Those round cheeks in babies and toddlers are adorable, but with the childhood obesity epidemic on the rise, paying attention to those extra kilograms is more important than ever, advises registered dietician Lindsay Archibald-Durham.
A recent edition of the South African National Health and Nutrition Examination Survey has shown that nearly 23 percent of South African children aged two to five years are either overweight or obese.
The local prevalence of overweight children is more than twice the global average of just over six percent. The toddler years are ideal for families to make healthier lifestyle choices to prevent obesity in childhood and into adulthood.
Overweight children are five times more likely to become obese adults, putting them at risk of heart disease and stroke. Medical causes of obesity are very rare. Most children become overweight because they eat more than they need to.
Some babies who are overweight slim down once they become active toddlers, while others are born big. The best way to assess this is by looking at your baby's growth curve.
If your baby's weight suddenly increases from the existing curve, it's time to address the issue. Most overweight children may not need to lose weight. Instead, if their weight remains the same as they grow taller, they will steadily get closer to a healthy weight for their stature.
If you're concerned about the weight of your baby or toddler, here's what you can do:
Talk to your doctor
Your child's GP or paediatrician can look at the growth chart to make sure weight gain is occurring consistently. It's also a great opportunity to chat about your child's diet and activity – and make changes if necessary.
If further assistance is required, seek support from your local paediatric dietitian.
Breastfeeding protects against obesity, whereas formula-fed babies can easily be overfed.
When an infant has had enough, they will signal they are full by stopping and turning away.
Start solids at the right time
The World Health Organisation recommends introducing solids at around six months. But in South Africa, these complementary foods are often introduced earlier. Infants who start eating solids before four months have a slightly increased risk of obesity.
At least one study has shown that formula-fed babies who start solids early are significantly more likely to be obese by the age of three.
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Establish healthy behaviours
When it comes to your child's diet, you don't need to count calories. Instead, lead by example, and focus on healthy eating principles that will set them up for life. Make small and gradual changes to your family's lifestyle.
List the changes you think will be possible and achievable
Choose three easier changes at first and move down the list once these have been completed. Tell your extended family members, such as Gogo and Mkhulu, and carers about the changes you're making so that they will be supportive.
Praise your children when they make these changes because they will be more likely to keep going if you do.
Establish a regular meal pattern
Instead of allowing your child to snack throughout the day, the whole family can sit down together. Don't rely on take-away food and ready meals.
Rather focus on home-cooked meals, which are usually healthier. Cook the same food for everybody, even if everybody can't eat at the same time.
At this stage, your child is learning how to eat in response to feelings of hunger and fullness. This is an important time to teach them how to identify hunger – to eat only when they're hungry and to stop when they're comfortably full.
Be careful of expecting them to clear their plates because it might cause them to eat beyond the point of being comfortably full so that they end up with an empty plate.
But also, don't take the plate away when a child is still hungry as this might encourage food-seeking behaviour that could lead to obesity. Children can also easily overreact when they're distracted by the television.
Avoid offering food as a way to alleviate boredom, and don't use food – especially sugar – to reward, treat, comfort or change your child's mood.
By not having high-fat or high-sugar foods in the house, the temptation is minimised. But plan a day in the week when the more desirable high-calorie foods can be enjoyed (in moderation).
Have an ice-cream in the park or a slice of cake at a birthday party.
Healthy snacks for under-5s
If your child is hungry between meals, give them healthy snacks, such as fresh fruit, vegetable sticks or a glass of milk.
Avoid sugary foods, such as biscuits, chocolate and cakes.
Calcium is particularly important for children, so make sure your child has three portions of calcium-rich food every day. These include a glass of low-fat milk and a matchbox-sized piece of cheese and yoghurt.
From the age of two onwards, you can give your child low-fat milk. Give them fat-free milk after the age of five.
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Despite our wonderful climate, the Healthy Active Kids South Africa Report shows that pre-school children spend nearly 75 percent of their time in sedentary behaviour, such as seated in front of a screen.
Nearly 86 per cent of their time is spent indoors. Physical activity is important for your child to develop strong, healthy bones and muscles, and to burn calories from the food that has been eaten. Children who can walk on their own should be physically active for at least three hours every day.
An activity can be spread throughout the day, either indoors or outside. Toddlers and pre-schoolers have loads of fun with active play – running, climbing, jumping and ball games – which make incorporating exercise as part of their daily routine easy.
Getting physical when you're a child is essential to develop habits for an active lifestyle later on. Apart from when they're sleeping, children under the age of five should avoid being inactive for long periods.
Watching TV for hours or being strapped into a buggy – or onto the back – for too long isn't good for their health and development. So, turn off the TV and head to the park, a gymnastics class or the pool.
Healthy eating principles for young children
Base your meals on complex carbohydrates, such as brown rice, wholewheat pasta, sweet potatoes and white potatoes. Eat five portions of fruit and vegetables a day. Eat lean proteins, such as meat, fish, eggs, beans, pulses and lentils. Cut down on saturated fat (found in processed meats, pies, cake and biscuits).
Cut down on sugary foods, such as biscuits, cake, sweets and chocolate. Cut out sugary drinks, such as sweetened fruit juices and fizzy drinks, and if you give your child unsweetened fruit juice, diluted with water. The best drinks to give children are water and low-fat milk.
Children who are introduced to sweet drinks at an early age tend to be less likely to consume water regularly later on in life. Cut down on salt, both in cooking and at the table. Take-away meals, ready meals and processed meats are often high in salt, so read the food labels when you're shopping.
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