Toddler Food Guidelines

  • Medical Author:
    John Mersch, MD, FAAP

    Dr. Mersch received his Bachelor of Arts degree from the University of California, San Diego, and prior to entering the University Of Southern California School Of Medicine, was a graduate student (attaining PhD candidate status) in Experimental Pathology at USC. He attended internship and residency at Children's Hospital Los Angeles.

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

Quick GuideYour Toddler: Typical Second-Year Milestones With Pictures

Your Toddler: Typical Second-Year Milestones With Pictures

Should I be feeding my toddler low-fat foods to avoid childhood obesity?

Children less than 2 years of age should not have restrictions placed on their intake based upon fat or cholesterol. These both promote brain maturation by providing building blocks for the "insulation" which surrounds nerve cells and thus optimizes their function. However, avoiding "empty calories" such as high sugar foods, foods with high fructose corn syrup, trans fats, and excessive salt is a good idea. Children older than 2 years of age may drink low-fat or nonfat milk, but also need to be wary of excessive juice intake (>4-6 oz/day), "fast foods" which may be laden with high fat and salt content, and soda (both regular and diet).

Should I be concerned that my toddler eats hair, sand, and dirt?

Pica is a "medical disorder characterized by persistent and compulsive cravings to eat non-food items." For infants and early toddlers, this fascination is generally considered age appropriate and exploratory in general. With increasing age, persistence of pica is considered a pathological behavior. Anecdotal information has linked dirt and excessive ice ingestion as indicative of iron, calcium, zinc, or vitamin deficiency. No studies have consistently confirmed these observations. There are, however, known risk factors for several non-food items:

  1. Lead toxicity: paint chips from older homes with lead-based paint
  2. Infection: dirt may harbor soil-borne parasites
  3. GI obstruction: eating hair may promote formation of a hairball (bezoar)
  4. Teeth: dental abrasion and fracture

How do I incorporate breastfeeding into my toddler's feeding schedule?

General breastfeeding guidelines from the American Academy of Pediatrics include:

  • 0-6 months of age: breast milk alone with an added source of vitamin D (unless >17oz/day formula)
  • 6-9 months of age: sequential addition of cereals, vegetables, meats, and fruit
  • 9-12 months of age: introduction of finger foods - there is no clear evidence that avoiding common allergens in the diet is helpful; avoid choking-hazard foods (for example, raisins, and popcorn), however.
  • >12 months of age: continued transition to table foods. Children will commonly prefer finger feeding in lieu of utensils until past 18 months of age. May wean from breast to whole milk -- maximum 15-24oz/day. Introduce sipper cup if not done already.
  • > 2 years of age: table foods using utensils. Can reduce to nonfat or low-fat milk.

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