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Toddler’s Nutrition

Information about the nutritional needs of toddlers (aged 1-3) and young children (aged 3-5)

Growing children need lots of energy (as calories) as well as other nutrients to ensure they grow and develop normally

There is evidence that the diets of children under 5 are not always optimal and are*:

  • Too high in the type of sugar that damages teeth
  • Too low in certain vitamins and minerals, such as vitamins A and D, as well as iron and zinc

Ref: *http://www.cwt.org.uk/pdfs/Under5s.pdf, accessed on 12 March 2012

What a toddler's diet should be made up of

  • As your child becomes a toddler, they should become fully integrated into family meals, though they may still need a hand cutting things up for a while
  • It's really important to make sure family meals are suitable for your child, so use as little sugar, salt and strong spices in your recipes as you can get away with
  • Milk still plays an important role in your toddler's diet, though they need slightly less now, about 350 ml of milk or 2-3 servings of dairy foods per day
  • Providing your toddler is eating a good, varied and balanced range of foods, you could consider using full fat cows' milk as the main drink after 12 months of age
  • Your toddler should be eating a wide variety of foods from each of the food groups and you should be aiming for:
    • 4 servings of carbohydrate foods a day
    • 2-3 servings of dairy foods a day (this includes their milk)
    • 1-2 servings of meat or meat alternatives a day
    • 5 servings of fruit and vegetables a day

What are the nutritional needs of toddlers and young children?

Energy

  • Toddlers and young children need energy about 980 calories to enable them to function and be active as well as for growth and development1
  • Adequate energy and nutrients are vital to assist in the continued development of bones, teeth, and muscle tissue.2
  1. Recommended Nutrient Intakes for Malaysia; Ministry of Health Malaysia 2005: pg 206
  2. Lucas BL. Nutrition in childhood. In: Mahan LK, Escott-Stump S, eds. Krause's Food, Nutrition & Diet Therapy. 11th ed. Philadelphia, PA: Saunders; 2004:214-233
  • The body gets energy from fat , carbohydrates and protein

Protein

  • Protein is needed for growth and the maintenance and repair of body tissues, as well as to make enzymes that control many body functions. A person's body makes many of its own proteins, which do many different things in the body. But no one, especially children, can make all of the proteins needed to be healthy.
  • Experts recommend that children aged 1 to 3 years consume 13 grams of protein per day.*

Ref: *Food and Nutrition Board, Institute of Medicine of the National Academies. Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids. Washington, DC: The National Academies Press; 2005

  • Requirements from Malaysia Recommended Nutrient Intake (MRNI)  that children from 1-3 should consume protein 17 g/day*

Ref: *RNI Recommended Nutrient Intakes for Malaysia; Ministry of Health Malaysia 2005; pg 61

  • The ideal protein contains all essential amino acids – the building blocks that the body uses to make protein – in the right amounts.
  • Complete proteins contain all of the essential amino acids in the right proportions. Animal foods, such as milk, meat, and fish are complete proteins.

Fat

  • Dietary fat provides a concentrated energy source and essential fatty acids that the body cannot make on its own. Essential fatty acids allow the body to absorb certain vitamins and affect other body functions.
  • Children need more fat than adults because their bodies use proportionally more energy as they grow and develop. For children 1 to 2 years of age, a fat intake supplying 30% to 40% of calories is recommended. For children 2 to 3 years of age, a fat intake supplying 30% to 35% of calories is recommended, with most fats coming from sources of polyunsaturated fats and monounsaturated fats, such as fish, nuts, and vegetable oils.1,2,
  1. US Department of Health and Human Services and US Department of Agriculture. Dietary Guidelines for Americans. 6th ed. Washington, DC: US Government Printing Office; 2005.
  2. Food and Nutrition Board, Institute of Medicine of the National Academies. Dietary Reference Intakes: recommended intakes for individuals. US Department of Agriculture, National Agricultural Library web site. http://fnic.nal.usda.gov/nal_display/index.php? info_center=4&tax_level=3&tax_subject=256&topic_id=1342&level3_id=5140&level4_id=0&level5_id=0 &placement_default=0. Accessed September 3, 2008.
  • In  Malaysia, the recommended nutrient intake (MRNI)  indicates that children from age 1-3 , a higher fat intake range of 25-35% kcal*

Ref: *RNI Recommended Nutrient Intakes for Malaysia; National Coordinating Committee on Food and Nutrition Ministry of Health Malaysia 2005; pg 34

  • Omega-3 fats are found in oily fish, which should be given 1-2 times per week

 

AA and DHA

  • The brain growth spurt begins before birth and continues during the toddler years.1 Rapid cell multiplication in the brain continues into the second year of life.1
  • The long-chain polyunsaturated fatty acids (LCPs), arachidonic acid (AA) and docosahexaenoic acid (DHA) help support cognitive and visual development in toddlers as the brain growth spurt continues.1-6
  1. Dobbing J. The later development of the brain and its vulnerability. In: Davis JA, Dobbing J, eds. Scientific  Foundations of Paediatrics. London, UK: William Heinemann Medical Books Ltd; 1974:565-577.
  2. Carlson SE. Behavioral methods used in the study of long-chain polyunsaturated fatty acid nutrition in primate infants. Am J Clin Nutr. 2000;71(suppl):268S-274S.
  3. Georgieff MK, Innis SM. Controversial nutrients that potentially affect preterm neurodevelopment: essential fatty acids and iron. Pediatr Res. 2005;57(5 pt 2):99R-103R.
  4. Lien V, Pramuk K, MacDonald I, Mickelson JR, Goh YK, Clandinin MT. Consuming an AA and DHA fortified beverage for 7 months improves visual perception among children 4–7 years old [abstract]. J Pediatr Gastroenterol Nutr. 2005;40(5):698. Abstract PN2-09.
  5. Morale SE, Hoffman DR, Castañeda YS, Wheaton DH, Burns RA, Birch EE. Duration of long-chain polyunsaturated fatty acids availability in the diet and visual acuity. Early Hum Dev. 2005;81(2):197-203.
  6. Willatts P, Forsyth JS, DiModugno MK, Varma S, Colvin M. Effect of long-chain polyunsaturated fatty acids in infant formula on problem solving at 10 months of age. Lancet. 1998;352(9129):688-691.

However, there is currently insufficient evidence to link an increased intake levels of DHA and / or EPA to improved physical or mental development or specific functional benefits in children 2 – 18 years.
There is some probable evidence to recommend an Adequate Intake range of EPA + DHA ( and not DHA alone) that may help at preventing chronic disease (adjusted for age) of*:
    100- 150 mg for 2-4 yrs
    150-200 mg for 4-6 yrs
    200-300 mg for 6-10 yrs

Ref: *Joint FAO/WHO Export Consultation on Fats and Fatty Acids in Human Nutrition, 10-14 Nov 2008, WHO, Geneva

Carbohydrates

  • Carbohydrates are a good source of energy for active, growing toddlers. The total carbohydrates needed range from 55-75% of total energy.1 The primary role of carbohydrates is to provide energy to cells throughout the body.
  • Carbohydrates are starch and sugars in foods
  • Starch is the major component of cereals, pulses, grains and root vegetables
  • The AAP recommends that carbohydrates should contribute 50% to 60% of energy by the age of 5 years.2,3,4
  1. RNI Recommended Nutrient Intakes for Malaysia; Ministry of Health Malaysia 2005: pg
  2. US Department of Health and Human Services and US Department of Agriculture. Dietary Guidelines for Americans. 6th ed. Washington, DC: US Government Printing Office; 2005.
  3. Dietz WH, Stern L, eds. Guide to Your Child's Nutrition: Making Peace at the Table and Building Healthy Eating Habits for Life. New York, NY: Villard Books; 1999.
  4. Data on file, Pfizer Nutrition (PROGRESS GOLD® macronutrient comparisons, September 2008).

Fibre

  • Fibre is the part of cereals and vegetables which are not broken down in the small intestine and which are important to prevent constipation and other bowel disorders
  • Oligofructose is a highly soluble dietary fiber that is classified as a nondigestible carbohydrate.1,2  Oligofructose may improve digestion, help promote regularity, promote softer stools, and help reduce the risk of constipation1,3
  1. Niness KR. Inulin and oligofructose: what are they? J Nutr. 1999;129:1402S-1406S.
  2. Roberfroid MB. Health benefits of non-digestible oligosaccharides. In: Kritchevsky D, Bonfield C, eds. Dietary Fiber in Health and Disease. New York, NY: Plenum Press; 1997:211-219. Advances in Experimental Medicine and Biology; vol 427.
  3. Schneeman BO. Fiber, inulin and oligofructose: similarities and differences. J Nutr. 1999;129:1424S-1427S.
  • In  Malaysia, the recommended nutrient intake (MRNI)  range from 19-25 g/day of total fibre for young children*.

Ref: *RNI  Recommended Nutrient Intakes for Malaysia; Ministry of Health Malaysia 2005; pg 48
 

Micronutrients: Vitamins and Minerals

Vitamins

  • Vitamins are complex organic substances that are needed in very small amounts for many of the essential processes carried out in the body
  • Children's diets must supply the right amounts of vitamins to help ensure proper growth. Each vitamin plays its own important part in children's development.

Vitamin A*

  • Aids in maintaining the health of skin and mucous membrane
  • Essential for functioning of eyes.    

Vitamin B*

  • B1 /Thiamine – needed for the release of energy from carbohydrates
  • B2/Riboflavin – needed for the release of energy from protein, fats and carbohydrates
  • B12/Cyanocobalamine – needed for red blood cell production

Vitamin C*

  • Enhances absorption of iron from non-meat source
  • Contributes to the absorption of iron from food

Vitamin D*

  • Helps the body utilize calcium and phosphorus
  • Necessary for the absorption and utilization of calcium and phosphorus
  • Severe vitamin D deficiency can result in rickets, a disease characterized by defective bone mineralization, which may present as bowed legs, delayed walking, or swollen wrists and ankles.1

Ref: * 1.MOH Guide to Nutrition Labelling and Claims; Dec 2010, 1.Blok BH, Grant CC, McNeil AR, Reid IR. Characteristics of children with florid vitamin D deficient rickets in the Auckland region in 1998. N Z Med J. 2000;113:374-376.

Minerals

  • Minerals are inorganic substances required by the body for a variety of functions
  • Minerals cannot be made by the body and must come from the diet. Iron, zinc, calcium, and phosphorus are among the most important minerals for growing children.

Iron*

  • Is a factor in red blood cell formation.
  • A component of heamoglobin in red blood cell which carries oxygen to all parts of the body. Iron is also critical for proper motor function.1
  1. Lozoff B, Jimenez E, Hagen J, Mollen E, Wolf AW. Poorer behavioral and developmental outcome more than 10 years after treatment for iron deficiency in infancy. Pediatrics [serial online].
     
  • If a child does not get enough iron for a prolonged time, he can develop iron deficiency anemia, a condition that limits the ability of the blood to carry oxygen. This can interfere with mind development, affecting a child's motor skills and ability to learn.

Zinc*

  • Essential for growth.

Calcium*

  • Calcium aids in the development of strong bones and teeth.

Ref: *MOH Guide to Nutrition Labelling and Claims; Dec 2010

Meeting the nutritional needs of young children

  • Different foods provide different vitamins and minerals and having a varied and balanced diet is essential for providing adequate amounts of all of these nutrients
  • Young children should be eating a wide variety of foods from each of the food groups to meet their nutritional requirements
  • Toddler milks are specially formulated to complement a toddler's diet and are fortified with iron as well as other key vitamins and minerals and can be a useful addition to a young child's diet
     

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