A: Dear Ms. Hab, I’m assuming your 2-year old is otherwise healthy and has normal weight and height. If this is the case, then you have entered the 2-year old eating twilight zone, a phenomena we parents simply cannot understand. Nothing is more frustrating than preparing a meal for your child, only to have them pick a few bites and then walk away. Then to top things off, they still continue to do well on their growth charts. This is because, in general, most children will eat enough to maintain growth. But it’s still important to present the child a healthy balanced meal each time.
There are several things to know about children at this age. They tend to be very picky in quantity of food as well as variety. My 3-year old still only eats mac and cheese, chicken nuggets, or pasta as her main meal of choice. Getting her to eat a vegetable or fruit can be quite an ordeal at times. They also aren’t growing as fast as they were during infancy, so their calorie per weight ratio is different. Toddlers and preschoolers also prefer smaller and more frequent meals than the three meals a day that we are used to.
Don’t try to force eating or use it as a punishment or bribe. This will lead to other problems in the future. Offer healthy meals at each sitting, and let them eat what they eat. If they want snacks between meals, choose healthy foods. Avoid juice as much as possible, since this will suppress appetite – or at least water it down. Most children will decrease their milk intake once they start eating solids. If they drink very little milk or dairy, you can always offer more foods high in calcium, such as spinach, broccoli, collard or mustard greens, navy beans, black beans, almonds, sesame seeds, canned salmon or sardines, oysters, cooked soy beans, tofu, fortified orange juice, or fortified waffles/cereals. Sometimes I have my parents mix in a crushed Tums into their child’s food. I also tell parents that they can offer a multivitamin if their child’s eating habits worry them.
Ways to encourage children to eat include: giving them simple choices, let time them help with food prep, having the entire family sit down and eat together, eliminating TV during meals, speaking positively about the food you’re eating (how can you convince your child to eat it if you won’t?), and providing proper portions.
One thing that I noted in your question is that your child is still being offered a bottle. I routinely recommend that all bottle feeding stop at one year of age. By this time, the child should be able to use either a sippy cup or regular cup/glass. Continued use of the bottle could eventually lead to things you don’t want, like tooth decay, ear infections, obesity, and speech problems.
If your child continues to have eating issues, especially if he is underweight or small for age, then have his pediatrician examine him and review his eating history. Hope this was helpful.
Dr. Bill
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