Nutritional Guidance for Feeding a 15-Month-Old: Tips and Concerns

How should the main or complementary foods for a one-year and three-month-old infant be prepared?

Hello, Director Shi.
My daughter is one year and three months old, with a height of approximately 78 cm and a weight of 9 kg.
The pediatrician has informed me that her weight seems insufficient, which makes me very concerned about her nutrition.
Recently, she appears to have developed a feeding aversion.
I feed her formula milk mixed with cereal at around 1 to 2 AM, about 170 cc.
She wakes up around 7 to 8 AM and finishes about 180 cc of formula.
For lunch or in the afternoon, I feed her porridge with fish roe, approximately half a bowl.
For dinner around 5 to 6 PM, I offer her rice or a variety of vegetables, fish, and meat, but she doesn't eat much.
Around 8 PM, I give her 150 cc of formula again to soothe her to sleep.
However, she often struggles to finish the formula; for instance, she might only drink 100 cc out of 200 cc, and if she doesn't want to drink, she simply won't.
Yet, she remains curious about snacks like cookies or pasta.
My husband is considering switching her formula to a different brand and incorporating goat milk.
I would like to prepare her meals separately but am unsure how to combine ingredients or cooking methods.
What is your assessment of her weight being insufficient? What nutritional aspects should we adults focus on? Additionally, could you advise on the nutritional components to prioritize in formula milk, whether cow's or goat's milk, and if adding olive oil has any potential side effects or negative impacts on children? Thank you for your guidance, Director Shi! Thank you!

Wei Ni Ma, 30~39 year old female. Ask Date: 2009/10/30

Dr. Shi Guimei reply Nutrition

Hello! Based on the baby's height, they are assessed at the 50th percentile (meaning they rank around the 50th out of 100 individuals from tallest to shortest), but their weight is approximately at the 25th percentile (meaning they rank around the 25th out of 100 individuals from heaviest to lightest).
Since the baby is over 1 year old, you can provide regular growth milk without added sugar or any seasonings, but it is important to pay attention to the supplementation of solid foods.
The Department of Health's Food Information Network (http://food.doh.gov.tw/Children/Children/infant/infant.htm) has a wealth of information regarding infant nutrition.
Here are some excerpts for your reference:
The toddler stage is a critical period for developing eating behaviors.
In terms of diet, it is essential to focus not only on calorie intake but also on balance, ensuring that the child receives a variety of nutrients.
To help your child establish balanced eating habits, you can do the following:
- Simply drinking growth formula is not enough! Children over one year old need to consume a variety of foods and practice chewing and eating on their own, so it is important to include minced meat, fruit puree, porridge, and other foods.
- Encourage your child to try various foods! The dietary choices made during this period can influence their lifelong food preferences and health.
- Spark your child's interest in food! Take opportunities to eat together, shop, watch TV, and read books to introduce and discuss different types of food.
Nutritional tips: As your child grows, their eating patterns will gradually change, so pay special attention to the following:
- Cultivate a lifelong habit of drinking milk! While children no longer rely on breast milk or infant formula as their main food source, they should still drink milk daily to provide adequate protein, calcium, and vitamins A and B2.
- Increase the intake of iron-rich foods! Children aged 1 to 2 years are more prone to iron deficiency, so include red meats, egg yolks, and dark green vegetables in their diet.
- Ensure vegetables and fruits are included! These foods are rich in vitamins, minerals, and dietary fiber, all of which are essential for a child's growth.
- Offer snacks between meals! However, provide them about 2 hours before meals and keep the portions small.
Good snack options include milk, eggs, tofu, fruits, vegetables, and bread.
- Limit sugary drinks! Encourage drinking plain water.
Wishing you peace and health,
Director of the Nutrition Department, Taoyuan Hospital, Department of Health,
Shih Kuei-Mei

Reply Date: 2009/10/30

More Info

Feeding a 15-month-old child can be a challenging yet rewarding experience, especially when concerns about their nutritional intake and growth arise. Based on the details you've provided, it appears that your daughter is experiencing some difficulties with her appetite and weight gain, which is understandably concerning for you as a parent. Here are some insights and recommendations to help ensure your child receives a balanced diet and adequate nutrition.

Understanding Growth and Nutrition
At 15 months, a child's growth can vary significantly, and weight alone does not always indicate overall health. The World Health Organization (WHO) growth standards suggest that a healthy weight-for-height ratio is crucial. For a girl of 78 cm in height, a weight of 9 kg may be on the lower side, but it’s essential to consider her growth trajectory over time rather than a single measurement. Regular check-ups with a pediatrician can help monitor her growth patterns and nutritional needs.

Feeding Strategies
1. Balanced Diet: Aim for a variety of foods from all food groups. This includes:
- Fruits and Vegetables: These should make up a significant part of her diet. Offer a range of colors and types to ensure she gets various vitamins and minerals.

- Proteins: Include lean meats, fish, eggs, beans, and legumes. These are essential for growth and development.

- Grains: Whole grains like brown rice, whole wheat bread, and oatmeal provide energy and fiber.

- Dairy: Whole milk, yogurt, and cheese are excellent sources of calcium and vitamin D, which are vital for bone health.

2. Meal Timing and Structure: It’s good to have a structured meal schedule. Offer three main meals and two to three healthy snacks daily. If she is not finishing her milk or meals, try to adjust the portion sizes. Smaller, more frequent meals can sometimes be more appealing to toddlers.

3. Encourage Self-Feeding: Allow her to explore food on her own. Children often eat better when they can choose and feed themselves. Offer finger foods that are easy to grasp and chew.

4. Limit Distractions: During mealtime, minimize distractions such as television or toys. This helps her focus on eating.

5. Hydration: Ensure she is drinking enough fluids throughout the day. Water is the best option, but you can also include diluted fruit juices occasionally.

Addressing Milk Intake
If your daughter is showing signs of disinterest in formula milk, it may be time to transition to whole cow's milk or goat's milk, provided she is not allergic. The American Academy of Pediatrics recommends whole milk for children aged 1 to 2 years because it contains the necessary fats for brain development. If you decide to introduce goat's milk, ensure it is fortified with vitamin D and calcium.

Nutritional Supplements
If you are considering changing her formula or introducing goat's milk, consult with your pediatrician first. They can provide guidance on the best options for her specific nutritional needs. Additionally, incorporating healthy fats, such as olive oil, into her meals can help increase calorie intake without overwhelming her with large portions. However, moderation is key, as excessive fat intake can lead to other health issues.

Monitoring and Adjustments
Keep a food diary to track what she eats and her reactions to different foods. This can help identify any patterns in her eating habits and preferences. If she continues to show signs of poor appetite or weight gain issues, it may be beneficial to consult a pediatric nutritionist for personalized advice.

Conclusion
In summary, focus on providing a balanced diet with a variety of foods, encourage self-feeding, and maintain a structured meal schedule. Monitor her growth and consult healthcare professionals as needed. Remember, every child is unique, and their nutritional needs can vary widely. With patience and creativity, you can help foster a positive eating environment that supports her growth and development.

Similar Q&A

Is My 15-Month-Old Daughter Underweight at 7.8 kg? Pediatric Concerns

Hello, my little sister was born weighing 3200 grams, but her current weight is less than 8 kg, approximately 7.8 kg. When we take her to the hospital for check-ups due to colds, the doctors say she is underweight. However, after inquiring about her meals, they cannot provide a s...

Dr. Huang Zheming reply Pediatrics
Your child seems to be slightly underweight, but this does not necessarily indicate a problem. While the normal weight range for a 15-month-old girl is approximately 8.6 to 13.4 kilograms, if the parents are on the shorter side, it can result in the child being smaller in stature...

Nutritional Guidance for Toddlers with Dietary Restrictions

Hello, I would like to consult a nutritionist regarding a child who is about to turn 3.5 years old and has white matter softening (similar to symptoms of cerebral palsy). The child requires extensive therapy for motor skills but cannot consume any dairy products due to personal h...

Dr. Lu Guanqi reply Nutrition
Hello, it truly requires a lot of care to look after such special children. There are many reasons that can lead to fatigue in young children, and insufficient nutritional caloric intake is one of them. This could be due to a lack of certain nutrients or an overall inadequate tot...

Nutritional Guidance for 14-Month-Olds: What to Feed Your Baby

Hello. My baby is now over 14 months old. When she was 2 to 3 months old, we discovered she had a hemangioma. We previously treated it with corticosteroids. Later, when she turned one, the doctor said she could stop taking the medication since it would gradually improve after the...

Dr. Shi Guimei reply Nutrition
Dear Xiao Yu, Hello! Regarding nutrition during early childhood, the Food Information Network of the Department of Health provides very rich and detailed information for reference (http://food.doh.gov.tw/children/children/infant/02h.htm). As for sweating during sleep, you may wa...

Struggles with Milk Intake: Pediatric Tips for Parents

Dear Dr. Lin, Happy New Year! My daughter has only been drinking 60cc of milk since she was brought home from the obstetrics and gynecology department. She really dislikes milk and refuses to drink it from a bottle, so I have to feed her with a spoon, one spoonful at a time. Sh...

Dr. Lin Wenxian reply Pediatrics
Dear Concerned Father, Happy New Year! It sounds like you and your partner are truly remarkable and are working very hard. Feeding a child often requires the effort of both parents. Indeed, correcting a child's eating habits can sometimes be quite challenging for parents, a...