Help from USDA

Are you concerned about the way your day care children eat? Do you have a problem with "picky eaters"? These articles can help you plan for a successful event when it comes to meal times.

 

Eating Behaviors

Where are your daycare children on this chart? Have you even wondered what the usual eating behaviors are of children at a specific age? You might find this interesting:

Development of Eating Behavior

Age	Appetite	Refusals and Preferences	Self Help
1 Year	May be poor for breakfast, but usually good for other meals	May refuse milk from bottle, especially if new nipple style or some other change has been made. Favorite bottle is the evening one. If weaned, may refuse milk from cup. Food preferences becoming well defined: certain cereals and vegetables.	May finger feed part of their meal. A few refuse and help. May need toy or two to hold if being fed.
18 Months	May be decreasing. Usually less than that of vigorous infant. May want milk more from bottle than cup. Appetite usually best for noon meal.	Changes a lot.	Enjoys feeding self. May do so for all meals with help filling spoon. Gives empty dish when finished.
2 years	Fair to moderately good. Noon meal usually best	Many are fussy and hard to please. Go on food jags or refusals. Can name foods and voices likes and dislikes. Likes whole pieces. Doesn't like strained foods or foods mixed together. May like certain tastes, shapes, feels, colors, especially red or yellow.	Some can feed self without help. May want no one enarby. Some may need help. Two extremes of eaters, messy and neat.
2 1/2 Years	Often varies between very good and very poor. Usually eats one good meal; noon or evening. May eat better between meals.	More defined than at 2. Food jags continue. May favor meat, fruit and butter. Feeds self-preferred foods. Eats other foods if fed. Totally refuses to eat disliked foods, especially green vegetables.	May feed self the entire meal or want to eat some and ask help with the rest. Likes routines. Demands same foods, dishes or arrangements of dishes.
3 Years	Fairly good. Less changeable than before. Milk intake increasing.	Less defined than earlier. Meat, fruit, milk, desserts, sweets favored. Eats vegetables. Likes foods that need chewing. May ask for special foods as meal is being prepared.	Feeds self, eats well. Demands for attention while eating may be excessive.
4 Years	Fair. Drinks milk rapidly and well.	Food jags show definite likes and dislikes.	Starts to help plan meals. Helps set table. May be a slow eater.
5 Years	Usually good, but can vary greatly. Breakfast often poorest.	Definite dislikes: cooked root vegetables, gravies, casseroles and puddings. Likes: meats, potatoes, raw vegetables, milk, fruit.	Feeds self slowly but steadily and fairly well. Beginning to spread foods with knife.
6 Years	Usually large. Eyes bigger than stomach. Favors snacks more than meals, especially at bedtime. Breakfast is often still poorest meal.	Food jags. Dislikes some foods because of how they feel. Tries new foods. Doesn't like cooked desserts, cooked vegetables. Likes meat, potatoes, milk, raw vegetables, peanut butter, ice cream and candy	Many finger feed. May still have trouble with knife for spreading.
7 Years	Moderate. Extremes of appetite in different children.	May eat disliked foods, but still dislikes strongly flavored cooked vegetables or cheeses. Likes milk, ic cream, peanut butter sandwiches.	Very little difficulty handling knife, fork, spoon. Still uses fingers to push food onto fork or spoon.
8 Years	Excellent. Poor eater's appetites improve. Some need amount limited.	Preferences similar to 7. Tries new foods. Smell of food important. Loves certain foods.	Less use of fingers. Starts to use knife to cut meat, but not skillfully.
9 Years	Eats about as much as adult. Even poor eaters settle into adequate amounts for needs.	Refuses certain foods, especially if cooked in unfamiliar ways. Likes sweetened desserts.	Good coordination with implements. Tends to saw meat with knife. Cuts pieces too large. May need help.

FOOD PROGRAM TIP
The CACFP recommends letting children's internal signals of hunger and fullness determine how much or how little they eat from the foods offered at a meal. This applies to children of all ages.

Help for Picky Eaters and Their Providers

Snacks are an important part of a healthy diet and quality child care for our children. As a supplement to regular meals they help children get the calories and other nutrients needed to fuel activity and growth. Snacks have an important role in the diet for a variety of reasons:

• Small Children, Big Appetites
  Since children's stomachs are small they often eat only a small amount of food at any one time. At the same time, children need food for their growth and activity. Serving several small "meals" a day is one way to assure that children get plenty of healthy foods. Nutrition professionals recommend offering children healthy foods every 2 to 3 hours during the day. This means 3 meals and 2 healthy snacks each day.

• Everyday and Sometimes Foods
  Everyone enjoys salty snack foods and sweets once in awhile. The key to planning healthy snacks for children is to keep high salt and sweet foods as “sometimes� foods. Since snacks are such an important part of the food a child eats each day they should be planned around healthy "everyday" foods.

• Eating Together Provides a time to Enjoy Each Other
  Eating together is a social activity. It promotes language development and social skills that benefit children for a lifetime. Providing healthy snacks and allowing children to choose the foods they want provides a relaxed time for children to learn table manners, sharing and conversation skills. It should be a fun and relaxing time for everyone.

 

Offering Healthy Snacks Takes Planning

Planning a healthy snack is like planning a healthy meal- it starts with selecting the main food. Select a main food that is nutrient dense (high in food value).

• Vitamin A, C and iron foods
  Children's diets are often low vitamin A, vitamin C, iron or calcium. Foods high in these nutrients are often a good place to start when planning healthy snacks.

• Fruits and Vegetables
  Research is showing the health benefits of diets that include more fruits and vegetables. Look for ways to serve more fruits and vegetables as part of children's snacks. Strive for at least "5-A-Day" (5 or more servings of fruits and vegetables each day.)

• "Superfoods"
  Superfoods are foods high in nutrients and the other newly discovered health promoting substances. Some of the superfoods include: peaches, pumpkin, winter squash, kale, spinach, collard greens, carrots, tomatoes and soy products.

• New Foods
  Helping children enjoy new foods is one of the greatest gifts we can give our children. Planning snacks around new foods is a great way to gradually introduce new foods into children's diets. Serve smaller "sampling" portions the first time you offer a new food in addition to the other familiar foods the children already enjoy.

Consider the color, texture, flavor and temperature of foods to make snacks tasty and appealing for the children in care.

Plan regular snack times to assure children are offered food before they are overly hungry. Children often act out or are irritable even before they are aware they are hungry. Children who are overly hungry may be more likely to eat too quickly and may overeat if they are not aware of their feelings of fullness.

When claiming snacks for reimbursement on the Food Program be sure to select foods from two different food groups. The food groups are: Milk, Grain/Bread, Meat/Meat Alternate and Fruit/Vegetable/Juice.

 

High Octane Snack Ideas

Tortillas/Salsa Melted Cheese	English Muffin Peanut Butter	Fruit Yogurt Animal Crackers
Pumpkin Muffins Milk	Milk (shake) Frozen Fruit	Corkscrew Noodles Mixed Fruit w/yogurt
Grapes String Cheese	Wheat Crackers Tuna Salad	Waffles Applesauce
Banana Bread Chocolate Milk	Peaches Cinnamon Toast	Oatmeal Cookies Milk
Soy nuts V- 8 Juice	Orange Wedges Raisin Cookie	Apple Juice Tomato Sauce Breadsticks
Rice Cakes Cheese	Cottage Cheese Fruit Cocktail	Gingerbread Apple Cider
Raw Vegetables Cot. Cheese Dip	Graham Crackers Yogurt	.

 

Nutrient Rich Foods

Vitamin C	Vitamin A	Iron
Cantaloupe	Cantaloupe	Dry Beans
Citrus Fruits and juices	Mandarin Oranges	Dry Peas
Kiwi	Mango	Eggs
Pineapple	Papaya	Meat
Raspberries	Apricot	Poultry
Watermelon	Peaches	Enriched Breads
Strawberries	Carrot	Fortified Cereals
Asparagus	Greens (Collards, Kale)	Dark Green, Leafy Vegetables
Broccoli	Red Pepper
Cabbage	Broccoli
Cauliflower	Pumpkin
Kale	Spinach
Peppers	Winter Squash
Potatoes	Yogurt
Tomatoes	Milk

FOOD PROGRAM TIP
Foods from two different food groups must be offered at snack. Fruits, vegetables and their juices are all in the same category. Keep this in mind when choosing those high octane snacks.

 

Eating is one of life's simple pleasures, except if you are at a table surrounded by preschoolers, all sharing their opinions about the food offered at the meal. Because children are easily influenced by others, even the most adventurous eaters in the group are bound to be affected.

 

What can a provider do to encourage children to experiment with new foods?

• Give permission to not like the new food. This removes some of the pressure. If a child doesn't like the food after tasting it a possible response might be "maybe your taster is not old enough to like this food yet" and "we'll try it again when you're a little older".
• Don't give up. Children are naturally cautious about new foods. They are born with inexperienced taste buds and need to experiment with new tastes before incorporating them into their diets by choice. It often takes 10-15 exposures to accept a new food.
• Set an example. Show that you enjoy it and are enthusiastic about eating it. You can be a positive role model for the children by showing how much you enjoy the foods served at the meal.

 

Tips for Introducing New Foods to Children

• Use a small plate and a teaspoon for a serving spoon.
• Offer small portions. Children can easily feel overwhelmed and defeated.
• Offer one new food at a time. Fill out the meal with familiar foods that are well liked.
• Use the "sneak preview" technique. Leave the new food sitting on the counter as you finish preparing the meal. When one of the hungry children wanders in the kitchen they may be interested in a pre-meal hors d'oeuvres.
• Involve the children in the preparation of the food. Washing the vegetable or sprinkling some chopped pepper on a salad is often all that's needed to encourage eating.
• Associate a new food with the story or activity first. This offers time for discussion before the children actually see the food prepared.
• Create fun and silly names for the food. Broccoli trees and red pepper boats are more fun to eat.
• Set aside one day a month to have as Adventure Day. The advantage to this strategy is two-fold. The children know that there is going to be something "odd" happening that day and all other days are "safe days".

Source: Adapted from Ellyn Satter, Feeding with Love and Good Sense.

 

FOOD PROGRAM TIP
No single food offers all the nutrients needed for optimal health. Offer a variety of foods throughout the week to help children meet their nutritional needs. Find ways to enable picky eaters to eat as wide a variety of foods as possible.

 

He Can't Eat That! - Caring for Children with Food Allergies

You've probably heard the common concern "he or she is allergic to..." As professional child care providers you are put in the position of sorting out what exactly that means and how to serve these children in a relaxed home setting while meeting their special needs.

The term food allergy is commonly used to mean any reaction to a food. It has become a "catch all" term for everything from foods the parents prefer the child not to eat to full-blown, life-threatening reactions to certain foods. It's important to discuss each child's specific situation with the parents to determine each child's needs. Some good starting questions are:

• What food(s) is the child "allergic" to?
• What happens to the child when they eat that/those foods?
• What needs to be done for the child when they have those reactions?
• How long does the reaction usually last?
• Have any other foods had a similar or lesser effect on the child?
• Has a recognized medical authority diagnosed this "allergy"?
• Can other foods within the food group be substituted for the food the child is allergic to?

 

What food(s) is the child "allergic" to?"

Occasionally families will tell you about a food the child has had a reaction to but will forget that several other related foods also cause a similar reaction. For example, a child who develops bloating stomach cramps after drinking milk may be able to eat cheese and yogurt without a problem. However, large amounts of ice cream may cause a similar reaction.

 

What happens to the child when they eat that/those foods?

The purpose of this question is twofold: how serious is the child's reaction to the food and is it a true food allergy, food intolerance or another type of reaction to food.

As mentioned before, reactions to food can be subtle or serious. Children who are allergic to strawberries can have a hive-like reaction or red blotches on the skin. This reaction can be painless with no itching or irritation to the child or it can be more serious with itching and possible breathing problems.

There are several types of reaction to food. Knowing the type of reaction can help in deciding what foods to avoid. A few of the most common food reactions are outlined below:

Food	Type of Reaction	Symptoms	Offending Substance-Notes
Cow's Milk	True Allergy - Allergic to cow's milk protein	Variable	All cow's milk A physician may recommend a modified cows milk or soy based milk as a substitute.
Cow's Milk	Lactose Intolerance	Bloating and stomach cramps	Cow's milk Lactose (milk sugar) intolerance is often "dose related." The person may tolerate a half-cup of milk while a full cup causes symptoms. The lactose in cheese and yogurt is broken down making these foods acceptable to individuals with lactose intolerance.
Peanuts	True Allergy - Allergic to peanuts and peanut oil	Variable - Breathing Problems	Sensitive individuals can have skin or breathing problems when they eat peanuts or products containing peanuts or peanut oil. Care should be taken to avoid products containing peanut oil and traces of peanuts as can be found in fried foods and many candy or cookie products. New data suggests that some children can outgrow this allergy.
Shellfish	True Allergy	Hives or Breathing Problems	Avoid all shellfish (Crab, oysters, scallops, lobster and shrimp).
Wheat	True Allergy - Allergic to the gluten protein in wheat	Stomach cramps, diarrhea and poor absorption of nutrients in food	All wheat and wheat flour products. Small amounts of gluten may not cause symptoms but may prevent healing of the intestine and limit absorption of other foods and nutrients.

 

What needs to be done for the child when they have those reactions?

Reactions to foods may be uncomfortable or life threatening. A cool cloth may be sufficient to make the child with hives more comfortable while a child that is having trouble breathing may require a trip to the emergency room for an injection of epinephrine or another form of treatment. Epinephrine has become available in a self-injection "pen" and may be prescribed by the physician for the most severe of allergic reactions.

 

How long does the reaction usually last?

Understanding the "usual course" of an allergic reaction will help you know what to expect if a child does have a reaction while in your care. If the reaction seems unusual, contact the family or seek medical advice immediately.

 

Have any other foods had a similar or lesser effect on the child?

Foods from the same botanical family may have similar or lesser allergic reactions in the individual. Examples of foods in the same botanical family are: eggs, chicken, duck, turkey, goose, pheasant and grouse. Plums, almonds, peaches, apricots, cherries, prunes and nectarines are in another botanical family.

 

Has a recognized medical authority diagnosed this "allergy"?

Although you do not want a child to be offered a food that can cause him or her to be uncomfortable you also do not want to unnecessarily restrict the variety of foods in a child's diet. Some food allergies, especially in infants, can be outgrown while other types of food allergies require dietary supplementation or monitoring if they continue for a long period of time. For your own safety and the well being of the child, Providers Choice recommends that when you are asked to limit the types of foods you offer to a child you obtain a statement in writing from the family and the child's physician.

 

Can other foods within the food group be substituted for food the child is "allergic" to?

The USDA regulations state that if a child cannot be offered the regular meal pattern you need a Special Diet Statement Form from a medical doctor or a licensed nurse practitioner to claim a child on the Food Program. For many food allergies, you can substitute another food with the food group for the offending food. For example, a child who cannot eat pork can easily be given another meat alternative so no Special Diet Statement is needed. However, a child who cannot drink milk will need a Special Diet Statement since nothing else within the milk group can meet the requirement for fluid milk.

 

For further information on food allergies check out the following resources, web sites and support groups:

American Academy of Allergy, Asthma and Immunology (AAAAI)
611 East Wells Street
Milwaukee, WI 53202
800-822-2762
http://www.aaaai.org

American College of Allergy, Asthma and Immunology (ACAAI)
85 West Algonquin Road, Suite 550
Arlington Heights, IL 60005
847-427-1200
http://allergy.mcg.edu

American Dietetic Association
216 West Jackson Blvd.
Chicago, IL 60606
800-366-1655
http://eatright.com

Ashtma and Allergy Foundation of America (AAFA)
1125 Fifteenth Street NW, Suite 502
Washington, DC 20005
800-7-ASTHMA
http://www.aasa.org

Food Allergy Network (FAN)
10400 Eaton Place, Suite 107
Fairfax, VA 22040-2208
703-691-3179
http://www.foodallergy.org

Allergy and Asthma Network - Mothers of Asthmatics, Inc.
3554 Chain Bridge Road, Suite 200
Fairfax, VA 22030-2709

International Food Information Council (IFIC)
1100 Connecticut Avenue NW, Suite 430
Washington, DC 20036
202-296-6540
http://ificinfo.health.org

Please Note: Referrence to these and other sites are provided as a service of Midwest Child Care Association but does not imply endorsement of these sites.

FOOD PROGRAM TIP
The CACFP regulations require a special diet statement any time a child of any age cannot eat one or more of the meal pattern requirements of the Child and Adult Care Food Program.

 

Seven Strategies to Establishing Healthy Eating Habits

• Accept a division of control.
  Focus on putting healthy foods on the table and let the children decide how much or how little to eat. Let their biological signals determine hunger and fullness.
  
  
• Exploit the window of opportunity to jump-start healthy eating.
  From 12 – 21 months babies and young children put everything in their mouths. It’s a great time for getting all safe foods accepted and enjoyed. By the time a child is two he or she can have a repertoire of 100 to 200 healthy foods that are recognized eaten and enjoyed.
  
  
• Offer a varied selection of healthful foods.
  Almost any menu can supply enough calories and protein but only a varied diet with a rotating supply of vegetables, fruits and protein sources can supply the right balance of vitamins and minerals for lifelong health. Children push their parents and caregivers to provide variety by refusing to touch what they ate yesterday.
  
  
• Be patient and persistent with offering new foods to children.
  Around the age of 2, children instinctively become more cautious. It may be necessary to offer a food 15 times before it’s accepted and enjoyed. Don’t try to offer the food in question at every meal. Let it go for several days, then offer again.
  
  
• Create bridges of familiarity to speed acceptance of new foods.
  Children learn by comparing new experiences to familiar ones. Appearance, taste and texture are all things a child notices when given a new food.
  
  
• Expect imitation of yourself.
  It is most important to be good role models with eating. Kids learn to love anything they see their caregivers and friends enjoy.
  
  
• Involve children with food.
  Children are thrilled to plant a seed and see what grows. They enjoy cooking, learning and exploring foods. All of these activities increase their willingness to try new foods.

  Helping young children develop and grow is a wonderful task that parents and caregivers share. When you realize that children learn to enjoy healthful foods, know that you have given the children one of the most important gifts of all, the best chance for a long and healthy life.

Source: Adapted from "Zero to Three", Nutrition of Very Young Children, Aug/Sept. 2000, National Center for Infants, Toddlers and Families.

FOOD PROGRAM TIP
Offer new foods at the beginning of a meal when children are hungry.

 

Kids and Caffeine

Whether they're decking the halls or cruising the malls, kids are popping open soda cans and guzzling caffeinated beverages like never before. In a holiday season filled with festive parties, it's not unusual to hear parents say, "Sure, you can have another Coke."

True, a couple cans of pop won't kill our kids. But health experts warn that we may have underestimated the effects on a child's growth and development.

"Caffeine is mildly addictive," notes Michael Jacobson, executive director of the Center for Science in the Public Interest (CSPI.) "Twenty years ago, teens drank twice as much milk as soda pop. Now they drink twice as much soda pop as milk."

Indeed, the soda consumption of teenage boys, the all-time pop-guzzling champs, nearly tripled from 1978 to 1994, according to the U.S. Department of Agriculture's research service. In 1994, nearly three-quarters of teen boys drank an average 34 ounces, the equivalent of almost three cans daily.

All told, children and teens down more than 64 million gallons of soda per year. Not only are teens drinking more; soda consumption for 6- to 11-year-olds doubled between 1978 and 1994.

 

Soft Drink Companies Market Through Schools, Ads

While soda companies (not unlike cigarette companies) deny any attempt to reach the under-12 market, a look at both demographics and marketing suggests otherwise. Research shows that coffee consumption rises between ages 15 and 24, and declines thereafter.

Meanwhile, growing numbers of cash-strapped school districts are reaping millions from soda manufacturers who pay for the right to sell their products in cafeterias and vending machines. Often the marketing deals allow companies to place ads in strategic locations like the school gym or school buses. Savvy media messages, crafted with youth in mind, link soda with desirable traits like energy and winning.

"It's crazy to be pushing junk food on kids at schools," protests Jacobson. Several years ago, his organization petitioned the Food and Drug Administration to require manufacturers to list caffeine as a product ingredient. To date, CSPI has not received a response.

Parents are well-advised to remember that caffeinated soda is a non-nutrient that can cause sleep problems, irritability, and stomach upset, says Mary Rimsca, M.D., director of health for Arizona State University and a spokesperson for the American Academy of Pediatrics. In addition, the phosphoric acid that causes carbonation in soft drinks hinders the absorption of calcium.

"It binds the calcium," says Rimsca. "We are starting to see increases in incidents of osteoporosis at a young age. It's just beginning to come out in studies."

 

Advice for Parents

You don't want to be The Grinch Who Stole Pepsi, but you also want your children to get the nutrients they need. Some suggestions from health experts:

• Limit soda consumption to parties or special occasions only. Most pediatricians recommend no more than one 12-ounce can per day, tops.
• Make sure soda is not a regular substitute for milk or other calcium sources.
• Avoid the "added caffeine" drinks like Coca-Cola's Surge or Pepsi's Josta.
• Become "soda savvy." Mountain Dew weighs in with 55 milligrams of caffeine per 12-ounce can; Sunkist has 40, Coke, 45, Pepsi, 37. Sprite is caffeine-free.
• Talk with school administrators, food service workers, and school nurses. Does your district have a contract with a soda manufacturer? Express your concerns about soda in schools.
• Talk frankly with kids about nutrition and marketing messages. "I know you like Coke or Pepsi and it's okay to have once in a while, but the ads that make it look as if you'll play better in gym if you drink soda are filled with lies. You need strong bones to play well and bones need calcium. Soda doesn't have calcium."

 

Note: To receive credit for this module you must speak to each section in this module:

• Eating Behaviors High Octane Snacks
• Help for Picky Eaters and Their Providers
• He Can't Eat That! - Caring for Children with Food Allergies
• Seven Strategies to Establishing Healthy Eating Habits Kids and Caffeine