Nutrition of preschool children

Preschool children (1 to 6 years) grow more slowly than babies but are very active. They are still learning to chew, swallow and eat on their own, and the eating habits formed now tend to last. Their needs are like the family's, only in different amounts. ICMR (2010) suggests about 1240 kcal a day at 1-3 years and 1690 kcal at 4-6 years.

Building healthy eating habits:

• Make meals family time: children copy how others eat.
• Offer variety in child-size portions, and give enough time to finish.
• Keep regular meal and snack times so the child comes to the table hungry.
• Put a new food beside a favourite one; mix soft, crunchy and colourful foods.
• Offer finger foods that small hands can manage: small rolls, mini idlis, pieces of fruit, a boiled egg.
• Serve meals in one place, not while the child wanders about, with comfortable seating.
• Let the child rest before meals: a tired child will not eat well.
• Never bribe or punish a child to eat.

Planning balanced meals rests on three ideas:

• Variety of textures, tastes, smells and colours.
• Balance of complex carbohydrates, lean proteins and essential fats, using all five food groups.
• Moderation with sweets, ice cream and fried or refined-flour fast food.

ICMR's balanced diet gives daily amounts by food group: for a 4-6-year-old, about 120 g cereals, 30 g pulses, 500 ml milk, vegetables (roots, greens and others) and fruit, and small amounts of sugar and fat. Spread it as three meals and two snacks: small stomachs cannot take enough in three meals, and snack time is a good time to try new foods and fits a school tiffin.

Snacks can be traditional and cheap: murukku, laddoo, upma, mathri, sundal, dhokla, payasam, peanut chikki, vegetable soup made with local vegetables, poha with vegetables, or spiced baked potatoes. Example (new): a mid-morning bowl of poha with peas and peanuts, and a banana, gives energy, some protein and fruit in one easy snack.

Feeding children with special needs:

• Observe: how the child handles food, their preferences, allergies and any condition.
• Build eating skills patiently: they may need more time and make more mess; praise effort, seat them comfortably, do not feed them what they can feed themselves, move to harder textures gradually, and use adaptive equipment if needed. Respect their choices and keep regular meal times.
• Special diets: thicken thin liquids and chop or soften lumpy foods for a child who finds swallowing hard; some children tend to put on weight, and some, such as autistic children, sense taste or smell differently. Remove at once any food the child is allergic to.

Health. Lacking protein, vitamin A or iron leads to PEM, xerophthalmia (dry eyes leading to blindness) or anaemia. Using iodised salt is a simple, cheap way to prevent iodine deficiency. Vaccines continue: MMR (measles, mumps, rubella) at 15-18 months, DPT and OPV boosters at 16 months-2 years, typhoid at 2 years, DT at 5 years, and vitamin A drops every six months from 18 to 36 months.