Ask Dr. Jay: Healthy Food, Preemies and Calorie Counting

Pediatrician Jay Gordon answers questions about your babys health.

Good eats

Can you give me some ideas of healthful foods for my 1-year-old? My husband and I are both overweight, and we'd like to keep this from becoming our little girl's problem, too.
You are absolutely correct in believing you can help prevent a weight problem if you start your daughter on the right foods now and help her develop a healthy attitude toward nutrition. To that end, here is my ideal diet for all kids. (To prevent choking, cut food into fingertip-size pieces.)
- Fresh fruit and vegetables of all kinds
- Simple, unprocessed grains such as oatmeal, brown rice and plain puffed corn
- Whole-grain pastas (you need to teach her about more than white spaghetti)
- Beans of all kinds: garbanzos, black beans, kidney beans, limas, edamame, etc.
- A little tofu and maybe some fish, chicken or turkey (I'm a vegetarian and have a bias)
- Olive oil in moderation
- Garlic and other seasonings, except salt
- Lots of green leafy vegetables and seeds (great sources of omega-3 fatty acids)
- And, of course, as little sugar as possible
Maintain this diet throughout your daughters childhood and she will be very grateful for your efforts later on.

How preemies develop

My baby was born four weeks early, weighing 5 pounds, 3 ounces. She is now 6 weeks old and is doing well, but we wonder about her future development. Will she always be a month behind full-term babies in terms of milestones?
When a baby is born near, but not at, term, its hard to be definitive about development. Some aspects are almost strictly dependent on physical age, while others depend on stimulus and response. In general, however, milestones in preemies tend to lag in the first six months and then smooth out. A baby born a month early may smile at 3 months of age rather than at 2 months; a baby born two months early may not sit up by herself until she's 8 months old.
The crucial principle: Don't compare preemies with other babies. Rather, look at their individual development. Just as with full-term babies, they should be bigger and more developmentally advanced each month.

Do calories count?

How many calories does a 1-year-old need? Mine seems to get through most days with almost none!
Rest assured that for many kids, the number of calories recommended is huge compared with the number they take in. Sure, I know of some toddlers who eat more than I do, but most do very nicely on half of the 1,000 calories recommended daily.
Offer a healthful, varied menu as described above and let your child decide how much to eat. If he's growing nicely, playing hard and smiling a lot, you can bet he's doing well, even if he eats less than you think he should. However, if your child just doesn't seem well (say, if he's pale and has low energy), call your doctor. While rare, such conditions as iron deficiency and malabsorption may need to be ruled out.