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These are some of the questions parents have about feeding young children. We cover these topics and more in detail in our book, Food for Tots. Questions are answered by pediatrician Janice W. Woolley, M.D. Past newsletters are archived on this site. We cannot answer specific medical questions about individual children. Any answers provided are not to be considered medical advice. Consult your pediatrician if you have concerns about your child's health.
There are only a few foods my three year old will eat. He absolutely refuses to try anything new. What can I do? I have often thought that food manufacturers are missing a great opportunity. If they could only make foods look like chalk and crayons! I've known many finicky toddlers who sample the chalk in my office waiting room but won't touch a new food. Children at this age like routines. They may insist on hearing the same bedtime story, or wearing the same clothes every day. Preferring to eat only a few foods may be part of this developmental stage. When your child is in a fussy phase be sure there is always something available that he will eat, such as fruit and whole grain bread and peanut butter. Buy only foods you want your child to eat. Set a good example by the way you eat and let your child make choices from a variety of good foods that you provide. Your child is likely to eventually copy many of your food habits, likes and dislikes. It is important to make mealtimes pleasant and avoid power struggles. Don't give up, keep offering foods that he has previously rejected. Studies have demonstrated that a child may need to be exposed to a food eight to ten times before he will eat it. Try including your child in meal planning, grocery shopping and cooking. You might allow him to choose the main course for a meal once in awhile. Let him know that other family members also have favorites so he can't always have his. When you are in the grocery allow him to choose a fruit or a vegetable to try. Most preschoolers love to help with food preparation. Involving him helps eliminate power struggles because he will feel he has some control. I have heard that honey should not be given to young children. Why is that? Honey should never be fed to children younger than 12 months of age. Honey can contain a bacteria called Clostridium botulinum. This bacteria can grow in an infant's digestive system and release a toxin that causes botulism, a potentially fatal illness. The bacteria will not grow in the intestines of older children and adults. What is e. coli and how can I protect my child from it? E. coli bacteria is a normal inhabitant of the intestinal tract of many animals, including humans. One strain of the bacteria can cause a life threatening infection. The most common source of e. coli infection is ground meat that was contaminated in the food packing plant. Outbreaks of the illness have also been traced to unpasteurized fruit juices, raw vegetables, unpasteurized milk, and contaminated water. It can also be transmitted from person to person. Symptoms of e. coli illness include abdominal pain, cramping, and bloody diarrhea and eventually kidney failure. To protect your child, ground meats should always be cooked until thoroughly browned in the center. Use a meat thermometer and cook until the food is at least 160°F to ensure thorough cooking. Raw vegetables and fruits, including salad greens should be thoroughly rinsed with water before they are eaten. Children should never be given unpasteurized fruit juices or ciders. Children should be reminded to wash their hands with soap and water before eating. Well water should be tested for bacteria on a regular basis. What can I feed my child to keep him from being constipated? Increasing high fiber foods and water in your child's diet usually helps. The recommended amount of fiber is your child's age plus 5 grams. For example, a three year old would need eight grams a day. Studies have shown that more than 50% of U.S. children's diets do not meet this recommendation. Foods that are high in fiber include most fruits and vegetables, legumes, nuts and nut butters, oatmeal, bran, brown rice, whole grain breads, waffles, muffins, cereals, and crackers. Look for products that list high fiber products as the first ingredient. Be sure your child can handle the texture of these foods to avoid choking. Prune juice, apple juice and pear juice contain natural ingredients that have a laxative effect and can also be helpful for treating constipation. Infants who are starting solids can get fiber from commercially or home prepared pureed fruits and vegetables, whole cereals and legumes. Fiber supplements are only recommended if intake has been inadequate and constipation or encopresis (stool holding and bowel accidents) have resulted. Talk with your pediatrician before using a supplement on a regular basis. Should I give my child bottled water or water from the tap? Most city water supplies are safe for children of all ages, however, there have been problems in some areas with the water supply. It may not be a bad idea to boil, for one minute, any water used for infants under the age of 3 months before mixing it with formula. Boiling water for longer periods of time can actually be harmful as it concentrates the minerals in water. Bottled water is not necessarily sterile and should probably be boiled for infants of this age as well. Breast feeding avoids this problem entirely. Breast fed babies of this age don't need additional water. Tap water should be fine for older infants and children. Well water should be tested on a regular basis for impurities such as bacteria and harmful minerals. If you are on a municipal water system, check with the supplier to see if your water is fluoridated. Fluoride in the proper amounts is very important to healthy tooth development. If there is not enough in your water, or if your child drinks bottled or filtered water she should receive a supplement. Your pediatrician can prescribe the correct dose. How can I tell if my child might be allergic to a food? Food allergies can cause a variety of symptoms. Hives or other skin rashes, swelling of the lips or tongue, vomiting, diarrhea or respiratory symptoms such as wheezing or difficulty breathing are the most common reactions. There is no evidence that behavioral problems are related to food allergy or intolerance. The most serious type of allergic reaction, anaphylaxis, can result from a tiny amount of a food to which a person is highly sensitive. Anaphylaxis is a life threatening reaction which is sudden and severe. It can cause wheezing, hives, swelling of the throat, and shock. More people die each year from anaphylaxis to foods than from reactions to stinging insects, so these reactions need to be taken seriously. Not all reactions to foods are caused by allergy. For example, a child with lactose intolerance may get diarrhea after drinking milk but she is not allergic to milk. Allergic reactions are caused by an immune system reaction. Lactose intolerance is the lack of an intestinal enzyme that is necessary to digest the lactose (milk sugar) in milk. Another example of a food intolerance that is not allergy is celiac sprue. People with sprue cannot tolerate gluten, which is in wheat, oats, barley and rye. Which foods are most likely to cause allergic reactions? Most of the reactions to foods are caused by milk, eggs, peanuts and other nuts, wheat, soy, fish and shellfish. Anaphylactic, or life threatening reactions, most often are caused by peanuts, other nuts, shellfish, and eggs but can be caused by other foods. |
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