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TOPIC - Infants & Children
Question
Adults are advised to avoid fats or high fat foods. Children, being active, requires fats to burn off. Is this a fact or fallacy? Or should children also avoid fats to prevent future health problems?
Answer
That is an excellent question. Children under 2 years of age should have full fat foods such as homogenized/whole milk, regular cheese & yoghurt, eggs, and the use of fats & oils does not have to be restricted. Young children require the fat for brain and organ development, as well they require the calorie density to provide them with sufficient calories in a small amount of food. After age 2, you can switch to 2% milk & yoghurt and reduce the use of added fats while maintaining a well-balanced diet.

We use carbohydrate (starches) for energy, rather than fat. So it is better to give children starchy foods such as bread, buns, potatoes, pasta, crackers, etc. to supply fuel for energy. As children get older, it is a good idea to introduce healthy eating habits and gradually reduce the high fat foods in their diet. Emphasize wholegrain foods that are not highly sweetened or salted, lots of fruits and vegetables, and ensure they take at least 2 cups of milk a day. Limit fast food, candy, cakes, cookies, ice cream, etc. and other high-fat foods.
Question
My daughter is 8 months of age and I have breastfed her so far. I am now considering introducing formula/whole cow milk - which of these is a better way to go? Also I want to factor in that she will be going to India and will be exposed to buffalo milk there - will that be a problem?
Answer
Most experts recommend introducing formula if you are weaning a baby under a year old, minimally you should wait till 9 months before introducing whole cow's milk. The reason for this is that the nutrient profile in formula (such as casein to whey ratio, amount of protein, etc.) is closer to that in breast milk. Cow's milk contains a higher amount of protein and places a higher renal solute load on an infant's immature kidneys. Similarly, buffalo milk may be the same although I do not have a full nutrient profile on it.
Question
I have a child who is 6 years and just refuses to take anything that are healthy. How can I ensure he eats healthier? What are his nutritional needs as he is hyperactive??
Answer
It depends on what your child is eating right now and what you define as "healthy" food. The other question is where is he getting "unhealthy" food from? If he is only offered healthy food when he is hungry, what does he do? Will he eat the healthy foods or refuse to eat?

As I mentioned in the previous answer, offer him a variety of healthy alternatives at each meal time. Let him eat what he wants and take the food away when he does not want anymore. Do not offer him anything else, especially unhealthy food if he ask for it. If you persist with this approach, he should come around and start accepting the healthier choices offered. Also do not give him too much juice (no more than 1/2 cup twice per day) or other high-sugar drinks as he could easily fill up on those.

If he is hyperactive & will not sit down long for meals, offer him snacks often. Snacks such as peanut butter sandwich, cheese & crackers and fruit can be important addition to his diet and help meet his caloric needs. If you would like to get a full assessment of whether he is getting enough, see a dietitian.
Question
I have a 2-1/2 old girl who does not eat, she'll go for weeks without, all she asks for is juice. What can I do to increase her appetite? The site of food also makes her revolt, she has sometimes thrown up after taking a few bites forcefully.
Answer
Feeding toddlers can be a challenge. You may want to start by not giving her too much juice. Small tummies gets filled up on juice & the sugar content keeps them going for a while. Offer her water as an alternative if she is thirsty and she may kick up a fuss, but she may be more willing to try some food if she is not filled up with juice.

Continue to offer her a variety of food and have her sit with the rest of the family as you all have your meal, but do not force her to eat. Take away the food at the end of the meal if she does not want anymore, even if she has not eaten or have only taken a few bites. The more you battle with her, the less likely she is to eat. Toddlers have small appetites and do not need as much food as before due to slowing of their growth at this age.

Do not be too concerned about her seemingly not eating for weeks if she is maintaining weight. They only gain 5-6 pounds per year at this stage. If you like more information, read the article on Healthy Eating for Children on the website. Ellyn Satter has a good book on "How to Get Your Kid to Eat....But Not Too Much" (1987) which you may want to check out. Good luck!
Question
I'm curious as to what is the recommended serving size for children in the different food groups.
Answer
The serving sizes given in the Pyramid are for adults. For children, the serving sizes are generally half to three-quarters of the adult serving sizes depending on the age of the child and how active they are ie. 1 slices of bread or 1/2 cup of cereal for one serving. Read the section on Healthy Eating for Children for more information.

The USDA has a booklet on appropriate serving sizes for children in their Food Guide Pyramid for kids (aged 2-6 years).
Question
What are kids overall energy needs? Kids aged from 4 to 6 and is active - what kind of meal (balanced) is suitable for them? What is their nutrition value?
Answer
Please refer to the article on Healthy Eating for Children for information on what to feed a 4-6 year old. Use the Recommended Dietary Allowance to determine the energy needs. For balanced meal plans, you should follow the guidelines of the Food Guide Pyramid for the number of servings, but use child-size portions.
Question
My 7.5 mths old baby has a reflux condition which leads to urinary tract condition. Is it OK to give him cranberry juice which is believed to be good for urinary problem?
Answer
Cranberry juice is found to reduce urinary tract infection in adults, however little research has been done on children. It probably would be alright to give him small amounts of cranberry juice. You can give him up to 4 oz. diluted cranberry juice per day, add equal volume of water to regular strength juice to dilute.
Question
My 13-month old does not like whole milk. I am worried she will not get enough calcium. What is the calcium requirements of one year olds and what other ways can I provide it to her?
Answer
US RDA for a one-year child is 800 mg for 1-3 year olds. There is 290 mg of calcium in 1 cup of whole milk, 220 mg in 1/2 cup of yoghurt and 200 mg in 30 grams (1 oz) of cheese. You can substitute yoghurt & cheese for the whole milk if she does not like it. You could also try giving her different types of milk such as reconstitued full-fat milk powder, continue giving infant formula or follow-up formulas. Sometimes children prefer the taste of one type of milk over another. You can also add the milk powder/formula to food to boost her calcium intake. Some examples of this would be adding it to oatmeal, soups, casseroles and baked goods such as muffins, cookies, etc. You can also give her other calcium-rich foods, see the list in the Focus on Calcium article found in the Healthy Eating section.
Question
Is it ok to serve fish as the main course for my 13 month old baby's daily diet?
Answer
Lightly seasoned steamed fish with no bones certainly make a good choice from the Meat Group for your child. You will want to avoid highly spiced or pickled fish till your child is much older. If you are introducing fish for the first time, give him/her a small amount to try and watch for any signs of allergies. This is particularly true for shellfish (such as prawns, crab, clams, mussels, etc.) which tends to be more allergenic than finfish (such as sole, sea bass, cod, etc.). To balance out the meal for your child, you should serve choices from the other food groups as well but in child-size portions.

For more information, read the sections on Healthy Eating for Infants and Children if you have not done so.

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