Common nutrition concerns for toddlers

Allergies tend to run in families. A baby is at an increased risk of food allergies if:

• A parent or sibling has food allergies, eczema, asthma, or hay fever.
• The baby has severe eczema.

To decrease the risk of food allergies, introduce common food allergens such as peanuts, tree nuts, egg, milk, wheat, soy, sesame, and seafood at around 6 months of age, but not before 4 months, or when infant is showing developmental signs of readiness, see Introducing Solid Foods.

Here are some tips when introducing common food allergens

• Prioritize allergenic foods that are usually eaten at home or part of the family diet.
• Offer these foods one at a time because it may make it easier to identify the culprit food should an allergic reaction occur. Wait for 3-4 hours before offering another common food allergen.
• Start with a small amount (1/4 or 1/8 teaspoon) before trying a little more around 15-20 minutes later, to determine if your baby has an allergic reaction.
• If no allergic reactions occur, the food should be included in your child’s diet regularly (e.g., at least 2-3 times a week if possible) to reduce the chance of allergy in the future.

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Constipation is when stools are dry and hard and your child has difficulty passing them.

Every child is different in what is considered normal for their bowels. The type, colour, and smell of stool and how often they have a bowel movement will change as they get older.

Changes in stool consistency also happen when solids are introduced or when weaning from breast milk.

Some children have a bowel movement several times a day and others go for days before passing stool. As long as the stool is soft, that is normal. If the stool is hard and dry, it is constipation.

• Drinking less fluid than usual or not drinking enough fluids, especially in hot weather.
• Incorrect dilution of infant formula. Always follow label instructions.
• Introducing cow’s milk before nine to 12 months of age.
• Introducing infant cereal before six months of age.
• Too much infant cereal.
• Switching from breast milk to infant formula may impact stool consistency.
• Certain medications.
• Changes in routine, such as the start of daycare.
• During or after illness with fever or vomiting.

When your baby is over six months of age and has started on solids:

• Continue to breastfeed for two years and beyond or offer infant formula.
• Offer extra fluids. In addition to breast milk, you can offer plenty of water in an open cup between meals and at regular feeding times, but offer the breast first. For toddlers nine months and older, limit cow’s milk to no more than three cups per day as more will fill them up and leave less room for other foods.
• If you are offering formula, make sure that you prepare formula with the right amount of water.
• Offer a variety of foods that are the right texture for your child’s age.
• Do not stop giving certain foods because you think they will cause constipation. Individual foods do not usually cause constipation.
• Offer foods that are good sources of fibre every day, such as whole grains, legumes, vegetables and fruit. Add higher fibre foods gradually as this will help prevent gas and stomach pains:
  • If using infant rice cereal, switch to infant brown rice, barley or oat cereal.
  • Offer pureed prunes. Start with one tablespoon (15 mL) a day. Slowly increase to four tablespoons a day if needed. Try adding them to baby cereal along with mashed banana for a tasty breakfast.
  • Add soft, fresh fruit or cooked vegetables to diet.
  • Offer soft cooked lentils, beans, or peas.
• Do not give your toddler fibre supplements.

If short-term constipation does not improve within one week after trying these suggestions, speak with your health care provider.

Diarrhea, or watery and foul smelling stool, is a sign of illness. Whenever this happens, care must be taken to make sure your child does not get dehydrated. If your child shows signs of dehydration, see your health care provider right away.  Signs of dehydration include: 

• Decreased urination (fewer than four wet diapers in 24 hours for a baby older than four or five days)
• Increased thirst
• No tears
• Dry skin, mouth and tongue
• Accelerated heart beat
• Sunken eyes
• Greyish skin
• Sunken soft spot (fontanelle) on baby's head
• Irritable or extremely sleepy and difficult to wake up