Toddlers and the Battle of Wills

• Toddlers Need Less Food Than You Think
• How to Increase Your Milk Supply
• Are Cereals Good for Children?
• What About Honey?
• Exactly What and How Much?
• Juice and Vitamin Pills
• Child Behavior
• Feed Love

Toddlers Need Less Food Than You Think

Feeding toddlers can be challenging. By that statement Dr. Salma started her informing session. They are picky eaters, and they are often hesitant to try anything new. In general, they don't seem to eat very much. To begin planning your toddler's diet, start with the idea that toddlers need a lot less to eat than you think. Remember that children aren't growing as fast as they were during their first year, so they have lower energy demands (calorie needs) and smaller appetites.

• So, if your child is active,
• healthy,
• is growing and developing normally

 ... then they are likely to be getting enough food!

After the age of 1, children can eat just about anything as long as they do not have any food allergies, and as long as the food is in a child- friendly form (pureed, mashed, or cut into small pieces). You could go by the 'Rule of One': For each year of your child's life, serve one tablespoon of each food you're eating in a meal, plus breast milk which is very important in the second year, as an important source of digestible protein and energy, it also strengthens the child's immunity who is increasingly subjected to

germs and illness while walking, crawling and trying to explore the world.

How to Increase Your Milk Supply?                                                                                              

One of the mothers asked, "How can I increase my milk supply?"

Dr. Salma replied that the best way to increase supply is through suckling. Suckling is a major stimulant. So while at home, breastfeed your child as much as you can, and adjust meal times so that the child will be hungry when you return from work. This would make your child suckle more.

Another way is to be well hydrated — to maintain high body fluid content. Drink about 3-3.5 liters of water distributed through the whole day, even when you are away from the child.

Milk is a very good stimulant too. In addition, you can drink 1–2 cups of shamar (fennel) and 4-5 cups of helba (fenugreek) with molasses a day (To make it, boil one -2 teaspoons for every cup of water).

Once your child reaches one year of age, they will need foods from the same four basic nutrition groups that you do. A well-balanced diet contains at least one item from each of the following groups:

• Meat, fish, poultry, eggs, and legumes
• Dairy products
• Fruits and vegetables
• Cereal grains, potatoes, rice, bread, and pasta

No one group is more important than the other, and nothing can substitute the other. Cholesterol and other fats are very important for the child's normal growth and development, so your child should not be restricted to one type of food during this period.

Ideally, toddlers should eat three full meals and two healthy snacks. In reality, they may not eat three full meals, but this is no problem if throughout the week they eat more or less.

Try not to worry if your child:

• Doesn't eat any new foods. You can keep trying to introduce new foods by putting a very small amount (like half a teaspoon) on their plate, but don't force them to eat or finish it.
• Doesn't eat a balanced diet each day — most children don't! As long as their diet seems balanced over a period of a week or two, it is likely that they are getting enough variety.
• Doesn't finish everything on the plate. Don't force them to. If your toddler isn't finishing what you offer, offer smaller portions.

The only time that you should worry is if your child isn't gaining weight or isn't very active. If your toddler is a little overweight, encourage a healthy diet and some physical activity. Be sure to watch the portion sizes that you serve (offer toddler-size portions), and don't offer too much whole milk, juice, or high-calorie snacks.

Are Cereals Good for Children?

Another neighbor asked, "What are cereals? And are they really good for children?"

Dr. Salma replied that cereals, originally, are grass-related plants cultivated for their edible grains and seeds such as corn (maize), barley, rice, sorghum, millet, oats, rye, teff, buckwheat, wheat, and quinoa. Cereal grains supply most of their food energy in the form of starch. Whole grains are good sources of dietary fiber, essential fatty acids, protein, and other important nutrients.

Milk and cereal together make an ideal match, because the milk makes up for the lack of amino acids in the grain. But you can occasionally replace milk with fruit juices high in vitamin C (orange, grapefruit, or tangerine) increases the absorption of iron in the grain. Barley is an example of a grain that gives a lot of benefits. Barley protects the digestive tract, increases immunity, purifies the kidneys, and aids quicker recovery from illnesses.

The Prophet's wife `A'ishah (may Allah be pleased with her) said that Prophet Muhammad (peace and blessings be upon him) used to recommend at-talbina (barley soup) and said, "It is disliked (by the patient) although it is beneficial" (Al-Bukhari Book 7, Hadith 594).

Cereals are a great way to obtain a lot of nutrition in one go. In fact, a nutritious cereal is like a multivitamin, multimineral supplement. One cup of cereal can supply as much as half of the daily nutritional requirements from the top 15 vitamins and minerals, plus a very important element, namely fiber. Opt for whole grains rather than milled ones. Removing the outer layers (milling) markedly lessens their nutritional values.

Fresh foods are, of course, more nutritious than packed ones, which should only be used in times of need. When you need to use packed food, read cereal labels and consider the following: 

• The grains should be whole ("whole wheat," "whole rice," etc., not just "wheat" for example ).
• The protein content should be at least 3 grams per serving.
• The total carbohydrate-to-sugar ratio should be no less than 4:1. This means that if the total carbohydrate is 24 grams, the sugars should be 6 grams or less. That tells you that most of the carbohydrates come from the grain and fibers, not from the added sugars. Also look for the "5–5 Rule": less than 5 grams of sugar and at least 5 grams of fiber.
• Make sure you get good content of zinc, iron, and other vitamins and minerals.

A nutritious cereal should not contain the following:

• Hydrogenated oils
• Dyes or artificial colors
• Chemical preservatives

What About Honey?

Another mother asked about giving honey to toddlers.

Dr. Salma said that honey is very nutritious. It increases the body's immunity against viral, bacterial, and fungal diseases. Honey also keeps the gastrointestinal tract healthy and it is a potent anti-allergenic.

The best way to take honey is by dissolving it in room-temperature water early in the morning. That's how Prophet Muhammad (peace and blessings be upon him) used to drink it.

Allah says in the Qur'an,

(And your Lord revealed to the bee saying: Make hives in the mountains and in the trees and in what they build. Then eat of all the fruits and walk in the ways of your Lord submissively. There comes forth from within it a beverage of many colors, in which there is a healing for people; most surely there is a sign in this for a people who reflect.) (An-Nahl 16:68–69)

Some pediatricians, Dr. Salma said, prefer not to give honey to children who are less than 12 months out of fear of botulism. But as a nutritionist, she gave her children honey after they reached 6 months, and never saw a case of botulism from honey where she lives. But in some states in the US and Canada, there are some cases. So as a rule of thumb for mothers, if you know such cases exist in your area, or if you're not likely to hear if they happen, wait until your child is over 12 months. Otherwise, start when they are 6 months old.

Exactly What and How Much?

Safaa`, wanting some clarification, asked, "I'd like to know exactly how much and what to feed my child on a daily basis."

Dr. Salma replied they can eat same food as family, mashed, pureed or cut into small bite-sized pieces while  offering a simple schedule that shows mothers what they need to know.

Remember, try to avoid large chunks. Nuts, popcorn, cough drops, hard candies, raisins, and other small dried fruit and seeds are potential choking hazards. Chewing gum, soft foods like marshmallows and jellied candies might lodge in your child's throat. If allergies run in your family, you may want to avoid the food that the family is allergic to like peanut butter, nuts, fish, etc., until your child is 3 or 4 years old. All this goes alongside breastfeeding.

Juice and Vitamin Pills

Another question was, "Can fruit juices and vitamin pills substitute for eating deficiencies?"

Dr. Salma answered giving the American Academy of Pediatrics guidelines:

• Parents need to know the difference between 100 percent fruit juices and fruit juice drinks, beverages, or cocktails, which may contain very little real fruit juice.
• Children aged 1 to 6 should be limited to 4–6 ounces (1/2 – 3/4 cup) per day. Too much juice can lead to poor nutrition, diarrhea, flatulence, abdominal pain, bloating, and tooth decay, especially if drunk at bed time.
• All children should be encouraged to eat whole fruits.

A vitamin or mineral pill cannot supply the 50-plus nutrients your child needs. Also, children can overdose on vitamin pills if they take too many.

If you are concerned that your child is lacking in any area (for example, they won't put anything green in their mouth, or they seem to eat nothing but cheese and crackers for days), then you might want to give them supplements for peace of mind, but also take steps to improve their eating habits. Here is a list of essential vitamins and minerals, and where you can naturally find them:

Dr. Salma then talked to her audience about genetically modified (GM) foods. She explained that they are made from plants that have had their DNA changed, and that right now, it is a very controversial issue. Soybeans, corn, and canola are the most common GM crops. “If it were up to me, I would prefer food the way Allah Almighty intended — free from any change. It is possible that, by introducing a new gene into a plant, a new allergen is created that could lead to an allergic reaction in susceptible people like children."

Signs of allergy include the following:

• Vomiting
• Diarrhea
• Rash
• Swelling
• Abdominal pain
• Coughing
• Crankiness
• Excessive flatulence
• Hives
• Itching
• Runny nose
• Shortness of breath
• Bloating
• Wheezing

Child Behavior

Hoda spoke up asking, "Can food affect my children's behavior? I can tell when my children have eaten sugar — it makes them bounce off the walls!"

Dr. Salma replied. Some people wonder if food plays a role in a child's behavior, and sugar is sometimes incriminated. Some say that artificial colors, flavors, and preservatives are linked to hyperactivity and learning disorders. For instance, the caffeine in soft drinks combines with other ingredients and can have a greater impact on children, who are smaller in body mass than adults. You can find caffeine in many things besides coffee, such as tea, cola and chocolate. Caffeine is a stimulant to the brain, and soft drinks may dehydrate the body.

Also, not enough sleep, over-stimulation, hunger, too much TV, not getting enough physical activity, and a lack of attention from parents can have an impact on behavior too. So do the following:

Make sure your toddler eats only while seated and supervised by an adult.

Encourage self-feeding as it builds up a child's confidence and helps them to practice their motor skills.

Offer water to your child several times a day.

Expect and tolerate child-like table manners.

Do not bribe or reward with food. Present food in a neutral fashion.

Keep the TV off during mealtimes.

Wash your hands before each meal.

Wash the top of any can or food container before opening it, and wash the can opener too.   

Feed Love

Feeding an infant or a young child involves more than simply supplying nutrients. Souls and emotions need to be fed too! When the food is offered by the same caring persons every day bonding will occur and secure attachments will be formed. Familiar words and routines will help the child to understand what is expected. When feeding an infant or toddler, think not only of what is fed, but also when, how, and by whom it is fed.

• Be intimate by holding, cuddling — it is not a battle of wills, but time together.
• Talk with your child about what you are doing.
• Be unhurried — allow a child to suckle, pause, and suckle again; let your toddler chew for as long as they like on a piece of food.
• Have mealtimes with the rest of the family to increase sense of family.
• Remove the bowl without comment after a reasonable length of time.
• Teach manners along with the food, like saying bismillah, jazakum Allahu khayran, al-hamdu lillah, please, thank you, etc.
  
  And always be a good role model.

*This information is not meant to substitute the doctor's role. Medical help and close checkup should be sought for each individual case.

Mona Salama is a nutritionist and a pediatrician. She obtained her BSc from the Faculty of Medicine, Cairo University, and is currently pursuing her master's. With her certificate in "Child Education in Islam," she holds halaqas (small religious educational circles) in masjids, mostly for youth. She is a Parenting Counselor for IslamOnline.net and also writes stories for children.