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    Are food pouches healthy for toddlers?

    Q: What’s your advice about toddler convenience foods like squeezable pouches, snack bars and special drinks?

    Toddlers need to snack, no question about it. Their stomachs are too small to get them through those long gaps from meal to meal, and it generally makes sense to give them a morning snack and then an afternoon snack, in addition to their regular meals.

    For many parents, feeding young children is a generally fraught topic. You want to satisfy their (sometimes urgent) demands while still building the foundation of healthy eating habits. All of this parental anxiety is complicated by marketing — you can find all kinds of packaged toddler snacks making all kinds of promises, from squeezable pouches of salmon teriyaki puree to special “smart” bars.

    As a pediatrician who has raised three children myself, I don’t want to make parents feel guilty about occasionally using convenience foods like squeezable pouches and toddler snacks. These foods are clearly helpful for busy families, and there’s nothing wrong with using them sometimes. But in terms of a child’s health and development, I want parents to know that snack time also presents a huge opportunity to shape their children’s eating and behavioral habits.

    That message isn’t always getting through to parents. Research suggests that some parents view breakfast, lunch and dinner as opportunities to provide healthy nutrition — but see snacks as more about behavior management. A 2020 study analyzed the meals and snack foods parents chose for young children, and observed that parents and siblings were less likely to sit down and eat with a toddler at snack time than at mealtime.

    Here’s my advice about snack time and toddler foods.

    We want toddlers to learn to handle real food — with their fingers, with spoons and with their mouths in terms of chewing and swallowing. But a toddler who prefers purées and sucking on pouches to chewing is not getting the chance to play with food textures, to handle food, to learn about ways of getting it into the mouth and what to do with it when it’s there. These skills develop in the toddler years, and children need practice.

    “Eating a lot of puréed foods in pouches as a toddler can negatively impact a toddler’s oral motor development and development of important feeding skills,” said Natalie Muth, pediatrician and registered dietitian and Well Clinic director at Children’s Primary Care Medical Group in San Diego. “My recommendation to parents is that it’s okay to offer pouches sometimes. To raise healthy eaters, it’s really important to offer the real fruits and vegetables early and often to help kids learn to love and enjoy fruits and vegetables in their natural form. It’s a process that can take time and patience, but it pays off in a big way at the end of the day.”

    Don’t use snacks as a fix for boredom

    Eating isn’t a purely nutritional activity for toddlers, any more than for the rest of us. Kids are learning about food, but they’re also learning about healthy patterns, about sociability and even about deferred gratification.

    So don’t encourage your child to get into the routine of “grazing” or constant all-day nibbling. Convenience foods can make everything a little too convenient. You don’t want the message to be that it’s good to go through life with a pouch of something edible always clutched in your hand. Toddlers get meals and they get snacks, and then the rest of the time, they need both hands free to explore the world.

    That puts the onus on parents not to respond to toddler boredom or frustration with a placating snack. There are other ways to distract a cranky toddler, and after all, many of us (as adults) wish fervently that we had never absorbed the idea of eating to relieve boredom or frustration.

    Choose real food vs. processed snack foods when you can

    For both regular meals and snacks, try to serve your toddler fruits and vegetables, and avoid processed foods, salty snacks and especially sweet snacks. A 2019 consensus statement by nutritional experts emphasized that toddlers should be drinking milk or water, and definitely not sugary drinks. There are lots of ideas for healthy snacks available from the American Academy of Pediatrics and from other medical authorities.

    My colleague Nicholle Francis, a registered dietitian and lactation counselor in New York City, said that snacks should ideally combine a protein and a healthy carbohydrate, and that parents should keep it “as close to the earth as possible; it doesn’t have to be packaged or processed.” She suggested cottage cheese, plain yogurt or homemade hummus as good sources of protein, combined with thinly sliced cucumber, softer squashable fruits or wholegrain crackers..

    Be aware of choking hazards

    Cut seedless grapes into spears (never give whole grapes) and apples into matchsticks, and squash whole berries. Avoid nuts, popcorn, hot dogs and anything that comes in big chunks. To keep young eaters safe, sit with your child during meals and snack time, and don’t let them walk, run, play or lie down with food in their mouth.

    Ignore food marketing claims

    Food marketing can leave you feeling that prepared and processed foods are somehow better, more nutritious or more brain-building than real foods you prepare yourself. But with toddlers, parents have control (and we hope the marketers can’t reach them directly yet). Parents can “sell” real foods to children by exposing them to different tastes and textures.

    And yes, as we know, it can be a little messy. But that’s what the transition to the toddler years is all about. Messy goes with learning, and playing with your food can be very educational.

    Eating — even snacks — should be social

    We want toddlers to learn that eating is social — you do it with family (or the other day care kids). Social interactions around snacking matter, just as they do around meals. When you can, sit down with your toddler and have your own healthy snack. Follow basic rules of civility — no screens at the table, a little conversation. And then when snack time is over, hands get washed, food gets put away and it’s time to get on with the day.

    Perri Klass is a pediatrician and professor of journalism and pediatrics at New York University, and author of “The Best Medicine: How Science and Public Health Gave Children a Future.”

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