Healthy Eating for 6 to 24 month old children (3)
Ready to go (12- 24 months)
- Eating behaviours of children at 1 to 2 years old
- Combining foods to make a balanced diet
- Weaning from the bottle
- How to arrange daily meals?
- Offering foods of various textures
- Helping your child to eat properly
- Do these things happen during your child's mealtimes?
- Making mealtime enjoyable
- Developing proper mealtime behaviour
- Picky eating
- Establishing a healthy lifestyle
- Reminder to parents
Eating behaviours of children at 1 to 2 years old
- Children like eating and sharing food with the family;
- They can use a cup to drink and use a spoon to feed themselves;
- They are less willing to taste new foods than before;
- They get impatient if the mealtime is too long;
- They do not eat much at a time;
- They use actions and words to tell you what they want to eat, and indicate when they are full.
Your child's growth
Your child still grows quickly but weight gain slows down after he is 1 year old. As he grows taller, he may look less chubby.
Combining foods to make a balanced diet
(Watch related video: http://s.fhs.gov.hk/myjdj)
- Include foods from the 5 food groups for your child every day;
- Offer a variety of foods in turns;
- Offer your child a suitable amount of milk;
- Continue to breastfeed your child.
Daily menu for your child
- 1 to 2 bowls
- Include some whole grain foods, such as brown rice and whole wheat bread.
Fish, Meat, Eggs and Beans
- 2 to 4 heaped table tablespoons;
- Avoid eating large predatory fish (such as swordfish, sharks or large tuna);
- Store and defrost frozen meat properly. Frozen and fresh meat provides similar nutrients.
- 4 to 8 heaped table tablespoons
- ¼ to ½ bowl of fruit slices;
- Fruits provide more dietary fibres than fruit juice;
- Offer your child fruits of different colours
Milk & Milk Products
- 360 to 480 ml
Q&A: Can my child eat food seasoned with salt or sauces?
- A limited amount of salt is fine. High salt intake puts your child at risk for high blood pressure in the future;
- Use ginger, garlic or spring onion as alternatives for seasoning;
- Limit foods high in salt such as sausages, canned foods, foods preserved in salt, and savoury snack.
- Use a suitable amount of vegetable oil when cooking.
For more information, please refer to the food exchange table in the booklet “7-day Healthy Meal Planning Guide for 6 to 24 month old children”.
A suitable amount of milk
(Watch related infomation: http://s.fhs.gov.hk/aify0)
- Continue breastfeeding your child until she is 2 years old or older
- Breastmilk provides her with antibodies against infection, and is also beneficial to your child's and your long-term health.
- As your child eats a variety of foods in her meals, milk is no longer the major source of nutrients;
- Your child can drink 360 to 480 ml of milk a day. Offer her milk two to three times a day;
- You can serve milk (about 120 ml) in a small cup with other food at breakfast or as a snack;
- Drinking too much milk will reduce your child's appetite for other food.
Milk and dairy products
- A child over 1 year old can switch to drinking full-fat cow's milk;
- You can choose fresh cow's milk, ultra-high-temperature (UHT) milk, or full-fat milk powder;
- Parents can give yoghurt or cheese in place of milk for some variety;
- When your child reaches 2 years old, she can drink low fat milk;
- Formula milk contains more iron and vitamins than fresh milk. For children who eat little solid food or meat, or are vegetarians, drinking a suitable amount of formula milk can provide additional iron;
- Do not substitute cow's milk by condensed milk as it is high in sugar.
The amount of calcium provided by 120 ml cow's milk is same as one slice of cheese or about 100 g of yoghurt.
Note: Children with cow's milk protein allergy require special formula. Please consult a health professional for more information.
Weaning from the bottle
Staying on the bottle too long can:
- Cause tooth decay in young children;
- Reduce children's appetite for other foods, as they tend to drink more milk;
- Cause children to become overweight. Wean your child from the bottle when he reaches 1 year old. Weaning becomes harder as he gets older.
Help your child give up the bottle
- First, replace the bottle with a cup for one feeding during the daytime;
- When he gets used to it, switch him to a cup during other milk feedings. By 18 months, stop using the bottle entirely.
- Let him use a training cup for milk, or drink with a straw. You should sit close to him to help him if necessary;
- Avoid offering your child a cup at the place he is normally bottle-fed;
- If he demands a bottle, offer a pacifier or a bottle of water to comfort him.
Tips for parents
- Your child may protest at first. Be persistent. Respond by giving hugs and kisses rather than giving in;
- Ensure that the whole family works together during the weaning process. This helps your child get through weaning smoothly.
How to cut out the bottle before bedtime?
Note: Avoid exciting activities before bedtime.
- If necessary, give your child some food or milk as the evening snack.
- Then brush his teeth, and lead him to bed.
- Cuddle him and read picture story books with him. As he calms down, he will fall asleep.
How to arrange daily meals?
- Children need 3 meals plus 2 or 3 snacks a day;
- Parents should provide a healthy snack 2 to 3 hours after the main meal to top up her intake of energy and nutrients;
- Arranging your child to dine with the family;
- Organising a regular meal schedule that matches with the family's and the child's routines.
Sharing family dishes
- Provide choices in each meal by preparing 2 to 3 dishes with at least 3 to 4 kinds of food;
- Include both foods that she likes and foods that she is not familiar with or dislikes.
Q&A: My baby is sometimes picky with food and eats little. Does she get enough nutrients?
- Children's appetites change from day to day. Their likes and dislikes of food also vary. They will eat more on certain days and less on the other days;
- Offer your child foods from each food groups in appropriate proportion. Over a period of 1 to 2 weeks, she will get on average what she needs.
Tips for parents
- Sleepy children do not want to eat;
- Avoid giving frequent snacks as this may reduce your child's appetites for main meals.
Choosing snacks for your child
- Choose foods that are not usually included in family dishes;
- The portion size should be smaller than that in the main meals;
- Sweet foods should only be offered occasionally.
- Limit fruit juice to 120 ml per day and offer juice in a cup. Juices or sugary drink are not alternatives to water.
- Read the nutrition labels for lower sugar, sodium and fat options when buying processed food.
- Fruits, milk, plain yoghurt or cheese, bread, sandwiches, oatmeal, steamed sweet potato and boiled corn can be offered to your child more often.
- Sweetened food should only be given occasionally. Examples are fruit yoghurt added with sugar, plain biscuits, muffin, fruit juice, raisins, breakfast cereals, Chinese bean dessert with kelp or tofu pudding etc.
Adequate water intake
- Offer your child water to drink after meals or snacks and after physical activities;
- When the weather is hot or your child has a fever, she needs more water;
- Put small cups filled with water in places within her reach so that your child can help herself.
Q&A: How can I tell If my child has enough water?
His water intake is adequate if he passes urine once every 3 to 4 hours. The urine should be light in colour and the smell should not be strong.
Offering foods of various textures
- After 1 year of age, children can chew and swallow food of a range of textures. They may prefer to eat soft rice rather than congee;
- When the molar teeth appear, they can try more stringy or firm foods;
- At around 2 years old, children can eat most of the family foods.
An example of dishes for child about 1 year old
- Thick congee or soft rice
- Soft chopped meat and vegetables
An example of dishes for child about 1 ½ years old
- Soft rice
- Small pieces of vegetables and meat
- Short pieces of noodles
- Thin slices of fruits
An example of dishes for child about 2 years old
- Rice with texture similar to that of adult rice
- Short pieces of noodles
- Small cubes of meat and vegetable strips
Tips: Some children do not like to eat foods mixed together. Some do not like to eat food with sauces.
Beware of choking
Children should eat only when seated. This prevents choking. Cut grapes, cherries or other small and roundish fruits into small pieces for young children. Avoid the following foods which can easily cause choking:
- Whole nuts, peanuts and candies, etc.;
- Roundish springy-texture foods such as meatballs (fish balls, etc.), mini-jelly, sausages and siu mai;
- Sticky foods such as sweetened glutinous rice dumplings and marshmallows.
Helping your child to eat properly
(Watch related information: http://s.fhs.gov.hk/j34up)
Apart from providing a variety of foods, it is also important to set up mealtime routines and prepare your child for meals:
Setting up mealtime routines
- Provide your child with 3 main meals plus 2 or 3 snacks at regular times;
- Let your child eat at the dining table with the rest of the family;
- Seat your child in the same place;
- Avoid offering snacks or drinks within 2 hours before or after meals;
- Allow a set time of 30 minutes for each meal.
When he sees the family eating the same food, he will be more willing to try it.
Parent's Concern: Just 30 minutes! My son won't eat enough in such a short time!
Toddlers' tummies are small. Usually they get full within 20 to 30 minutes. Instead of getting them to have a big meal, offer them healthy snack in a few hours to get another “shot” of nutrients and energy.
Preparing your child for meals
- Get your child ready by doing a regular activity, such as washing his hands. It tells him that "It is time to eat";
- Take your child to the dining table only when the food is ready;
- Remove distractions: turn off the TV, put away toys and items that may harm your child.
Do these things happen during your child's mealtimes?
Parents use many methods to feed their children, so that they would eat more. These methods may cause mealtime problems rather than helping children to develop good eating habits.
Pitfall 1: Feeding your child when she has just woken up or is playing excitedly.
- Possible outcome: When children are not yet ready to eat, they will throw a tantrum and refuse to eat.
- Suggestion to parent: Set some routine activities with your child 10 minutes before the meals to prepare her for eating.
Pitfall 2: Your child usually eats or is fed alone.
- Possible outcome: Eating alone reduces appetite. It is harder for her to adapt to eating a variety of foods.
- Suggestion to parent: Plan and make arrangements so that she can eat with you or other caregivers.
Pitfall 3: Giving your child a snack or milk very soon after a poorly eaten meal.
- Possible outcome: Your child will learn that "If I refuse to eat the meal, I can have the food I like." She will get more fussy during mealtimes.
- Suggestion to parent: Provide a choice of 2 to 3 dishes on the dining table; if needed, offer the snack slightly earlier.
Pitfall 4: Giving your child toys to play with and following your child around to feed her.
- Possible outcome: This teaches your child that playing or running while eating is the right thing to do during mealtimes. She may also overeat. Running while eating increases the risk of choking.
- Suggestion to parent: Seat her on the chair to eat. Stop feeding when she indicates that she is full.
Pitfall 5: Offering too much food to your child
- Possible outcome: Forcing him to eat all his food can stress him out.
- Suggestion to parent: Give your child a small amount of food first; wait until he asks for more.
Pitfall 6: Offering your child only her preferred foods.
- Possible outcome: Lack of chances to try other foods will turn her into a picky eater.
- Suggestion to parent: Include both foods that she likes and dislikes in her meal.
Pitfall 7: Not letting your child feed himself
- Possible outcome: Your child lacks participation. This makes eating uninteresting and he will be easily distracted. It prevents him from mastering self-feeding skills.
- Suggestion to parent: Even if your child is not proficient in using utensils, you should still give him the opportunity to try feeding himself, so that he can gradually master the skills.
Making mealtime enjoyable
- Chat with your child, describe what he is eating and praise him when he behaves well;
- Avoid rushing your child or giving negative comments as this may reduce his appetite;
- Stop feeding your child when he indicates he is full.
Encourage your child to feed himself
Let your child feed himself while you are feeding him. An 18 to 24 month-old child normally can feed himself. You can:
- Give him a spoon to use, while you feed him with another one;
- Supervise and assist him;
- Gradually give him less help so that he learns to eat independently;
- Give lots of praise.
Q&A: Has my child eaten enough?
Toddlers can express themselves when they have eaten enough. Do not pressure them to eat more.
When a toddler is full, he will:
- Appear distracted;
- Hold food in his mouth;
- Play with the food;
- Shake his head, push the spoon away, or have a tantrum when offered food;
- He may tell you he is done and leave his seat.
Developing proper mealtime behaviour
(Watch related video: http://s.fhs.gov.hk/j34up)
Children love parents' attention. When your child behaves well, give her your attention and praise her right away.
Praise your child as she behaves well
- Smile at her, pat her nicely or raise your thumb when she cooperates, such as when she sits properly on her chair, or tries a new food;
- Let her know what she did well, such as saying "You sit down and eat nicely! This is lovely!", rather than "You are not running around today".
When your child misbehaves
- Find out if she has already eaten enough;
- For minor misbehaviours, such as crying, playing with food or spoons, or other attention-seeking behaviours, it is best to use the "planned ignoring" strategy.
- Step 1: Make sure she is safe;
- Step 2: Do not give her any attention;
- Note: When she receives no response from you, her behaviour may get worse initially. If you persist, she will stop as she learns that such behaviour cannot draw your attention.
- Step 3: As soon as she stops the misbehaviour, attend to her right away. Direct her attention to the meal again;
- Step 4: When she is cooperative and continues to eat, praise her.
- By following these steps, your child will understand that she cannot gain your attention with tantrums.
Tips from Psychologist:
Reacting to your child's misbehaviour by shouting at her or wiping her face makes her more likely to misbehave to get your attention. All family members should handle the child's misbehaviours in the same way.
Parenting Series (8) - "Discipline Your Toddler in a Positive Way" gives you more tips on managing toddlers' behaviours.
Beginning in the second year, it is common for children to become "picky" eaters. Most will improve with time. Handling this properly will prevent your child from developing bad eating habits.
Why do children become picky?
- Children at 1 to 2 years old become guarded in trying unfamiliar food;
- Some have strong likes and dislikes;
- Some are sensitive to a particular food textures or flavours;
- Drinking too much milk leads to loss of interest in foods.
Dos and Don'ts with picky eaters
- Eat with your child as often as you can and eat the food that he dislikes with him;
- Provide choices by including 3 to 4 kinds of food at each meal;
- Cook and present the food in different ways, such as offering tomato puree soup in place of tomatoes;
- Help your child become familiar with the food by showing him the real food or pictures of it.
- Mix the food that you want your child to eat with his preferred food;
- Tell him that he will get a reward if he eats the food he dislikes;
- Plead or nag him to eat;
- Offer him his favourite food shortly after a poorly eaten meal;
- Offer only his favourite food;
- Rely on "picky eater formula" to solve the problem.
Will my child become malnourished if he is picky with food?
Eating less of certain foods generally will not lead to malnutrition. You can record the foods and the quantity your child eats over a week for review; if his diet includes foods from the 5 food groups and he is active, he is generally not malnourished. If your child often rejects to eat a certain group of foods, you should consult health care professionals.
Does my son need nutritional supplements?
- Children usually do not need nutritional supplements if they consume a variety of foods and have adequate exposure to sunlight.
- Consult your doctor if your child refuses eating foods in a particular food group, or if you want to give your child supplements.
Establishing a healthy lifestyle
(Watch related information: http://s.fhs.gov.hk/doczw)
Limit sugary, high fat snacks
- Limit cookies, cream puffs, crisps and sugary drinks. Offer these only occasionally as snack:
- Avoid stocking unhealthy snacks at home. This helps you reduce the conflicts resulted from refusing to give your child these foods ;
- Avoid using snacks to soothe your child;
- Do not use snacks as a reward.
Tips:Your child will be much happier if you reward him with your praise, cuddling, a kiss or playing in the park, rather than giving him a snack.
Look after your child's teeth
You should clean your child's mouth and teeth each morning and evening.
When her incisors erupt, you can start brushing her teeth with a soft infant toothbrush and drinking water.
For more information, please refer to the booklet "Oral Health Care for your Children".
Avoid prolong seating
- When sedentary, engage in interactive games, reading and storytelling with caregivers is encouraged;
- For 1-year-old, sedentary screen time (such as watching TV or videos, playing computer games) is not recommended；
- For those aged 2 years, the daily accumulated screen time should be restricted to within one hour. The screen activities should be interactive and educative, and to be carried out under your guidance.
Keep children physically active
Physical activities are important for children. Physical activities help strengthen their bones and muscles and enhance body coordination. Let your children be physically active several times a day in a variety of ways through hopping, running, moving their bodies either by playing at home or getting outdoors.
Provide a safe environment for activities
- Ensure home safety:
- Cover up electric sockets;
- Put a soft mat on the floor;
- Use corner cushions for corners of the furniture.
- Activities in the home:
- Let your child play and jump on the soft mat;
- You can also sing, dance, or play a ball with your child.
- Outdoor activities: Take your child to play in a well maintained playground.
Always keep an eye on your child while he is playing.
Reminder to parents
- At around 6 months old, children should start eating solid food to meet their nutritional needs. They can try pureed or mashed food taken out from the family meals;
- About 2 years old, they should eat family meals with minor modifications. Their milk intake should be reduced to 360 to 480 ml a day;
- Offer your 1-year-old child 3 meals and 2 to 3 snacks at regular times, and arrange him to dine with the family;
- Help your child learn to self-feed;
- Wean your child from the feeding bottle by 18 months old.
If you have any queries concerning child feeding, please consult your doctor or nurse.
For more information about oral health care for your child, please visit: http://www.toothclub.gov.hk.
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