A nutrient-rich diet is important for healthy development in babies and toddlers. Nutrients play an important role in brain development, eyesight and the growth of your child.

Breastmilk or formula has all the nutrients that babies need until they are about 6 months old. From around the age of 6 months, babies and toddlers need different nutrients such as fibre, vitamins and minerals that are found in a range of foods such as fruits, vegetables, grains, dairy, meat and meat alternatives.

When unhealthy food choices (foods that are high in salt, fat or sugar) replace nutrient-rich foods, it can lead to long-term health consequences like obesity, tooth decay and iron deficiency.

A healthy diet with the right nutrition also plays a vital role in maintaining a healthy weight in babies and toddlers. Eating patterns established in childhood continue into adulthood, so the more healthy choices children are offered, the better.

Signs and symptoms of a poor diet

Symptoms of nutritional deficiencies can include:

• being underweight, overweight or obese
• constipation or changes in bowel habits
• being pale or lethargic
• tooth decay
• poor physical growth.

What causes nutrient deficiency?

Nutrient deficiencies may occur in children who do not eat a balanced diet, which often results in inadequate intake of fibre, vitamins and minerals. Some common problems that affect a healthy diet in young children include:

Too much cow’s milk

While dairy products (e.g. cow’s milk, cheese, natural yogurt) are an important source of calcium for toddlers, they should be given in moderation as part of a balanced diet.

Toddlers who drink lots of cow’s milk (more than 500ml in 24 hours) can become low in iron and fibre, often because they don’t eat as much food as they should because they are full on milk. This means they miss out on key vitamins and minerals found in healthy foods. Having too much milk with meals may also prevent the body’s ability to absorb iron from food.

• Limit your child’s cow’s milk intake to no more than 500ml in 24 hours, and to reduce tooth decay avoid putting children to bed with a bottle of milk.
• Continue breastfeeding or formula feeding while foods are introduced through the first year of life. Keep breastfeeding for as long as mum and baby desire, but stop bottles and infant formula from around 12 months. Offer cow’s milk from a cup after 12 months.
• Water from a cup can be offered from 6 months of age and should be the main drink from 12 months.

Not enough fruits and vegetables

Fibre keeps the digestive and immune systems healthy. If your child doesn’t eat enough whole grains, fruits and vegetables, they may not get enough fibre. Low-fibre diets can cause constipation, and put children at greater risk of developing bowel cancers and heart disease later in life. Having adequate amounts of fibre in the diet can also be protective against excess weight gain and type 2 diabetes.

Fruits and vegetables are also a good source of Vitamin C, which is needed by the body to assist with iron absorption, fighting infection and wound healing.

Choosing a variety of different coloured whole fruits and vegetables (yellow, red and green) and including these as part of your child’s normal diet can help prevent problems associated with nutrient deficiencies.

• Aim for 4 serves of grains (e.g. brown bread, pasta and rice), 2-3 serves of vegetables and 1 serve of fruit each day. Read more on number of serves here.  
• Fresh fruit and vegetables are best, but canned (in natural juice, drained) or frozen varieties are also good options and generally contain the same amount of nutrients as fresh. Dried fruit is nutritious, but has a high amount of natural sugar so should be eaten less frequently.

Poor food choices

Often parents think their children are eating healthily because they buy products marketed as ‘low-fat’, ‘no added sugar’ or ‘containing fruit’.

Store-bought juices, purees and products that say they contain fruit and vegetables (e.g. bars, fruit straps, vegetable chips) are generally high in sugar or fats. Some foods marketed at children (e.g. chicken nuggets, fish fingers, hotdogs) and pre-packaged snack foods (e.g. puree in pouches) are low in nutritional value and should be given sparingly.

Reading food labels is the best way to know how healthy a product is. Always look for the fat and sugar values, as these will guide you in making good choices. It’s helpful to know that:

• There are many names for fat (e.g. oils, shortening, milk solids, monoglycerides) and sugar (e.g. sucrose, glucose, dextrose, syrups, malt).
• The ‘Per 100g’ values listed in the nutrition information panel should be used to compare values between products.
• Ingredients are listed in descending order (i.e. a product contains the most of the first ingredient and the least of the last ingredient).
• The fewer ingredients listed, the better.

There are resources and apps that can help understand labelling. Try Eat for Health or the FoodSwitch app.

Allergies and intolerances

Cutting out food groups to prevent allergies is not recommended without the advice of a doctor. There is no need to delay or avoid giving your baby foods like egg, peanuts, wheat, cow’s milk and fish to prevent food allergy. In fact, eliminating food groups at an early age can lead to unhealthy eating habits later in life.

Babies or toddlers who have been diagnosed with food allergy or intolerances should have their diet modified or supervised by a dietitian to ensure they get the nutrients required for healthy growth and development.

Care at home

Generally, most nutritional deficiencies can be managed at home with minor changes to diet. Making healthy food choices and knowing how many serves your child needs for their age can be helpful. See more at the Australian Guide to Healthy Eating.

Some other things you can do:

• Get your child involved in planning, preparing or cooking food.
• Make sure healthy snack options are readily available for your child when they are showing signs of hunger in between meal times.
• Reduce the number of treats given to babies and toddlers, and avoid using treats as rewards. Using treats for behavioural or emotional reasons does not support the development of healthy eating habits in children.
• Learn how to read food labels and to look for hidden sugars.

When to see a doctor

You should take your child to see your GP if you are unsure about your child’s general health, weight or diet. Your GP will be able to refer you to a dietitian for additional support to ensure your child has a balanced diet.

You should take your baby or toddler to see your GP if:

• You are concerned that your baby or toddler may have a food allergy or intolerance.
• Your child has an unbalanced diet and you are concerned about nutritional deficiencies.
• You are concerned that they are not growing or developing appropriately.

Key points to remember

• A nutrient-rich diet is important for healthy growth and development.
• Generally, most vitamin deficiencies can be managed at home with minor changes to diet.
• You should take your child to see your GP if you are unsure about your child’s weight or diet or if you are concerned they may have an allergy to particular foods.

For more information

• Dr Margie: Cow's milk and infants
• Dr Margie: How to deal with the fussy eater
• Dr Margie: Problem feeders – beyond fussy to something more serious
• Visit The Royal Children’s Hospital Food and Nutrition Services website
• The Royal Children’s Hospital’s Weight Management Service
• The RCH National Child Health Poll: Kids and food
• Kids Health Info fact sheets: Breastfeeding
• Your GP, maternal child health nurse or a dietitian
• Raising Children Network Introducing solids, Healthy food for babies and toddlers: the five food groups and Cooking with kids and teenagers.
• Australian Guide to Healthy Eating.