Written by Rhiannon Lambert, our Registered Nutritionist and mum-of-two.
Making sure your little one eats nutritiously, enables them to thrive in this period of rapid growth, development and exploration. Adequate nutrition is important if we want to keep our bodies healthy and functioning optimally and the most growth happens in the first two years for our little ones, this research is called the first 1000 days.
When we don’t eat enough of the right foods (this could be influenced by many factors) or there is a lack of variety within the diet this can lead to a deficiency in certain nutrients, particularly micronutrients, namely vitamins and minerals.
Common nutrient deficiencies in children include iron and vitamin D deficiencies. These types of deficiencies can lead to conditions such as anaemia (iron), rickets, muscle aches and pains, deformities, and delayed growth and development (vitamin D). Deficiencies can have many negative and debilitating effects on the body, regardless of age, so it’s important we optimise our own and our children’s diets to ensure these are avoided.
What causes nutrient deficiencies in babies and young children?
Luckily in the UK severe nutritional deficiencies in infants and toddlers aren’t that common. However, there may be some factors which may increase their risk of becoming deficient in certain nutrients.
Food intolerances or allergies
Whilst these cannot be helped, if your child has an allergy or intolerance to foods such as eggs or cow’s milk, they may not be getting enough vitamins & minerals like calcium, vitamin B12, iodine, or vitamin D. If you’re worried about your child not getting enough nutrients due to allergies, then it’s important to speak with a GP and a specialist paediatric dietitian for support and guidance with how best to manage this, to ensure your little one is eating the right amounts.
Younger children, particularly babies, will have much smaller stomachs, owing to their size at this age. This means they will need to eat more frequently throughout the day to make sure they are getting the right amount of nutrients. For some parents this can be a juggle to fit numerous feeding times across the day. To help manage this, always make sure you have nutrient-dense, energy-dense snacks when you’re out and about, or in the cupboards at home.
It’s also important to note that due to having smaller stomachs, too much fibre in the diet can fill up little tummies quickly, meaning food and nutrient intake from other sources may be reduced which can lead to deficiencies.
I’m sure that throughout your weaning journey with your baby, just like adults, there will be days where they simply don’t want to eat or they become fussy with the food that is put in front of them. Persistent fussy eating, or a lack of variety within the diet - particularly with fruits and vegetables, can increase the risk of vitamin and mineral deficiencies. It may also mean that they are not meeting the energy requirements to help support their growth and development too.
The key here is to be consistent and patient with your little one when this does happen. Keep offering a wide variety of colours, textures, and flavours too, as well as encouraging good role modelling and creating a positive and calming environment for your baby to eat in.
Simply put, when raising your child as vegan/vegetarian/plant-based it is possible to give them all of the nutrients they need to enable optimal growth and development. However, it requires careful planning and there may be the need to supplement to ensure they are meeting nutritional requirements. A poorly planned plant-based diet in both adults and children can lead to deficiencies, so it’s important food choices are well thought through to avoid this happening.
Key nutrients to consider and why they are important
Iron is needed to help make the haemoglobin in red blood cells, which transports oxygen around our bodies. Babies also need iron to support the healthy development of their brain too.
If your little one was born full-term with a healthy birth weight and the mother had adequate iron stores throughout her pregnancy, then new born babies should have the required iron stores needed in the first 6 months of life. Owing to this, breastmilk and/or infant formula are the only source of nutrients that babies require during this time.
Once they reach 6 months and onwards, this is no longer sufficient to support their increasing iron demands as they begin to grow and develop. This is where weaning and the introduction of food comes into play.
Make sure you include a variety of iron-rich foods within your baby’s diet to ensure that they are meeting the daily requirements - between the ages 1 to 4 years this is 6.9 mg/day. There are currently no guidelines for babies aged 6 months to 1 year.
Iron-rich food sources include:
- Red meat
- Ground nuts or smooth nut butters
- Steamed greens such as broccoli
- Bean mixes, such as kidney beans or baked beans (just be mindful of the salt and sugar content if you are buying shop-bought)
Remember, plant-based sources of iron are less easily absorbed by the body. Pair with a source of vitamin C such as citrus fruit, peppers, or kiwis to help aid absorption.
Vitamin D is an important mineral that should be part of a child’s diet because it is essential for maintaining healthy bones. Low vitamin D levels in children have been linked to increased risks of rickets (a condition that causes bones to become soft and weak which may lead to bone deformities) and reduced bone mineral density. There is also evidence to suggest that vitamin D plays a role in children’s immune systems and brain health, especially when they are growing and developing in the womb.
It is estimated that 16% of children in the UK are deficient in vitamin D and this may lead to adverse effects and symptoms, such as pain, bone deformities, delayed development, and a calcium imbalance.
Although the main source of vitamin D is from the sunlight, like the rest of the population, the UK government recommends that children aged between six months to 5 years should still be given daily vitamin D supplements even if they have safe sun exposure.
According to the Department of Health and Social care:
- Babies from birth to 1 year of age who are being breastfed should be given 8.5 to 10µg of vitamin D. This is irrespective of whether or not you're taking a supplement containing vitamin D yourself.
- Babies should not be given a vitamin D supplement if they are being fed more than 500ml of infant formula milk a day.
- Children aged 1 to 4 years old should be given a daily supplement containing 10µg of vitamin D.
There are also some dietary sources of vitamin D including:
- Oily fish
- Fortified foods and infant formula
Vitamin A & C
Vitamin A is needed for keeping your child’s immune system and skin healthy, as well as maintaining good eye health so that they are able to see in dim lighting. Vitamin A can be found in:
- Most yellow, red, and orange fruits and vegetables such as carrots, sweet potatoes, swede, and mangos
- Dark green vegetables such as spinach, cabbage, and broccoli
- Dairy products
- Fortified foods such as spreads.
Another vitamin which is also important for your child’s immune system is vitamin C. This can be found in most fruits, including oranges and other citrus fruits, kiwi fruit, strawberries, broccoli, tomatoes, and peppers.
In some cases the NHS also suggests supplementing the diet with vitamin A and C in children, but as long as your baby is eating a balanced, varied and healthy diet, then supplementation is not necessary - except for vitamin D. If you are concerned about your child’s vitamin and mineral intakes it’s always best to speak to a specialist paediatric dietitian for advice.
Babies and young children need calcium in their diets to help support strong teeth, bones and muscles. Calcium requirements vary at different stages of life. Up to the age of 1 years old it’s recommended to consume 525 mg of calcium each day, and aged 1 to 3 years it’s 350 mg/day.
Try to include calcium-rich sources such as:
- Dairy products, such as cheese, yoghurts, fromage frais, or full-fat/whole cow’s milk (from 1 years old)
- Fortified plant-based dairy alternatives and other calcium-fortified foods
- Dark green leafy vegetables like broccoli
- Wholemeal bread
- Fish with bones like salmon and sardines
Protein is essential for your little one’s growth, as well as for the maintenance and repair of their bodies. Protein requirements can be easily met if your child eats a wide variety of foods that contain protein at each meal. Dairy products like yoghurts and cheese, non-dairy alternatives, as well as beans, pulses, peas, lentils, grains such as quinoa, rice and buckwheat, and soya-based products like tofu are great sources of protein for your child.
The risk of a protein deficiency may be higher in plant-based or vegan children, however, there are plenty of complete plant-based sources which contain the essential amino acids needed for growth and development.
Iodine is an important mineral that is required to make thyroid hormones. These hormones are needed to support processes within the body such as growth, regulating metabolism and, during pregnancy and early life, the development of a baby’s brain. Iodine is also needed for bone maintenance too. Up to the age of 4 years old, infants and young children require 70µg of iodine a day.
There are a limited number of foods in which you can find iodine, and deficiency may be more likely in vegan and plant-based eaters. Sources include:
- Milk and dairy products
- Fish and shellfish
- Plant-based foods such as some nuts, fruits, veg, and bread
How to avoid nutrient deficiencies
Following a balanced, varied and healthy diet is the best way to ensure your child is meeting all of their nutrient requirements. Supplementation should only be used in specific circumstances and if you are concerned about your child’s nutritional needs or whether they are getting enough, then it’s encouraged to seek specialist advice from your GP and/or a paediatric dietitian.