Adequate nutrition duringthe first 2 years of life is necessary for healthy growth and development. Early nutrition and good practices can help children develop healthy dietary habits and patterns. Following WHO recommendations, breastmilk provides all the energy and nutrients that the infant needs for the first 6 months of life. After 6 months, children should begin eating safe and adequate complementary foods while continuing to be breastfeed for up to 2 years and beyond. In this period, from 6 months to 2 years old, your child will also develop the skills needed to participate in family meals. Some skills, such as finger feeding or using a spoon are part of your child’s nutrition development milestones and the transition from milk to solid food.

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After birth, all babies under pediatrician recommendations, are supplemented with Vitamin D. It is akey nutrient that helps their bodies absorb calcium, one of the main building blocks for strong bones and teeth.

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From Birth

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Babies are born with adequate iron stores for the first 6 months of life, after this period you can introduce your baby to nutrient-dense complementaryfoods rich in iron. Iron helps red blood cells to carry oxygen through the body, thus supporting children’s ability to learn. Having enough iron in the body can also help prevent iron deficiency anemia.
During the complementary feeding period, the immune system matures, and the babies’ digestive system is developed enough to introduce soft and solid food.

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Introducing potentially allergenic foods along with other complementary foods is also important at this stage, as it gives the opportunity to spot any adverse reaction to certain foods. Nutrient-dense foods provide vitamins, minerals, and other health-promoting components and have little added sugars, saturated fat, and sodium. Purees of vegetables, fruits, potatoes, dairy products, and lean meats and poultry should then be introduced to meet babies’ nutritional requirements. It is also essential to include foods rich in zinc, as it plays a critical rolein biological processes including cell growth, zinc deficiency entailschildhood growth restriction and less resistance to infections.

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From 12 months to 3 years

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From 12 months to 3 years, toddlers have high nutritional requirements to support rapid growth and development. It is a period of rapid emotional, intellectual and social development; language and motor skills extensively increase during this stage. Compared to the first year of life, physical growth slows down but mineral and vitamin requirements per kg of body weight are still high compared to adults.

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At around 15 months

Also, at around 15 months, toddlers start eating mashed, or chopped foods and they are exposed to a wide range of new different textures while eating. Inthis transition period, behaviors like neophobia or picky eating are often observed. While in most cases they are normal and transitory, they put young children at risk of nutritional inadequacies.

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Feeding challenges in toddlers and children

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Picky eating

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It refers to the acceptance of only a narrow range of foods, and rejection of both familiar and unfamiliar foods. Several studies in healthy young children from developed countries have reported excessive protein and sodium intake, as well as insufficient intake of vitamins D, E, A and fiber. Fortified young child formula may be strategic in ensuring that nutritional requirements are met.

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Neophobia

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It refers to the tendency to reject unfamiliar foods and emerge during the second year of life. It is thought to be an innate predisposition evolved to protect the toddler from putting toxic elements in their mouth. To avoid nutrient inadequacies in this situation, it is important to get nutritional advice from your pediatrician to ensure appropriate intakes of iron, vitamin D, vitamin E, and fiber as well as making sure that the protein intake is not too high.

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Fundamental micronutrients for healthy development

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Micronutrients often referred to as vitamins and minerals, are crucial forhealthy development and disease prevention. Except for Vitamin D, micronutrients are not produced in the body and must be derived from the diet.

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Zinc

Zinc promotes immune functions and helps infants’ resist infectious diseases including diarrhea.

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Iron

Ironis critical for motor and cognitive development. Children and pregnant women are vulnerable to the consequences of iron deficiency.

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Vitamin A

Vitamin A supports immune system functions. Children with vitamin A deficiency face an increased risk of blindness and are more exposed to infections and diarrhea.

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Vitamin D

Vitamin D is an important building block to strengthen bones by helping the body absorb calcium.

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Folate

Folic acid is a form of vitamin B9. In the prenatal period, it is essential for foetal growth and for the healthy development of the brain and spine.

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References

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1. The state of the world’s children 2019, children, food and nutrition. UNICEF; 2019.

2. World Health Organization Guideline: vitamin A supplementation in infants and children 6-59 months of age; 2011external icon. Accessed June 18, 2021.
https://www.cdc.gov/nutrition/micronutrient

3. Friis H et al. The impact of zinc supplementation on growth and body composition: a randomized, controlled trial among rural Zimbabwean school children. European Journal ofClinical Nutrition.1997, 51:38-45.

4. Cooke, L., C. Higgins, andÚ. McCrann, Managing common feeding difficulties in toddlers and pre-school children. Paediatrics and Child Health, 2017. 27(8): p. 366-370.

5. Taylor, C.M., et al.,Picky/ fussy eating in children: Review of definitions, assessment, prevalence and dietary intakes. Appetite, 2015. 95: p. 349-359.

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