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One of the best things you can do to ensure that your child remains happy and healthy is to make sure that they are well nourished. Children who experience irregular or disrupted eating patterns may have an increased risk for lower dietary quality and under-nutrition. This can negatively affect overall health, cognitive development, and even school performance. Healthy eating habits can help prevent obesity, high cholesterol, high blood pressure and reduce the risk of developing chronic conditions such as cardiovascular disease, cancer, and diabetes. This is why it is extremely important to help children establish healthy eating habits early and teach them to make healthy decisions later in life.


Learn more information about the ways in which nutrition can affect the health and development of your child by clicking the following sections:

For additional resources about pediatric nutrition, explore these websites: (a resource from the American Academy of Pediatrics) (a website operated by local nutritionists)

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Planning Healthy Meal

Breakfast is often a battle in the morning, but growing children need a near-constant supply of nutrients and protein in order to remain alert and attentive. If your child leaves for school without breakfast, he or she may have to go 12-14 hours without eating before they get to lunch. If time is tight, think about preparing breakfast the night before. A nutritious breakfast should provide a minimum of 200-300 calories and provide a blend of protein, starch and fat.

Make sure to pack your child a HEALTHY snack. Some schools are starting to “police” snacks brought to school, and teachers have been instructed to allow only healthy snacks such as fruits, vegetables, pretzels, crackers, yogurt, granola bars, etc. By not allowing chips, fruit roll-ups and other sugary snacks to enter the lunch box, you are encouraging healthier eating habits that can last a lifetime. Remember that each 12-ounce soda, juice, Gatorade®, or chocolate milk contains approximately 10 tsp of sugar and 150-200 calories. Drinking just one soda per day increases a child’s risk of obesity by 60%!

Infant Feeding Tips

Parents are often looking for exact instructions on how to feed their infant. Unfortunately, no such instructions exist. Every child is unique and has their own idiosyncratic cues that indicate when they are hungry or satisfied. Learn your child’s cues and feed them accordingly, using your child’s growth chart as a reflection on how well you are doing. Infants 0-4 months of age should receive their complete nutrition in the form of infant formula or breast milk. Do NOT use low iron formulas; iron is important for brain growth and development. It is also recommended that young infants do not receive water before six months of age.

For more comprehensive information about feeding your infant, consult the American Academy of Pediatrics or schedule an appointment with our knowledgeable physicians at Children’s Wellness Center for a more detailed discussion.

Body Mass Index (BMI)

What’s the Big Deal About BMI?

Childhood obesity is a national problem begging for our intervention. We know that currently more than 15% of 6 – 19 year olds are at or above the 95th percentile for BMI on a standard growth chart. Studies have shown that a 4 year old who is obese has a 20% chance of becoming an obese adult, with all the associated health problems, but that chance rises to 80% if a child is obese at 14 years of age.  So, it is clear that early prevention can be extremely effective.  As a result, many public school systems have begun identifying “at risk” children by calculating BMIs as a routine screening practice, and physicians are being encouraged to track children’s BMIs beginning at 3 years of age in an effort to promote healthier lifestyle habits early. We will calculate your child’s BMI at every Well-Child Visit starting at age 3 so we identify those children at risk.

The body mass index, or BMI, is simply a calculation that compares the weight of a child with their height. It is widely used to define the terms “overweight” and “obese” because it correlates well with more accurate measures of body fatness and is easily obtained from routinely measured height/weight/age data. So if your child has a BMI between the 85th and 95th percentile for their age and gender, they are considered “at risk” for becoming overweight while a child with a BMI at or above the 95th percentile is considered overweight or obese. Similarly, children at the other end of the BMI chart are considered underweight if their BMI is at or below the 5th percentile. However, the BMI is only a statistical approximation and clinical judgment must be used in applying these criteria to a specific patient. There is a wide range of “normal” for the BMI, and school nurses are being trained to identify those students who MAY BE at risk. Factors like activity level and genetics play major roles in determining what is “normal” for an individual child.

It is for this reason that the BMI should never be interpreted without additional information, including lifestyle habits (dietary habits, exercise habits, sedentary activities), existing medical conditions, and growth trends over time. Ultimately, studying your children’s body mass index is not just about making them “thinner.” It is about creating a lifetime of healthy eating and exercise habits, so they can become healthy adults.

If you still have concerns about your child’s BMI, here are some helpful tips. Good luck and good health!


The best time to start your baby on solid/strained foods is when they can sit upright, with some support, and voluntarily move their head to engage in the feeding process. This usually occurs when they reach about 4-6 months of age. The American Academy of Pediatrics recommends exclusive breastfeeding or formula until 6 months. Our practice recognizes that some infants may not be able to get all their caloric needs from breast milk or formula and therefore, they may be ready for pureed food sooner. Breast milk or iron-fortified formulas are sufficient to meet all of your baby’s nutritional needs until then. Cereal should be mixed with breast milk or formula, but don’t expect your baby to eat much at first. Most infants will start with either rice cereal or oatmeal (preferred if your infant has infrequent or hard BMs). Start them off with just a few tablespoons and feed them until they look away and no longer appear interested. Initially feedings should occur once daily. The time of day does not matter, but try to feed your child at a time when your household is calm and your child is not over hungry. After 1-2 weeks with one daily feeding, feel free to move to 2 solid feedings a day. Most of the infant’s nutrition should still come from breast milk or formula at this stage.

Current recommendations say any single grain, fruit, or vegetable, in whichever order you desire. Only introduce one new food every 3 days (so if your child has an allergic reaction or digestive issue, you can tell what it is from). It does NOT matter in which order you introduce foods. Some people say to start vegetables before fruits so your child doesn’t get a “sweet tooth”, however, there is no scientific evidence to support such claims.  Once your child has tried all the different single fruits and vegetables, they can start “stage 2” baby foods which are more combined foods, thicker consistency, and larger volume. At this point, they can be given two to three solid feedings a day. Their formula or breast milk intakes will natural decrease at this time to a range of 20-30oz. per day.

There is nothing nutritionally necessary in juice. Infants who like juice often become toddlers who only want to drink juice. Excessive juice intake has been linked to a higher likelihood of childhood obesity. Water at age 6 months is okay in small amounts and can be given by Sippy cup, but should not replace formula or breast milk as the drink of choice.

All of the protein that your infant needs is in formula or breast milk. It is not necessary to give your infant pureed meats. You may want to start introducing meats and other protein sources (such as beans, peas, lentils, cottage cheese and yogurt) when your infant is around 8-9 months old.

The strength and condition of your baby’s esophagus is reflected in his or her body tone. If your child can sit up well on his own, and “right” himself into an upright position after leaning over, he is probably ready to feed himself. Dissolvable crackers such as “puffs or wagon wheels” can be introduced at about 8 months of age, but you should absolutely NOT walk away from an infant feeding themselves solids at this point. Review your handout on “what to do if your child chokes”. You can begin to introduce finger foods, or small, bite-sized pieces of soft foods, when your baby develops a pincer grasp (finger-thumb pickup), usually around age 8-9 months. Start with dry cereals that are easy to dissolve in saliva. Only put a few pieces on your child’s tray because they often have a tendency to “squirrel” food in their cheeks and you want them to learn to take a piece, chew and then swallow. Other suggestions for table foods include cooked vegetables, beans, soft, cut up meats, rice, eggs, pasta, breads, etc.

Most children have an interest in sitting at the table for meals, and have the ability to finger feed by 9 months. This is a good time to introduce them to the family meal routine, and to begin gradually increasing the amount of finger foods and table foods in their diet while decreasing the amount of mashed foods that require a spoon. Encourage Sippy  cup (usually with water) use at meal time.

Honey should be avoided during the infant’s first year because of its link to infant botulism. Avoid sweet foods and desserts in the first year of life. No sugary drinks should be introduced. Avoid any choking hazard foods (i.e. popcorn, nuts, hard circular pieces of food such as hot dogs, hard carrots, etc.)

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