This question does come up every now and again in my practice and I do often see young children on low fat yogurts, skimmed milk, very lean meat, only whole grain products and looking very skinny and often iron deficient. Firstly, I want to say that the suggestions I am making today, are for children that grow normally and where overweight and obesity is not a problem.
Fat is the most energy dense source of nutrition in our toddlers’s diets and does not only play an essential role in the development of the cell membranes of the organs (i.e. retina) and the central nervous system, but with a small stomach capacity plays an important role in achieving energy requirements. Do you remember expressing breast milk and being surprised at the thick fat layer when the breast milk separates out? Well, almost half of the energy from breast milk comes from fat. The World Health Organization recommends that breast feeding ideally should continue until 2 years of age, meaning also that they have requirements for higher fat until this age.
Of course there is fat, fat and fat. So breast milk is high in essential fatty acids and therefore an ideal source of fat. We also do not want young children to have a diet high in saturated fat (i.e. animal fat), but rather a mixture of different fats – olive oil, rapeseed oil, coconut oil, avocado oil and yes they can have real butter (remember that butter can be high in salt, so check this) as well. Its best though to provide a variety of fat as each type of fat has a different role.
When it comes to protein that often contributes to fat intake – ideally one should aim for 2 portions of oily fish per week, the rest white meat, white fish and pulses and limit red meat to twice per week. When it comes to milk products, in a child that grows normally the recommendation is to have full fat milk and products until 2 year of age and then you can consider changing this to semi-skimmed milk and lower fat milk products. Remember, that fat does not only contribute energy but some of the fat sources contain fat soluble vitamins like vitamin D, E and A and omega-3-fatty acids.
Now what about fibre content of foods. Should you give whole grain rice/pasta and bread from the time you start weaning? The exact amount of fibre young infants require is unclear, but we do know that excessive fibre leads to rapid gut transit time, meaning that the food moves faster through the gut and can reduce the time for absorption. In addition, too much fibre can bind essential vitamins and minerals and reduce the availability for absorption. It is therefore better to have a balanced approach as your toddler should already have 5 portions of fruit/vegetables per day which provides plenty of fibre. I usually suggest providing whole grain (not granary) bread from when they are able to finger feed and they can have Weetabix or other whole grain breakfast cereal from 7-8 months of age (make sure low in salt and sugar), but to wait for whole grain rice/pasta and other similar products until they are one year of age.
It has become a big fashion to add ground up flaxseed and other seeds to toddler meals, but remember flaxseed for example is very very high in fibre, so your child does not get the time to absorb the omega-3-fatty acids, so rather use the oil than the seeds themselves if you want to increase the omega-3-fatty acid intake.