JoanAvolio  By Joan Avolio, R.D., L.D.N.


In 1983 Ellyn Satter, RD wrote Child of Mine: Feeding With Love And Good Sense, a book about nutrition for lactating mothers and their infants and toddlers.  Nearly thirty years later, I use this book as a reference in my practice because most of what she wrote then still holds true today.  She believes that as a parent you are responsible for what your child is presented to eat, and they are responsible for what and how much they will eat.  Mealtime is an opportunity to teach your child many lessons in addition to just eating.  In today’s fast-paced world of working and running to activities classic mealtimes may be difficult to accomplish.  Here is a list of advice that can help instill healthy eating patterns in children and aid in preventing childhood obesity:

  1. Have your toddler sit at the table and eat with the rest of the family.  Make sure they are in a seat that is comfortable and works for their size and stage of development (highchair, booster seat, etc.).
  2. Minimize distractions — turn off TV and don’t allow older children (and adults!) to text, email, or play video games during a meal.
  3. Provide healthy, balanced meals for the entire family. Work towards feeding your toddler the same foods that your family eats with texture modifications as needed.
  4. Avoid making typical “kid items” (mac-n-cheese, chicken nuggets, pasta) when your child won’t eat what you are serving.  This just reinforces their reliance on and taste for prepared foods, and gives them no reason to ever try or develop a taste for more grown-up, regular foods.
  5. Snacks should be real food (fruit, veggies, yogurt, cheese, meat) most of the time.  Since some toddlers can’t or won’t eat too much at one time, utilize snack time to round out a healthy diet.
  6. Beverages should be white milk (2% or lower, depending on the child) or water.  Limit juice to 1 serving/day:  more can actually lessen a child’s appetite so they won’t be as interested in eating a meal.  Steer clear of flavored milk, juice drinks, and soda.
  7. Don’t force, fight, punish or reward with food.   As parents we can encourage our child to try or take a bite and praise them when they do, but it is not a good idea to make a child sit at the table until they have cleaned their plate or eaten all their vegetables.  (I have never met an adult who was forced to eat their brussel sprouts who actually eats them now, so I know this does not work!)
  8. It can take up to 17 exposures for taste buds to adjust to a new food!  With that in mind, be patient and keep offering new foods.   What doesn’t work today may work next week or in a few months.


Cause for Concern

While it is common for toddlers to change their food patterns, preferences, and intake without adverse effects on health, it is important for parents to know when their child is really not getting enough nutrition and when intervention is needed.  Contact your pediatrician if your child refuses to eat or drink for more than a day in the absence of illness, has a significant decrease in urination, or experiences weight loss.  Height, weight and head circumference are measured at well checks to insure your child is growing appropriately and getting the nutrition they need.


** Joan Avolio is a registered dietician.  She sees children and their families at the Arcadia Division of Pediatric Alliance.  Joan is a regular contributor to The PediaBlog.  You can read her Taste Buds columns here.