Kimberly Hudson, MD, Lexington Clinic Pediatrics and Internal Medicine
As I raise my second daughter, who is now 2, I continue to marvel at my own mistakes and insecurities. I know that it is normal for the appetite of a child between the ages of 1 and 5 to decrease and I know that it is usual for a child in this age range to gain only 3 – 4 pounds per year. Yet, I am still influenced by my husband and my mother who both comment that my younger daughter “doesn’t eat enough”, “is picky”, and “doesn’t eat as well as her older sister”. I have to continue to remind myself that her growth is normal, that she is, in fact, larger in both height and weight than her older sister at the same age, that she eats quite regularly, and that children, toddlers especially, are very good at regulating the amount of food they eat to meet their growth and activity needs.
I do acknowledge that she is a picky eater, a common toddler trait. My daughter will only eat meat in the form of bacon and fish sticks. My main concern for my child who doesn’t eat much meat is that she won’t get enough iron in her diet, which can lead to iron-deficiency anemia, which could cause some decrease in her cognitive ability (i.e. her smarts). Now, I don’t stay up nights worrying about this, because it is pretty easy to get the recommended daily amount of iron in a diet limited in meat, or even in a vegetarian diet, one just has to be conscious of the task. (A child between the ages of 6 months and 10 years should get about 10 milligrams of iron per day.)
We offer our daughter other meats when we eat them, but do not require her to try them. Fortunately, she does like peanut butter, peanuts, cashews, other nuts (sometimes), and dried fruit. We incorporate these into her daily diet to be sure that she gets enough protein and iron. In order to be sure she gets enough iron, we also give her ½ of a children’s chewable vitamin 2 – 3 times per week (when we remember, or when she and her sister request them). We also look for iron-fortified snacks, such as crackers, cereals (I look for the ones lowest in sugar), and bread products (including frozen waffles and pancakes). Other foods (not an all-inclusive list) which are good sources of iron include eggs, spinach, broccoli, molasses, sweet potato, and peas. We are still working on expanding our daughter’s diet to include these and many other foods.
I have to keep reminding myself that you can’t force a child to eat, pee or poop. I also have to remind myself that I need to relax, offer healthy choices, encourage active play and exercise, and the rest will work itself out.