One of the goals behind my Kids Nutrition Series is to help calm the worry that I know (firsthand!) most of you go through. In this post — after some background articles — we are getting to the meat of what it really takes to meet your child’s nutritional needs.
Nutritionists set up food guides with nutrient needs in mind. The chart below, adapted from the Pediatric Nutrition Handbook, reviews the food groups and number of servings that kids need to meet their nutritional needs.
Kids’ Eating Guide
|Food Groups||2-3 Years Portion||Daily||4-8 Years Portion||Daily||9-12 Years Portion||Daily|
|Milk, yogurt, and cheese||1/2 cup||2 cups||1/2 cups to 3/4 cups||2-3* cups||1/2 to 1 cups||3|
|Meat, fish, poultry, dry beans, eggs and nuts||1-2 oz||2 oz||1-2 oz||3 oz||2 oz||5 oz|
|Vegetables||2-3 Tbsp cooked/ few pieces raw||1 cup||3-4 Tbsp/few pieces raw||1.5 cups||1/4 to 1/2 cups/several pieces raw||2 cups|
|Fruit||1/2-1 (small)/2-4 Tbsp canned/3-4oz juice||1 cup||1/2-1 (small)/4-6 Tbsp canned/4oz juice||1 cup||1 medium pieces/1/4 -1/2 cup canned/4oz juice||1.5 cups|
|Grains||1/2 to 1 slice bread/1/4 to 1/2 cup cooked cereal and 1/2- 1 cup dry cereal||3 oz||1 slice bread/1/2 cup cooked cereal/1 cup dry cereal||4 oz||1 slice bread/1/2-1 cup cooked cereal/1 cup dry cereal||5 oz|
Adapted from Pediatric Nutrition Handbook 6th Edition*Calcium recommendations increased to 1000mg for 4- 8 year olds since this chart was developed. Reminders: You can substitute 1 oz meat, fish or poultry with 1 egg, 2 Tbsp of peanut butter or 4 Tbsp of cooked beans. Can offer reduced/low fat dairy after age 2. See our Infant Feeding Guide for details for kids under 2.
This all looks great but what happens when children skip, or skimp on, entire food groups?
I think you’ll find the task of meeting your (imperfect) child’s nutritional needs easier than you imagined, especially after reading the following real-life case studies.
Case Study #1: Shunning Meat
Shannon* was worried that her 4-year-old son, Jack,*didn’t eat many protein foods besides cheese, milk and hot dogs. He was also lacking a bit in the fruit and vegetable department. He refused to take supplements.
Summary of eating: Breakfast is 1-2 bowls of cereal (sometimes fortified other times not) with milk. Lunch is one slice of whole wheat bread with mayo and a slice of cheese (sometimes with avocado) with fruit like apple sauce, grapes or melon and 1 cup of whole milk.
Jack will only eat dinner if it’s quesadilla, hot dog, mac and cheese or breakfast for dinner (pancakes or French toast). He will sometimes eat canned green beans, corn/corn cob, cucumber and carrots. For snacks he gets Trader Joe’s cereal bars, veggie straws, yogurt, graham crackers and pretzels.
On a good food day with no cereal he is still low on vitamin D and potassium, but also iron (50%). He’s getting enough protein as his minimum needs are 19g and he’s consuming 30-50g!
-Add a liquid vitamin D supplement to his milk (The RDA is 600IU). Provide fortified cereal every other day to meet his iron needs. He doesn’t need a multivitamin if he’s consuming fortified cereal (he would get excess nutrients especially for folic acid and vitamin A, if he gets both).
-Use accepted meals to introduce protein sources like mashed beans in a quesadilla and tuna/peas in the mac and cheese. Keep exposing him to different protein sources without pressuring him.
-Serve fruits and vegetables with most meals and snacks to increase his exposure and increase the fiber and potassium. Since he accepts fruit more than veggies, make sure that you vary the fruit (include a source rich in vitamins A and C daily) and always include a bowl at dinner.
Case study 2: No Dairy
Shauna* wrote in about her 3-year-old daughter, Lori,* who skips dairy except for a small amount of cheese. She no longer takes vitamins or the Viactiv chocolate calcium chews that her doctor recommended.
Lori drinks 16 ounces of calcium-fortified orange juice daily and eats a small amount of cheese, about one ounce.
Nutrition assessment: The recommended amount of calcium for 3 year olds is 700mg. Between the amount of calcium in the orange juice and cheese she is getting about 800mg of calcium — more than what is recommended.
-Continue to offer dairy such as milk, yogurt and cheese at meals as her food preferences are likely to change.
-Try smoothies made with milk, soy beverages, tofu and fortified cereal to cut down the orange juice consumption to once daily (preferably only 6 ounces daily).
-Remember that the DV for calcium is 1000mg (what most adults need) so if a food product contains 30% DV, that’s 300mg.
Case Study #3: No Veggies
Jackie* wrote in about her 16-month-old, Charlie,* who eats a variety of foods except for veggies.
Summary of Eating: Breakfast is usually 2 (3-inch) pumpkin pancakes, 1/3 cup of fruit (pears, watermelon or applesauce) and 1/2 cup of milk. The mid-morning snack is whole wheat blueberry muffin – 1/2 regular muffin or 2 mini-muffins and 1/2 cup milk.
Lunch is 2 chicken meatballs made with basil and sundried tomatoes, 1/2 slice of whole wheat bread, mixed veggies (refused), 1/3 cup of diced fruit or applesauce and 1/2 cup milk. The afternoon snack is a homemade smoothie with whole milk yogurt and pureed fruit.
Dinner is the toughest meal because there are only select items Charlie will eat such as a quesadilla with whole wheat tortilla, mozzarella cheese, mashed black beans, 1/3 cup diced fruit and sometimes yogurt for dessert and 1/2 cup milk.
Nutrition assessment: This boy gets a wide variety of fruit (and food in general) so has no trouble meeting his vitamin and minerals needs. Like everyone who relies on D from their diet, he is only getting 30% of the DV. Another potential problem is that he is borderline low in iron (80%)– a big watch out at this age.
-include iron-rich foods such as iron-fortified cereals (good for snacks), raisins, soybeans, beans, meat and shrimp.
-Give him a vitamin D supplement (RDA is 600IU) and keep offering the veggies. Continue to vary the fruit with meals.
-Try to eat the same meal at dinner at least a few times per week. Rotate meals he likes with ones he doesn’t. On the nights it’s a meal that he usually doesn’t eat, provide some sides he likes. The nights it’s a meal he usually accepts, provide sides that are new. He needs the exposure to start trying different foods. See How to Make Dinners More Kid Friendly.
Quick Nutrition Tips
• It’s normal for young children to skimp on certain foods groups but it’s still relatively easy to meet their nutritional needs. Remember that how they eat over time is what matters, not one day or even a bad week.
• Watch your child’s eating pattern. Are they hungriest at breakfast or lunch? That might be the best time to bulk up on nutrition. For example, a 4-year-old needs 3 ounces of protein. Two eggs (or two slices of French toast) in the morning and 2 Tbsp of peanut butter at lunch gets him there. So making him choke down the chicken at dinner isn’t necessary.
• Don’t leave the most nutritious foods for the end of the day (dinner) when children are tired and don’t eat as well. Offer them fruits and veggies all day long along with the other foods groups so you can relax at dinner –and make it about family time.
• If you child doesn’t eat fish, consider fish oil supplements to ensure they get adequate essential fatty acids DHA and EPA. The U.S. is slow to provide recommended dietary allowances. See this article to determine how much your child needs.
• If you child eats more than the recommended amounts — don’t worry. Just make sure they eat at the table and until they are full. Appetites vary greatly in kids.
Did this post help ease your nutrition worries? Or do you have an issue you still want to discuss?
Don’t miss our last post in this nutrition series where we’ll be reviewing the best vitamins.
*Names have been changed to protect privacy