Ask Katie

Katie Elwig is a state registered paediatric dietician and a consultant to Little Dish. We get Katie's nutritional input on every Little Dish recipe. She makes sure we use the right ingredients to address the needs of children aged 1-5 years old. You can read more about Katie here.

Katie also writes interesting articles for us:

Nutritional Guidelines for Under 5’s
Healthy hints for your toddler’s diet

I’m worried about the sugar overload at Christmas. With so much sweet stuff on offer, I don’t want to be too strict with my little boy, but what do you advise?

There is little harm in your baby enjoying a little naughtiness at Christmas. That is what Christmas is all about - having something a little special. Some little chocolates, scoop of ice-cream or meringue is hardly going to hinder their feeding routine so long as it’s given at an appropriate time. However, it is best to offer something sweet after your little one has had their main meal to ensure they have eaten something nutritious first. Little treats are absolutely fine and will not be detrimental to their health or turn them overnight into sweet treat monsters so long as you are in control of their intake. Do allow grandparents and other family members to spoil children over this time but be firm with them about how much and when you would like them to eat their treats. Christmas is a special occasion so let the kids have a little fun.

My daughter is 22 months and has refused to eat meat since around her first birthday. She eats fish and cheese, and some vegetables, mainly spinach, peas and sweetcorn. Is this enough to compensate for the lack of meat? I have tried every possible way of disguising it, but with no luck.
Becky

Those tricky toddlers! Obviously from your short message I can't give you a proper nutritional assessment but it is important firstly to stress that nearly ALL toddlers will go through a food refusal phase - be it all foods or just some particular foods. Try not to be concerned, as this will encourage your toddler to continue to refuse as they can pick up on your anxieties and play on it for attention.

It does sound like she has some good sources of protein in her diet and good vegetables that will compensate for the lack of meat. Meat, in particular red meat is high in iron. However there are plenty of toddlers following a vegetarian diet that have very good iron levels from their diets.

I would suggest giving up disguising meats for a while and just focus on what she does enjoy eating. She will no doubt end up eating meat again in the future - probably when you are not around!

Encourage two protein sources per day (one for lunch and one for supper) and include fish, cheese and eggs (if she likes them). In order to ensure she continues to get all the iron she needs - focus on oilier fish such as salmon and encourage a good fortified breakfast cereal every day. Also by getting her to take some vitamin C with her meals from fresh fruit or a little diluted orange juice - this will help her absorb any iron she takes from her foods.

My sons are both vegetarian. They are easy to feed and like most food but I do worry about them getting enough nutrients. Firstly, there's so much hype about omega-3. They have dairy and seeds but are there any other sources or shall I start them on a supplement? Secondly, how do I know if they are getting enough protein? Is there a set amount of daily servings I should aim for? Do have any tips for bringing up healthy vegetarian children?
Toni mum to Gregor 3, and Douglas 9 months

It’s really important for people to know that you can successfully wean your children on to a vegetarian diet with no detrimental effect to their health, growth and development. In fact some vegetarian diets are far more healthy than diets with animal sources of protein. There are plenty of cultures around the world that adopt vegetarianism and have nutritionally balanced diets. It is only those who are not sensible in choosing good alternatives to protein sources that fail to follow a nutritionally balanced diet.

Omega 3's are getting a lot of attention at the moment and your children will be getting all the vitamins and minerals they need from their lovely balanced diets. By offering them nuts and seeds they will probably get more omega-3 oils than most other children their own age. I would recommend continuing with seeds and perhaps looking for a milk enriched with omega-3 oils. Don't worry too much about supplementation at this time. It’s expensive and hard to maintain.

Your children need 2 portions of protein per day - a serving at lunch and a serving at dinner time. A serving would be an egg (up to 1 per day is fine), a good portion of lentils, beans, pulses, tofu or a Textured Vegetable Protein and a portion of vegetarian cheese.

My only other suggestion is that you ensure that they have some vitamin C in their diets. This is not normally a problem for children but it does enhance the absorption of available iron from the vegetable sources you provide them. Usually we recommend a glass of fruit juice with a meal as it works better at the time of the meal.

I’m not sure how much salt a child should have in their daily diet. Are there any foods, apart from the obvious things like crisps, which I should watch out for? What’s the best approach to reducing the amount of salt my kids eat?
Jude, mum to Sofia (4) and Ben (2).

With the recent publication of research into the salt intakes of children and adolescents related to blood pressure, as well as increased awareness of our general salt intake with the Food Standards Agencies (FSA) "Salt Awareness" campaign, salt is a very ‘hot topic’.

It is generally recognised that children under 12 months should have a very small intake of salt due to their developing kidneys (<1g/d salt). This is easily achievable by offering under one's fresh home-cooked weaning foods where possible and avoiding snacks high in salt. It is not advisable to add salt to cooking or at the table for children under one year of age.

1-3 year olds - 2g salt/d (0.8g sodium)
4-6 year olds - 3g salt/d (1.2g sodium)
7-10 year olds - 5g salt/d (2g sodium)
>11yrs - 6g salt/d (2.5g sodium)

These are the recommended maximums for children. It is obviously better for their health to have less.

Labelling - check items for salt / sodium per 100g
High is more than 1.5g salt per 100g (or 0.6g sodium)
Low is 0.3g salt or less per 100g (or 0.1g sodium)
If the amount of salt per 100g is in between these figures, then that is a medium level of salt.

My general salt lowering advice for children is:
• Avoid adding salt at the table or in cooking where possible - the whole family should follow this advice too.
• Limit savoury snacks such as crisps to treats once or twice a week and try healthier alternatives such as plain popcorn, fruit, smoothies, unsalted nuts and seeds (>5 years of age), vegetables sticks and dips.
• Be aware that processed meats and bacon contain higher levels of salt and limit their intake.
• If you are going to use tinned vegetables, beans and pulses - try those canned in water.
• If you’re choosing a ready meal or a ready-made pasta sauce, compare different types and choose the one that is lower in salt.
• Go easy with ketchup, soy sauce, mustard, pickles and mayonnaise – these can all be high in salt. Some sauces now come in low salt varieties.

For further information on salt, diet and your family why not refer to www.salt.gov.uk

My son always eats Weetabix or Shreddies for breakfast. Do you have any suggestions for alternative quick and easy breakfasts?
Tara, Mum to Rory 18 months

It is important to remember that children like routine and can often eat the same food at each meal for weeks, even months on end. Adults would find this a very boring diet, but to children, this is normal.

Breakfast cereals are fortified with vitamins and minerals and are extremely healthy for a child. Don’t be too concerned about the lack of variety. You could try other unsweetened breakfast cereals such as rice, oat or corn based ones. As breakfast cereals are fortified it is reassuring to know that children receive some good vitamins and minerals, but they don’t just have to be given at breakfast. A small cup of cereal makes a great mid-morning snack. Perhaps your son would enjoy fruit and yoghurt or toast, bagels and crumpets as an alternative breakfast.