What to Expect the Toddler Years (176 page)
Read What to Expect the Toddler Years Online
Authors: Heidi Murkoff
Stress and deprivation.
Severe emotional stress or a deprived environment may also contribute to FTT.
Growth hormone deficiency.
A small percentage of children who exhibit poor growth suffer from a deficiency of growth hormone. Some of these children can be treated with injections of a synthetic form of the hormone. Best candidates for treatment are those growth-hormone-deficient children with short stature, subnormal growth rate, “doll-like” faces, mid-section chubbiness, a history of hypoglycemia (low blood sugar). In boys, who are most frequently affected, there may occasionally be an unusually small penis and undescended testicles.
“Idiopathic” or FTT of unknown origin.
Sometimes no cause can be found for failure to thrive. But it can still be treated with improved nutrition and feeding regimens. It is important to diagnose and treat FTT because it can interfere with all forms of development (social, emotional, physical, intellectual).
ACTICS FOR THE TABLE
When there’s a toddler in the house, the best planned menus oft go astray. The toddler refuses to eat what’s being served, insists on the same menu meal after meal, suddenly turns fickle (yesterday’s favorite food is on today’s
blacklist). Most parents have seen one or more of these behaviors at least occasionally, and some see all of them all of the time. Fortunately, there are practical ways to deal with toddler eating issues.
INESSING THE FINICKY EATER
Every parent who’s ever tried to feed a fussy eater knows full well the frustrations. Most toddlers are fussy eaters at least some of the time, and many are always fussy. Like other eccentricities, food fussiness seems to go with the toddler territory. While it may not be possible to turn a finicky two-year-old into a full-fledged gourmand, it is possible to cut down on the frustration of feeding one:
Offer only the best.
The best foods, that is. If your toddler doesn’t eat all that much, or eats erratically, it’s especially important that what he or she
does
eat is as nutritious as possible. A petite appetite is quickly sated; if it’s sated by French fries or candy, you’ve missed an opportunity to provide the nutrients your toddler needs.
If your toddler is underweight, offer such calorie and nutrient dense foods as: meat, poultry, fish, peanut butter, cheese, bananas, beans and peas, dried fruit, and avocado. To increase caloric and protein intake, you can add dry skim milk or canned evaporated whole milk to puddings, custards, soups, cereals, and whole milk. Add grated cheese to soups, pastas, and vegetables. Use some oil, butter, margarine, and mayonnaise in food preparation, but not so much that these fat calories take place of other essential nutrients. The doctor may also prescribe a multivitamin supplement with iron and zinc and advise increasing your child’s calorie and protein intakes beyond The Toddler Diet recommendations.
Feed when hunger strikes.
It may sound obvious, but often the reason children don’t eat well at meals is because they aren’t hungry when they’re served. Some toddlers get out of bed in the morning ravenous, ready to dive into their bowl of cereal; others need some time to wake up and work up an appetite. Some toddlers can wait until the working parent or parents are home from work to eat their evening meal, others have lost their appetite by then. Try to tune in to your toddler’s individual hunger pattern. For a few days, if it’s practical, wait until your toddler actually expresses an interest in eating (or, if your child never complains of hunger, until hunger symptoms, such as crankiness, set in) before presenting a meal. Keep track of when hunger strikes, and if you can identify a pattern, try to set mealtimes a little before each hunger period (on the assumption that a toddler doesn’t ask for food until he or she is really starving). Once you’ve set the mealtimes, try to stick with them; for most toddlers, regular and predictable mealtimes, with food served in the same place at the same time, works best. Don’t hold a hungry toddler off until the rest of the family is ready to eat; if necessary, serve your child earlier. Or, serve part of the meal—a raw vegetable or some bread—as a snack to tide your toddler over until the family can sit down together.
Serve up an atmosphere conducive to eating.
Even the most appetizing meal is hard to swallow when it’s offered in a stressful environment. Make certain the eating environment in your home is pleasant and relaxing, free of squabbles, loud voices, and hustle bustle. And leave pressure to eat
off
the menu, allowing your toddler to eat to his or her appetite’s content from the nutritious selections you present. When it’s clear he or she has had enough, let the meal end without comment; regularly struggling to get a child to eat a little more can set the stage for future eating problems. So ban forcing, bribing, and cajoling “here-comes-the-choo-choo-into-the-tunnel” games, allowing your toddler’s appetite to take its natural course instead.
FAST FOOD—FUN OR FOLLY?
It’s been a long day at the office, the shop, the day-care center, the park, the mall, the market—or any combination of these. You’re too tired to think, never mind cook. Your toddler’s too hungry to wait, and too cranky to sit in a restaurant and be waited on. Those golden arches or that drive-through window beckon seductively, promising a quick, inexpensive, and virtually effortless family meal. You waver, and then as the pleas (“I wanna kid’s meal! I wanna kid’s meal”) drown out any remnants of your resolve (“No kid of mine is going to eat fast food”), you relent. As you watch your toddler gleefully dunking greasy fries and chicken nuggets into sugary ketchup and barbeque sauce with the kind of appetite that young children seem to reserve for foods their parents
don’t
want them to eat, you silently vow to be stronger next time, to resist the temptation of fast foods—knowing, deep inside, that you’re vowing in vain.
But don’t be too hard on yourself. Fast-food franchises cater to the most basic human needs, and when you’re the harried parent of a toddler, you’re only human for responding. But do keep fast-food excursions from compromising your toddler’s overall diet—and health—by adhering (at least, most of the time) to these caveats:
Don’t make fast food a habit. Try to limit your visits to fast-food restaurants to a couple of times a month at most. Make these fast-food meals an occasion that you and your toddler can look forward to enjoying together.
Ask for a side of nutrition information. Many fast-food restaurants will provide, on request, a nutritional breakdown of their menu items. This information can help guide your selections.
Cut your nutritional losses, when possible. More fast-food chains are offering “lighter,” “leaner,” and “healthier” options—everything from less fatty burgers to whole-grain buns to put them on. Pizza is also a nutritionally sound selection (but “blot” any excess grease with a paper napkin first), as is a baked potato stuffed with cheese and broccoli. Selections from a salad bar—most are stocked with grated carrots, shredded cheese, chick-peas (halve or mash for a young toddler), cottage cheese, and other toddler suitable foods in addition to things green and leafy—make worthy accompaniments to a fast-food meal. The occcasional toddler who loves salad can even make a meal out of salad bar selections, especially when there is pasta or baked potato among the choices. (But avoid drowning salad fixings in ladlesful of high-fat dressings.) Frozen yogurt can make a nutritious dessert (at least when compared to pies and cookies). Ordering a container of milk or orange juice instead of soda or a high-fat milk shake can also help improve the meal’s nutritional profile.
Compensate cleverly. Your toddler’s had nary a nibble of anything nutritious. No problem—just head home for an after-dinner carrot, plateful of cantaloupe cubes, a whole-grain muffin.
Don’t spoil the treat with guilt. If you’re not overdoing the visits to fast-food restaurants, you’re not putting your toddler’s health in jeopardy. So hold the guilt, relax, and enjoy.
Decrease distractions.
Eliminate, too, other distractions that may keep your toddler from eating. Television can be distracting, even for a toddler who isn’t really watching it. So are siblings or other children playing within view; so
be sure that distraction is absent. Toys or other playthings on or near the table also present a problem. If your toddler won’t come to the table without a favorite toy, make a deal: “You can take your teddy (or truck, or doll, or giraffe) with you, but you can’t play with it. It can watch you eat.”
Let pokey eaters poke.
Many toddlers are slow eaters, particularly once they’ve started feeding themselves. Each pea must be popped in the mouth individually, strands of spaghetti slithered up one at a time. Give your toddler all the time he or she needs to complete the meal (and be certain that any other caregivers do, too), building the extra time into your schedule, as needed. Sit with your child while he or she eats, if it’s necessary to prevent an early departure from the table, keeping up the conversation, and providing company. When eating dissolves into playing, however (the peas are being plopped into the orange juice instead of popped into the mouth, the spaghetti strands are being strung from the high chair like garlands), end the meal promptly.