by Dr. Vinson Diep and Stephanie Lopes
Food provides all the essential nutrients for our bodies to function. As parents who know the importance of food, ensuring our children are eating the appropriate amounts of the right foods can cause anxiety.
Dr. Vinson Diep, pediatrician with an office at Kapiolani Medical Center for Women & Children, offers advice about eating to help alleviate any anxiety.
How often should my child eat?
Every baby is different. How much and how often an infant eats will depend on the baby’s needs. Therefore, the Center for Disease Control and Prevention (CDC) and American Academy of Pediatrics recommend feeding infants when they show signs of hunger – or responsive feeding. Some of these signs of hunger include putting hands to mouth, turning head towards breast or bottle, puckering, smacking, licking lips, and having clenched hands. When a child closes their mouth, turns their head away from the breast or bottle, or relaxes their hands, then they may be full.
From birth to 6 months, breastfed babies typically feed about eight to twelve times in 24 hours or every two to three hours, and formula fed babies typically feed about every three to four hours. Note that some newborns may be sleepy and not interested in feeding, so parents should wake their young baby to feed every two to four hours if their child is not waking on their own. In this age range, some babies may be able to sleep up to five hours without feeding; on the other hand, some babies may need to eat every hour to assist in a growth spurt. In short, feed your young infant when they are showing signs of hunger.
From six to twelve months, it is recommended to continue to feed on demand based on your baby’s hunger cues. As solid foods are introduced and baby’s stomach grows, the frequency of feedings may decrease.
Dr. Diep explains, “Parents can slowly increase the amount their child eats until age one, when there really isn’t a limit to how much they eat. Babies after the age of one generally can eat three meals per day with snacks in between.”
What should a child eat?
From birth, babies should only eat breastmilk or formula. “I generally recommend introduction of baby food at four months of age,” says Dr. Diep. “In the past, six months was the recommended age, but more studies have shown that food introduction as early as four months is safe.”
From four months to one year, babies can eat a variety of foods while also continuing to eat breastmilk or formula. Dr. Diep explains, “Before age one, the only foods that babies should stay away from are cow’s milk and raw honey. Even foods that are common allergens, including peanuts, eggs, and seafood, can be started prior to age one; parents don’t need to wait until after age one to start these foods. Most parents will introduce solid food with oatmeal or rice cereal, and this can be mixed with breastmilk or formula. Poi is also a common first food in Hawaii, and poi mixed with breastmilk or formula is fine too.”
“Parents may have also heard of baby-led weaning, which involves putting various foods on a plate and letting their child eat what they want,” Dr. Diep continues. “I generally don’t recommend this until closer to nine months old, when babies are better able to sit unassisted and they have developed more fine motor skills that they can pick up food with their fingers.”
“Babies after age one can eat anything that adults eat. They should also be getting a good variety from all food groups, which includes carbohydrates, protein, dairy, fruits, and vegetables,” Dr. Diep states.
How do I know if my child is eating enough?
Ounces of formula by age, number of dirty diapers, comparison of weight to other children: these are all ideas that parents have used to tell if their child is eating enough or too much. But studies show these indicators vary widely by child; therefore, they are often simply stress-inducing signs that will not truly be able to tell if your child is eating enough.
“The best determination of knowing whether your child is eating enough is to have regular check-ups with your pediatrician. At those visits, weight and height can be monitored,” Dr. Diep says. “Good weight and height gain, based on your child’s individual history, are indicators of getting enough to eat.”
How can I help my picky eater?
To prevent a picky eater, Dr. Diep recommends, “Introduce a variety of foods, from basic foods such as oatmeal and rice cereal to veggies, fruits, and protein. The variety keeps things interesting for kids.”
What if your child has already become a picky eater? Don’t give up on certain foods! Dr. Diep says, “Continue introducing a variety of foods. Sometimes it takes three or even more times for a child to try a food before they like it. Their taste buds are constantly changing, and one day they could spit out carrots but then start liking carrots a few months later.”
“You also don’t want to give your kids too many options when it comes to food,” Dr. Diep continues. “For example, at dinner time, don’t allow them to dictate the meal, and don’t specifically make three or four dishes for them to choose from. Maybe have one alternate meal for them to have, but nothing else.”
Also remember that actions always speak louder than words when parenting. “Parents should demonstrate good eating habits too. If the kids see their parents eating a variety of foods, they are more likely to follow,” Dr. Diep discusses. “Mealtimes should also be modeled, and parents and their children should sit together without distractions, such as having the TV on or using their phones for social media.”
When should I worry about my child’s eating habits?
Eating should not cause parents any anxiety, especially when it is known that children should eat when they are hungry and the foods they can eat as they age are as diverse as the rainbow.
However, unintentional weight loss and frequent vomiting are two symptoms to discuss with a pediatrician. “Kids should generally always be gaining weight, not losing weight. Losing weight could be more of a sign of a systemic disease,” Dr. Diep explains. “Frequent vomiting after eating may be another sign that something is wrong in either the gastrointestinal tract or in the brain.”
If you would like to speak more with Dr. Diep, call 808-945-9955 or email pediatrics@doctordiep.com.
