Nutrition - Early childhood

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Early Childhood Nutrition FAQs

WHAT FOOD GROUPS SHOULD I FEED MY CHILD?

A very generalized diet should consist of a caloric macronutrient breakdown with 20 percent protein, 30 percent fat, 50 percent carbohydrates. 

HOW MUCH FAT IS OKAY FOR MY CHILD?

Fat consumption is necessary for the transport of vitamins as well as for essential fatty acids (omega 3 and omega 6 groups). Fat should not be restricted for children younger than 2 years. For children older than two years, fat intake can be decreased to 40 percent of caloric energy intake, but should not be restricted below 20 percent. Parents should be advised to feed primarily unsaturated fatty acids. Saturated fats like those from dairy and meat products should comprise less than 10 percent of all fat intake. Trans fats should be avoided.

HOW MUCH SUGAR IS OKAY FOR MY CHILD?

Added sugars should be avoided in infants <2 years. For children older than this, added sugars should be limited to 100 calories daily; this is equal to 2 tablespoons of sugar. Fruit juice should only be given if it is 100% fruit, and should be limited to 4-6oz per day.

HOW MUCH SODIUM IS OKAY FOR MY CHILD?

Sodium should be limited to less than 1500 mg for toddlers, and less than 2000 mg (<1 teaspoon) for school aged children.

HOW MUCH FIBER IS ENOUGH FOR MY CHILD?

Dietary fiber amount should be increased yearly up until adulthood, so that a child’s daily consumption of fiber equals their age plus 10 mg. So a 5 year old child should consume 15mg of fiber daily, while a 15 year old teen should consume 25 mg of fiber. One serving of fruit is approximately 3mg fiber.

I AM WORRIED ABOUT A PEANUT ALLERGY. WHEN SHOULD I FEED MY BABY PEANUTS?

In a study of 600 children with family history of atopy, the LEAP study showed that children who were introduced to peanut protein early at 4-6 months were 86% less likely to have a peanut allergy at age 5. Even among children who exhibited sensitivity to peanut protein on skin prick testing during infancy, early exposure to peanut protein demonstrated a 70% risk reduction for developing peanut allergy. The EAT study, which followed infants from the general population showed congruent benefit to early introduction. 
The suggested approach for most infants is to trial highly allergenic foods with an oral anti-histamine readily available at 4-6 months. For those infants who have already demonstrated highly allergenic features (eg. refractory atopic dermatitis despite treatment, previous signs of immediate allergic reaction), referral to allergy testing is appropriate. This approach applies to all highly allergenic foods including peanuts, egg, shellfish, etc. Cow’s milk is the exception, which should not be introduced until 1 year of age.

References

1. Butte NF, Fox MK, Briefel RR, et al. Nutrient intakes of US infants, toddlers, and preschoolers meet or exceed dietary reference intakes.  J Am Diet Assoc. 2010

2. Beck AL, Heyman M, Chao C, Wojcicki J. Full fat milk consumption protects against severe childhood obesity in Latinos.  Prev Med Rep. 2017

3. Rolland-Cachera MF, Akrout M, Péneau S. Nutrient intakes in early life and risk of obesity.  Int J Environ Res Public Health. 2016

4. van Gijssel RM, Braun KV, Kiefte-de Jong JC, Jaddoe VW, Franco OH, Voortman T. Associations between dietary fiber intake in infancy and cardiometabolic health at school age: The Generation R Study.  Nutrients. 2016

5. Michaelsen KF, Greer FR. Protein needs early in life and long-term health.  Am J Clin Nutr. 2014

6. Hauk L. Peanut allergy prevention: guidelines from the NIAID.  Am Fam Physician. 2017