By: T. Berry Brazelton, M.D., and Joshua Sparrow, M.D.

Q. My 6-year-old son will not eat meat, chicken or cheese. Is half a peanut-butter sandwich, one yogurt and one glass of milk enough protein for a day? He eats plenty of fruits and several vegetables.

A. A few simple rules apply to nutrition and growth.

A child whose height and weight stay on his growth curve at each checkup is consuming enough calories.

For example, a child who has always been at the 25th percentile for weight on the standard growth chart should continue on that percentile over time. If he drops below it, he may not be eating enough calories, or may have a medical problem interfering with growth. A child’s height is determined not only by nutrition but also by his parents’ height.

Children are naturally programmed to seek the foods they need for healthy growth and nutrition. Processed foods that are unnaturally sweet, salty or fatty undermine that ability.

Around the world, a robust variety of healthy diets balance human needs with local foods. These diets typically include different kinds of foods. Many cultures have developed diets with small amounts of meats (the most costly protein source) and larger amounts of vegetables and grains.

Children’s taste preferences mature and broaden with time. A child who rejects a food early on may learn to like it later. Many children need to be presented with the same food up to 15 times before they’ll even try it.

Children’s interactions with the adults who feed them also drive what and how much they eat. Parents’ sense of urgency about feeding their child can backfire. A child is bound to react to pressure by becoming even pickier.

The menu can turn the kitchen into a battlefield. But healthy eating is more likely when mealtimes are relaxed occasions, with no pressure about food.

If the otherwise healthy child doesn’t like a particular food, he’ll just have to eat what’s on his plate or wait until the next meal.

A child’s nutritional requirements vary by age, gender, height, weight, metabolism and activity level. Protein requirements also depend on total daily calories.

Eating enough calories every day allows a child’s body to use proteins for growth instead of breaking them down to provide energy.

Milk, yogurt and peanut butter all contain proteins, as do eggs. Alternative sources include soy foods (soy milk, tofu, tempeh and ice cream). Children who don’t eat meat, fish, poultry, eggs and dairy products may need 1 to 9 grams more of protein per day than those who do.

Check with your pediatrician about your child’s protein requirements.

Children’s daily nutrition guidelines:

“The Pediatric Nutrition Handbook,” edited by Ronald E. Kleinman, M.D., offers these daily nutritional guidelines for 7- to 12-year-olds:

  • 24 to 32 ounces per day of milk or other dairy products. 1/2 cup of milk can be replaced with 1/2 to 3/4 ounces of cheese, or 1/2 cup of yogurt, or 2 1/2 tablespoons of nonfat dry milk stirred into other foods the child likes.
  • 6 to 8 ounces per day of meat, fish or poultry are recommended. 1 ounce of meat, fish or poultry may be replaced with 1 egg, 2 tablespoons of peanut butter, or 4 to 5 tablespoons of cooked legumes such as peas, beans or lentils.
  • 3 to 4 servings of vegetables (each one about 1/4 to 1/2 cup) per day should include a green leafy or yellow or orange vegetable.
  • 1 medium-size portion of fruit or 4 ounces of fruit juice (avoid added sugar, corn syrup or high-fructose sweeteners).
  • 4 to 5 portions of grain (especially whole grain) products such as bread (1 slice equals 1 portion), cereal (1 cup equals 1 portion), pasta, macaroni or rice (1/2 cup equals 1 portion), crackers (5 pieces equals 1 portion), English muffins or bagels (1/2 equal 1 portion), corn grits and the like.

Responses to questions are not intended to constitute or to take the place of medical or psychiatric evaluation, diagnosis or treatment. If you have a question about your child’s health or well-being, consult your child’s health-care provider.

Dr. Brazelton, prior to his passing, was the founder and head of the Brazelton Touchpoints Center, which promotes and supports community initiatives that are collaborative, strength-based, prevention-focused sources of support for families raising children in our increasingly stressful world. Dr. Sparrow, a child psychiatrist, is currently the Director of the Brazelton Touchpoints Center. Learn more about the Center at www.touchpoints.org.

Reprinted with permission from the authors.