are smaller and will eat smaller portions. I am including the chart of recommended intake below, since parents often ask me about appropriate portion sizes for their children. But keep in mind, these are general guidelines. Please don’t stress if your child is not meeting them precisely. The overarching idea is to try to create a balanced diet and include all of the food groups. If you have concerns or questions about your child’s growth, contact your pediatrician.
|1-3 years||4-8 years||Equivalencies|
|Fruit||1 cup (Limit 100% fruit juice to 4-6 oz per day)||1 – 1½ cups (Limit 100% fruit juice to 4-6 oz per day)||1 cup =1 small apple1 large banana1 medium pear½ cup dried fruit|
|Vegetables||1 cup||1½ cups||1 cup =1 cup cooked vegetables2 cups raw greens1 medium potato|
|Grains||1½ – 3 oz-equivalents (At least half should be whole grains)||2½ – 5 oz-equivalents (At least half should be whole grains)||1 oz-equivalent =1 slice bread½ English muffin½ cup oatmeal½ cup rice or pasta|
|Protein||2 oz-equivalents||4 oz-equivalents||1 oz-equivalent =1 oz animal protein1 egg1 tbsp nut butter¼ cup legumes|
|Dairy||2 cups Children under 2:use full-fat dairy**||2½ cups||1 cup =1 cup milk / yogurt1½ oz hard cheese1½ cup ice cream|
*Children who are still having breast milk will have smaller portion sizes
**If growth is normal, I recommend full-fat dairy for children older than 2 years old
I hope this takes some of the guesswork out of how to offer these foods to your child and in what amounts. As parents, what we can do is offer healthy foods to our children, including all of the recommended food groups. Every child is different and will ideally eat according to their own hunger cues.