Health

The First Three Years: A Complete Nutritional Guide

What you feed your child in the first few years of their life has long-lasting consequences. Here's how to get it right.

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What you feed your baby matters — a lot. A growing body of evidence shows that what a child eats in the first few years of their lives is linked to cognitive and motor development, success in school, lifelong eating habits, and obesity.

“Science is showing how critical the earliest years are for babies in terms of nutrition,” says Adrianna Logalbo, managing director of nonprofit 1,000 Days, an organization working to improve nutrition for pregnant mothers and young children. “It isn’t just about preventing malnutrition, it’s about fostering healthy beginnings for all kids, building healthy brains, enabling kids to grow, and ensuring kids are a healthy weight.”

To add to this, kids experience some of the fastest brain and immune system development in the first two years of their lives, notes Angela Lemond, a registered dietitian, board-certified specialist in pediatric nutrition, and co-founder of Lemond Nutrition in Dallas. Adequate nutrition has a significant impact on both.

We get it, what kids eat in the first few years of life is really important. But what, exactly, to feed kids is also really confusing. There aren’t any federal dietary guidelines for children under two years old, so many parents try to figure out what to do based on sometimes conflicting advice from family members, friends, and online parenting groups. Furthermore, dietary recommendations for children change with great regularity, and often drastically (Pop quiz: Should you feed your kids peanuts early, late, or never?).

In reality, feeding babies and toddlers a healthy diet is pretty straightforward. Listen to your doctor on specifics and then trust your instincts, aiming to make mealtime as mellow and fun as possible. To help you find that path, here’s your (exhaustive) expert-driven guide to feeding your baby in the first three years

0 to 6 Months: The Breast and The Bottle

The newborn menu couldn’t get any simpler, or more nutritious: Both the American Academy of Pediatrics and Centers for Disease Control recommend that babies be fed breast milk (the best option) or formula (when breastfeeding is not possible) exclusively for their first six months. Infants’ digestive systems aren’t developed enough at this stage to handle anything else, and breast milk or formula provides for all of your baby’s nutritional needs. Breast milk is a little light on vitamin D, however, so discuss with your pediatrician whether your baby would benefit from a liquid supplement. (Formula is fortified with vitamin D.)

Two things to note: During the first month of a baby’s life, babies should dine whenever they want. So give them food when they ask (and they will ask). Also, an estimated one in two kids is introduced to solid food too early, which babies this young can’t digest, so there’s no benefit to rushing the transition.

Parent Insight #1: Yes, Your Newborn Has Hunger Cues During this stage, your baby’s hunger cues will start to develop. These include thrusting her tongue, smacking her lips, and sucking on her fingers or fists.

6 to 9 months: Time To Experiment

Generally, most babies are ready to try solid food around six months. For many years, parents were told to introduce one single new food at a time to make sure the food didn’t cause an allergic or otherwise bad reaction, but that recommendation is shifting.

Parent Insight #2: Texture Matters By now – if your toothless child has bitten you — you’ve probably learned that babies don’t need teeth to eat because their gums are very strong. They can gum pieces of food, says Sharon Somekh, MD, a pediatrician and parenting consultant in Long Island, New York. At this stage, introducing babies to different food textures is important, so don’t be afraid to offer babies some mashed banana, small cubes of pasteurized cheese, or small pieces of meat such as a cut-up meatball or piece of meatloaf, which provides selenium and zinc for brain health and immunity.

Recent changes to recommendations illustrate the confusion about how allergies even develop: Doctors used to advise avoiding peanuts until kids were three years old, but the prevailing logic is now that not introducing peanuts to kids sooner might be causing allergies rather than preventing them.

Recommendations for a baby’s first food have also evolved. Whereas once doctors generally recommended only infant cereal, now they say there’s no one perfect first-time food for babies. In fact, some experts have begun recommending that parents might start with pureed meats to help babies get a jump on the iron they need; by six months, babies’ iron stores that they built up in utero are starting to deplete.

Parent Insight #3: Babies Know When They’re Full By six months, babies will express excitement when they’re hungry and see food. They might reach for it or turn their heads away or shake their heads when they’ve had enough. More than ever, experts recommend that parents pay attention to these cues and be less rigid when it comes to feeding. One of the most important changes to dietary recommendations for babies and toddlers is to let kids decide when they’re hungry or when they’re full.

You might have read that it’s better to start babies off with a vegetable rather than a fruit – this is because babies naturally dig sweet foods, so the theory is that if you start with a fruit, they might reject vegetables later. There’s no evidence that this is the case, Somekh says, but she recommends it anyway, noting that her four vegetable-loving kids started on green vegetables.

“Taste preference is fairly individualized depending on the child,” Lemond says. “However, most babies do prefer sweeter flavors because they innately know what foods are more dense in calories.”

Parent Insight #4: What Parents Eat Matters Mothers’ diets when kids were small had a bigger positive effect on kids’ fruit and vegetable consumption than what the moms ate during their pregnancies, according to an Australian study published in 2016. Kids are most receptive to vegetables between six and 12 months old, and introducing them at that stage promotes veggie eating later in life, researchers concluded.

If you want to tread more traditionally, first try, for example, a little grain cereal such as oatmeal, barley, or whole grain (feeding them a diet of only rice cereal currently isn’t recommended because it could contain arsenic and cause constipation). Then mix some pureed spinach into a little oatmeal and breast milk for extra vitamins. Somekh also recommends introducing new foods early in the day rather than in the evening so you can monitor any bad reactions your baby might have to the new food.

What to Feed Them:

At this stage, think of these first solid foods as fun, experimental add-ons to babies’ healthy diet of breast milk or formula. You can also give babies small, soft pieces of food so they can start learning how to pick them up and feed themselves. Don’t worry too much about whether most of the food is smeared across their faces or on their high chair trays — they’re still getting much of their nutrition from breast milk or formula. This is a learning experience.

Breast milk or formula plus …

  • Oat, barley, or multi-grain fortified infant cereal
  • Pureed meats such as beef (which provides iron and selenium), chicken (selenium and vitamins B6 and B12) or turkey, which provides vitamin B6 for brain development and mood regulation, iron, zinc, and potassium
  • Pureed tofu or legumes such as black beans or lentils (which provide iron and protein)
  • Pureed, cooked vegetables such as spinach (which provides folate for brain development), sweet potatoes (which provide vitamin A for vision and develops the heart, lungs and other organs), butternut squash or carrots (vitamins A, K, and B6)
  • Pureed, strained fruits such as banana (folate and potassium), pears, peaches, or avocado (vitamins C, K, B6 and omega-3 fatty acids)
  • You can also start giving babies water in a sippy cup, but fruit juice isn’t recommended because of its high sugar content.

What Not to Feed Them:

  • Honey contains botulism spores that babies are unable to process like older children can, Somekh says. Save honey for after they turn one year old.
  • Drinking cow’s milk is another no-no – kids’ digestive systems aren’t developed enough at this stage to process it (milk products like cheese and yogurt, on the other hand, are fine if there’s no history of milk allergies in the family).
  • Fruit juice isn’t recommended until kids are 6; they’re better off with pureed or diced fruit. If you do give them juice, they shouldn’t have more than 4 ounces a day.

9 to 12 months: Offering Vegetables and Meeting Demands

Researchers noted a correlation between the number of times parents in the UK, Denmark, and France offered vegetables to children and how well kids liked them, according to a study published in the journal Appetite in 2013. So between bottle or breastfeeding, continue offering a new food such as a fruit or vegetable even if your baby initially refuses it, Somekh says. Your baby’s ever-changing food preferences might not make sense to you, but try to be patient. One of Somekh’s daughters refused avocado at first but loved it after Somekh put a sprinkle of salt on before giving it to her.

Parent Insight #5: CPR Can Save Lives To keep babies safe as well as healthy, it might be a good idea to learn CPR before kids start eating small bits of cooked food to make sure you’re prepared to deal if your baby starts choking, Somekh says. Definitely watch your baby while they are eating to ensure their safety.

By nine months, your baby will likely have some more teeth and have developed the ability to pick things up between thumb and forefinger (called the pincer grasp) so he or she might be ready for bite-sized cooked veggies and fruits as well as cooked pasta spirals or round pieces of cereal.

While food options are broadening at this stage, experts are more reticent than they were in the past to give specific prescriptions for how much to feed kids.

Parent Insight #6: It’s Never too Early to Sit at the Dinner TableBy now, you’ll be developing a more refined grasp of kids’ hunger cues and food tastes. Even at this age, establish regular meal and snack times for kids – routines make them feel comfortable and safe. They might not be able to sit at the table for more than 10 minutes without fussing, which is normal, but it’s best to tiptoe into the habit of regular mealtimes sooner than later.

“Parents often ask, ‘How much do I feed my child?’ but our recommendation is to teach kids healthy habits early on and let babies decide when they’re hungry and full,” says Andrea Beegle, the Director of Strategic Partnerships at 1,000 Days.

It can be frustrating, certainly, when a kid eats everything on her plate for a week then refuses to eat anything the week after, Logalbo says: “There’s a lot going on in this period; kids are growing really rapidly and at different rates. I have to trust that when my daughter needs something, she’ll tell me, and make sure what I’m providing her is as healthful as possible.”

What to Feed Them:

Breast milk or formula, plus

  • Small pieces of round cereal or cooked pasta
  • Cheese cubes
  • Cooked broccoli or small cubes of cooked squash
  • Mashed or cut-up bananas
  • Mashed black beans or lentils
  • Small pieces of melon or grapefruit
  • Cooked carrots
  • Bits of cooked chicken or turkey
  • Bits of scrambled egg
  • Yogurt

What Not to Feed Them:

Any food can be a choking hazard. Watch your kids carefully while they’re eating.

12 to 24 months: Meeting 1,000 Calories

By one year old, many kids are capable of feeding themselves an entire meal and should eat around 1,000 calories a day, according to the American Academy of Pediatrics. They’re typically learning how to use a spoon or fork around one, but they might be pretty bad at it and will use their fingers most of the time. Let them try to use utensils, because it helps develop their motor skills. At 15 months, most kids can signal whether they’re full or want more food, Somekh says.

When they don’t eat, try not to panic. It’s normal for 1 or 2 year olds to not eat much of anything for a day or two, according to the CDC. Overall nutrition in the span of a week is more important.

Parent Insight #7: Yes, You Can Put a Stop to Picky Eating“It’s important in the toddler years to combat picky eating,” Somekh says. “Most kids will go through a picky phase, but our reaction will determine whether we’ll have a picky eater. Many kids become picky because their parents have a hard time accepting it when kids won’t eat at a certain meal and will offer alternatives.”

What to Feed Them:

Kids can eat just about anything at this stage, but stay vigilant about choking hazards.

  • Milk. Once they’re a year old, babies can drink whole milk. Typical recommendations are for one-year-olds to drink a cup and a half of milk per day, but whole milk is pretty filling, so if you’re concerned your baby doesn’t have much appetite for food, try giving them less milk
  • Fish. If you haven’t already, introduce cooked, boneless, low-mercury fish, such as salmon, which provides omega-3 fatty acids (important for brain heart and eye function), plus vitamins B12, B6, and D
  • Greens. Leafy greens such as kale are also packed with nutrients such as vitamins A, C, K, and B6 and minerals iron and folate

Parent Insight #8: Iron MattersAn estimated 15 percent of kids between one- and two-years-old are iron-deficient, so make sure you’re feeding kids iron-rich foods. To help their bodies absorb extra iron, pair foods that are high in vitamin C with iron-rich meals. Vegetarian or vegan parents need to especially vigilant about iron and should talk to their pediatricians about whether their kids are getting enough calcium, vitamins D, and B12 and protein from their diet alone.

What Not to Feed Them:

While they are older, any food can still be a choking hazard. Watch your kids carefully while they’re eating.

24 months to 36 months: A Very Nutritious Year

Growth slows a bit after the first year, so your two-year-old might not appear as ravenous as they did last year. Generally, kids between 1 and 3 years old need about 40 calories per inch of height, according to The American Academy of Pediatrics. A typical toddler-appropriate meal at this age, the Academy says, is one or two tablespoons each of a vegetable and a fruit, an ounce of meat or one or two tablespoons of beans, and a quarter of a piece of bread.

Parent Insight #9: French Fries Aren’t Vegetables It is really important that parents try to get kids to eat healthy food. Among American toddlers, the most commonly consumed “vegetable” is French fries, according to a 2013 survey published in the Annals of Nutrition & Metabolism. Health experts want to steer parents’ ideas of toddler meals away from a plate of nuggets and Fries while the rest of the family eats “adult” food. Studies show that the earlier kids get familiar with healthy foods, the easier it is to get them to eat them later. And the more likely they are to eat them through adulthood.

The Academy of Nutrition and Dietetics recommends that 2 to 3 year olds eat around 1,000 to 1,400 calories a day or roughly half of what you’re eating. A healthy breakdown of those calories, they suggest, is 3 to 5 ounces of grains, 2 to 4 ounces of protein, a cup to a cup and a half each of fruits and vegetables, and 2 to 2 ½ cups of dairy products. Talk to your pediatrician about whether your child should switch to drinking 2% milk after he turns 2.

What to Feed Them:

The sky’s the limit at this point, when it comes to food choice, but stay wary of choking hazards. Try …

  • Lasagna
  • Macaroni and cheese
  • Fish
  • Eggs
  • Meat
  • Hummus and pita
  • Cooked vegetables
  • Pancakes or waffles topped with fruit and nut butters
  • Beans and avocado
  • Tofu and rice
  • Pasta
  • Soups
  • Applesauce
  • Pudding
  • Yogurt with fruit such as melon, berries, citrus, and banana.

Parent Insight #10: Give Them Choices, Avoid a Fight Toddlers in this stage have developed food preferences, and will want to assert their independence and make their own choices about what to eat. When you want to introduce a new healthy food, it can be helpful to give them a few choices that include a food they’re already familiar with. Best-case scenario, they’ll try and love the new food, but failing that, they’ll probably at least eat the food they’ve expressed a liking for in the past.

What Not to Feed Them:

Choking continues to be a hazard. Watch your kids carefully while they’re eating.

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