Basic Nutritional Concepts and What Children Need

As parents, we all want to provide our children with the very best. This includes what they are eating on a daily basis. But it can be overwhelming to keep up with the nutritional needs of children as they grow and as family life becomes busier. Parents may feel like they are trying to juggle meal planning, meal prep, arranging seated mealtimes with the whole family, and nutritious variety in food cooked at home that will also be motivating for all family members to eat.

Nutritional Needs of Children

Good nutrition is critical to a child's overall health and development. Nutrition provides children with the required building blocks for physical growth as well as brain and cognitive development. A balanced diet rich in vitamins and minerals also provides the child with immune system support so that they can more robustly fend off common childhood illnesses. Good nutrition supports healthy sleep and contributes to a child's energy levels throughout the day for seated activities like classwork, as well as exercise-related activities. 

Let's start by discussing quantity of food. For an infant, anywhere from 19 to 30 ounces of total formula per 24 hour period split into feedings of about 4-6 ounces at a time is appropriate. The newborn will take in less than this and in smaller feeding sizes as the stomach starts out with an extremely low maximum capacity and then increases over the first month of life. Solid foods in the form of puree or infant grain cereal can be introduced in the 6-to-12 month age range but almost all of the baby's nutritional needs will still be met by breast milk or formula during this time. The baby's weight will triple during the first year, meaning that their nutritional needs are intensive for physical growth. After the first year, weight gain begins to slow down a bit as the child's  rate of size increase levels off. This means that nutritional needs related to quantity of food intake can vary a lot and sometimes toddlers at this stage will eat much less on a day than they had the previous day. This is completely normal as long as there are no other signs or symptoms of illness or otherwise underlying issues. Parents should continue to offer quantities of food that match the child's needs and provide the child with appropriate strategies for refusal perhaps by gesturing "no thank you," providing an "all done" bowl where the child can place food items that they are not going to eat. Once the child reaches around age two, nutritional needs are about half that of an adult's in terms of total calories. This can vary slightly depending on weight and it's always best to confirm individual nutritional needs with the child's pediatrician during well-child checkups. This means that portion sizes of individual meal components will often be much smaller or half the size of what is on an adult's plate. A good rule of thumb for fruits and vegetables is to match the portion size with about the size of the child's hand when closed in a fist. For meat and fish, an appropriate portion size is about the size of a deck of cards or three ounces as opposed to six ounces for an adult. For children ages four to eight, overall caloric needs increase by about 200 to 400 calories a day for a total of 1,200 to 1,400 calories a day, and then again at age nine to 13. This is also the age range where nutritional needs start to vary based on the male or female body. Females ages nine to 13 will require around 1,400 to 1,600 calories a day, while males in this age range will require 1,600 to 2,000 calories per day. By the time the child reaches around age 14, their bodies now have the same nutritional requirements as an adult. This is around 1,800 calories for the female body and anywhere from 2,000 to 2,400 calories for the male body. Of course, these total caloric needs are for growth and development, as well as daily functioning, and don't take into account additional caloric needs related to higher rates of physical activity throughout the day. High rates of exercise can increase total caloric intake required to meet the needs of the child's, teen's, or young adult's body. 

Now let's discuss quality of nutrition within the food that is provided to the child.

1. variety - Children need a variety of foods across grains, proteins, fruits, vegetables, and dairy in order to ensure all of their nutritional needs for macronutrients like proteins, healthy fats, healthy carbohydrates, plus micronutrients like dietary fiber, vitamins and minerals are met. Healthy grain options include whole grain breads, brown rice, and quinoa. Healthy proteins can include lean meats and poultry or fish but do not have to. A vegetarian child can have their protein needs met through beans, eggs, and legumes. For fruits and vegetables, it's usually a good rule of thumb to choose intense colors like very bright and/or dark foods, as the more vibrant a fruit or vegetable is, the more full it is of vitamins and minerals. Dairy options include milk and cheese, and this is also where many children obtain their vital vitamin D, though as an alternative to dairy sources, a child's vitamin D supplement may be used.

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2. what to avoid - Parents and caregivers should limit empty calories, meaning calories that don't have nutritional value, such as soda and pizza, whenever possible. Saturated fats can be avoided by choosing lean proteins and encouraging intake of foods with healthy fat, as well as dietary fiber like avocado. Foods containing high amounts of added sugar should also be avoided as well as foods with high sodium levels. Always check the label on processed foods to monitor high sodium levels before purchasing. Lastly, avoid foods that present choking hazards especially for very young children like hot dogs and hard candies. Grapes and cherry tomatoes should be sliced at least in half before serving to a child, and better still, sliced into quarters for very young children.

Good Nutrition at Home

Maintaining good nutrition at home can be a difficult process for families, especially when both parents work. An additional challenge comes as children get older and start to have commitments outside the home like after school enrichment activities and sports. Families can start small by targeting one area of good nutrition for a week at a time and discussing together. For example, the family might choose to focus on including foods with dietary fiber into their meals throughout the week. Examples of these foods include avocados, sweet potatoes, bananas, lentils or beans, chia seeds, and a vast array of other fruits and vegetables. Families will want to focus on foods that have naturally occurring fiber as opposed to fiber that is added-in during processing, such as some cereal or grain bars. As the family begins to include more foods that have naturally occurring dietary fiber, they will subsequently meet other nutritional goals and targets without specifically planning it. For example, in focusing on eating foods from the above list, the child will become full by eating healthy foods and be less likely to gravitate toward foods with empty calories or other less healthy options. The foods in the above list also include a variety of other beneficial vitamins and minerals in addition to dietary fiber.

Another strategy for encouraging good nutrition at home is meal planning. Meal planning for busy families is best done with some element of repetition while consciously embedding variety into the routine. For example, the parents may plan that every Wednesday night, they make "sheet pan vegetables" to go with the family meal. The process for making the sheet pan vegetables is always the same. Slice the vegetables up or purchase pre-cut vegetables from the grocery store, douse them in olive oil and spices, and bake them at 450 degrees on baking sheets using parchment paper or aluminum foil for easier clean up as an option. However, the actual vegetables themselves can vary based on season and personal preferences of the family members from week to week. This encourages nutrition needs to be met by incorporating variety without requiring too much extra planning. Meal planning and preparation for families can also be made easier by using strategies like cooking as many meals or meal components as possible ahead of time on the weekends for the week ahead, shopping for shelf items like rice in bulk for a month at a time to decrease weekly shopping needs and time, and utilizing crockpot recipes that allow the family to spend less time on meal prep but still enjoy a healthy homemade meal. When in doubt, it is a good idea to keep it simple by applying the guidelines of dividing up the plate by nutritional section and planning the meal accordingly. For example, carrots, brown rice, grilled chicken, and blueberries with a cup of milk can comprise a healthy and delicious meal for a child.

For more "on the go" meals like breakfast and snacks, parents can model healthy choices for the child. It will be much easier for the child to gravitate toward healthy nutrition if this is what they are seeing modeled for them on a daily basis at home. For example, choose an apple rather than chips for a snack. Prepare oatmeal for breakfast and offer the child a sample bite so they can try it as well even if they are not interested in a whole bowl. Have tea after dinner instead of dessert and offer your child some sort of special but healthy treat like steamed milk with cinnamon. Talk about these choices as you are making them and actively discuss nutritional options with your child as they occur in real time to encourage reflection and information seeking around nutritional health.

When time allows, consider incorporating more involved meal planning and cooking or baking projects into family life. For example, select a weekend meal from a recipe book with the child's input. Teach your child how to go through the process of obtaining the ingredients from the store and then engage them in the cooking or baking process. Depending on age, you can create a list, budget, clip coupons, and navigate the store together. This will help to instill a lifelong commitment to nutrition and encourage children to take an active role in planning for their own nutritional needs. When children enjoy participating in the process of meal planning and preparation, they are more likely to maintain healthy eating habits over the longer term and into adulthood.

Finally, it is important for families to continue to take an active role in facilitating good nutrition and monitoring for potential issues, especially as the child gets older. While the parent will want to be conscious of providing appropriate portion sizes according to the guidelines discussed above, it is also important to make sure that children are eating enough according to their body's nutritional needs. Signs of malnutrition or a lack of adequate nutrition include excess sleepiness, difficulty completing daily routines and activities like homework, and overall disinterest in activities that are normally preferred. These signs may often precede a more obvious signal of lack of nutrition like weight loss. If the family has concerns about childhood eating disorders regarding their child, it's always best to seek help from a professional right away and make an appointment with the child's doctor to discuss next steps. Childhood obesity concerns should also be addressed with support from a professional to help the family restructure nutritional routines at home and prioritize steps to take to ensure immediate and long-term health.