What to Expect the Toddler Years (121 page)

“Now that my toddler’s over two, shouldn’t I start limiting her fat intake so she won’t have a weight or cholesterol problem later in life?”

Alas, the days of whole milk, and full-fat cheese and yogurt are gone for your toddler—or at least they should be. The development of artery clogging plaque begins in childhood, which is why the American Academy of Pediatrics suggests that parents reduce dietary fat and cholesterol when their children turn two. (If the child already tends toward obesity, a switch may be recommended sooner.)

The most current recommendations are simple, and The Toddler Diet (see page 500) will help you plan meals. The guidelines suggest that kids over two should:

Eat a varied diet (or as varied as a toddler’s eccentric tastes allow) with sufficient calories for normal growth.

Get from 25% to 30% of their total calories from fat. No more than one-third of these (10% of their total calories) should come from saturated fat (found in dairy products, meats, and eggs); and trans-fats (such as any items with hydrogenated shortening), should be as close to zero as possible. The rest should come from polyunsaturated fats (found in corn, safflower, sunflower, and soybean oils) and especially from monounsaturated fats (found in olive and canola oils), which are believed to be the best fats for heart health.

Get less than 300 milligrams of dietary cholesterol per day, unless there’s a strong family history of high cholesterol (in this case, the level should be under 200 milligrams). Cholesterol is found only in animal products, such as eggs, meat, poultry, whole milk, cheese, and other dairy products.

To compensate for the reduction in fat, your toddler’s diet should be high in filling, fiber-rich whole grains, legumes, fruits, and vegetables, and include moderate amounts of low-fat dairy products, meat, poultry, and fish. And to further reduce the risk of early accumulation of plaque in the arteries, she should be encouraged to be physically active and spend little time watching television. Children who watch a lot of TV tend to have higher cholesterol levels—not only because they snack on high-fat foods while watching, but because they’re sitting in front of the TV instead of getting cholesterol reducing, health promoting exercise.

But keep in mind as you go about modifying your toddler’s diet, that there’s a limit to how much you can, and should, limit a child’s cholesterol and fat intake. An overly restrictive diet, in fact, poses several problems. First, children need fat to grow, both physically and intellectually; weight, height, and the ability to learn can be adversely affected by a diet that’s too low in fat. Second, a totally fat-free diet can be unappetizing and tough to chew (a definite drawback for those still perfecting the skill). Third, fat-free meals don’t stick to the ribs as long, making chronic hunger—and sagging energy between meals—potential problems. Fourth, in severely restricting certain foods that are naturally moderate to high in fat (dairy products, for example), there’s the risk that vital nutrients in these foods will also be restricted. And last, as with any overly restrictive diet, a fat-free regimen can lead to mealtime rebellion and unhealthy attitudes towards food, particularly once your child starts seeing that the other kids are eating what she’s never allowed.

For a list of high-fat foods appropriate for toddlers, see page 507.

“Should we have our toddler tested to see if his cholesterol is high?”

Not unless there’s a good reason—and concern over your toddler’s future cardiac health isn’t reason enough. It’s presently recommended that a child’s
cholesterol level be tested
only
when there is a family history of onset of heart disease before age 55, or when at least one parent has an elevated cholesterol reading (240 mg/dL or more).

If there is such a history, or the history is unknown, talk to your toddler’s doctor about testing. Children who have high cholesterol levels (see table, page 349) should, like all over-two’s, be put on the low-fat, low-cholesterol diet recommended on page 348. If three months on the diet does not lower a child’s cholesterol readings, a “step two” diet is usually prescribed. This diet reduces saturated fat intake to less than 7% of total calories (less than one-quarter of total calories from fat) and limits cholesterol to less than 200 mg a day (less cholesterol than is in one egg yolk).

“We’ve always had trouble getting vitamin drops into our son, but lately he’s gotten even more stubborn about it. Our doctor recommends we give him vitamins. What can we do?”

Young children don’t always know what’s best for them—and most of the time, they don’t care. At this age, they feel invincible, don’t understand the concept of present behavior affecting the future, and are unmoved by parental pleas to “take your vitamins so you can stay healthy and not get sick.” Like your toddler, most see no good reason to open wide for the medicine dropper. (For the pros and cons of vitamin supplementation, see page 508.)

Which doesn’t mean it’s time to drop the vitamins, but it might be time to drop the dropper. A sturdy set of teeth and a taste for sweets are the only prerequisites for starting chewable vitamins, and the vast majority of two-year-olds meet both of these requirements. Not only are the enticing shapes, colors, and fruity tastes and scents of chewables easier for a toddler to take, the dosing process is usually less objectionable; instead of being the unwilling target of a dropper-wielding parent, a toddler can pop and chew his vitamin himself.

When choosing a chewable vitamin, it’s a good idea to ask your pediatrician for a recommendation. If you plan to select one yourself, read labels carefully. Some chewables provide
more
nutrients than toddlers require, so look for a formula that provides no more than 100% of the toddler RDA (it is different than the RDA for children four and older) for any one nutrient.

Though most toddlers relish a chewable, and begin looking forward to their daily dose, there are some who find the taste and/or smell objectionable. You can try switching around until you find a brand your toddler will tolerate, although such experimentation can be expensive. In the end, it’s likely your toddler will find at least one brand acceptable. If he doesn’t, you’ll have to try a little sleight of hand (just remember excess doses of vitamins can be dangerous). Crush a chewable and mix it with applesauce or into a shake; disguise a liquid preparation in juice (it’s best if the flavor of the supplement and the flavor of the juice are the same—both orange, or both cherry, for example), a strong-flavored all-juice punch, or a natural juice spritzer (the bubbles may help disguise the supplement). Dividing the dose (liquid or chewable) in two, and giving the first half in the morning and the second later in the day, may make each less noticeable.

In the end, of course, you can’t really force vitamins on a child—particularly not on a daily basis. If you find you are squandering money, effort, time, and your child’s good will trying to get the supplement down, give up for a month, then try again. At that point your
toddler may have reached a more cooperative stage and/or may have lost his distaste for the taste of vitamins.

Unfortunately, the very properties that can make chewable supplements palatable to many toddlers can also make them dangerous. No bitter pill, these supplements can easily tempt toddlers to overdose. Protect your toddler by keeping the vitamins out of his reach, with the child-guard top secured, and never referring to vitamins as “candy.” (These rules should also be observed for over-the-counter and prescription medicines, which often come in palate-pleasing flavors and colors.)

“When we take our toddler to religious services, he can’t sit still or be quiet, no matter how many times we tell him to settle down. We don’t want to stop taking him, but we can’t continue to have him disturbing everyone around us.”

You’re asking your toddler to perform two tricks that aren’t in his repertoire—sitting still and remaining quiet. Most children his age can’t pull these off at a Disney movie, never mind a religious service.

For the time being, you’re going to have to accept your toddler’s limitations in the decorum department—which are less likely to be indicative of his disposition than of his tender years. As he gains maturity, he’ll also gain the ability to control physical and verbal impulses—though he may not resemble the proverbial church mouse in restraint for many years to come. In the meantime, that doesn’t necessarily mean you’ll have to leave the service—or leave your toddler at home—just that you’ll have to practice a lot of the patience you’ve been preaching to him. And while you’re at it, give these tips a try; they should work in any house of worship or similar environment.

Seat for success.
And a speedy retreat. Choose a seat that’s on the aisle, and as far away from other congregants (in the back or in an unoccupied row) and as close to an exit as possible. Not only will this minimize the disturbance caused by your toddler (and you, if you must slip in and out of the service with him), but your toddler may be less fidgety with more room to spread out.

Dress him down.
The discomfort of starchy collars, stiff trousers, and binding bow ties and shoes often bring out the squirmies in toddlers. Though he may not be picture-perfect, your child may be much more comfortable and therefore more cooperative in his Monday clothes than in his Sunday best. Of course, some children love dressing up; if yours does, let him.

Carry more than a prayer book.
A few picture books and quiet toys may occupy your toddler for a short time. So may putting him in charge of keeping a doll or teddy quiet. And don’t forget to bring along a drink and a snack for him to enjoy during “intermissions” from the service; hunger and thirst can completely sabotage a child’s chances of behaving.