Ask The Expert is a weekly column on Littlestomaks.com. The idea is to have a reader-submitted question answered by a nutrition expert or a pediatrician. Feel free to submit your question in the comments section below.

This week Registered dietitian Jill Weisenberger offers ideas for foods that can help your child build a stronger immune system.

Jill Weisenberger, MS, RD, CDE  Education: M.S. Food Science & Human Nutrition, University of Florida Degree in Communications, University of Florida Nutrition consultant, writer, speaker, educator Expertise in diabetes nutrition Writer for Eating Well, Diabetic Living, Her Sports and Fitness magazines Twitter: @nutritionjill Website: All That’s Nutrition LinkedIn Profile Contact via email: jill@allthatsnutrition.com

Question: What kinds of foods will keep my child’s immune system as healthy as possible?

Answer:

Winter colds and flu are making the rounds. In some households, it seems that just as one family member is well, another gets sick. A well-running immune system can mount a powerful attack against viruses and other invaders, so paying attention to diet is especially important now. An apple a day is a good start to keeping the doctor away, but it’s the total diet – not any individual food or supplement – that stokes the immune system and keeps it humming.

The types of foods your child needs to fend off colds and illnesses are the same ones you need. Don’t fall for the hype of immune-boosting supplements and fortified foods. Simply eat a balanced diet. For most, that means a stronger emphasis on fruits, vegetables and whole grains. Try to eat a whole grain and at least one fruit or vegetable at every meal. Here are a few to try, but again a balanced diet is required – not any specific food.

Beans: Baked beans, kidney beans and others are a powerhouse of nutrients including zinc which may reduce some upper respiratory infections. Smash up some white beans to thicken soups and stews. No one will ever know they’re there. Add red or black beans to salads and pasta.

Oats: another good source of zinc and a perfect breakfast food. Instead of using breadcrumbs, you can also add oats to meatballs and meatloaf.

Bell peppers, broccoli, citrus, kiwis and berries: These are all good sources of vitamin C. Research isn’t clear that extra vitamin C helps treat or prevent colds, but vitamin C-rich foods are packed with other antioxidants and nutrients, so it’s a good idea to include them daily. Clementines are especially nice for children because they are small, seedless, easy-to-peel, delicious and not as messy as other citrus fruits.

Mushrooms: Researchers at Tufts University suspect that the simple white button mushroom may enhance immune function by increasing the production of antiviral compounds. If your kids aren’t used to eating mushrooms, introduce them with foods they already like such as pastas and casseroles.

Finally, don’t forget that frequent hand washing and other good hygiene habits are also necessary to protect your health and your family’s health. Oh and get outside in the sunshine too.

©2011 Littlestomaks.com. All Rights Reserved

Disclaimer – Information provided in Ask The Expert column on Littlestomaks.com is intended to give you general guidance on a question related to toddler nutrition. It is not meant to be treated as medical advice. You are welcome to contact this expert for a detailed consultation on your specific situation to determine what actions, if any, you should take regarding nutrition and health of your toddlers. We do not recommend you to take any action based solely on the information presented in this column. Experts have agreed to provide their professional opinion on toddler nutrition related questions on a voluntary basis and no compensation is offered to them by Littlestomaks.com.

photo credit: Ani Carrington

“If you could be a fruit, what would you be?”, I asked my daughter on a whim at bath time tonight.

“Pineapple!”, she said without any hesitation.

“Why?”, I asked to get the conversation going…

“Because it is sweet and I love it!”, again came the reply without any hesitation…

It came as a surprise because we aren’t really into pineapple in our household. No special reason, it just turns out to be that way.

Maybe they get it at daycare, I thought.

I turned my attention to my son this time.

“If you could be a vegetable, what would you be?”

“a potato”, he said after a brief pause.

“Why?”

“Because I love it”.

Hmmm, it must be the waffle fries we got him last Friday at a Chick-Fil-A take out, I thought.

Whatever the reason may be, kids relate to a specific fruit or a vegetable because they love it, not because it is good for them.

So often, we get carried away by the science and what we read that we try to motivate kids to eat fruits and veggies because we think it is good for them.

Somehow, we need to figure out how we can get them to fall in love with fruits and veggies.

What has worked for you? Please share.

©2011 Littlestomaks.com

This is a guest post by Isabella York.

photo credit: miheco

As a mother, proper nutrition for my children is first and foremost on my mind. To raise healthy children, I must pay attention to what I feed them. It is common knowledge that living right means eating well, and that a healthy lifestyle starts at a very early age. My kids are on the younger side (Girl Child is 6, Boy Child is 4), so it’s easier to instill the practices that lead to good health. Lately I’ve been transforming family meals, and I’m proud that I’ve got several nutritious dishes on hand that are easy to prepare and that my children enjoy. While researching, I came across several web articles on cooking methods. It seems that how you prepare food in general has a huge impact on its nutritional content.

Of course, our earliest ancestors had no qualms about nutrition, with food being mostly about survival. Most viands were eaten raw until the discovery of fire, which came much, much later. With the knowledge of planting and harvesting, vegetables and other grains were introduced. At this time various cultures, mostly the Egyptians and Chinese, were all about spices as a form of enhancing the taste of their food. Once the trade routes were firmly established, this practice quickly spread to other parts of the world. Very soon, new dishes were being introduced to the general public and this resulted in the publishing of the first cook books. Cuisine evolved with the demand for new gastronomic delights, and now there is a focus on the nutritional content of food – and how preparation methods affect that nutritional value.

Any type of food preparation entails a loss of nutrients to some degree. However, some aspects of the process of preparing food cannot be overlooked due to other health purposes. For example, some forms of raw food may be harmful to your health, such as raw eggs that cause Salmonella poisoning. The main objective of proper food preparation is to ensure that the food isn’t over processed. For optimal nutrition, cook only as much as necessary to maintain essential vitamins and minerals, and here’s how:

Meat

The main health deterrent in meat and poultry dishes is the grease that comes from the use of too much cooking oil. This practice not only detracts from the taste but piles on the pounds as well. It’s ideal to use techniques that don’t include oil or batter. Shorter cooking times are also desired in the event that large amounts of grease cannot be avoided. These methods include:

• Grilling:When using this method, avoid overcooking or burning the meat. Charred portions of meat present significant health hazards. This is an ideal technique for low fat delicacies.
• Broiling:Low fat meats are also recommended with this method. The high heat and quick preparation time ensure that very little nutrients are lost. At my house, we’re big fans of broiled chicken and vegetables. In the fall I slice some apples and broil them with the chicken; the house smells of an autumnal heaven.
• Pressure Cooking:Tough meats are made tender by this cooking technique. It also preserves nutrients by making short work of the preparation time.
• Stir-fry:Only small amounts of oil and fat are required when doing a stir-fry. It decreases the amount of grease while preserving vitamins and minerals with the quick cooking time. Stir fry is quick and nutritious when the kids are howling for food. They munch on carrot sticks and hummus while I prepare. I’m not the most creative cook in the kitchen, so the internet has been a wonderful source for a variety of recipes. This Thai stir fry recipe is one of my favorites; I make a double batch of sauce and preserve half of it for later in the week. It tastes so fresh and light, and the jasmine rice is so fragrant.

Fruits/Vegetables

This food group possesses vital nutrients, and improper cooking methods could detract from their precious store. Even before the actual cooking begins, fruits and vegetables must be properly washed, peeled, and cut.

Most nutrients are present in the skin and just below the skin of fresh produce. More often than not, it is advised that they be eaten raw after washing in cold water, since hot water tends to dehydrate them and results in a loss of moisture and possible nutrients. When peeling, keep the amount removed as thin as possible and avoid including the fleshy portions. Cutting fruits and vegetables should also be done with care to avoid bruising which results in loss of nutrients.

Steaming and stir frying are ideal to cook vegetables. These techniques do little to detract from valuable nutrients and, in the case of steaming, do more to lock them in and preserve them in the food. Boiling, on the other hand, should be avoided since the prolonged cooking time inevitably depletes vegetables and fruit of their nutrients. If you are preparing vegetable soup, this method is suitable since the nutrients lost from the vegetables remain in the broth.

Pasta/Grains

This is a category I generally stay away from, as I don’t like how I feel after I consume gluten, and I’m not a fan of gluten-free pastas and breads, and their alternatives. What I and my family like is rice. It is a nice alternative, especially because it comes in so many forms and can be healthy. For Mother’s Day two years ago the kids bought me a rice cooker (Smart Husband gave me pretty earrings), and it saves me a lot of time; it allows me to cook without having to think about cooking. I use simple, old-time preparation methods for the lentils – I buy Goya lentils and I soak them overnight. To get the kids to eat wild rice and lentils, I add a dash of sea salt to their servings. It’s a simple, nutritious solution.

Now that you know, always keep in mind that it’s not only what you eat but also how it’s prepared. Hopefully, these methods will help in preparing healthier meals for your children as well as yourself. Of course, don’t forget to add imagination to every dish so that they will be not only nutritious and appealing to the palate, but they’ll also be attractive to the eye as well. Your children will definitely enjoy meal times from now on.

Isabella York is a mother dedicated to a healthy and organic lifestyle, without giving up her life in the process. Along with raising her son, she works for Balsam Hill, a purveyor of Artificial Christmas Trees and Christmas Trees.

©2011 Littlestomaks.com

photo credit: DesertNana aka majamom

Chances are you have not had a whole lot of opportunity to ask your family physician or pediatrician about a few rules of thumb for your child’s nutrition. After all, there is hardly any time to talk about nutrition even on a routine wellness visit. Our experience has been no different as the doctor always seems to be in such a big rush to get you out of there!

That is why, I read with great interest an article written by a physician and a registered dietitian published in the American Family Physician, which is a peer reviewed journal of the American Academy of Family Physicians. The title of this article is Nutrition in Toddlers and it contains a nice table of 7 consensus recommendations you can use to manage your child’s nutrition. I wanted to share them with you in this article.

A toddler diet should include 2-3 servings of milk or other dairy products  per day

Not a problem in most cases unless your child has a milk allergy or intolerance. Milk is a great way to meet your growing child’s calcium and vitamin D needs.

Toddlers older than 2 years old should get 30% of daily calories from fat

Not all fat is bad, even though we live in a world where low fat seems to be the golden rule. What you need to limit is saturated fat or trans fat and watch dietary cholesterol. Very easy to do if you reduce processed foods and rely more on home-cooked meals. Polyunsaturated or monounsaturated fats and fatty acids are among the healthy fats you must include in your child’s diet.

Limit fruit juices to no more than 4-6 oz per day and emphasize whole fruits and veggies

It is easy to get comfortable with the no-sugar 100% pure fruit juice label on the box, but fruit juices are no replacement for real fruit. Getting your child to love fruits and veggies takes effort and patience, but don’t give up!

Vitamin supplementation is unnecessary except in undernourished or chronically ill children

I could not agree more! It is natural to worry as a parent, and sometimes feel the pressure to start using a vitamin supplement just to be safe. There days we hear so much about vitamin D deficiency but a supplement is not needed unless your child doesn’t get enough sun exposure or if he does not or cannot drink at least 2 cups of milk. There are situations where you may consider a multivitamin for your toddler, but the general advice is to manage your child’s vitamins and minerals needs through diet and healthy lifestyle.

Good nutritional habits should be fostered by sitting at the table, turning off the television and interacting socially

Sometimes we get so focused on the what of eating, that we forget about the how of feeding! Having a family meal without the distraction of TV or video games is a very powerful way of building lifelong healthy eating habits. Dr Kathleen Cuneo of Dinner Together is an expert in this matter whose opinion I respect a lot. I really like her approach and belief that feeding is parenting. That is what matters in the long run, not the nutritional facts on the label!

Parents should offer children a variety of foods, expose them repeatedly to healthy foods and model healthy eating behaviors

Like it or not, you are a role model for your young child. And when it comes to building lifelong healthy eating habits, your attitude towards food and eating is the most important factor. Being a role model is not difficult; just be consistent and completely natural with your child.

To reassure parents and detect undernourished children, physicians should monitor growth patterns including body mass index

While it is natural to worry if your child falls below the 50th percentile on weight and height growth charts, body mass index is a better tool to assess if your child is overweight or underweight. Body mass index uses both height and weight. It is very easy and you can use an online calculator if you don’t want to wait until your next wellness check appointment.

I think these recommendations pretty much sum up the latest thinking in child nutrition. They are based on sound evidence and practical experience of doctors and dietitians. You don’t have to try to follow all of them on a daily basis. You can try to make them a part of your child’s overall eating habits in the long run. It is also a good idea to tailor your approach to your child’s individual personality without getting hung up on a certain best way to practice them.

Good luck!

©2010 Littlestomaks.com

This is a guest article by pediatrician Dr Ayala.

photo credit: mia3mom

I believe that anyone can cook, and that everyone should know how to cook.  I believe that teaching our kids how to cook healthy food is an important life skill that will not only enable good choices; it can also influence their food preferences.

I started teaching my kids how to cook as soon as they showed the slightest interest. My first lesson involved making a good green salad, and included the basics of how to wash and dry lettuce, and the simple principles of mixing a good salad dressing. The second session’s product was a nice bowl of lightly salted edamame in their shell, which my kids still think of as “addictive food”.

I didn’t get into brownies and cupcakes until much later. I figured that creating a dish makes its creator treasure it, and why waste a lesson of love on brownies, which any kid’s bound to fancy anyway.

In his new book The Upside of Irrationality Dan Ariely, professor of behavioral economics, devotes a chapter to the well know phenomenon of falling in love with the things we make, and the irrational value we attribute to the objects we had a more intimate relationship with. Ariely titles the chapter “the IKEA effect”— the Swedish maker’s assemble-it-yourself shelf Ariely labored over for hours somehow has a special place in his heart, and Ariely investigates why it’s so.

Through a series of experiments, involving the creation of origami animals, Lego patterns, and real-life examples of successful and unsuccessful businesses, Ariely comes to several conclusions regarding the evident connection between labor and love:

• Putting effort to an object changes how we feel about it — we value the things we labor over
• The harder we work on something, the more we love it
• We’re so invested in the things we labored over, and value them so much, that we assume others share our (biased) overvaluation of our creation
• Although working hard on a task makes us love it more, not completing the task is a deal breaker. We have no attachment to tasks we failed at or failed to complete.

Interestingly, Ariely also shows that both people and animals would rather earn their keep and work for their food. Even mice seem not to value free meals, at least not on a regular basis.

Kids in the kitchen

The lessons above are valuable and applicable to many aspects of life: I think “the IKEA effect” chapter (the whole book in fact) is a good read for any employer or employee seekeng greater work productivity and satisfaction, and for any parent contemplating showing his kids photos to a stranger (no, he doesn’t think your kids are the cutest — he couldn’t care less).

But back to kids in the kitchen. Learning how to cook is a valuable life skill that will not only enable kids to eat healthier — no matter what you make at home it will usually be healthier than the bought version — but can also be a great tool in directing their preferences toward those foods you’d like them to eat more of, namely, fruits and veggies.

Ariely’s lesson also made me think of the importance of giving kids a task they can complete. I suppose that being responsible for just one small step in a complicated dish would result in much less creator’s pride than being able to claim the creation from start to finish as your work. So selecting recipes that are of just the right technical difficulty to be challenging, but not too hard for a kid to complete is the name of the game.

This week we made potato gnocchi from scratch. I wasn’t sure my kids would be able to create dumplings that hold up in the boiling water their first try — I had many less than stellar attempts at this dish before I sort of mastered it — but beginners luck, or maybe I can take some credit as the instructor, they made incredible light-as-a-cloud gnocchi.

Ariely wrote nothing about clean-up having anything to do with the creator’s adoration of his handwork. Wish he did — I tend to find myself all alone when clean-up comes, and honestly, I can’t tell my kids that clean-up will result in great satisfaction in the same way cooking and serving your creation does.

I’d love to hear about your adventures in the kitchen as a kid or with kids.

Dr. Ayala

Read more from Dr. Ayala at  Ayala’s Herbal Water blog.
Follow Dr. Ayala on  Twitter

©2010 Littlestomaks.com

Ask The Expert is a weekly column on Littlestomaks.com. The idea is to have a reader-submitted question answered by a nutrition expert or a pediatrician. Feel free to submit your question in the comments section below.

We all know that growing children need to eat a variety of fruits and vegetables each day. But getting them to actually do that is every parent’s most difficult challenge. This week, Registered Dietitian Patricia O’Keefe offers 10 ways to get your kids eating (and loving) fruits and vegetables.

Patricia O’ Keefe Girbal, RD B.S. in Dietetics from Montclair State University B.A. in Communication from Rutgers University Experience: Nutrition Research Associate II for Cooperative Extension of Alameda County, University of California at Davis; Nutrition Educator for Share Our Strength: Operation Frontline; Nutrition Panelist for Shop Well Expertise: Healthy cooking, food allergies and intolerances, early childhood nutrition Website: Dish by Trish Twitter: @DishByTrish LinkedIn Profile Contact: via email patricia.girbal@gmail.com

Question: How can I get my child to love eating fruits and veggies?

Answer:

We already know that fruits and veggies are associated with good health and reduced disease risk. Unfortunately, very few of us are meeting recommendations for these foods, particularly our little ones. Less than 10% of kids are eating the recommended amount of fruits and veggies.

Two of the biggest things that predict whether kids will eat veggies are preference and availability. Let’s first start with making these foods available. Let’s give our kids veggies regularly and let them taste-test different foods. Even if they don’t like it or try it the first few times, they may eventually warm up to it.

A new study finds that the more (higher amount) a certain veggie was given to kids, the more they ate that veggie. Here they discuss carrots:

As the amount of carrots the kids were given increased, from 30 grams to 60 grams (about a half cup) to 90 grams, so did the amount eaten. Doubling the portion size of the carrots resulted in the kids eating 47% more

The kids ate up to twice the amount- but after that there was no effect. Studies have also shown that kids are more likely to try new foods if they helped prepare them or grew them from a garden.

Top 10 Ways to Get Kids Eating (and Loving) Vegetables

1. Serve them. As obvious as it sounds, serve veggies with every meal or snack. Young kids need about 2-3 cups of vegetables every day. Make half the veggies leafy greens or orange veggies, such as spinach, broccoli, sweet potatoes, and carrots.
2. Display them. Keep a bowl of fresh vegetables on the counter. Refrigerate cut up vegetables in small bags or containers for easy snacking so they’re ready to go.
3. Experiment. Encourage kids to be experimental and let them regularly taste-test different veggies. By trying new foods, kids are more likely to grow into adventurous eaters. Try pairing some new foods with some of their favorites. Don’t forget to praise your child for being brave and trying new foods.
4. Taste-test. Offer small tastes at first and introduce one new food at a time. Try to offer new foods at the beginning of the meal when they are hungry.
5. Beautify. Try to make food fun and beautiful. Cut veggies up into fun shapes, such as cubes or matchsticks. Make the plate beautiful using color. Serve a rainbow of foods, such as white fish, brown rice, red tomatoes, and green broccoli.
6. Vary your cooking style. Try using different textures and temperatures of foods. For an exciting change, alternate between pureed, lightly cooked, roasted, and raw veggies. Along the same lines, alternate between serving veggies cool with a chilled dip and heated in a casserole or warm soup.
7. Name it. Give a veggie a clever name, such Fire Engine Red Peppers, Sunshine Yellow Squash, and Mighty Strong Spinach.
8. Involve kids. Let kids help out with the food shopping, prepping and cooking. Let them help set the table, bring food to the table, chop herbs and greens with safe scissors, crack eggs, and be in charge of stirring. Here are some more quick tips on involving kids in cooking and shopping.
9. Plant veggies. Try planting a small vegetable garden, if you have the space, or a tomato plant. Research shows kids are more accepting of veggies and eat more of them when they plant them themselves.
10. Set a good example. Kids pick up on adult attitudes towards foods. Eat at the table with them and encourage conversation about how the food tastes, smells and looks. So eat your veggies too!

Remember, kids may take a while to warm up to veggies. Try to be patient. Studies show some kids need to be offered a food up to ten times or more before they will taste it.

Don’t give up and stay positive.

©2010 Littlestomaks.com. All Rights Reserved

Disclaimer – Information provided in Ask The Expert column on Littlestomaks.com is intended to give you general guidance on a question related to toddler nutrition. It is not meant to be treated as medical advice. You are welcome to contact this expert for a detailed consultation on your specific situation to determine what actions, if any, you should take regarding nutrition and health of your toddlers. We do not recommend you to take any action based solely on the information presented in this column. Experts have agreed to provide their professional opinion on toddler nutrition related questions on a voluntary basis and no compensation is offered to them by Littlestomaks.com.

Struggling to get your growing child interested in fruits and veggies? Well, you are not alone because this is a big challenge for most toddler parents. There is a lot of advice out there on how to encourage your child to eat fruits and veggies, but no good tool that can help you succeed. That is why I was super excited to get this handy kit from Kia Robertson of Today I Ate A Rainbow!^TM. She has developed this tool especially for young children to get them excited about fruits and veggies. It is a very simple colorful chart you can post on a refrigerator or a magnetic board. The chart has 5 columns corresponding to different colored fruits and veggies – red, orange, yellow, green and blue/purple. Using color coded round or square shaped magnets, you can teach your child to track his intake of fruits and veggies during the day.  If they complete all 5 colors, they get a reward sticker!

We had a lot of fun with our twins the other night who found it fun as they tried fruits and veggies of these 5 different colors just to be able to stick those magnets on the chart.

My son picked the square shaped magnets while his sister got the round ones.

Here is what we like about this product -

1. It works!
2. It is simple and colorful
3. Kids love it and get a sense of accomplishment
4. They learn about different colored fruits and veggies
5. The kit also contains a very nice illustrated book “The Rainbow Bunch” written by Kia Robertson, perfect for bed time reading to reinforce the idea of eating fruits and veggies
6. There is a blank shopping list you can use to involve your kids in selecting their favorite fruits and veggies

Here is what we don’t like about this product -

1. The kit is supposed to have 4 sets of distinct round and square magnets for family of upto 4 children to track their progress. We found it a little confusing because it was not easy to separate them in groups. Still, it worked out for us since we have only 2 and we decided to play round magnets vs. square magnets.
2. If you have a stainless steel fridge, like we do, the magnets will not work. We decided to use a small magnetic dry erase board instead.

Overall, we love this product and will continue using it as long as our twins remain excited about it! Check out the Today I Ate A Rainbow!^TM website for details.

Disclaimer – The Today I Ate My Rainbow!^TM kit was sent as a gift to us for this review. Our opinions are based on our personal experience.

©2010 Littlestomaks.com

We found these fig bars in a local allergy-free food store called Chase Foods. If you live in the Jacksonville, FL area, you got to check out this store!

The twins loved the free samples of these fig bars we received at an event so we decided to buy a whole box of 12 packs. Each packet contains 2 pieces which makes a nice built-in portion control feature. In the whole wheat type we are trying right now, the dough is made up of whole wheat flour, organic evaporated cane juice, canola oil, brown rice syrup, caramel color, apple fiber, sea salt, citric acid, baking soda, lecithin and baking powder. The filling contains fig paste, brown rice syrup, organic evaporated cane juice, rolled oats, molasses, citric acid and sea salt.

Here is what we like about this product -

1. A dairy-free option for people with dairy allergy
2. Simple, natural ingredients
3. Tastes good
4. Only 110 calories per bar
5. No saturated fat or trans fat
6. No cholesterol
7. Provides fiber, calcium and iron

Here is what we don’t like about this product -

1. Not organic
2. Label says it is made on equipment shared with peanut and dairy products. Can’t claim true “dairy free”
3. It could use a little less sugar – for a small 28 g bar, it has 11 g of sugar.

Overall, we like these fig bars a lot. Give them a try!

Disclaimer – Although we were introduced to this product through a free sample, I have not received any sponsorship or free product for writing this review.

©2010 Littlestomaks.com

Ask The Expert is a weekly column on Littlestomaks.com. The idea is to have a reader-submitted question answered by a nutrition expert or a pediatrician. Feel free to submit your question in the comments section below.

Kids love Mac’ n Cheese! Sometimes, so much that they don’t want to eat anything else! This is challenging for toddler parents who try hard to provide a healthy, balanced nutrition. This week, registered dietitian  Lindsey Walder tackles this issue and advises parents to shift their focus from nutrient intake to establishing and maintaining a healthy eating environment.

Question: My child eats only cereal and mac & cheese. How can I improve his nutrition?

Young children commonly go through phases during which a few foods are accepted and everything else refused.  One reason these food jags occur is that young eaters are neophobic—in other words, they fear new foods and tastes.  Interestingly, toddlers’ taste buds become much more perceptive around the time they start walking, making them increasingly selective about what they eat.  Researchers believe that the sudden change around age two from eating a wide variety of foods to eating a limited number actually may have a genetic link that could have served to protect our prehistoric baby ancestors as they first toddled out of the cave.  What exacerbates children’s innate reluctance to try new foods at this age is the pure delight most toddlers take in attempting to, for the first time, exert control over some aspect of their lives.

While having a picky eater is extremely frustrating for parents, the good news is that nutritional deficiencies in the United States are rare.  If your children are growing normally according to your pediatrician, rest assured that they are more than likely adequately well-nourished.  So, take a deep breath and present your child with broccoli for the tenth time.  Even if you are turned away – again – take comfort in knowing that this stage usually only lasts until age four or five.  That said, the malleable years of early childhood are still crucial for establishing good eating habits, and parents should make the most of it.  It’s not as difficult as you may think.

First, to avoid driving yourself crazy worrying if your toddler is getting the right nutrition while also trying to accommodate his seemingly undying yearnings for macaroni and cheese, I recommend shifting your focus from nutrient intake to establishing and maintaining a healthy eating environment.  Doing so will lay the foundation for an appreciation of a wide variety of healthy foods.   In my practice, parents who fret and stress about their child’s eating (or lack thereof) during meal time are the ones who usually face the most resistance from their child.  In addition to not worrying so much, there are five simple things parents can do now to foster good eating habits and encourage venturing beyond mac & cheese.

Expose your toddler repeatedly to new foods

Offering the same new food every day for 5-14 days can be effective.  Including these unfamiliar or previously-rejected items at meal times without forcing your child to eat them helps him to become more comfortable with the food item and may increase his willingness to try it.  Remember, meals should be eaten together as a family (without any short-order cooking), so your child can see you enjoying a wide variety of foods.

Give 2-3 choices of healthy foods

One mother told me she successfully employs this tactic with her four-year old: for snacks, she asks her son if he would like an apple or a banana.  This is a win-win approach to avoid a power-struggle since both parent and child are part of the decision.

Avoid forging a connection between eating and good or bad behavior

Too often we use food to assist with parenting responsibilities—down the road this practice can lead to an unhealthy food relationship.  Consequently, do not bribe your child with food.  Instead of offering food for rewards or comfort, give your child stickers or a hug.  And, try not to put any food or food group on a pedestal; simply teach your child that some foods are healthier than others.

Keep the highly-processed, sodium and sugar-heavy, refined foods like packaged frozen meals, chips, high-fat meats, cookies, cakes, and sugary drinks out of the house

Your three-year old can’t take the car and go pick up a box of sugary cereal at the grocery store.  Take advantage of the fact that you are the food gatekeeper and have control over what foods get offered.  Go ahead–cross the hot dogs off your shopping list!

And finally, stock your kitchen with healthy, delicious foods such as fruits, vegetables, whole grains, nuts, beans, fish, lean protein, and reduced-fat dairy products

Not immediately, but over time, your youngsters will learn to prefer healthy types of foods if that is what they’re accustomed to.

©2010 Littlestomaks.com. All Rights Reserved

Disclaimer – Information provided in Ask The Expert column on Littlestomaks.com is intended to give you general guidance on a question related to toddler nutrition. It is not meant to be treated as medical advice. You are welcome to contact this expert for a detailed consultation on your specific situation to determine what actions, if any, you should take regarding nutrition and health of your toddlers. We do not recommend you to take any action based solely on the information presented in this column. Experts have agreed to provide their professional opinion on toddler nutrition related questions on a voluntary basis and no compensation is offered to them by Littlestomaks.com.

Ask The Expert is a weekly column on Littlestomaks.com. The idea is to have a reader-submitted question answered by a nutrition expert or a pediatrician. Feel free to submit your question in the comments section below.

Growing children need both calcium and iron in their early years. This week, Registered Dietitian Cindy Williams explains why you need to balance milk and meat for your toddler so he doesn’t miss out on these critical minerals.

Question: How much milk and meat should I feed my child?

Answer:

Milk

Milk is an excellent source of calcium. Children need plenty of calcium to build strong bones and teeth. Up until 12 months a baby should not drink cows’ milk because the protein is too large for the baby’s immature digestive system. After 7-8 months babies can have a little cooked cow’s milk as part of a milk pudding or custard. Yogurt and cheese are also fine for this age group – and a great source of calcium. Babies who drink cows’ milk before 12 months are at greater risk of iron deficiency.

Up to the age of two children should have full fat cows’ milk. They need the extra energy from the fat for growth. After the age of two toddlers can drink reduced fat milk so long as they are eating a good variety of food.

Up until the age of five, health authorities recommend children should drink about two cups of milk a day. Some toddlers love milk and would be happy to drink it all the time. Stick to two cups a day otherwise they will fill up on milk and have no room to eat their meat and vegetables. Toddlers who regularly drink more than two cups of milk a day are at greater risk of iron deficiency.

In a day they could have milk on cereal for breakfast, a small glass of milk sometime during the day, a little cheese and perhaps a milk pudding or half a carton of yogurt. The amounts will vary according to the child’s appetite. Remember the parent decides the quality and the child decides quantity.

Meat

Meat, especially beef and lamb, is the best source of iron and zinc for a child. The type of iron found in meat is called heme iron and it is easily absorbed. Children can also get iron from non meat foods such as iron fortified cereal, legumes (split peas, dried beans, lentils) and green leafy vegetables. Only about 5% of this iron is absorbed but having vitamin C with the food will increase absorption. Give your child some vitamin C rich fruit such as orange or kiwifruit with their breakfast cereal and they will absorb about four times more iron from the food.

Research has found that children who eat fruit with their meals are less likely to be iron deficient than those who eat fruit between meals.

Babies are born with enough iron stores to last about six months. Premature babies have lower iron stores because iron is mostly stored in the last three months of pregnancy so it is especially important for these babies to start eating iron rich foods sooner rather than later.

At six or seven months a baby can eat cooked, pureed meat, chicken or fish. It provides essential iron for brain development but at this young age is still a top-up after the usual milk feed. By 7-8 months a baby should be eating two or three small meals a day with 2 tablespoons to 1/2 a cup per meal. Increase the amount gradually before increasing the number of meals. Include some cooked minced meat with mashed vegetables most days.

A one year old needs more iron than his or her dad. It is vitally important that toddlers get enough iron from their food. This is when their brain is developing the most rapidly. If they miss out on iron at this stage their brain will not develop to its full potential – and they can’t make up for it later. The American Academy of Pediatrics recommends two serves of meat (or protein equivalent) a day for children under six years. A serve is 1oz of meat, fish or poultry or 1 egg or 2 tablespoons peanut butter or 4-5 tablespoons legumes. Remember to give your child an orange or piece of fruit with the egg, peanut butter or legumes to increase iron absorption. Give your child a mixture of meat, chicken, fish and vegetarian meals each week. Variety is good for both their health and training their taste-buds to enjoy different flavours.

KEY POINTS

• Don’t drink cows’ milk before 12 months.
• Toddlers should drink no more than 2 cups milk a day.
• Eat fruit with meals rather than between meals.

©2010 Littlestomaks.com. All Rights Reserved

Disclaimer – Information provided in Ask The Expert column on Littlestomaks.com is intended to give you general guidance on a question related to toddler nutrition. It is not meant to be treated as medical advice. You are welcome to contact this expert for a detailed consultation on your specific situation to determine what actions, if any, you should take regarding nutrition and health of your toddlers. We do not recommend you to take any action based solely on the information presented in this column. Experts have agreed to provide their professional opinion on toddler nutrition related questions on a voluntary basis and no compensation is offered to them by Littlestomaks.com.

Can you imagine a breakfast cereal which you can customize based on your own unique tastes? Not happy with the amount of sugar in your favorite cereal? Would like to have more of your favorite yogurt covered raisins and less of the freeze-dried strawberries or blueberries? How about other exotic nuts, fruits and seeds not usually available in standard brands?

Well, now you can! If you live in Germany, UK, Netherlands check out mymuseli custom-mixed cereals! I just returned from a symposium on mass customization, a recent trend of producing custom-made products, where I heard this success story. I wanted to share it with you because cereal is such a common breakfast item everywhere.

You can select your personal favorite museli base, enhance it by adding a variety of flakes, and then choose from a very broad range of fruits, nuts and seeds. Over 75 ingredients are available, which can offer you 566 quadrillion mixes of museli -the question is, which one is yours! They claim certified organic quality ingredients, although the nutritional information about the mixed cereal seems to be missing.

The cereal aisle in a typical grocery supermarket is long and filled with a variety of brands and types of cereals. That is why the idea of custom mix cereal may sound strange, but it seems to have caught on in Europe. What do you think of this idea? Answer the quick poll question below.

©2010 Littlestomaks.com

Ask The Expert is a weekly column on Littlestomaks.com. The idea is to have a reader-submitted question answered by a nutrition expert or a pediatrician. Feel free to submit your question in the comments section below.

Worried your toddler is not getting enough fiber? How much should he consume on average each day? Check out these handy tips from Registered Dietitian Keri Gans!

Question:How much fiber should a 4 year old be getting in his diet? How can I get him to eat fiber rich foods?

Answer:

I really love that you are asking this question. Too many children (and adults) today fall very short on meeting their fiber needs. AND fiber is important for 2 main reasons:

1. Promotes regularity and prevents constipation.
2. May help reduce risk of heart disease and certain cancers later in life.

So how much is needed for our children?
1-3 years: 19 grams
4-8 years: 25 grams
boys 9-13 years: 31 grams
girls 9-13 years: 26 grams

First thing you need to do to get your child to eat fiber rich foods is be a role model. If you aren’t eating them and they are not in your house how can you expect your child to? So pack your kitchen with whole grains, fruits and veggies and encourage your child to eat them the following ways:

1. serve fruit with the skin on them, like apples and pears
2. have fruit cut-up in the refrigerator for easy grabbing, such as pineapple and melon
3. top breakfast cereals with berries instead of sugar
4. serve a breakfast cereal with minimum 3g fiber per serving (if they don’t love start by mixing a lower fiber cereal with it and then gradually increasing)
5. make waffles or pancakes with whole wheat flour
6. use whole wheat bread for sandwiches
7. slice a banana on a peanut butter sandwich
8. whip up afternoon smoothies for a snack that include low fat milk, low fat yogurt and fruit
9. keep raw veggies on hand for munching with lowfat dips
10. make whole wheat pasta and wild rice for the whole family

©2010 Littlestomaks.com. All Rights Reserved

Disclaimer – Information provided in Ask The Expert column on Littlestomaks.com is intended to give you general guidance on a question related to toddler nutrition. It is not meant to be treated as medical advice. You are welcome to contact this expert for a detailed consultation on your specific situation to determine what actions, if any, you should take regarding nutrition and health of your toddlers. We do not recommend you to take any action based solely on the information presented in this column. Experts have agreed to provide their professional opinion on toddler nutrition related questions on a voluntary basis and no compensation is offered to them by Littlestomaks.com.

Getting toddlers to sit down and eat as a family is a challenge for most parents, us included! What we try to do is to spin interesting stories and silly conversations to keep their interest. Sometimes it is the Diesel Food For a Diesel Engine while at another time it might be something like Eating Salad Like a Giraffe! Sometimes it works, sometimes it doesn’t, but when it does, it is a great way of capturing their imagination while stretching your own.

We had another silly, but fun conversation at dinner today. Before I get into it, here is what was served so you get an idea:

1. Fettuccine with Turkey meatballs
2. Green beans with olive oil
3. Mixed salad
4. Plain yogurt, Feta cheese, grated Parmesan cheese
5. Plain milk, water

The twins love to eat pasta with a sprinkle of organic cheese (their word for grated Parmesan cheese). They mostly nibbled on the pasta and took only a few bites out of the meatballs. My daughter tried the feta cheese and a little milk from her glass.

The delicious green beans were not even touched! Our initial offers were met with stubborn resistance from both the twins! I knew I had to think of something interesting to nudge them into at least trying a few of them!

An idea popped into my mind as I announced -

“Hey guys, I am hearing a faint voice from your stomach. Let me get closer and use my special powers to listen to what it is saying”

Daughter: (with a huge grin as she lifted her T-shirt to show her stomach) – what is my stomach saying baba?

Me: Hmm..let me listen. I think it wants to eat a green bean. Just like my stomach…Mmmmm, these beans are d-e-l-i-c-i-o-u-s!

Daughter: (giggling) Really? Give me a bean, give me a bean..

I popped one of those beans in my mouth as I announced loudly “bean coming…bean coming”

It worked…she went straight for the beans and pulled one out from the main dish in the center, imitating “bean coming…bean coming” as if to alert her craving stomach!

Me: Now ask what your little stomach would like to eat next…

Daughter: (lifting her T-shirt) My little stomach, what would you like to eat now?

Me: My stomach says it wants another green bean…

Daughter: Me too, give me a bean, give me a bean…

Bean coming…bean coming….

I had her hooked, and even though I enjoyed it a lot and wanted to laugh out loud, I kept the game going! Popping the whole green beans one by one in my mouth and relishing the rich tomato-onion sauce, I continued to eat while pointing to my own stomach. She imitated my every move and ate a few, one after the other, enjoying the taste and making Mmmm… sounds!

After a while, as she seemed satisfied and full, I asked again – “now what does your little stomach want to eat?”

She paused for a moment and reflected back – “it’s full now, it wants to drink a little milk”

Well done, I thought! I didn’t press any further as she finished her milk and left the table.

Bottom line – get creative, get silly and just try new ways of encouraging your kids to eat more fruits and veggies.

Good luck and let me know how it goes!

Ask The Expert is a weekly column on Littlestomaks.com. The idea is to have a reader-submitted question answered by a nutrition expert or a pediatrician. Feel free to submit your question in the comments section below.

This week, Registered Dietitian Nour El-Zibdeh offers tips for getting enough iron from a vegetarian diet without relying on supplements.

Question: How can I ensure enough iron if my child is on a strict vegetarian diet?

Answer:

Iron is important for health. It is part of hemoglobin, a protein found in red blood cells, and its main role is to transfer oxygen to body tissues and cells.

Too little iron causes fatigue, decreased immunity, and may impair psychomotor development in infants.  Iron deficiency occurs due to three general reasons:

1. increased needs of iron (growth),
2. decreased absorption (iron in the diet comes from sources that are not easily absorbed, such as plant foods),
3. decreased iron intake (low total food intake).

The prevalence of iron deficiency in the United States is low. However, toddlers are at a high risk because they don’t drink or eat iron-fortified formula or cereal anymore, and their intake of iron-containing foods may still be low. Toddlers who are on vegetarian diets, drink more than 24 ounces of milk a day, or suffer from decreased availability of food are at an increased risk.

Type of iron in the diet

There are two types of iron in the diet, heme and non-heme. Heme iron comes from animal sources and is the most easily absorbed. Non-heme iron is the most prevalent in food, found in both animal and plant sources, but its absorption is less efficient and can be influenced by many factors.

When discussing plant sources of iron, two points must be distinguished. First, the amount of iron in plant foods, and second, the amount that is actually absorbed. For example, half cup of soybeans has 4.5 mg of iron, but the fiber and protein in soybeans prevent its absorption. Half cup of tomatoes, on the other hand, has 1 to 2 mg of iron but is easier to absorb.  Vitamin C improves the absorption of iron, while phytates (in bran and whole grains), oxalates (in spinach, rhubarb, strawberries, nuts, chocolate, and wheat bran), polyphenols (in coffee and tea), calcium, and fiber prevent its absorption.

Tips for vegetarian toddlers

1. Offer a variety of plant foods, especially those high in vitamin C. These include guava, lemon, orange, papaya, tomatoes, beetroot, broccoli, cabbage, cauliflower, pumpkin, and turnips.
2. Choose iron-fortified cereals and grains when possible.
3. If you are interested in numbers, toddlers one to three years old need 7 mg or iron a day, and toddlers over four years old need 10 mg a day. Since iron in plant foods is not absorbed entirely, aim for more than the recommended amount from plant foods, not supplements. Here are some foods rich in iron.
4. Don’t give your toddler more than 24 ounces of milk (cow, goat, or soy) a day. Milk is low in iron and high in calcium (prevents iron absorption), and too much can be filling causing your child to be uninterested in other iron-containing foods. Too much cow’s milk can also irritate the gastrointestinal tract and cause bleeding, which will lead to iron losses.
5. Don’t stress about iron deficiency unless your child shows symptoms, which include fatigue and weakness, pale skin, mucous membranes, rapid heartbeat, irritability, decreased appetite, dizziness, or feeling lightheaded.
6. Consult with your pediatrician if you suspect deficiency, and don’t give your child iron supplements on your own. The human body doesn’t have a way to get rid of excess iron, so too much can be toxic and cause organ damage.

©2010 Littlestomaks.com. All Rights Reserved

Disclaimer – Information provided in Ask The Expert column on Littlestomaks.com is intended to give you general guidance on a question related to toddler nutrition. It is not meant to be treated as medical advice. You are welcome to contact this expert for a detailed consultation on your specific situation to determine what actions, if any, you should take regarding nutrition and health of your toddlers. We do not recommend you to take any action based solely on the information presented in this column. Experts have agreed to provide their professional opinion on toddler nutrition related questions on a voluntary basis and no compensation is offered to them by Littlestomaks.com.

Ask The Expert is a weekly column on Littlestomaks.com. The idea is to have a reader-submitted question answered by a nutrition expert or a pediatrician. Feel free to submit your question in the comments section below.

This week, registered dietitian and contributing editor of Parents magazine Sally Kuzemchak offers tips for managing fruit juices in a healthy diet.

Question: Is giving juice to my kids okay as long as it’s 100% fruit juice?

Truth is, if your child eats fruit everyday, she doesn’t need to drink any juice at all. It’s certainly a quick and easy way to fit in a fruit serving and get a day’s worth of vitamin C. But it doesn’t offer any nutritional advantages over fruit. And when you drink juice instead of eating fruit, you miss out on the fiber—something kids (and adults) need more of anyway. One medium apple with skin offers more than 4 grams of fiber, but a cup of apple juice has less than 1 gram. Plus, it’s not hard for a child to meet his C requirements without juice. Just one-half cup of broccoli or sliced strawberries provides more than a day’s worth of the vitamin.

The bigger issue with juice is that a serving provides more calories than a serving of fruit. One cup of orange juice contains about 122 calories, while a whole medium orange supplies just 69. Juice is easy to drink in large quantities: Without the fiber, it’s not nearly as filling as a whole piece of fruit. Children who gulp down multiple cups of juice a day (and many do) can take in hundreds of extra calories—and may start refusing beverages (like water) that aren’t sweet.

That said, if you want to work juice into a healthy diet, here’s how:

1. Stick with the current recommendations from the American Academy of Pediatrics: No more than 4-6 ounces for kids age 1-6 years, and no more than 8 ounces for older children. Diluting it with equal parts water will stretch small amounts further. Make milk the default beverage with meals and water the go-to thirst quencher in between meals.
2. Serve juice in a regular cup at the table (or highchair) with a meal or snack. Avoid letting your child drink juice from a sippy all day, which encourages over-consumption. Bathing the teeth all day in sugar, even the natural kind in fruit juice, can also increase the risk for cavities.
3. Choose 100 percent fruit juice, which will contain more natural vitamins and antioxidants. Fruit “drinks” contain just a little bit of juice and a whole lot of added sugar.
4. Keep only one type of juice in your house at one time, such as a carton of orange juice OR boxes of 100 percent apple juice so kids aren’t tempted by multiple kinds and flavors.

©2010 Littlestomaks.com. All Rights Reserved

Disclaimer – Information provided in Ask The Expert column on Littlestomaks.com is intended to give you general guidance on a question related to toddler nutrition. It is not meant to be treated as medical advice. You are welcome to contact this expert for a detailed consultation on your specific situation to determine what actions, if any, you should take regarding nutrition and health of your toddlers. We do not recommend you to take any action based solely on the information presented in this column. Experts have agreed to provide their professional opinion on toddler nutrition related questions on a voluntary basis and no compensation is offered to them by Littlestomaks.com.