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.

According to the 2nd edition of the PDR for Nutritional Supplements -

The absorption efficiency of calcium varies throughout the life span. It is highest during infancy when it is about 60%. In prepubertal children, it is about 28%. During early puberty, at the time of the growth spurt, it increases to 34% and then drops to 25% two years later.

How you can use this information -

1. Get your kids to drink milk and eat yogurt at an early age. Dairy is the best source of calcium. Unless you have an allergy problem, this should be your first choice. Milk also has vitamin D which is necessary for calcium absorption.
2. Other sources of calcium and vitamin D – fortified orange juice, cereals, collard greens, broccoli, tofu, salmon, spinach. Offering a variety of food sources in addition to, or instead of dairy, is a good way to get calcium in your child’s growing bones early on.
3. Recommended daily value for children 1-3 years is 500 mg (about 2 cups of milk) and for children 4-8 years is 800 mg (2-3 cups of milk).
4. In addition to food sources, physical activity is also important. Both exercise and nutrition help bones to increase their strength.

Building a calcium reserve at an early age is almost like building a bank balance of good health for the rest of your child’s life.

What has worked well for you in providing adequate amount of calcium and vitamin D in your child’s diet?

©2009 Littlestomaks.com
Information provided in this post is not meant to be treated as medical advice

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, Family Physician and Registered Dietitian Dr. Shelley Meyer explains the recommended levels of vitamin D and A for a toddler.

Question: What is a safe level of vitamins D and A to give a 31 month child that weighs about 40 pounds?

Answer:

Vitamins A and D are fat-soluble vitamins, quite essential to children’s diets.  Vitamin D has been a particularly hot topic in the news lately, due to recent findings that a lot of Americans are deficient, including toddlers and children.  Vitamin D is needed for healthy bones, and a deficiency can cause soft, weakened bones known as rickets, and even lead to osteoporosis.  The recommended daily intake of Vitamin D for infants, toddlers and children has recently been increased from 200 IU to 400 IU.  Sunshine is needed to make Vitamin D into its active form, and little ones tend to be covered in sunscreen to protect their delicate skin, therefore explaining how potential deficiencies can occur.  However, only 10-15 minutes per day is needed to activate this essential vitamin.

It is important to remember that food sources are always better absorbed by the body than supplements.   However, if your child is a picky eater and does not drink Vitamin D fortified milk or eat foods rich in Vitamin D, such as fish and egg yolks, then it can be difficult to meet the daily requirements.  In this case, a simple daily dose of a multivitamin or a 400 IU Vitamin D supplement will suffice.

Vitamin A is generally found in abundance, as long as your child or toddler will eat fruits and vegetables.  Vitamin A is essential for healthy eyes, skin, teeth and bones.  Good sources of Vitamin A are eggs, milk, dairy, carrots, sweet potatoes, cantaloupe and dark green vegetables .   Vitamin A can be toxic in excessive amounts so it is important not to exceed the amount found in a multivitamin, generally 2500 retinol equivalent.

©2009 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.