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NUTRITIONAL GUIDELINES

One of the most important discussions you’ll have with your pediatrician at each and every well visit centers on nutrition. While the science about which foods are healthiest and best to start at which time is always evolving, there are some general guidelines we can follow to make feeding your baby or young child as optimally healthy as possible. Note, this article does not take into account food allergies or sensitivities, which should be reviewed, based on your family history, with your doctor.

Babies (age 0-1)

Breastmilk (or formula) provides all the needed nutrition for babies from birth until approximately 6 months of age. Exclusively breastfeeding moms need to mind their nutritional balance, especially for calcium, iron, vitamin D and DHA, so that their babies are getting these nutrients. 6 months is a good time for introduction of solid foods to introduce nutrients for which babies have an increasing need – and they are developmentally ready in most cases to learn to enjoy eating solids.

Vitamins – Fruits and vegetables are ideal sources of most vitamins, including A, B and C. Vitamin D mainly comes nutritionally from fortified dairy products, and yogurt can be a good additional vitamin D source. Babies need at least 400IU vitamin D per day. Minerals – Iron and calcium are the two major mineral needs for children. Iron sources include fortified grain cereals, meats, eggs, lentils, and leafy green vegetables like spinach and kale.

Starting at 6 months of age, kids needs need at least 10mg iron per day. Calcium is also found in leafy greens, along with dairy products like yogurts and cheeses. Babies need about 200mg calcium per day. Proteins – Many pediatricians used to advise waiting on protein introduction until at least 9 months, but more recent studies have led to loosening these recommendations to begin introduction at 6 months. Depending on dietary preferences, protein sources can include meats, eggs, fish, beans, lentils, soy and even nut and seed products. Grains like quinoa are also great lesser-known sources of protein.

DHA – One of several essential fatty acids needed for optimal brain development, DHA is found fish like salmon, algae, flax seeds, and fortified foods like eggs and cereals. The optimal doses of DHA per age are not known, but general guidelines recommend 125-250mg per day for babies.

Toddlers (age 1-3)

The major shift at one year of age often is the introduction of dairy as a major source of protein and calcium. Breastmilk remains an optimal choice even after a year of age, but many families opt to use cow’s milk products as sources of these nutrients. Other sources of calcium include almonds, leafy greens, figs and blackstrap molasses. Toddlers need about 700 mg calcium and at least 600IU vitamin D per day. For those families who did not introduce certain proteins prior to a year, fish rich in DHA and nut- and seed-butters offer tasty new options.

Proteins should typically make up to about 20% of the toddler diet. DHA at this age is typically dosed at 250-500mg per day, but again, these are general guidelines not based on any clear scientific consensus. Toddlers are also always on the go, so having portable but healthy options becomes more crucial. Smoothies, bars and other snacks can be good meal options, as long as they are made with healthy nutrients like the ones reviewed above.

Preschoolers (age 3-5)

Preschool age children will normally eat more protein (up to 30% of their daily calories) and a greater variety, usually having moved passed the “picky-eater” stage by now. Take advantage of this opportunity by continuing to offer a rich variety of foods, predominantly still vegetables and fruits, with an assortment of lean proteins, whole grain carbohydrates and healthy fats like omega-3’s. Children this age often eat fairly frequently to keep their energy levels up, so make sure to provide healthy snack options with plenty of protein. Preschoolers will need about 750-1000mg calcium per day as well as minimum 600IU vitamin D per day. General recommendations for DHA dosing at this age remain 250-500mg per day.

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Written by:Dr. Lawrance Rosen


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