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Nutrition

• Breastfeeding is best for babies, even if only in the mornings and evenings.
• If breastfeeding is not possible, commercial infant formulas are a good alternative. Formula should be used for the entire first year of life.
• At one year of age, children should be switched to whole milk; at two years they should be started on 2%, 1% or skim milk.
• Solid foods are begun at 4-6 months of age. Start with rice cereal, then progress to barley and oatmeal cereals. Mix cereal with formula or breast milk and feed it by spoon. 100% fruit juices, such as apple juice, may also be started at this time (avoid orange and tomato juice until 8 months of age). Limit juice intake to 4 ounces a day.
• At 6-8 months of age, toast, teething biscuits, plain yogurt, strained or mashed fruits and vegetables are begun. Avoid corn until 1 year of age.
• At 8-10 months of age, add ground or finely chopped chicken, fish and lean meats; egg yolk; mild cheese; thinned peanut butter and cooked dried beans. Peeled soft fruit wedges are begun. Encourage self-feeding of finger foods. Practice with a spoon and a cup.
• At 10-12 months of age, add some raw vegetables, fresh fruits, other cheeses and whole egg.
• Do not give infants honey; it may cause infant botulism, a serious, and sometimes fatal, neurological disease.
• Avoid overfeeding. Stop feeding when baby turns away from food or shows disinterest. While parents are the best judges of when and what infants and children should eat, the child is the best judge of how much to eat.
• Boil any tap water used for feeding infants less than 4 months for at least 2 minutes.
• Cook all eggs well and do not use raw eggs in order to prevent salmonella infection.
• To avoid choking and aspiration, do not feed children less than 4 years of age any hard, small and round or smooth and sticky solid foods such as hard candies, nuts, popcorn or spoonfuls of peanut butter.
• Assure all infants and toddlers are always supervised during feedings.
• Avoid feeding infants by propping a bottle. Never put infants to bed with a bottle, it may cause tooth decay and loss of teeth.
• Do not add sugar or salt to infant's food.

• Offer an adequate amount of a variety of healthful and tasty foods. In the long term, the child will choose a nutritionally adequate diet.
• The use of the Food Guide Pyramid is helpful in assuring that the child gets the right foods in the proper quantities for growth and good health. The varieties of different foods can be started during the first year of life and the minimum number of servings from each food group should be offered beginning at age two years.

• Serve meals and snacks on a regular schedule.
• Teach good manners at the table and set a good example.
• Respect certain food dislikes; substitutes are always available. Fruits may be substituted for vegetables. It is easier and quicker to change the food than it is to change the child.
• Serve small portions; large quantities may frustrate the appetite. If more is desired, additional servings may be offered. Children develop desirable feeding patterns when they feel successful and when negative behavior is ignored.
• Children appreciate simple food that is attractively served. They may prefer raw vegetables to cooked ones. Spicy foods should be allowed according to taste.
• Avoid confrontations at the table. If insistence on good manners interferes with the child's appetite, manners may be temporarily neglected until the appetite improves. Don't discuss disciplinary problems or punishments at the table.
• Mealtime may be so late, or last so long, that the child's appetite is lost. It may be desirable to feed the children before their parents. Once the child's meal is finished, he/she should be excused from the table.
• Children should be included in conversation at the table. If not, disputes over eating may be the only means that the child has of getting attention.
• Children may request feedings 4-6 times a day. This is normal.
• Between-meal snacks should be given midway between meals and offered in small quantities. Juice, fruit or crackers are a good choice. Foods with high sugar and/or fat content, e.g., candy, cake, cookies or milk, may interfere with the appetite at the next meal.
• Avoid the use of dessert as a bribe or reward for eating. If dessert is part of a planned meal, don't insist that the child clean up the plate first. Rewarding a child for a clean plate may cause obesity.
• Children who are denied a meal as punishment may attach unpleasant associations to mealtime. Other forms of discipline should be used.
• Do not expect children to eat anything their parents don't like. Children often copy food habits, likes and dislikes. It is important, then, that parents make wise food choices; actions speak louder than words.
• New foods should be introduced in small portions when the child is hungriest.
• Fatigue, excitement or anxiety may cause temporary loss of appetite in children.
• Self-feeding by children during the first and second year of life should be encouraged and messiness should be expected.
• During the pre-school years, appetites are often erratic, food jags are common and likes and dislikes may change from day to day.
• A good breakfast, including protein, is important in maximizing school performance.

• Healthy eating habits begin early in infancy. During the first year food should be offered only when the infant shows signs of hunger. Older children should be taught to eat only when hungry; food should never be used as a bribe.
• Obesity can be a combination of family traits, inadequate physical exercise and increased calorie intake compared to energy used. It is much easier to prevent obesity than it is to cure it. Once obesity is established, it is extremely difficult to change previously learned habits.
• Putting young children on calorie restriction diets can be very dangerous. A pediatrician should be consulted first in these cases. It may be better to encourage and substitute low calorie, fat-free foods.
• Obese children suffer in various ways. They may grow up to be obese adults with diabetes, heart disease or other health problems. Other children may exclude them from sports and social activities. They are frequently teased about their weight and may become shy and withdrawn.
• Most children will not eat healthy, low-fat foods or exercise regularly unless their parents do the same. Therefore, it is important that parents set a good example in these areas, starting when their children are young.
• Parents can shop for low-calorie, low-fat foods and keep them stocked in the pantry for meals and snacks. Parents should set the example by eating a healthy diet and exercising regularly but should not pressure children into doing so; this frequently is not successful and causes unnecessary tension in the family.
• Limit time in front of the television to one hour per day on weekdays, two hours per day on weekends. Television promotes both inactivity and unnecessary snacking.
• Restrict the number of times in a week that children eat fast food meals. Fast food is typically high in calories, fat and sodium (salt) and low in other important nutrients.
• Obese children should participate in a program of healthy, low fat eating and regular exercise to maximize weight control. These children should also join in activities that are nonphysical at school, after school and on weekends, to improve their self-esteem.
• Most of all, parents of obese children should show their love and acceptance for their children regardless of their weight.