The 411 on Toddler Nutrition & Eating: Starting Solids, Allergies & Picky Eaters (w/ Dr. Ari Brown)

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Remember, like this video and subscribe to this page. So you don't miss episodes dropping every Monday and Thursday. Welcome back to another episode. I almost just said, "Of Dr. Ari Brown." "Of two parents in a podcast featuring Dr. Ari Brown."

Is this our fourth time with you? I think. - A fourth? - Yes. - Fourth time. - Yes. Yeah, this is our fourth episode with her, because we learned so much every time. And this is our first episode getting her in scrubs.

“I think you look very official. - This is what I usually wear every day.”

So I'm in my comfort zone. Well, if I like the color of them, thanks. Do you know what your color palette is? We talk about this, I'm a spring. Oh, I'm cool. So I guess I'm winter.

Is that right? Was winter an option? - Yeah. Is that right? But is this winter? - Yeah, plum is a plum. I do. - This is winter.

Yeah. - And it is jewel tones. Yeah, jewel tones. - Jewel tones. Jewel tones are your colors. - I love it. I think so. - Okay. We look great. - Thanks.

How many of this is so, and I know everyone in the room might know the answer is,

how many years did you go to school total to get the MD after the Ari Brown County MD? Yeah, stop counting. So four years of college and then four years of medical school. And then three years of residency. And I did a fellowship as well.

I don't count that one. But anyway, so what is that like 11 years or something? Wow. - And you were premed when you were in undergrad. Correct. - Correct. So, but that's not a major.

“So you have to fulfill your premed requirements”

to be able to apply to medical school, which proves that you can, you know, excel in science and know how to think, analytically, blah, blah, blah. And then you can select another major path of degree in. And so, I was a little bit of an outlier because I didn't get a degree in science,

because I like enough science actually want to learn something else. And so, my bachelor's of science is actually in child development. So, oh. - Yeah. - How applicable. It was perfect. And I can tell you I was a preschool teacher for, I've had to be a student teacher.

That is the hardest job ever. So, I have true appreciation for teachers, particularly preschool teachers. So, by really nice Christmas present for every preschool teacher you ever interface with. And do not give them food. I see that they don't want food.

I see they always say we have food at home.

Please give us something else. - Yes. Be kind. - Be kind. Okay. - They are the hardest job ever. For preschool teacher. - Mm-hmm. - Okay. Well, kind of applicable to today,

because we're talking about feeding the little ones, which you know all about. This episode is all about toddler nutrition and food.

“But where we're going to start is the initial feeding of an infant, right?”

Around six months. Like the first solid foods you give them. So, if you're listening and maybe your kids, 18 months old, we're going to get there. We're just going to cover off the top.

All the questions that I get, which is like, "I'm scared to start my solid foods. I'm scared to start the feeding journey." So, I'm trying not to spoil it, but I was fascinated to realize how wide they're.

What do you call this? - They're very. They're airways. - Mm-hmm. How not wide it is. - Mm-hmm. So, we're going to talk all about that. So, you guys can look forward to, basically,

the beginning stages of food all the way up to throwing food on the floor to wise my toddler so picky to what dies should you actually avoid? So, we're going to get into all of that. Do you think to add? - No. No. Excited for this. I love food in many ways.

A very interested in food. Both for our children and ourselves. I think as we start the episode, and we start by focusing on feeding and babies,

Okay. You're a new parent. You're doing some form of breast milk or formula.

“At what point do you start thinking about real food?”

And what is everything that should be on your mind? And then we can get into some specifics. Okay. I'm going to give a really high level on infant feeding. And so, yes, for the first six months of life, all your baby needs is breast milk or infant formula.

It provides complete nutrition for your baby. At around six months of life, that's when you're going to start adding in what we would call complimentary food or solid food. And I want to dispeel a myth that's out there,

which is food before one is just for fun. It is not just for fun. Whoever said that was not a pediatrician.

Well, I said it a million times.

It bears it. It doesn't matter. It's just for fun. No way. Okay. It should be fun now. I mean, that's important. It is an important to be fun. And we want food to be a joyous experience. It's a developmental experience.

So your child is learning how to move food around in their mouth and how to pick up food with their hands and bring it into their mouth. So that's a developmental experience. It's also a social experience where you're engaging

and having really quality time with your family. So, and I want food to be viewed that way. And then the other two pieces are, it does become a source of nutrition. And the key nutrient that babies don't get enough of from breast milk

or formula starting at six months is iron.

So you actually do need a source of iron

in your baby's diet starting at six months in addition to what they're getting elsewhere. And we want to introduce all of the high allergy foods because introducing them sooner rather than later proves to desensitize them to these food proteins

and lower the risk of developing a food allergy. Yeah, I just got not fun because now we have to think. Now if to find our iron foods and introduce all the allergens.

“Okay, I think we, so the first question that I was going to ask you”

is what do you think the best foods to introduce to your baby are at the six month mark? And those are going to be high iron foods. Well, what would love to hear Dr. Brown's answer? You go.

Oh, well, we she did just say hi. Is it salmon? Are they?

Is that what's high iron?

I'm going to talk about that. As, you know, given that we're about to go back into this. I guess. You know, we obviously, we went through. We had a program a date.

I really liked our program a date. But I also don't want to share anything. We did. I kind of want to hear. And then we can update.

All right, what did we do right? What did we do wrong? And how should we update it for baby number two? Yeah, I agree. Okay.

So what are the foods we start with? If that came off. It didn't come off. It's okay. It's for the sake of the episode in the name of content.

Okay.

“So what are the foods we should start with that six months?”

Okay. So let me take one step back. And this is again, high level comment is a lot of things have changed. And what I like to say is what we've learned about babies over the past 30 years has changed. Baby's haven't changed.

But what we've learned about them has. And so if you talk to a seasoned parent who has a five or ten year old or your own parent, you're going to get different information. And so what we used to tell people is you're going to start with, you know, rice cereal.

And then you're going to introduce vegetables. And then you're going to introduce fruits. We threw all of that out the window. That is no longer relevant. That is outdated.

So present day modern recommendation is I want your kid to just eat what you're eating. With the caveat that you are eating and healthy diet. But we want them to have all the foods. I don't care what you start with. It can be a breakfast taco.

I mean, heck, we live in Texas. Start with a breakfast taco. We want them to have all the foods. And so don't be afraid of introducing new foods. A variety of foods, the high allergy foods.

And yes, the source of the iron, which we're going to talk about. But what I found with Tate early on is like, it took a couple of months for her to actually figure out the process of how to eat. And there were foods that were just a lot easier for her to handle at the beginning. So like, the idea of giving her like a tortilla out of the gates was completely off our radar.

It would have been a choking hazard.

“Like, for us, the foods, I think that we were very intentional about what are foods that are nutritious.”

Our healthy, but also our easy for her to both chew and swallow. So out of the gates, we started with avocado. Mashed, yes, with avocado, mashed sweet potato, mashed broccoli, mashed cauliflower. And then transitioned, I think we went to bone marrow, chopped up muscles. Yeah, I've got it honey.

I'm sure, I'm sure what we did. The more I share the more noodles. No, I was like, oh my god, are we going to listen to that? Well, I just, I wanted to share our process. I mean, cakes and ribs.

No, but that came later. The ribs came later. So did the muscles. No, I did it. The muscles were like week one.

Okay, I love that. I love that. Okay, so when I say, I don't want to scare people with the breakfast taco. Okay, the ingredients that are in a breakfast taco.

“What would you, you know, you might have black beans.”

So you can mash them or you can puree them. You're probably going to have guacamole.

I love avocado is the first food.

I love avocado all the time, but first food. It's great. It's easy. It's mashable. And your right textures are going to be an issue.

That's really easy. You know, like, these are the things eggs. Super important to introduce. So like, all of those ingredients and, you know, is your baby going to be able to hold the tortilla and actually do something meaningful with it, probably not in the beginning. But I'm kind of talking about the ingredients to make people realize, wow.

I don't have to start with rice cereal and strain peas because that was, you know, 30 years ago. And that is absolutely, you know, we recommend now. These days, I'm all about quality over quantity. Especially the order you get the more you just want staples you guys, especially in your closet,

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Can you give us some good sources of iron, right? White meat and red meat, eggs, beans, lentils, green leafy vegetables, fortified cereals. There are hemsources of iron and non hemsources of iron. Heme blood is in meats, it's more, it's more bio-available.

So you can have lots of iron in spinach, but it's less bio-available than what's found in meats, but all of them have iron. Okay, okay, that's really good to know. So that's what a salmon have. What's the thing in salmon?

Omega 3? I guess that's what it is. Okay, okay. So then the red meat is, that's where that's where we're going to excel in our iron. Yeah, white meat too, you said.

Yes, all meats. And that's something that parents ask me all the time. They're like, oh, we don't eat red meat. I'm like, that's fine. They're still iron and beans.

Yeah.

And you know what we have never tried lentils.

So let's try those. So very much real food, but breaking down that real food into a foreign factor that a baby can consume, whether you're mashing it, pureing it, or whatever. Yeah.

And when they're first getting going, they are learning. Again, it's a developmental experience. So they may not know what to do with it. And you're going to start probably with something soft, pureed, or a little bit slightly chunky,

and you're going to work your way up. And we can talk about the different ways the baby can actually hold the food. So you can have like an omelette stick, you know, where they hold it in their palms. That's a six-but thing, or you're preloading a spoon of yogurt, or you can help them.

I don't have a problem with parents helping a baby eat, which is another whatever internet thing,

And then by nine months, as they get more proficient at it, yeah, then they're starting to do this pincer grass, where they're picking up bite-sized pieces of food. So yeah, I wouldn't expect a six-month-old to be able to manage a bite-sized piece of food,

but it's a building process, and the more you practice, the better they get at it.

And so I always tell people three times a day,

starting at six months, they're eating breakfast lunch and dinner. That may not be really a meal, the volume wise, but they're practicing, and they get three chances, and they're participating, which is really important.

“Yeah, you have to think back to the photos.”

Remember when she started, I mean, it was just everywhere. And I remember thinking, is she ever going to learn to get this food really in her mouth? But then you're right around nine months, we did. I saw a big leap, and she could pick up things more

and put them in her mouth. So it was very experimental at first. Like, I think you're imagining a breakfast talk out today with Tate, but you have to think back to when she was six months.

But that she couldn't pick it up. Yeah, that's why I said what? I knew what she meant, though. Yeah, like, you got to mash it up,

because you gave us a pro tip, which was bring the--

Oh, so, okay, okay, I love that. I have to share this hack, okay? Okay, because when I travel, when I travel the world, I love watching parents around the world. And I was in Asia last year, and I saw this mom pull out

scissors out of her diaper bag and cut up the pieces of food. Like, boom, boom, boom, boom, and the kid was sitting there eating. I'm like, oh, my God, should take me five minutes with a fork and a knife. Why did we not do this here?

Such a great tip. I loved that hack. Like, you get food scissors, right? We have a pair of scissors in our kitchen that are dedicated to food, and you just put some of those in your diaper bag.

Genius. Easy. So easy, because you have the knife in the fork. I mean, it just takes long and when they're hungry, they're hungry. And so, just to kind of continue on the timeline,

just to direct it, though, at six months, you start introducing healthy foods in the right form in baby friendly form factors. Are there any foods at six months to 12 or at six months that you should delay introducing? Because they're either a choke, healthy foods,

because they're per se, a choking hazard, or something else. You're exactly right, choking hazards, because a baby's airway is about the size of a peanut.

“And so, that's why you want to be really careful with things”

that they aren't that good at chewing, and could potentially get large. So, that would be a hot dog, or a grape, or a cherry tomato, or a hard carrot, or a big piece of steak. Like, these are things that your baby is not going to be able to

chew effectively, and potentially it could get stuck in their airway. And popcorn. Yeah. Plenty and chips. Yes.

Any kind of chip, I feel like, can break off in their right. So, their airway is the size of a peanut. That is so small. It's about, yeah, I mean, it's the diameter, the diameter. So, that's why you just need to be careful.

And so, one of the things, you know, they're, well, one of the many things that parents are afraid of when they introduce solid food. One is allergy risk, and the other is choking. And so, I actually have, like, the size, the dimensions in the

baby form one book. And I'm like, if you want to measure it, here it is. But if you want something to be in the palm of your child's hand, you want it to be about the size of your finger. So, like, an omelette stick, or a little toast stick.

They can hold her zucchini, or whatever. Avocado. They can hold in their hand, and when we're looking at her choking hazards, it's about the size of your pinky nail. So, it's about a quarter of an inch diameter.

That's small. Yeah, it's small. Okay, so that, so all, when it comes to choking, two, I see, and we have one. What is that device called?

Oh, those measures? No, it's a pump that goes in your mouth, like, if they do choke. Do you think those really work? Oh, yeah, I've seen them. I don't know.

Okay, I don't know, but here's what I do know,

is everyone should take an infant CPR class, so that you're prepared whether it's your own child, or some other kid, like, yes. Everyone should take CPR class. We took one, we took a refresher, because we took it too early.

We took it before she was born, and then six months rolled around, and we were like, what was that again? And so we took it again, and it did make us feel better. Just more equipped to know how to, you know, hit that middle of that back like it was really,

because I do think you're right. So let's talk. We've got the two, let's stay on choking. So what do parents need to know about choking when introducing foods and beyond?

“In summary, you should always supervise your child”

when they're eating. Number one, don't give them too many items,

in their cheeks and not swallow them. So, you know, a couple at a time, make sure they swallow it,

and then they can have more, they can always have more.

Have a CPR class, and then be aware of choking hazard foods. If you really want to offer some of these foods, you can cut them in quarters, but hot dogs, grapes, cherry tomatoes.

Those are kind of the obvious ones that a child might eat. Popcorn raisins, peanuts in their true form, a hard carrot, hard piece of steak. And what is the real risk with choking? Like I know it's probably its most parent's number one fear

when it comes to feeding, and it was ours too.

“But what is the real, do you have any statistics on choking?”

There are about 10,000 ER visits a year, due to choking, and about 140 deaths a year, and those are usually kids under the age of five. So, yeah, if you can't breathe, that is a problem. So, that's the issue with choking.

So, that's really interesting, because I was about to ask, like, how long should choking be a focus for parents? And that number going up to five is later than I would have thought. But it sounds like the choking risk is something that really does carry through.

It's not just in those first, you know, three, six, nine months,

and even now our tape is eating, you know, so seamlessly, it still should really be top of radar for us. Well, you just pay attention, you know? I mean, I'm sure she's very good at chewing food right now, but you just want to pay attention.

And again, don't give her too much. Make sure she's swallowing it, and make sure that they're bite-sized pieces. And so, at what point is it okay to leave a child unsupervised when eating? Probably kindergarten.

“I mean, I think your greatest risk is probably under age three,”

but I mean, the peanut-sized airway is small. And the airway does grow. Yeah, I mean, when we're talking about a baby, it's the size of a peanut. It does grow as the baby, you know, as the child grows.

But again, and they get more proficient at chewing, right? So you've got two things in your favor with age. Watching your loved ones age can be one of life's toughest milestones. I've seen many friends suffer and overwhelm from trying to balance kids, career, and home.

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start your senior care journey with confidence. When it's not you, it's care.com. Let me make one more comment about choking, because parents are fearful of choking, but there's a big difference between gagging and choking.

And they're will be gagging. So I just want to warn everybody that gagging is okay. That means your child doesn't know what to do with the food, and it just comes out of you. So that's very different from can't move air

because the food is launched. So as your child is practicing, I mean, it's definitely a buzzkill for dinner when your kid pukes over the table, but it might happen because they're learning.

“And what are the signs to differentiate between the two?”

Yes, silence, right? Because if they're choking, they can't make noise. So that's what you're looking for. But they're trying to get up and that's okay. Yes.

And do you recommend what age do you recommend? What are your thoughts on this? Because I see a lot of controversy both ways, fastening them into the high chairs, versus not fastening them in,

so you can pull them out easily. If they are choking, perhaps. I just saw this on TikTok. Did you guys just see that? Did you guys just see that little strap thing?

Were the kids are like...

Anyway, it's amazing that the products

that are out there for babies and parents. But anyway, my take is for a high chair. I like them to be secure

slide out because he wasn't belted in.

Wasn't on my watch. That's okay. I wasn't home.

“But if they choke what you just got to be fastening them.”

Okay. Okay. So you prefer to fasten them into the chair. Yeah. Then they're secure. That's the point of it. Right. I just see a lot of this course about do fasten them

and don't fasten them into a wasn't sure. Okay. So the other large fear around feeding your kid is when the allergens come into play. Right.

So what do parents need to know about allergies when introducing new foods? We've learned a lot about introducing foods and back when I started in practice, we used to tell people to wait to introduce eggs,

wait to introduce seafood, wait to introduce peanuts. And now we're like, please, full speed ahead starting at six months because the data is really clear

that countries that actually introduced peanut products to babies had a much lower risk of peanut allergy than in the US and in the UK where we waited. That is the memo to parents.

Please introduce these high allergy foods. The fear is not introducing them. Okay. Yes. So, and you want to keep it in the rotation too.

So it's not just one and done like, oh, we tried peanut butter and it was fine. Three times a week, peanut products and egg products starting at six months. And then all of the other high allergy foods,

which I'm happy to rattle off but you've got cow milk protein and you've got soy protein, and weed, and sesame, and shellfish, and fish, and tree nuts,

peanuts, all of those foods you want to introduce. I just can't tell you that your kids are not going to have a shrimp allergy because you're introducing it and doing it three times a week.

But we have real pretty clear data on peanut and egg products three times a week. On different days, you don't want to do peanuts and eggs and the same meal the same day,

or does that not matter? So you can track if they do have a reaction? Yeah. So that's a great and fair question. And again, what we used to tell people

is one new food every two or three days. So if there's a problem, you'll know which food is the problem.

“And I think that really fed into this fearful feeding.”

And I want people to have fearless feeding. Okay. So just do it. Just do it. And if there's a problem,

you go backwards. Okay. We're going to do an elimination to figure out what the problem was, but just full speed ahead. Because if you do one every two or three days

and they're taking forever to get through all the foods, and the goal is just start all the foods and move on. So there's this trend online

where the first time people introduce peanut butter

to their baby, they drive and they sit outside the hospital and they give the peanut butter there. What do you think about that? My office really.

Like, I have patients who sit out in my parking lot to introduce peanut butter to their kids. And I'm like, all right, whatever. Because they think you're going to eat it in like five minutes later,

like stop breathing. Right. But that's not the reality of how if your kid does have an allergy, how does it come to fruition? What does that look like?

Right. So a true reaction. Hives, which look like big welts,

“or they almost look like mosquito bites.”

They're popping up all over the place. Lip swelling, difficulty breathing, immediate and perfused vomiting. Those are red flags. Not my kid has this red area on their cheek,

which by the way happens all the time, because your kid is messy and their food all over their face and it can be irritating. That is not a food allergy, not a food allergy. Okay.

And so if that can happen, let's say that does happen, then what does the parent do? Right. So if they're actually having

labored breathing, you call 911. Okay. If they have hives, you can call your pediatrician. We're going to tell you to give,

believe it or not, Zertek or Claryton for babies. Benadryl is really out of vogue now.

That's the first generation.

Annie has to mean it's very sedating. Zertek or Claryton is what we recommend. And then we watch and we see and we don't use that food again. We don't eat that food again,

and then we do some testing. Okay. Okay. So that's the food. So that's what you're looking out for.

Okay. It's very interesting. Do you have any questions on top of the allergies? I will say this. Have you heard of these grow happy boxes?

There are a lot of brands that have like dusting of all of the proteins. Yeah. They have all the allergies. And they have little packets of them.

And so instead of keeping track of the foods, we got that it ours was called grow happy. And we just took one out and gave her a packet of it a day. Do you like the idea of that? I think conceptually it's fine.

There are a lot of brands that are out there that do that. It's fine. It's a micro dose of all of these different food proteins.

So that's the reason why I'm like,

because I really want them to start eating real food. Right. Like make the shrimp okay. Yeah. Give it to them.

Yeah. Which is well. We did too. Because if I found it to be hard to track, but yeah.

Okay. Okay. So there was a myth that I... Well, I think that we buffed three myths in this. Myth number one is when you start introducing food to your baby,

“you should do it by introducing the healthy foods that you're eating”

in a foreign factor for the baby, not like they need a specific ABC. So that's myth one. Myth one was food is fun under one. Okay.

Yes. So another myth is food is not fun under one. Food should be fun, but also the nutritional components are very important. Yeah. Myth number three is that you should not avoid introducing allergens to your children,

to your child, until a certain age. You just start slowly introducing specifically eggs and peanuts at six months, each three times a week in small doses. So any other myths that we should debunk as it... Whether you would like to debunk as it comes to babies in eating?

No. I think you did a great job. I just want to clarify one thing though,

is that when we talk about peanuts, people always say,

but I can't do peanuts because it's a choking hazard. So how do you introduce peanut products? So either peanut butter or you can... And it has to be really thin. It's because like a big glob of peanut butter is a choking hazard too.

So thin spread of peanut butter or add some water, make it into a peanut sauce, or you can buy peanut flour, and then you can mix it into things. Okay, that's smart. Those are good hacks.

Yeah, we did a pancake and we did them in little slippers. Okay, peanut butter in them. Yeah, and these little muffin things. Excellent. Chopped up.

Okay, now we're going to talk about the bottle really quickly. These are two listener questions and we have to cover them, because milk and food is, I guess, interchangeable. When should bottles be fully cut? I tell people at that one year well check.

It's time to go. Okay, and then my son is 15 months and right now at the one year mark we switched to cows milk from formula, but he refuses to drink it. If he isn't drinking any milk at all, what do I do?

Eat yogurt and cheese. I mean, these are things that really keep parents up.

“So I think they deserve a little bit more commentary if you want to hear more.”

We do. Yeah, okay. So because your child under age one is drinking breast milk or formula, and odds are even if you're breastfeeding, it's going to be in a bottle.

Like parents really cling to that because it's their meal, right? But once your child turns one, milk is a beverage. It's not a meal. It does have nutrition in it, but you don't have to rely on it.

That's why it's okay to get rid of the bottle, because your kid doesn't have to chug eight ounces in ten minutes. I am fine with them sipping it out of a cup. So it's not as important. It's very different.

So view it differently. And that said, if your child doesn't want to drink milk, it's fine. They just need a source of fat, calcium, vitamin D. A nice, you know, plain or Greek yogurt or cheese,

is going to be a serving that's going to get them what they need. They don't have to drink the dairy. They can eat it. Okay, there it is. They don't have to drink the dairy.

They can eat it. So that should help people have peace of mind. What's the latest trend in hiring you ask? Skills based hiring, which emphasizes capabilities over education and direct experiences.

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Meet your match on zip recruiter. Okay, let's start here. What should a standard day of eating look like from a one to two year old? The basic answer is three meals and two snacks a day.

The reality is is one of those meals is going to be a meal,

But the goal is offer three meals and two snacks a day.

Because people, myself included, we think you're not getting enough food because dinner goes untouched. But that's okay. Yes, because the meal might have been breakfast or it might have been that way.

“Or it might have been that mid afternoon snack, which that's why snacks are really important because that may be the best meal of the day.”

That snack may be the meal. So you got to make sure that when you have the opportunity that you're offering nutrient dense foods. So they do not need to clean three plates and all the snacks throughout the day. No, I think that is so important. That's the number one thing I think about all the time.

I'm like, there's no way she can go to bed. She's got to be starving and it's like she's not. To me, but it's also really important is like, I don't know where I feel like I've heard it. But I feel like I've heard like kind of there's you should lean away from snacks if possible.

But the idea that snacks are actually a critical part of of a baby or toddler in a child's nutrition is is great to know.

Because yeah, I don't know why. At some point I felt like I'd heard like meals over snacks, but the snack can be the meal. Sounds like it. Okay, let me let me add a couple of points to that. So one is that kids still need to eat about every three hours. And you're going to have a pretty grumpy kid if you have to get them from one meal to the next.

So and there's some, you know, maybe there's an argument to be made for adults too to have five small meals a day and not just three. Totally. But I don't take care of adults. So we're going to go back to the kids.

“That's why every three hours feed them something, right?”

Now, they may not eat much breakfast, but man, they eat that mid-morning snack.

So that mid-morning snack is just not to just tie them over to the next meal. That may be their best meal. So that's why I kind of explain it in those terms. And the snacks need to be, again, something nutrient dense probably something with protein in it and not just a car. But just depends on, you know, the day and where you are and what your kids doing.

So good segue to our listener question asking about the carbs versus, you know, what food groups are repeating. So how much protein carbs fats do our babies need? I swear my baby only eats fruits and carbs and I'm worried about her getting enough of a variety of nutrition. Yeah, I try not to focus too much on the macro nutrients, but I'm going to give you just a rundown for babies and then toddlers. So babies under a year of age, breast milk infant formula is like 50% fat about 40% carbs and then about 8% to 10% protein.

Okay. And then a toddler still needs quite a bit of fat, believe it or not, but probably more 50% carbs 40% fat. So those are a little bit reversed and then, you know, maybe 10%. There's a range, but anyway, less protein, maybe maximum 20% protein in their day. So you still need a lot of fat in a toddler's diet, good fat, because their brains are growing so much.

So that's the distribution, but you're going to just drive yourself crazy if you're trying to find a completely balanced meal at every meal.

“And every day, your child, it's going to be a wild card, what are they going to eat, what are they not going to eat? So I would try to look at, how did I do over the week?”

Did my child eat this week? And as long as you're trying to find that healthy balance and being my full that they might need more fat, then we do is adults. I think you've accomplished your goal. Okay. So I consider myself pretty well versed in food, like I understand my food groups, but even I need examples right now. So I can imagine the listener might too. If we're going to focus primarily on carbs and fat, but maybe you don't want to do chicken tenders. Like, can you give me some examples of what would be ideal foods?

Sure. Well, let's be clear about what carbs are, because it turns out not everybody understands what carbs are. People think carbs is like rice and bread, and guess what, your banana is a carb. Okay. Okay. So you're green beans. So she won't eat a green beans. Okay. Well, whatever, you know, fruits of vegetables are carbs.

So when I'm saying, you know, they're eating a lot of carbs. I'm not just telling you to eat pasta and whatever mac and cheese, right? Right. So they do need a decent amount of carbs, including fiber, which is really important. And they do need some good fats. So yes, there is fat in white meat and red meat. There is fat in there. So it's not just protein and eggs or great source dairy has, you know, that's where that milk is coming in or yogurt.

That's all.

Nuts, avocados, fatty fish.

I mean, those are those have fats in them. They also have proteins in them, but they have fats in them as well. We eat a pretty high fat diet. Well, I'm just in a non-traditional, not in a way that people don't traditionally think about that. Well, I, like, yeah, I agree on that too, especially with carbs, but I do think I wanted to delineate between, like, I don't know, chicken tenders and fruit for a source of carbs.

Yeah, the same for just chicken without the tender part. Or I love actually, I'm glad you mentioned the air fryer. I love sticking, like, panco bread crumbs and, like, flaxseas to air fryer. Like air fryer, it looks like a chicken tender. Like you can frame it, you know? I eat them all the time with bread crumbs.

She cheeses another really good one. Yeah, so dairy products, yep. Very, very high fat. Um, what? Um, I had something, but I, I forget it.

Well, okay, I like this question though, now that we're kind of talking about chicken tenders, etc. Are there foods, parents should limit or avoid at this age when they're one to two years old?

“Um, I think specifically here we're talking about how important is nutrition?”

I think is the general question there. Red dice, for example, have a lot of attention this year and last year. So what are some things, you know, and then there's also this Cheerios today are not the same Cheerios we had 50 years ago. There's more processing happening.

So what are foods that people should avoid giving their kids?

I would say it's important to look at your own diet first because we want your child to eat what you guys are eating.

But that makes an assumption that everybody's eating a healthy diet. So look at your own food first. And then that said, offer a variety of foods that as much as you can prepare in the home. I know that's a hard leap for parents that are working especially. It's real hard, but the more you prepare in your home, the healthier it's going to be.

Fresh foods if possible. Minimally processed if you're going to buy something that's in a package. And try to avoid fried foods. That's, you know, chicken tenders. They're probably fried and they're also processed.

So again, I'd rather you make your own chicken tenders with, you know, chicken and

“panco bread crumbs in an air fryer if that, you know, if that's what is a hit for your child.”

And I do think this is one thing that we found so fascinating was.

You see goldfish and you associate that to be like, that's what I'll give my little kid. But like we don't eat goldfish. So I love this concept of what would you eat? Because a lot of adults we try to make healthier choices. And so the idea of feeding your kid the same way that you would want to feed you.

So I, you know, I think is important. Like why why would the kid have the chicken tenders for dinner? But their mom and dad have like a chicken and veggies. Right. And you are building a foundation for your child.

Turns out to be really important. No pressure. But you are building a foundation for lifelong eating habits. And this is your opportunity for those little tiny taste buds to develop a broad palate. And this is why, you know, this is what kudos to you guys.

This is why Tate eats a variety of foods.

“Because that's what you're offering her with your seasonings, the way you have prepared it.”

So your kid should not be eating bland foods, not eating mac and cheese and chicken tenders. While you're eating the beautiful salmon that you've prepared, right? Like let her eat what you guys are, you know. So so important to have a foundation of a broad palate and healthy eating habits. Because that's what is going to be there go to their default as they grow up.

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“I think speaking to our specific, our specific situation is like food has not been a pain point for us.”

And to build off what you said in terms of our strategy, our strategy has really been like make food that tastes awesome and it's healthy that both we eat and she eats.

And if we just slap like a piece of turkey in front of her, that is going to just inherently get shut down over time. Versus like this morning, we made egg bites and it was eggs, cheese, peppers and bacon. Like I love them and she love them and great balanced nutrition in them. And so I think that like one way it hasn't been a pain point is because we've been very intentional about it. To what you said, we do cook pretty much everything at home and we've read up a lot on, you know, the to do's and and and the two avoids.

That we're shooting her on home here. The second thing that I found to be incredibly beneficial this to be much more recently is having her part of the meal process and having her cook.

Now every morning we cook together and oh boy, does she like see what's going on and know it's going on from like actually wanting it as it comes out of the oven to like under even just more developmental things like today. After we put the cottage cheese in the eggs, she like what I put it down and funny enough this was caught on video. She took the lid she like as I was putting down she's grabbing the lid and like slamming it on.

“So I'm sure I'll get in trouble here for like being to talking good about us, but I found that this is an area that like hasn't been a pain point and I think we've done the way we've done things could be helpful to others.”

Honestly, I think you guys are great role models. I mean, so I'm going to give you guys. I'm going to give you guys brandy points. You don't have to do your own horn. I love the videos with you guys cooking together and I think you're sending a great example for families who can't even fathom having their toddler in the kitchen and helping them and you proven that you have a toddler who knows like how to mix and knows how to put all the ingredients in like that's awesome and she's invested in the process and so that's one of the things I always tell families.

And we can talk about pegheters, but one of the tricks is your kid is going to be much more interested in eating something if they've helped, you know, put the effort in to make it. They're going to be invested. They want to know how it turned out totally and where we're lucky is we have time. I mean, I'm not granted this is happening to 5 a.m., but like it is. I know I got it. I got to like I know so often like it is so much apparently is so hard, but like. Starting with breakfast. There was a great Lebron James story about him turning his nutrition around at some point in his career. He realized, hey, what I put my body drastically affects my performance on court.

“And the follow up question was like, what advice do you have to someone else who's starting to turn their diet around? He's like, just start with breakfast.”

Oh, I like that. And so like, and what I found with tape is I didn't know what to do in the morning. And so it was like, okay, we have at some times like three hours to kill before the day gets going and so that's where a lot of the cooking came from. So now it's like truly an hour of activities. I do think the conversation around food is really important because as you're saying like you are building the foundation for them. And but why can you help draw a line of like, is it a gut microbiome like what are we, what's the underlying root here of what we're developing by putting healthier food options into their stomachs.

Well, you're correct that the microbiome is influenced by your dietary choices. So, I mean, I wish I could eat more, you know, keep her in kimchi and all these other things but at least at you over. But like there are some really good microbiome foods and also prebiotics, which are fiber, which helps that, you know, nurturing the microbiome. You're really important, but you're right, you're metabolic health. That builds over time or deteriorates over time. And so if you are building a foundation for healthy food choices, that's just going to be what your child is used to eating.

You know, it's really introductions to foods and we know they're going to go to birthday parties and they're going to have pizza and they're going to have chips and of course they are.

But we always just say the meals that we can control will control.

Yes, and I do think we have to be realistic and and I always say this to families like everything in moderation like everything in moderation. So sometimes you are, you know, on the go and you're going to have a snack that is not a great like whatever, but it is what it is. That you're stable and and actually that brings up a comment I want to make about what's in your pantry like foods in your pantry are a staple.

“If you have to go out and get it, it becomes a treat.”

So that's my go to when I talk about ice cream like it's okay to have ice cream your kid can have ice cream every once in a while, but don't have it in your freezer because then you're going to eat it all the time right. And you go out and get okay like this I like this topic of sugar. So this is this is a listener question is an important to stay away from sugar until two years old. I've heard that it's linked to healthier outcomes when the child's older. Right, I think we are learning more about sugar and being more mindful of sugar.

There are natural sugars which are fine to eat you just want to add sugar and I do want to warn people about pouches because pouches are really popular. They're a go-to snack and they're pretty healthy, ish, but they usually have some form of fruit in them and added sugar. So it just be really mindful of things that are maybe hidden sources of sugar. I want to plug a grant here, unpaid, but there's one that we'd love, I know who it is, yeah. So I hear you on the pouches. There's a company called Serenity Foods.

They do meat pouches, so like their pouches are like bison and sweet potato and salmon and like kale and these amazing blends.

And those we rarely ever ever ever use pouches at this point, like yeah, we rarely do, but when we have had to use them, that Serenity has been great. Ton of protein, a ton of fat, healthy carbs, healthy fat, like it's versus different than like those sugar loaded ones. So a ton of different ones. Yes. I like that.

There's the consistent rhetoric out there which is, do not give your child sugar for the first two years of their lives. And so just to clarify, your answer on that is, as long as it's natural sugars, you're fine, but no added sugars. So that's kind of number one.

And then is that correct?

Yeah. And no artificial sugars, too. Okay. Thank you. Yes. No added and no artificial sugars.

“And then my kind of less maybe more niche follow on question to that is what about adding more natural sweeteners?”

Is that something we should avoid? Like when I make though, when I make her her banana oat muffins, should I put some Stevie in there? Put a bit of maple syrup in there or no? I probably wouldn't do Stevie a. If you're going to add a natural sugar, I mean if you're going to do like a govine nectar, you're going to do maple.

I mean, you know, sometimes it really does add a little bit. I would just not do it for everything because we don't want that sweet flavor to be in everything. But I think in moderation, I think it's probably okay. Okay. Because then they'll start to just want that, right?

I'm going to blame them. We we've want to celebrate all the different flavors. Yeah. So everything doesn't have to be sweet.

“I think that's a good that's a good point.”

Okay. I'm going to move. Oh, I think this is a good one. Well, I want to do the red dye. Yeah. So what's going on with red dye? Because it became that I don't know anything about it. I just see red dye is the enemy we're taking it out of food.

Should we avoid red dye? Then I notice in Tylenol and ibuprofen there now advertising dye free. We're going to deal with red dye for for children. There are a lot of issues. I'm not going to go into all of them.

I'm just going to say that there are health concerns. There are behavioral concerns. And do you really need to eat something that is artificially colored? I mean, I think that's that's my hard stop is like, Does it really need to be artificially colored?

And so that leads you to is this an ultra-processed food, which probably is baseline is not going to be as healthy as something that's fresh.

Some dyes have been removed.

I think that's great. The other medications. They're have been die-free products that are on the market. Now consumer demand is going to drive more of those.

“And I think that's a step in the right direction.”

Okay. So you're saying if possible to avoid. Sure. For sure. Okay. Great. We all have those moments as parents. You're out at a restaurant or a playground.

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“Because I think the number one thing parents deal with when we're out of allergy land.”

We're out of, we're not out of choking land. But it's not top of mind because they can chew their food more. And one thing that I saw, because maybe you told me, was they get more picky because now they can chew their food. They're not so focused on chewing it.

Now they do want to pick, they want to pick their foods. And assert their autonomy. So enter really picky toddlers when it comes to eating. So why do toddlers suddenly refuse foods that they use to love? I'm going to be honest, I have no idea.

But they all do it. They all do it. So you can feel better that you're not alone in this. And they will want one thing for a few days or a month. And then they don't want it anymore.

And they, I don't know, maybe they're like, I'm tired of eating this. I just want to move on. But the one thing about picky eaters and the reason why toddlers are not interested in trying new foods. It's a term called Neophobia. They're afraid of new things.

And if you think about evolution, like these blueberries didn't kill me. So I'll keep eating those, but those red berries. I don't know what they are, right? So it's a fear. It's true.

And so that may be why they just eat the blueberries. Because that's safe. I feel good when I eat those. That's really sweet. I didn't think about that.

And is it not though building to what you were saying earlier on the importance of eating what your child is eating? Because if they then see you eating the red berries, it's going to just incline them to do the same. That's exactly right. So if you don't eat your vegetables, don't expect your kid to eat vegetables. You got to eat them.

You got to be the role model. You didn't die. You didn't die. You're safe. What did you just say?

We're hiding them in this field. Which is what I do. Like the egg bites. It means that you put brown broccoli, cauliflower peppers into it rather than serve them independently. Because when we serve them independently, she doesn't eat them.

Funny enough. I don't eat them. But when we blend them, we both eat them. Yeah. So in terms of picky eating habits, when it comes to a toddler, what's normal and what's not.

Right. So in general, you can expect that your child is going to eat one really good meal in a day. Or once every three days, they're famished and they really well. If you get a child who actually eats well at every meal, wow. That's a win.

But I wouldn't expect it. And they don't eat calories per body weight. They don't eat as much as your baby did.

“So you have to kind of be prepared for that.”

And not worry that your child is somehow going to, you know, be malnourished because they're not eating. If they're hungry, they're going to eat. If they're not hungry, they're not going to eat. So you provide the healthy meal. That's all you can do.

They're the ones that are just having to eat. And we should repeat the mantra. You can't make a toddler eat sleep or poop on the body. It has to be their idea. So that's where it comes in of like you make the healthy meal.

You put it on the plate.

Yes. So parents worry. And then they face that, you know, they say, parents worry. And then they face their decisions on that concern that their child is going to be hungry. They're not going to sleep at night or they're going to shrivel away, whatever.

And so then they start becoming a short order cook.

And so they make a different meal because the kid didn't like the first meal or they kind of chase them around.

And the house to try to get him to eat or offer food 24 hours a day, which I don't recommend. If your child's hungry, they're going to eat. Don't worry about it. Trust that if they're hungry, they will eat. And the beauty of it is we're all eating the same thing. Then you just eat it.

Like I eat her plate all the time. If she's like said, no, and we're off to the races that I'm just like, okay, that's mine. So I do like I do like this. Can I ask a question? Yes.

Like adults like I'm not picky on particular is what I say, but like if I don't like something I'm actually not going to eat it.

“So is there a time when a toddler like would be hungry and not eat it because they truly don't like something?”

And to build off of that, I want to I just want to add like a specific example. Like I think if we put a plate, a broccoli in front of tape, she wouldn't really eat it. And she would like choose to hold out until I think she'd 100% try it. But like this isn't for me and hold out until like either the next meal or something new came in front of her. Exactly.

So I like to use the word selective. So you're a selective eater. I am. And there is a point where it becomes like a feeding a version and we can talk about that. But in general, kids may be selective eaters because they don't like the color or the flavor or the smell or the texture.

And so one of the things which it sounds like you've done beautifully is called bridging. And so you bridge from their comfort color or texture into something that's palatable and a comfort color texture or whatever that you know is going to be a hit. So she doesn't like broccoli when it's sitting there on a plate looking like broccoli. But when you stick it in the eggs which she likes, she'll eat it. Yeah.

And so it's just like learning from the broccoli example. You don't give them the plate of broccoli again. Right. You try it a different way. And this is a trial and error and we all have our own food preferences.

Right. Like I love creme brule. I hate flan. It's the same ingredients. I just don't like it jiggles.

I don't like that. Right. Like we all have our quirks. So like that's the thing and that's okay. So your kid may have a specific preference and you can bridge.

And that's where, you know, the air fryer and the, you know, whatever. Maybe they like crunchy foods. So you're going to use panko breadcrumbs. Maybe they like smoother food. So you're going to make a sauce or a smoothie or a frittata or, you know, whatever you're going to make.

So just try them in different ways. But there is such thing is them not liking the food. But if they are hungry. And you trust they will eat.

You would never just offer the plate of broccoli five meals in a row.

Because that would be evil. Right. Yes. Nor would we ever offer one food. What we do try to get three off.

“Any thoughts on like a safety snack or a safety food?”

Yeah. So okay. So say you guys are having, I don't know. We'll go back to the salmon. Say you're having salmon and you're having.

A vegetable or something and she. Maybe eat salmon, but she's not going to eat the vegetable. Okay. Well, maybe you always offer her favorite. Baries that she likes to eat.

So that's your default or she gets a side of yogurt or whatever. Like that's okay to have one, you know, hit that you know, she's going to eat. But she doesn't get seconds and thirds of the berries because she didn't want to eat. The vegetable or didn't want to eat the salmon. Okay.

That's okay. That's fine. But I'm not worried that she's not going to sleep at night because she didn't need dinner. Right. Right.

“And I think that's the mindset a lot of parents have.”

So I need to feed them because they're starving and their families. And it's like, no, they're there. Okay. Okay. And so not seconds or thirds of the favorite foods.

Good to know. Okay. What's the number one thing parents do at meal time that accidentally makes picky eating

the first is it what you just said?

I think talking about the food. I think that's the big fail. Like, don't make a thing about the food. Don't even talk about it. Just talk about your day, talk about activities.

Because they, they're very smart and they're listening and they're watching. And if they know you want them to do something, they're absolutely not going to do it. Because then it, then it's a power struggle.

Then it's about the power.

So just here's your food. Here's our food moving on. Yeah. Oh, that's great. Okay.

So we're not going to, I mean, we just talked about this. We're not reacting to a lot of things. So funny how life works. We're like this self-fulfilling prophecy. Like the nature of how that plays out in so many facets of day to day.

Whether it's like with us and work or with your babies and the biggest pain points you deal with. And you just got to be confident and trust the process. Yeah. You may get a big deal. It's going to become a big deal.

They have parenting's a mirror.

Have a good game face. Yeah. No kidding. That we have to do that when she does a little give this little love tap on the face. We just don't react.

Okay. This is, this is the last question. And I think this is a good one.

“So when should you introduce a multivitamin if you have a picky eater, any suggestions on the best multivitamin's for kids?”

Do they need a multivitamin? That's a great question. Most kids, even your picky eaters, do not need a multivitamin as long as you get to a variety of foods. And again, look at over a week. That's pretty good.

They don't need a multivitamin. Most people, all people need a vitamin D supplement. But as far as multivitamin, they don't need that. If you have a child who truly has a feeding version who, you know, is being a value. Is being evaluated for a restrictive eating disorder.

Those kids, yes, they need multivitamin's. And I don't have a brand preference. And I think that's, that's probably a really interesting thing to unpack. Is like, on this curve you have okay, you know, like, are you doing everything as a parent to best position your child to eat? But we can only do so much, sometimes some children are easier with eating others are harder.

But then there does become a point where as you said, like, it, what was the, what did you say? What was, what did you call it? Disorder eating? Oh, I'd restrict a feeding pattern. Like, if, if your child, yeah, I'd love to hear more about that.

And like, how you draw the line between this is a toddler being picky. And we got to do everything we can as parents just to adjust and accommodate versus like, we've crossed the line. This is a really important topic. So I want, I want parents to hear this is a lot of kids are picky and selective eaters. But you cross a line into an actual eating disorder or feeding a version when you can't name five foods that your kid eats.

You should be able to name at least 10 or 15 foods. But maybe it, but that's a variety. Less than five foods, that really is an issue. And they may have significant texture issues. They avoid eating, you know, a certain color, flavor, smell, like, it's a no-go.

Those kids really probably need additional help and support to identify if they actually have. It, it is a form of an eating disorder, but it's, it's an avoidant restrictive eating pattern. And some of those kids can get identified as early as age three.

So I'm always on, I'm on the lookout for those kids.

“And on the front line, that's what we're looking for is, is your kid just a picky eater?”

It's fine, you're child to be fine, or do we really have an issue that needs help? And by the way, there are professionals. I default to, I'm not, I'm not the feeding specialist. And that's when I make her referral to a feeding specialist to get help to these kids. Totally.

I mean, that makes, but that, because it under five foods that they eat. That is, like, really good tip to know. I didn't really know anything. Yeah, yeah. I actually had a kid who only ate one particular type of ice cream.

Wow. And that was, no, that's all he ate, like, he just ate ice cream. Like, that was, yes. Yeah. Yeah.

So that, that definitely qualifies in, yeah, you need to talk to somebody about that. Okay, I mean, that is, like, so fascinating. And the other point that I'll make is that some people will have their child drinking a lot of milk. And then they don't eat any food. And you really need to be careful of that is, again, milk is a beverage.

It's not a meal.

“So you need to put a cap on it to cups a day.”

And the rest needs to be food. And then water. And are these, are you saying an actual one cup measurement? A cup is eight ounces. Okay.

So not more than, okay. So not more than eight ounces a day milk? No, 16. 16 ounces a day. But I'm cautious about saying that because people are like, it's going in a bottle.

And so when I say ounces people vision bottle and I actually want it in a cup. Yeah, you wanted it a cup, yeah. Okay, okay. So yes, so what are the three pit? What are the key things a parent should do if their child is a pick eater?

So figure out what comfort texture or comfort color or flavor and work with that to kind of make a food.

Look more like that. Be willing to offer them, you know, one go to food. But the rest of the foods are things that the family is eating. And if you can't name at least, you know, five or ten foods that your kid is willing to eat. You definitely need to check in with your pediatrician.

Okay, this was very helpful.

“I mean, eating is, I think it becomes your world, right?”

Like, not your whole world, but a big part of your world. Are you, you like forks and things like that? Like we learned these works. Do you want to talk about spoons really quick? Yeah, I would love to.

Oh, my gosh. We did something unconventional here and now we're dealing with a very interesting situation. What is that?

I would say that we never, we were very hands focused family.

She ate with her hands up until she made the decision that now she wants to eat with the fork and spoon because she sees us doing it. So that transition to the fork and spoon is just happening like at 18 months. And it's just like it's never been a fight, which I've just like absolutely loved. But now the point is like, she will, like, show what the fork or if I give her, like, last night we were at

Mendocino Farms and I like went and I took the chicken to just give it to her. And she, like, swan it away and then I put it on the fork and gave it to her and she ate it. And she'll also use her own fork and spoon. But like, this is new and on her own doing. I went to have expected her to use utensils under 18 months.

“Okay, good to know. Okay. So what do you, what do you want to talk about this fork?”

You're not behind. Okay. So this whole baby lead weaning, which I support the concepts of baby lead weaning or baby lead feeding is, I like to say that. However, the purists do not believe that parents should offer food on a spoon. And I'm here to say, I don't care what you do. And some foods have to be served on a spoon. It's real hard for your child to pick them up.

And yes, you can give them a pre-loaded spoon at six months. It's real hard to get it in their mouth. So the point and the reason why people are anti-spoon is they're afraid that parents are not going to see the child's satiety point and that they don't want to eat anymore and that you're overfeeding. And I trust parents to watch their child's cues.

And when your kid doesn't want to eat anymore, they're going to turn away or they're going to spit it out. So just watch your child that you don't have to do all the feeding with a spoon. And your child doesn't have to do all the feeding themselves. Six to nine month olds are not very proficient. It's okay to help them if you feel so inclined.

“Yeah, I think that's how you get yogurt and cottage cheese in the mouth is a pre-loaded spoon.”

So some people say, okay, so the purists are anti-spoon. I think the purists with anything just like they take a great concept and idea and they just take it too far. Okay, I'm happy to know so at 18 months though, it is normal to start wanting the fork in the spoon because you see mom and dad doing it. Sure.

And they should be able to from a fine motor skill standpoint be able to, you know, stab the food with their fork and get it into their mouth. That is so funny because yeah, we are starting to stab the food. Okay, so that this is the time for that. And I actually need to get more forks, but okay, I love hearing that.

You're right on time. Okay, so fork and spoon are good and you can pre-load them ahead of time and that is just fine according to you. Because if they're full, yeah, I mean, we don't take bites, we don't want that. Okay, is there anything else we missed? No?

Okay, well, Dr. Brown, as always, you were fabulous, full of information.

Food is not fun under one. It's fun, but it's important. It's important and also fun. Rephrase food isn't just fun under one. There we go, it's more than just fun.

Because like, food's fun right now, still, but it's also like everything. Yeah. Thank you very much. Tell people where to find you. So, I'm on social media at Ari Brown, MD and then you can find my books online.

Baby, 401, toddler, 401, and you can find me over it 401 pediatrics here in Austin. Choose the 401 one, girl. That's how we find you. Thank you so much. Thanks for listening.

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