Jill Castle, MS, RDN • January 2, 2019 • 5 min read
Food has calories, and while adults may wish them away, calories and nutrients are essential to your child’s health. But where do calories come from? Macronutrients — known as protein, fat, and carbohydrate — are the “big three” nutrients that supply energy and important nutrition for your child’s growth and development.
These macronutrients are included in the Dietary Reference Intakes, along with many other vitamins and minerals that comprise a healthy diet.
Macronutrients at a glance:
Protein is found in foods like meat, beans, eggs, dairy, soy and nuts. It is also found in breast milk and infant formula. Protein has four calories per gram and is involved in building new tissue and repairing damaged ones. Because young children are experiencing rapid growth, protein is an important component of their diet. Infants meet their protein needs through breast milk or infant formula. Toddlers meet their needs from a broader range of foods, including meat, beans, cheese, milk or milk alternative, egg, nuts, and nut butters. Compared to adults, the daily requirement for infants and young children is small because their body is smaller. More is not better in the case of protein—pushing too much can damage the kidneys and cause dehydration.
Fat makes up a large part of the infant diet, up to 50 percent of calorie needs! As babies age into toddlers and preschoolers, fat requirements decline to about 30-40 percent of calories. It’s easy to meet fat recommendations in the first year, as breast milk and infant formula incorporate the right amount of fat. As a vital part of the diet, fat is involved in brain growth and is a concentrated energy source (nine calories per gram). This high-calorie nutrient helps babies, toddlers and preschoolers meet their daily calorie goals without filling up on too much food. The toddler whose diet is highly concentrated in grains, fruits and vegetables but low in fat may grow poorly. Great sources of fat for the emerging eater are avocado, plant oils such as olive, sunflower and safflower, whole milk (up to age two), cheeses, full fat yogurt, and nut butters (after two years old).
Carbohydrate is found in nearly all foods, including fruit, vegetables, grains, and dairy products. Carbohydrate is the preferred energy source for working muscles, the brain and nervous system. There are many forms of carbohydrate such as refined sugar, fructose (sugar naturally found in fruit), lactose (sugar naturally found in milk) and complex carbohydrate, such as fiber, found in grains, beans, vegetables and fruit. A low carbohydrate diet could interfere with childhood growth and development. Carbohydrate weighs in at four calories per gram, similar to protein.
A diet representing all the macronutrients is exactly what young children need to grow well, enjoy food and eating, and develop normally. Don’t make the mistake of skipping out on fat in an effort to be “healthy” or trying a special diet, such as gluten-free or low carbohydrate, as these are not healthy for the growing body or brain of a young child. Consult your pediatrician or dietitian before significant changes are made to your child’s diet.
Reviewed by Dr. Sara Connolly, December 2018
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Is Performing a C-Section Better Than Inducing Labour, when it comes to giving birth, usually the preferred option is to let labour proceed naturally. However, there are times when it is not in the mother or baby’s interest for this to happen. When the health of either is at risk, or if gestation has exceeded [41 weeks duration,](https://nabtahealth.com/articles/doctor-tips-weeks-27-40/) then it is highly probable that an alternative strategy will need to be implemented. There are two options available, [inducing labour](../) or performing a [C-section](../). With an induction, the [uterus](https://nabtahealth.com/glossary/uterus/) is artificially stimulated to contract, and it is then hoped that labour will proceed as per a natural delivery. In contrast, a C-section is a surgical procedure, whereby a cut is made in the abdomen and the baby is removed that way, rather than via the [vagina](https://nabtahealth.com/glossary/vagina/). Sometimes the only safe option is to perform a C-section, for example if the baby is breach, or when an emergency situation arises. However, there are other times when you may be presented with a choice and if this happens, what is the correct answer? Unfortunately there is no definitive right answer. An induction can be at least as safe as spontaneous labour and, if performed in the week prior to the [due date](https://nabtahealth.com/glossary/due-date/), it is thought to reduce [the risk of](https://nabtahealth.com/articles/what-is-preeclampsia/) [preeclampsia](https://nabtahealth.com/glossary/preeclampsia/) in the mother and respiratory distress in the child, possibly as a result of the [placenta](https://nabtahealth.com/glossary/placenta/) remaining fully functional. Unlike C-sections, inductions are not surgical procedures and thus, if all goes to plan, the recovery period is shorter. It is however, a big ‘IF’. [Induced labours](https://nabtahealth.com/articles/induction-of-labour/) are typically more painful, meaning more women will request stronger pain relief including epidurals, and there is a greater likelihood of assisted delivery, such as the use of forceps or ventouse. There is also an increased [risk of hyperstimulation](https://nabtahealth.com/articles/what-is-ovarian-drilling/) of the [uterus](https://nabtahealth.com/glossary/uterus/)., Uterine hyperstimulation causes more frequent, longer [contractions](https://nabtahealth.com/glossary/contraction/), which can [lead](https://nabtahealth.com/glossary/lead/) to complications such as foetal heart rate abnormalities and, in rare cases, uterine rupture. In a significant number of women, induction does not work and a C-section becomes necessary. The advent of the C-section was undoubtedly a medical revolution, instantly saving the lives of millions of women and children. However, C-sections bring with them all the risks of regular surgery, including blood clots, wound infection and bleeding. The recovery period is typically longer after a C-section than after a natural birth, driving restrictions are enforced and a scar remains, although this will fade over time. Whilst current guidelines stipulate that an induction should only be performed when [the risks of continuing the pregnancy](https://nabtahealth.com/articles/complications-during-pregnancy-polyhydramnios/) outweighs the benefits, with more women than ever requesting elective C-sections, the World Health Organisation has highlighted an urgent need for medical assessment efforts to address the risks of induced labour compared to elective C-section. Until such work is undertaken, it becomes a matter of individual circumstance, personal choice and ultimately weighing up what is best for you and your baby. **Sources:** * Grobman, W A, et al. “Labor Induction versus Expectant Management in Low-Risk Nulliparous Women.” _The New England Journal of Medicine_, vol. 379, no. 6, 9 Aug. 2018, pp. 513–523., doi:10.1056/NEJMoa1800566. * WHO Recommendations for Induction of Labour. World Health Organisation, [http://apps.who.int/iris/bitstream/handle/10665/44531/9789241501156\_eng.pdf?sequence=1](http://apps.who.int/iris/bitstream/handle/10665/44531/9789241501156_eng.pdf?sequence=1). Accessed on 23/01/2019. * _Inducing Labour. Clinical Guideline \[CG70\]_. NICE (National Institute for Care and Health Excellence), July 2008, www.nice.org.uk/guidance/cg70/chapter/Introduction. Accessed on 23/01/2019

Sushi is considered a healthy eating option and its popularity is growing in the US. Many parents wonder if it is safe for their young child to eat sushi and when they can safely introduce it in the diet. According to the American Academy of Pediatrics (AAP), there is no need to delay the introduction of fish or shellfish beyond [4-6 months](https://nabtahealth.com/articles/when-can-your-child-eat-sushi-and-raw-fish/) of age in healthy, low food allergy risk children. Specifics about whether the fish is cooked or raw are not made, and the assumption is that this stance reflects cooked fish and shellfish. The Food and Drug Administration ([FDA](https://nabtahealth.com/glossary/fda-2/)) specifies that no raw fish or shellfish should be given to high-risk groups, highlighting very young children as one such group. At what age is a child no longer considered at high-risk? --------------------------------------------------------- A [child’s immune system](https://nabtahealth.com/articles/when-can-your-child-eat-sushi-and-raw-fish/) development is slow and steady during the first 2-3 years of life, and by age 4-6 years old, adult levels of immunity are seen. Your [child’s immune](https://nabtahealth.com/articles/can-daycare-build-your-childs-immune-system/) system continues to develop throughout [puberty](https://nabtahealth.com/glossary/puberty/). Given this information, waiting until 5-6 years of age to introduce raw fish and uncooked sushi is the best way. This will ensure your child is defended against potentially harmful substances. Bacterial contamination is a threat to any temperature sensitive food and cannot be seen, smelled or tasted. [Food poisoning](https://nabtahealth.com/articles/how-to-avoid-food-poisoning-during-pregnancy/) symptoms are similar to the stomach flu, so they may be hard to detect. Asking questions about the quality of food and how it is prepared is good. However, taking care to eat at reputable restaurants that you trust can help prevent adverse reactions to contaminated sushi. US restaurants are required to use sushi that has been properly frozen and/or cooked to eliminate parasitic contamination. ##### Food allergies The [Food Allergy](https://nabtahealth.com/articles/4-ways-to-know-if-your-child-has-a-food-allergy/) and Anaphylaxis Network states that about 7 million people in the US have a reported seafood allergy. In addition to seafood allergy risk, Asian cuisine can often contain other allergens such as peanut, egg, tree nut, and soy ingredients. Raw or cooked sushi is typically assembled into a firm, round food. Sashimi is a raw piece of fish set atop a small amount of rice; it has a slippery texture. Both sushi and sashimi may present a choking hazard, especially for young toddlers. A child to eat sushi may also have a sticky texture that may be foreign to the child. Cutting cooked sushi into small pieces before serving it to your toddler can minimize the risk of choking. When it comes to raw sushi or sashimi, it may be best to leave it out of your child’s diet as they are young and building a strong immune system. However, there is no reason why your toddler can’t safely enjoy cooked or vegetarian Asian cuisine, with special attention paid to its ingredients. If you enjoy sushi and other Asian cuisines and want to pass this along to your child, think about alternatives to raw fish such as: Vegetable rolls ##### **Those containing only cooked fish and/or shellfish** * Rice bowls * Tempura * Soups * Salads * Stir-fry * Teriyaki The truth is that while food safety, allergies, and choking hazards should always be considered. There really is no consensus on an exact age that is appropriate to give a young child raw fish. By 5-6 years old, a healthy [child’s immune system](https://nabtahealth.com/articles/can-daycare-build-your-childs-immune-system/) should be strong enough to graduate to raw sushi with the rest of the family. No magical age, grade level, or number of exposures to sushi will prevent the occurrence of an illness from contaminated food. Good judgment and necessary precautions should always be in place. **Sources:** * U.S * Food & Drug Administration * Fresh and Frozen Seafood: Selecting and Serving it Safely. KidsSafe Seafood. Food Allergy and Anaphylactic Network. Powered by Bundoo®

Food-borne illnesses do not discriminate — anyone can become sick. Raw oysters have earned a reputation as a potentially dangerous food. Also, some groups of people have a [greater risk of serious illness](https://nabtahealth.com/articles/is-fish-oil-safe-for-children/) than others, including children. Eating raw oysters comes with the risk of being exposed to Vibrio vulnificus, a potentially life-threatening bacteria. Young children, those under 5 years of age, are more susceptible to food-borne illness because their immunity isn’t fully developed. Here are some facts you should know before you give your young child raw oysters: ##### What will happen if my child eats a contaminated oyster? In reality, allowing your [child to eat](https://nabtahealth.com/articles/is-it-safe-for-toddlers-and-children-to-eat-raw-oysters/) raw oysters might have zero consequences, no matter how many he or she eats. Unlike other bacteria, V. vulnificus cannot be smelled, seen, or tasted. There is no way to determine if the raw oyster is safe to eat. V. vulnificus cannot be killed by a lot of hot sauce, nor are you guaranteed safety by letting your child just try one or two oysters. If your [child eats a raw oyster](https://nabtahealth.com/articles/is-it-safe-for-toddlers-and-children-to-eat-raw-oysters/) that is contaminated with V. vulnificus, it is important to be familiar with the signs and symptoms of food poisoning. In generally healthy people, V. vulnificus can cause vomiting, diarrhea, and abdominal pain. In some cases, it can become worse and infect the blood (invasive septicemia) resulting in fever, chills, and septic shock. V. vulnificus is a serious cause for concern because about half of people who contract the blood infection die. If you are suspicious of food poisoning and/or your child has symptoms, get in touch with your healthcare provider, or even head to the ER. ##### What should I do? To be safe, you may want to hold off on feeding your child raw oysters for a few years, or at least until he or she is five years of age. If oysters are a staple in your household, or a special treat here and there, make sure to thoroughly cook a few for your little one to try. Cooking (prolonged exposure to high heat) is the only way to kill the bacteria and make sure you and your family will be safe. Get yourself a [coach](https://nabtahealth.com/product/conscious-motherhood-coaching-session/) and learn more. **Sources:** * Food & Drug Administration * Raw Oyster Myths. Powered by Bundoo®