Nutrition: toddlers and preschoolers

Toddlers and preschoolers are acquiring more dexterity and coordination than in infancy; also their tongue movement is more refined and chewing becomes easier.  As a rule of thumb, a serving size for a child in this age range (2-4) is about 1 tablespoon of each food group per year of age (e.g. a 2 year old gets several 2 TBSP size servings of vegetables, grains, etc. each day).   Toddlers and preschoolers will want to have more control over their eating and drinking than they have exhibited before.  

Tips for parents: 

1. VARIETY: Provide a variety of foods for meals and snacks.  Even if they refuse it, exposing them to a variety of food is one of the best things a parent can do to establish healthy eating habits.  They probably won't be this picky forever.  :) 
2. PROPORTIONS: Remember the rule of thumb for proportion sizes: 1 tablespoon for each food group per year of age.  Give them a small proportion and let them ask for more if they want more.
3. BEVERAGE CONSUMPTION: Limit milk and juice to no more than 24 oz per day.  If possible, avoid giving milk or juice 60-90 minutes before meal time so that they are actually hungry to eat.  Toddlers and preschoolers don't need energy drinks or soda pop. 
4. MEAL TIME PREFERENCES: Try to avoid extreme hot/cold foods since young children tend to not like extreme temperatures.  Also, try to keep foods separate on a plate and present food in fun ways so that the child learns to enjoy eating and meal times.  Make food fun!
5. SELF-FEEDING: For toddlers, try to offer things that are easy for them to grasp since they are learning to feed themselves and want to feed themselves (no, I do it!).  Be patient as they learn to get it into their mouths and as they try using utensils. 
6. VARIETY CONTINUED: Expose them to different textures, even if they initially refuse it (can take up to 20 times exposing a child to a food before he/she will actually eat it)
7. Ellyn Satter's division of responsibility: Parents get to decide WHAT food is being offered and WHEN it is offered and the child gets to choose IF they want to eat it or not and HOW MUCH they want to eat.  Choose your battles: don't force feed or allow grazing (eating whatever they want whenever they want).  
8. SLOWING GROWTH RATE: Children's appetites tend to slow down as they age because they aren't growing as rapidly as they were.  Infants consume the most per kg of their body weight and they grow at the fastest rate.  Toddlers continue to gain weight and grow quickly, but at a lesser rate than they were.  Preschoolers are growing at an even slower rate than when they were toddlers.  It's normal for 3-4 year olds to have a decrease in appetite. They are beginning to grow in spurts instead of at a constant pace.  They will eat more right before a growth spurt and then have a smaller appetite until the next growth spurt.
9. SNACK TIMES: Offer snacks between meals (usually 3 meals per day and 3 snacks per day is about right).  Since children are getting a lot (almost half) of their daily energy requirements from snacks try to provide nutrient dense options for snack time: carrots and peanut butter, raisins, bananas, blue berries, apple bites, whole grain crackers, cheese, cherry tomatoes or grapes (cut in half if you're feeding someone who is 2 and under), edamame or peas (let them shell it since it's fun to do), etc.
10. WHOLE GRAINS: Try to make half of the grains all of your family members consume to be whole grains.  This can include whole wheat bread, oatmeal, tortilla chips (many are whole grain), whole grain pastas, whole grain cereals, or other less common grains like barley.  I've found several cool recipes with whole grains from the  http://www.wholegrainscouncil.org/.  
11. LITTLE HELPING HANDS:  Try to involve children in food planning or preparation as they are able to.  A 2-year-old can help put groceries away or tear the lettuce for a salad.  A 3-year-old can add ingredients to a bowl, stir or mash, and can rinse fruits and vegetables.  A 4-year old can help measure ingredients, set the table, or make sandwiches.  Let them help in the garden if you have a garden and let them pick/gather the fruits or vegetables needed for dinnertime.

Scenario to apply Ellyn Satter's principles to: 

Johnny doesn't want to eat the family dinner and throws his food on the ground.  He drank two cups of apple juice right before dinner and asks for fishy crackers and fruit snacks right after dinner is put away. 

>> next time give Johnny water instead of juice if dinner is going to be ready within an hour or two so that he's actually hungry at meal time.  Give him a variety of foods (including at least one thing you know he likes, maybe bread or corn or strawberries) at meal time.  Explain that throwing food is not allowed during dinner.  If he continues give him a warning that this is his opportunity to eat and the next time for eating won't be until... X (1 hour later, 2 hours later, tomorrow morning?).  Excuse him from the table if he continues to throw food (don't make a big deal about it; let him get down and play on his own while the family finishes dinner).  When he asks for fishy crackers or fruit snacks right afterwards gently explain that dinner just finished it isn't snack time (or breakfast) yet.  When it is time  to eat again the parent decides what is being served--if all he's had is juice and fishy crackers all day offer him something else and give him a choice (would you like strawberries, or yogurt?).  

Trouble-shooting or good things to know: 

• A lot of kids don't like whole groups of food (vegetables for some, meat for others, etc.).  It's normal.  Keep offering them a variety of food from these groups even if they choose not to eat it.  Chances are good they'll learn to like some kinds of vegetables before you send them off to college.  :) 
• Giving your child plenty of opportunities to be active will also help him/her to be more willing to eat.  This becomes more important as they become school-age (6-11).  Plus, it's just a good habit to set for everyone's wellness in your family. 

Estimated energy requirements (RDA):

1-3 year-olds need about 102 calories per kilogram of body weight per day

4-6 year-olds need about 90 calories per kilogram of body weight per day

(example: a 3 year old weighing 30 lbs (13.6 kg) would need between 1350 and 1400 calories per day)

*Energy needs also vary based on how active the child is.  

Macronutrient distribution:

Carbohydrates (% calories): 45-65% calories

Protein (% calories): 10-30% calories

Total Fat (% calories): 10-35% calories