Barts and The London Children's Hospital | For patients, families and carers | Health tips | Health tips - Nutrition
Health tips - Nutrition
Q. How can I tell if my child is getting enough iron?
Q. How can I tell if my child is overweight?
Q. How can I make sure my child has a balanced diet?
Q. My child is a fussy eater, what should I do?
Q. How can I reduce my child’s sugar intake?
How can I tell if my child is getting enough iron?
Answered by: Sara Mancell, Paediatric Dietitian, Barts and The London Children’s Hospital.
Iron is a very important nutrient that is needed to make blood and keep the body healthy. Your body cannot make iron so it has to come from the food you eat.
If your child’s diet lacks iron, they may show symptoms such as tiredness, poor appetite, lack of concentration, pale skin and poor growth.
There are ways to ensure your child is getting enough iron. Give breast or formula milk until your child is one year old, then introduce full cream/fat pasteurised milk and do not give more than one pint (500ml) a day.
Avoid giving your child tea to drink, particularly with meals, as this will prevent the body from absorbing iron. Meat, fish and eggs are rich in iron and should be given daily. Vegetable sources of iron are less easily absorbed so it is important to give your child a variety of iron-rich foods, including dark green vegetables such as broccoli, breakfast cereals fortified with iron, beans and pulses, and dried fruit such as raisins.
Vitamin C helps us to absorb iron from food. Encourage your child to have food high in vitamin C, such as vegetables, fruit or a glass of juice, when they are having an iron-rich food at mealtimes.
If you are worried that your child may be deficient in iron, consult your GP.
How can I tell if my child is overweight?
Answered by: Marie Griffin, Paediatric Dietetic Support Worker, Barts and The London Children’s Hospital
Sometimes you can tell by the size/fit of their clothes. However, the best way is to ask your clinic nurse, health visitor or GP to calculate your child’s body mass index (BMI). This is done by dividing their weight in kilograms by their height in metres squared, and there are special BMI charts for children.
If you think your child is overweight, then he/she almost certainly is. Have your child’s BMI checked as this is the only way to spot weight problems early.
Being very overweight as a child can lead to health problems in later life, including life-threatening conditions such as heart disease, high blood pressure, and type 2 diabetes.
Overweight children may also experience breathing problems, difficulty playing sport, bullying and low self esteem, while losing even a small amount of weight can bring many health benefits.
If you want to discuss issues around your child’s weight, see your GP, health visitor or nurse. Raising any concerns now can count towards a healthier future for your child. If measurements show that your child is overweight, you may be referred to a dietitian for advice.
You can also help your child by reducing fats and sugar in their diet. Encourage them to eat fruit and vegetables, substitute fizzy drinks for low-sugar drinks or juice, and make fatty and sugary snacks an occasional treat.
How can I make sure my child has a balanced diet?
Answered by: Michelle Webber, Paediatric Dietitian, Barts and The London Children’s Hospital
Healthy eating should start young for good growth and development, and to develop good eating patterns which last a lifetime. It is important that children eat foods every day from all five food groups: fruit and vegetables; meat, fish, or alternatives; starchy foods; dairy products; and small amounts of fatty and sugary foods.
Children can enjoy the same foods as the rest of the family. Remember that mealtimes should be fun so eat together as a family.
Here is a guide to what your child should be eating:
Fruit and vegetables: aim for at least five portions daily to provide vitamins, minerals and fibre. A glass of 100 per cent juice only counts as one portion no matter how much your child drinks.
Meat, fish and alternatives: at least one portion of meat, fish or alternatives such as eggs, beans and lentils, every day ensures growth and development. For vegetarians, two portions of vegetable protein and/or nuts contain enough protein for children.
Starchy foods: include a portion, such as potatoes, rice, pasta, cereals, bread or couscous, at each meal.
Dairy products: encourage your child to have half a pint of milk a day, or include more yoghurt, cheese or fromage frais in their diet. Dairy provides calcium for strong bones and teeth and protein for growth. Too much milk may suppress your child’s appetite for other nutrient rich-foods so limit it to no more than 500ml per day.
Foods containing fat and sugar: your child needs some fat for fuel and growth so allow them to choose some of these foods. Limit sugary foods as they damage teeth. It is better for a sweet treat to be eaten at the end of a meal and not as snacks.
Lastly, ensure your child gets enough iron by including iron-rich food such as meat, eggs, beans, spinach, dried fruit and enriched breakfast cereals regularly. They can be eaten with foods high in Vitamin C (such as carrots, orange juice, salad) to help iron absorption.
My child is a fussy eater, what should I do?
Answered by: Christie Graham, Paediatric Dietitian, Barts and The London Children’s Hospital
Food refusal or being a ‘picky eater’ is a phase that most children go through at some stage. It is very difficult for parents as understandably it can cause a lot anxiety and stress.
There are ways to encourage your child to eat a healthy, balanced diet but it is important never to force a child to eat. A good rule is that it is the parent’s responsibility to provide appropriate food and the child’s responsibility to eat it. If you have more questions, your health visitor or local children’s centre are great places to start.
Here are some suggestions that may help if your child is a ‘picky eater’:
- Try to establish a regular routine for meals and snacks rather than allowing your child to ‘pick’ during the day.
- Eat with your child when possible and allow your child to eat with other children as they learn by copying each other.
- Try to have a calm, relaxed environment without distractions such as the TV.
- Use unbreakable brightly coloured plates and bowls with sides, short handled spoons and blunt ended forks.
- Try not to rush slow eaters but don’t let meals drag on. Set a meal time limit of about 20 minutes.
- Allow your child to feed him or herself and don’t worry about mess. If you are feeding your child with a spoon, give him/her a spoon as well.
- Reward positive eating behaviour with verbal praise and smiling. If your child is behaving badly at mealtimes ignore it and remove food without comment.
- Give him/her small meals, you can always offer more
- If a meal is refused, do not offer any other food until the next meal/snack and allow at least two hours between meals.
- Be consistent. Everyone who is involved in mealtimes with your child should deal with mealtimes in the same way. This way your child knows what is expected of them.
How can I reduce my child’s sugar intake?
Answered by Marie Griffin, Dietetic Support Worker
Sugary foods and drinks can cause tooth decay, the major cause of tooth loss in children and young adults. The sugar in food reacts with bacteria that are naturally present in the mouth to cause acid which attacks the teeth.
To protect your child’s teeth, try to limit sugar in their diet. Keep all sugary foods and drinks to mealtimes and encourage them to snack on sugar-free foods and drinks in-between meals to prevent their teeth from being under constant attack.
Saliva neutralises the acid caused by sugary foods after 20-30 minutes, when teeth are ‘safe’ again. But if you carry on consuming sugary foods or drinks, the acid process starts again and our teeth are once more under attack.
Constant attack causes tooth enamel to decay and a cavity will form. The dentist may fill the cavity, but if decay is severe the tooth may be lost and need to be extracted. Tooth decay and tooth loss in children can lead to problems with eating, speech and with permanent teeth coming through if there is no longer a milk tooth acting as a guide for its placement.
This is why it is important to limit your child’s sugar intake. Try to make sure they mainly snack on sugar-free food between meals. Some teeth-friendly snacks include milk, water, fruit (chopped or sliced), vegetables (chopped or sliced), crackers with cheese, fingers of toast with cheese or Marmite, breadsticks, rice cakes, oat cakes, muffins, crumpets, pita bread, chapatti, small sandwiches filled with cheese or egg, and plain yogurt with added fruit.
