Nutrition FAQs

How can my center help to promote breastfeeding of the infants in our care?

Breastfeeding is one of the most important things a mother can do for their newborn. Breastfeeding provides many benefits to both mother and baby. Benefits to mother include losing pregnancy weight faster, decreased risk of breast and ovarian cancer, bonding time with baby, and monetary savings (as parents will not have to buy formula!). Benefits for baby include building baby’s immune system, decreasing risk of allergies, teaching baby to self-regulate and learn hunger cues from a very early age.

As a child care center it is important that you provide parents with this information. When parents arrive to your facility, especially those with a newborn or an expecting mother, provide them with information regarding the benefits of breastfeeding, frequent breastfeeding concerns, or breastfeeding support groups. Visit https://www.womenshealth.gov/breastfeeding/ or https://www.lalecheleague.org/nb.html for more information.

Also, inform parents of the system your center has in place to assist them with their breastfeeding needs. Your center will play a vital role in encouraging mothers to continue breastfeeding while baby is in your care. Make sure your facility can provide the following:

  • Culturally appropriate breastfeeding support materials
  • Proper handling and storage of breast milk
  • Private breastfeeding rooms for lactating mother’s to pump or feed baby

Finally, be available for support. Breastfeeding is not an easy endeavor, and we need to fully support mothers who are committed to providing the best nutrition to their infants. Be accommodating of mothers needs and requests and continue encouraging them throughout the breastfeeding process!

My toddler always wants to watch TV or play video games after child care. Do you have any suggestions on how to increase his physical activity?

oday our children are growing up in the era of technology. Instead of playing outside after school, children are excited to come home and watch their favorite TV shows or play the latest video games. Unfortunately, all of this technology has significantly decreased our children’s play and physical activity. To reduce screen time try some of these suggestions:

  • Remove TV, computer, and other electronics from your child’s bedroom
  • Do not watch TV during meals or homework time
  • Do not use the TV for “background” noise, try playing music instead!
  • Chose which programs you will watch ahead of time and turn the TV off when the program is over

To help your child become more active, try one or more of the following:

  • Play with your child!
  • Play or make up a game that requires movement (think “tag,” “Simon says,” “Red Light, Green Light,” etc.)
  • Enroll your child in an organized sport (soccer, t-ball, gymnastics, the options are endless)
  • Turn on some music and dance!
  • Create an obstacle course and challenge your child to beat their best time.
  • Invite your child’s friends over and encourage outdoor play.
  • Ask your child to teach you any active games he/she played in school that day.

Also, recognize that inactive time does not have to mean TV time– try reading a book with your child or allowing your child to play leisurely with toys. Current recommendations state that children less than 2 should not have access to TV, computers, or other screen time. And for children 2+ it is recommended that screen time be limited to 2 hours per day or less.

Physical activity is extremely important as it will help your child stay healthy and can provide an outlet for them to release their energy. Increased physical activity can even make your child a better student! By releasing their energy through active play, your child may be able to focus more in school or on homework. So get your child off the couch and be an active role model! Chances are if your child sees you having fun while being active, they will want to be more active as well!

For more information and ideas for active play, check out: https://www.choosemyplate.gov/preschoolers/physical-activity.html

Is there a ‘master list’ you can refer me to that clarifies what solids are safe to feed toddlers and twos?

According to the American Academy of Pediatrics, hot dogs are the food most commonly associated with fatal choking among children. Other high risk foods include hard candy, peanuts, nuts, seeds, whole grapes, cherry tomatoes, raw carrots, apples, popcorn, chunks of peanut butter, marshmallows, chewing gum and sausages.

In my opinion, small blueberries should be OK, but could be halved for small children. Raw carrots should be quartered lengthwise, then cut into small pieces. Chicken on the bone may be a risk for some children depending on the cut and cooking method of the chicken, so I would advise that adults remove the chicken from the bone and chop it into small pieces.

To avoid choking, it is important that all foods are chopped into small pieces, and that children are not allowed to eat while running or walking around.

For more information, visit https://www.healthychildren.org/English/health-issues/injuries-emergencies/pages/Choking-Prevention.aspx.

This post was written by Monica Griffin, MS, RD, LD.

Please explain the importance of parents maintaining and modeling healthy eating habits for their families?

Parents or primary caregivers are the most important role models in a child’s life. Children cannot purchase or prepare their own meals, and are therefore dependent on the adults in their lives to provide healthy foods. Children, especially picky eaters, are more likely to eat foods they see their parents and caregivers eating and enjoying.

Providing a positive eating environment is as important a providing healthy foods. Children are born with a natural ability to regulate their food intake, as long as a division of responsibility in feeding is established. Adults are responsible for providing healthy foods at consistent times for young children. Children, on the other hand, are responsible for deciding to (or not to) eat, what to eat from the foods that are offered, and how much to eat. Don’t let yourself become a short order cook by only providing the 1 or 2 foods your child demands. If they are hungry, they will eventually eat, and if they skip a meal, they will naturally make up for it at the next meal or snack. Allow children to eat based on their internal hunger cues instead of forcing them to “clean their plate”.

Here are some other ways parents and caregivers can be healthy role models:

  • Show by example-enjoy healthy foods and beverages in front of your children.
  • Have family meals-sit down as a family to a healthy meal. Be sure to serve the same healthy foods to everyone at the table.
  • Encourage your child to help with grocery shopping and cooking-children are more likely to try a healthy food they helped pick out and prepare.
  • Don’t use food as incentive or punishment-reward with non-food items like hugs, encouraging words, playing a favorite game, or reading a favorite book.

For more information, visit https://www.choosemyplate.gov/food-groups/downloads/TenTips/DGTipsheet12BeAHealthyRoleModel.pdf.

This post was written by Monica Griffin, MS, RD, LD.

What resources are available to encourage healthy eating habits during the prenatal period?

Good nutrition during pregnancy is essential for both mom and baby. Eating well can help mom feel better and more energized, set the stage for an easier labor, and lay the foundation for baby’s health. Because the need for some vitamins and minerals is so high during pregnancy, especially for iron, pregnant women should take a prenatal vitamin. Talk to your healthcare provider to find out which type of prenatal vitamin is best for you.

Each trimester is different, so here are some tips to get you through each:

  • 1st trimester: women do not need any additional calories in their first trimester. A healthy diet including plenty of water and a prenatal vitamin are usually enough to support the developing baby and placenta during this time
  • 2nd trimester: women need approximately 300-350 additional calories in the 2nd trimester. This can be done by adding 2 healthy snacks to your diet, for example, an apple with peanut butter and a handful of baby carrots in the morning, and a bowl of whole grain cereal with low-fat milk in the evening
  • 3rd trimester: women need an additional 400-450 calories. This can be achieved by eating slightly larger portions at 1 or 2 meals or snacks, or by adding another small snack during the day, like a low-fat yogurt, handful of nuts, or hummus with whole wheat pita bread

Your doctor or dietitian may need to modify the above recommendations, depending on your pre-pregnancy weight, overall health, and history of medical conditions during previous pregnancies (like gestational diabetes).

Pregnant moms should avoid alcohol; seafood high in mercury (swordfish, shark, king mackerel and tilefish); undercooked or raw meat, eggs or seafood; deli meats and hot dogs; and unpasteurized milk, juice and cheese (many types of brie, feta, camembert, bleu cheese and Mexican-style cheese). Limit or eliminate caffeine, and talk to your doctor about any herbal teas or supplements you take.

You can get your own customized daily food plan for pregnant moms at https://www.choosemyplate.gov/supertracker-tools/daily-food-plans/moms.html.

You can find more information about nutrition and pregnancy at  https://www.americanpregnancy.org/pregnancyhealth/pregnancynutrition.html.  A pregnancy and nutrition resource list is available at https://www.nal.usda.gov/fnic/pubs/bibs/topics/pregnancy/pregcon.pdf.

This post was written by Monica Griffin, MS, RD, LD.

When the baby is born what type of food can you or do you feed it?

Breastmilk or formula provide all the nutrition baby needs for the first 6 months.  Before 6 months of age, baby’s digestive tract is not ready to tolerate any type of solid food, including infant cereal (which should never be offered in a bottle!). Signs that baby is ready for solid food include the ability to hold her head up, sit up on her own or with little assistance, turn her head from side to side, and when she has lost the tongue-thrust reflex. Babies who are not yet ready for foods still have a tongue-thrust reflex in place, and when food is put on their tongue, they will stick their tongue back out to spit out the food. That’s their way of saying “I’m not ready yet.”

Once baby is ready, around 6 months, their first solid food should provide iron. Examples include plain, pureed meat or iron-fortified infant cereal. Once baby learns to eat their first solid food, you can continue introducing new foods like vegetables, fruits and grains. Read labels to ensure the baby food does not contain added sugars or salt, and stay away from “baby desserts”. Introduce new foods, one at a time, waiting at least 3 days in between to help you identify the cause of any food allergies.

Because all babies are unique, your pediatrician may need to adjust these recommendations to fit your baby’s growth and eating patterns. For more information, visit https://www.healthychildren.org/English/ages-stages/baby/feeding-nutrition/Pages/default.aspx.

This post was written by Monica Griffin, MS, RD, LD.

Is there a law that requires food labels to list ingredients that commonly cause food allergies along with other problems?

The Food and Drug Administration (FDA) requires food labels to clearly identify the 8 major food allergens:

  • Milk
  • Eggs
  • Fish
  • Shellfish
  • Tree Nuts
  • Peanuts
  • Wheat
  • Soybeans

The allergen may be identified in one of two ways:

1. In parenthesis following the name of the ingredient. For example:

Ingredients: Unbleached enriched  flour (wheat), sugar, butter (milk)

2. As a separate statement underneath the ingredients list. For example:

This product contains wheat and milk

The above major food allergens are responsible for 90% of food allergies, however, those with allergies that are not on this list will need to carefully read through the ingredients to ensure the food product is safe to eat. For more information, visit https://www.fda.gov/Food/ResourcesForYou/Consumers/ucm079311.htm.

This post was written by Monica Griffin, MS, RD, LD.

Should a provider inform parents about recent Consumer Reports surrounding arsenic levels of rice and rice products?

Consumer Reports recently tested samples of rice and rice products to determine arsenic levels. Arsenic is a potential human carcinogen and may cause other health problems. The results showed higher than expected arsenic levels in a variety of rice products, like infant cereal, ready-to-eat cereal, brown and white rice, rice cakes and rice milk.

Consumer Reports has published a set of suggestions for rice consumption:

  • Limit infant rice cereal to one serving per day for infants
  • Limit rice cereal to one serving per day for children under 5 years
  • Do not serve rice milk or rice drinks on a regular basis for children under 5 years

If parents choose to eliminate rice cereal from their infant’s diet, it is important that they provide other sources of iron, like pureed beef or chicken, cooked egg yolks and some vegetables like sweet potatoes and broccoli.

A related set of tests published in January also found elevated levels of arsenic in apple and grape juice. Children 6 years and under should limit consumption to 4-6 ounces per day.

The US Food and Drug Administration has not made any specific recommendations for limiting rice consumption, but does recommend eating a balanced diet that includes a variety of grains. You can find more information at https://www.consumerreports.org/cro/magazine/2012/11/arsenic-in-your-food/index.htm#chart and https://www.fda.gov/ForConsumers/ConsumerUpdates/ucm319827.htm.

In regards to posting within individual centers and family home providers, please be sure to check with your licensing consultant regarding specific posting requirements.  Parent who are not aware of the Consumer Report findings may certainly appreciate the posting of information.

This post was written by Monica Griffin, MS, RD, LD.

My 4 year old child only eats chicken nuggets for dinner. If we do not have time to get them on the way home he pitches a fit. How can I help him learn to try something else?

Helping your child develop healthy eating habits can be hard work! The way you feed your child is just as important as what you feed your child. Setting an appropriate division of responsibility in feeding can help make your job easier (www.ellynsatter.com).

  • Parents are responsible for what, when and where.
  • Children are responsible for how much and whether.

This means that a parent’s job is to decide what’s for dinner, when dinner time begins, and where dinner is eaten. However, the child gets to decide how much to eat and whether or not to eat, but from the food that is offered. There may be times when your child chooses not to eat, and that’s OK. Do not become a short order cook and give in to his requests. Accept his decision, and let him know there will be nothing else offered until the next scheduled meal or snack.

When offering new foods, remember that a child may need to see a new food up to a dozen times before deciding to try it. Offer new foods alongside foods you know he will like, and be a good role model by trying new foods yourself. Some preschoolers prefer their foods to be separate, for example, noodles, chicken and vegetables served on the same plate, but not necessarily mixed in a casserole-type meal.

Make trying new foods fun by allowing your child to pick out a new fruit or vegetable at the grocery store, and letting him help prepare dinner. Children that help in the kitchen tend to try and like more foods, feel important and proud of their accomplishment, and are learning early math, science and vocabulary skills. Find more information at www.choosemyplate.gov/preschoolers.html.

It’s possible that your son is feeling very hungry on the way home. Pack a healthy snack, like a piece of fruit, baby carrots, whole wheat crackers or string cheese. If he is not hungry enough to eat a healthy snack, he’s not hungry.

We develop our taste preferences in early childhood, so it’s important to expose young children to a variety of healthy foods. Be patient, and soon your child will get used to eating what, when, and where you choose.

This post was written by Monica Griffin, MS, RD, LD.

I have a parent who wants me to feed a 4 month old a whole bottle at 11:30 AM. Typically he does not want to drink it all and he really fusses if I make him. What should I do?
It sounds like baby is telling you he is done eating, and you are listening! One of the biggest concerns parents have is whether their child is getting enough to eat. Infants should decide how much to eat based on internal hunger cues, and should not be forced to finish a bottle when they are showing signs of fullness. The parent’s feeding instructions may be conflicting with the baby’s internal cues because there is either too much breast milk or formula being offered, or the infant is not ready to eat at 11:30 AM.

You can educate the parent about the following feeding guidelines from the American Academy of Pediatrics (www.healthychildren.org):

  • On average, babies will eat 2.5 ounces of formula a day for every pound of body weight
  • Babies will eat about 3 to 4 ounces per feeding during the first month, and will increase the volume by 1 ounce per month until they have reached a maximum of 7 to 8 ounces.
  • By 6 months, infants will likely eat 6-8 ounces at 4 or 5 feedings over 24 hours.

These are general guidelines, and it’s normal for an infant’s intake to vary from day to day. As baby grows older and the volume of breast milk or formula eaten at each feeding increases, their natural feeding schedule will change to allow more time between feedings. He may no longer be ready for a bottle at 11:30 AM, and you can help the parent identify baby’s hunger signals and work with him or her to adjust the feeding schedule.

If you think the parent is asking you to feed the whole bottle because they are concerned about “wasting” leftover breast milk or formula, ask them to provide 5-6 ounces of milk or formula for each feeding, along with a few additional bottles containing 1-2 ounces in case baby is hungry for more.

Encouraging infants to continue eating after they are full can set the stage for overeating and obesity later in life. Don’t be afraid to educate parents in a positive, supportive way. However, if the parent reports continued feeding problems, encourage them to talk to their pediatrician.

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The Virginia Infant and Toddler Specialist Network is supported by the Administration for Children and Families (ACF) of the U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $5,350,000 with 100% funded by ACF/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by ACF/HHS, or the U.S. Government.