Sam Shaw, aged two, right, is becoming fussier about food as he gets older. He does not like fruit much, refuses to drink water, and if allowed, would drink milk all day, then refuse food (except sweets and chocolate). Lately, when presented with dinner, he pushes it away (regardless of contents), yelling "Yeuch, that's disgusting."
All milk is whole milk.
7am One cup Cheerios with milk. Cup of milk.
10am Chocolate digestive biscuit. Cup apple juice (not diluted).
12am Peanut butter sandwich (two slices brown bread). Cup of milk.
3pm Two homemade oatmeal/raisin cookies.
5pm Cup of milk.
5.30pm Two chicken nuggets, piece broccoli. One carton of low-fat strawberry yogurt.
7pm Cup of milk.
7am Porridge made with whole milk, one tsp honey, cinnamon. Cup milk.
10am (on car journey). Small bag teddy-shaped sweets. One third banana.
1pm Pork sausage, two sips homemade vegetable soup, piece white bread. Cup of Ribena.
3pm Piece wholemeal toast, butter and Marmite.
5.30pm One fish finger, cup of baked beans, three pieces of cucumber, one scoop of vanilla ice cream.
7pm Cup of milk.
7am (grandparents' house) Variety pack Ricicles. Cup milk.
10am Piece toast and Marmite. Cup of Ribena.
1pm (in restaurant) One mini sausage, cooked carrots, cup of water.
3pm (in car) Five Jelly Babies. Cup of milk.
4pm One cup of milk.
5.30pm Piece of toast and peanut butter, a piece of broccoli.
7pm Cup of milk.
"Preschool children are active and growing rapidly so they need food that is energy-dense but packed with nutrients, vitamins and minerals," says nutritionist Dr Toni Steer. Sam, like many of his peers, is reluctant to eat fruit and vegetables. Parents' own eating behaviour is important: "Telling a child that a food is good for them simply doesn't work," Steer explains.
"The best influences on a child's eating habits are his parents or other adult carers - studies have shown that if he sees you enjoying these foods, he is more likely to enjoy them himself.
"Parents also tend to give up too soon. When a child refuses a certain food, we say 'He just doesn't like broccoli.' But studies have shown that small children usually have to be exposed to a new food up to 10 or 12 times before they accept it".
Sam's heavy milk consumption is slightly concerning. By the age of two a child's daily milk intake should decrease to about 350ml (just over half a pint) as too much milk reduces appetite and limits dietary variety. "Children who continue to consume large quantities of milk instead of food may have less iron in their blood," says Steer. "While milk is a great source of calcium and protein it is low in iron." He should also be switched to semi-skimmed. Government recommendations are that a child should have full-fat milk from 12 months, but graduate to semi-skimmed at around two. (Skimmed milk should not be given to a child under five). It would also be a good idea to replace the butter on Sam's toast with a vegetable-based spread such as Olivio or Flora: "It's never too young to substitute polyunsaturated fat for saturated fats," says Steer.
Sam's breakfasts are good, particularly the porridge. Cheerios are wholegrain, but contain more sugar than Weetabix or Raisinwheats which might be better choices (high-fibre cereals such as AllBran are too fibre-rich).
As for the biscuits and Jelly Babies: "Sugary foods are unavoidable," Steer admits. "But limit them as much as possible. Rich Tea biscuits, for instance, have less sugar than chocolate ones, and a banana would make a better snack than sweets for the car." Drinks such as Ribena are also high in sugar which can damage teeth. "Offer drinks like this only at mealtimes," says Steer.
Many parents worry about their child eating enough but although he may only eat half a sausage at a sitting, Sam's eating pattern - small meals and regular snacks - is fine. Young children may not follow the adult pattern of three meals a day simply because their stomachs are smaller. Sam does, however, eat convenience foods. "Fishfingers once every couple of weeks won't do any harm," says Steer "but relying on such foods as staples may increase your child's intake of salt and unhealthy fats."
Tips for toddlers
· If weekday family meals are out, eat together at weekends: let him see you enjoying eating vegetables and fruit.
· Saying, "Have a yummy banana," may sound silly, but your attitude makes a difference.
· If food is not eaten after 20-30 minutes, remove it without comment.
· Don't let him see that you are anxious: small children need to feel some control over life (and their parents). If they know they are getting to you they will repeat the behaviour (eg, Sam's "yeuch" at mealtimes).
· Keep trying: re-introduce a "disliked" food, after waiting a week or so, even up to 12 times.
· A child who refuses water may drink it from a bright cup with a straw.