Nutrition for babies, toddlers and pre-school children: A Q&A with Frankie Phillips

Question: What's the best healthy option between meals?

Frankie says: There are plenty of options for healthy snacks for kids and the best advice is to go for a variety. This means there are more chances to get in extra vitamins and minerals. Snacks get a bad press, but they can be a really useful part of the diet and one or two snacks can help boost nutrition for children. Fruit is always a good snack, but go for other foods too – yogurt, vegetable sticks and dips, mini sandwiches, rice cakes and oatcakes with a few chunks of cheese.

2. Fussy eating

Question: My youngest is particularly fussy. His fruit and veg intake is basically raisins with his cereal and peas and sweetcorn, which is only on occasion. No red meat or chicken either. I need help.

Frankie says: It’s difficult dealing with children who seem to be fussy eaters, but do be reassured that for most cases it does pass, but in the meantime, try not to worry too much. There are lots of strategies to try, and some of these I’ve put in other posts here. Try to keep a diary of exactly what he does eat - sometimes it can be really useful to get a full idea of what he's eating over a full week.

A sure fire way that helps most people is to get their children involved in the food planning, shopping, cooking. You can also try having friends over to act as good role models - and of course eating together as a family always helps. Red meat and chicken aren't essential, but other protein foods are fish, eggs, beans, peas and dairy foods, so you can include these too. Have a look at the strategies for fussy eating that are on the NHS choices website.

3. Ideal weight

Question: My son is four years old and his weight is 14kg, he is very active and jumping up and down all the time although he doesn’t have any eating preferences, which means whatever I cook he eats. But he can’t swallow meat, he chews and chews but keeps it in his mouth, that’s why I guess his protein needs are not being fulfilled. I want to ask you what is the ideal weight for a four year old and and tips on getting him to eat by himself?

Frankie says: Meat is a good source of protein, but it’s easy to get plenty of protein from non-meat sources, such as dairy foods, eggs, beans and fish, so you can include these as an alternative to meat. Some meat can be tough, depending on the cut used and the way it is cooked, so perhaps you could try casseroling or slow cooking a stew and cutting the meat into smaller pieces to see how he gets on with that.

Having different textures in food is essential for good development so think about how he manages with other tough foods such as jacket potato skin or raw vegetables. As for his weight, there isn’t an ideal weight for age, but your health visitor will be able to see from his growth records if he is about the right weight for his height.

4. Over eating

Question: My daughter won't stop eating. She's 3 years old. She likes to snack (though she eats all of her meals) & I'm running out of ideas as to what to give her that's filling and healthy and relatively low in sugar. She has a very healthy diet and I home cook all of her dinners but she just says she's hungry all day and it's driving me mad.

Frankie says: Your daughter sounds like she may be going through a rapid growth spurt. That, alongside the busy lifestyle that lots of 3 year olds have is certainly giving her an appetite. It seems like you are doing a lot of the right things already, with home cooked food being a great way to know exactly what your daughter is eating, and no added junk! A couple of ideas you may like to try, perhaps she might need slightly bigger portions for some meals, so add an extra spoonful of veg and an extra spoonful of potato / rice / pasta. Add a nutritious pudding too – a milky pudding such as rice pudding with some fruit puree, a fruit crumble with homemade low-sugar custard or a yogurt and some slices of fruit can all help to fill her up and boost nutrition too.

Be aware that some days she might not want as much to eat, and so don’t insist that she finishes every meal. As for snacks, fruit is great, but try mixing things up a bit and go for crumpets or teacakes, or some cheese and crackers or mini sandwiches.

5. Fruit avoidance

Question: My 4 year old has never liked meat or fish (so I provide protein in other ways). She has gone off fruit and veg. I can hide the veg in pasta sauces and soups but how can I hide fruit?

Frankie says: Smoothies can be a good way to introduce more fruit in the diet, but let her help you to make them so that she sees that fruit is in them. You can also try adding fruit purees to natural yogurt – swirl in different colours to make them look good. Hiding fruit and veg can be useful in the short term, but try to re-introduce the whole veg and fruit in as soon as you can – go shopping with her and get her to help you choose things – brightly coloured fruit and veg can often attract attention – and then help you to prepare them to eat.

Make a good example of yourself, always show her that you enjoy eating fruit and veg too as this is a powerful way of helping her see they are an enjoyable part of the meal. Try dried fruit as well – it can be a useful way of getting her back into fruit.

6. Gluten intolerance

Question: Is there any nutritional reason why toddlers might need gluten in their diet? I suspected intolerance and cut it out (since doing so, we've seen a small increase in his growth; he has extreme short stature for his age) but doctors seem skeptical about my choice.

Frankie says: Gluten is a type of protein that is naturally present in wheat, rye and other cereals. It’s not essential to the diet as the protein we need can come from other sources. The problem is that avoiding gluten means avoiding a lot of foods which normally provide us with a good balance of nutrients. For example, bread made from wheat contains gluten, but we also get a lot of vitamins and minerals from bread, so if we stopped eating it, those vitamins and minerals would need to come from another source.

Many people try cutting out gluten, but it’s actually quite rare to have a true gluten intolerance. If you are concerned that your little one might be affected by gluten, your GP can refer on for further tests. It can be dangerous to simply exclude any food groups from the diet without proper advice, so ask to see a dietitian. There is some really useful information about food allergies and intolerances here on the British Dietetic Association website.

7. Lactose intolerance

Question: How do you know if your toddler has become lactose intolerant?

Frankie says: It’s rare for children to be truly lactose intolerant, but if your child is suspected lactose intolerant, your GP can do some simple tests to check. Symptoms often include severe bloating and diarrhoea. Lactose is a type of sugar found naturally in milk and dairy products, and with lactose intolerance, this cannot be digested properly.

However, even people with lactose intolerance can often include some dairy products, especially live yogurt and cheese. Avoiding dairy can have serious nutritional implications for toddlers if there isn’t proper dietary advice – so make sure you see a dietitian who can advise you if your little one is diagnosed with an intolerance.

8. Corn-on-the-cob

Question: Does corn-on-the-cob have nutritional value? Seems as it goes through whole?

Frankie says: Yes, it does appear to go through whole at times! However, the inner part of the sweetcorn kernel is actually digested, it’s just the outer skin, which is mainly cellulose, that isn’t digested. The inside of the sweetcorn is mainly starch, which is broken down and used by the body. The skin is useful as a source of fibre that helps keep the gut content moving and prevents constipation.

9. General meal plans

Question: Kindly send me some menu sample for a 9 month old baby?

Frankie says: It’s a real adventure during the first few months of weaning, so make sure you can enjoy it too. There are lots of useful resources on the web, and some have menu planners with easy recipes to follow. At 9 months, your baby should be trying most tastes and textures, with the aim to move onto family foods around 12 months. Try to get in as many new tastes and textures as possible during this time of the ‘weaning window’.

Got more than one child on your hands? You might also be interested in reading Frankie Phillips Q&A for school children and teenagers.

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Bringing up a fussy eater? We'd love to hear your thoughts and comments.