Food, Nutrition & Your Sick Baby/Toddler

The most dreaded season of the year. No, I’m not talking about pothole season. 

I’m talking about the germy, snotty, cough-every-two-seconds-and-get-your-siblings-sick-too season.

And it doesn’t only suck because you’ve got to watch your poor little one go through sleepless nights and low energy, but also because in the back of your mind you’re thinking…”I worked so hard to get my baby/toddler’s eating to be where it is now and this is going to undo everything!”

It’s ok…we all think it. 

Let’s review what normal eating behaviours you can expect when your little one is sick.

First off, this is a time where your little one is going to need some extra love and attention from you. No doubt. So being a little forgiving with how things typically go is more than ok while they get through the roughest few days of illness.

They may need to nap more, schedules may be off, and they likely display more clingy, groggy and possibly temperamental behaviour. 

When it comes to their eating, this is no exception. It’s very normal to see them have a significant reduction in appetite, show a general lack of interest in food or may even refuse food they usually eat and gravitate towards more snacky, carby or liquidy foods (think yogurt, applesauce, crackers, and popsicles). Sometimes even getting your toddler to come to the table is a struggle, and you start to think…do I let them eat on the sofa? Do I let them skip a meal? Should I cater to their favourite foods so they’ll eat? Feed a cold and starve a fever?

It’s all very confusing!

The thing is…we know they need nutrition to strengthen their immune system and give them energy to fight off the illness. At the same time, digestion takes a fair amount of energy — energy that may be better used to fight off invaders when we’re sick. So there may be a balance to strike here.

So how do you feed your baby/toddler when they’re struggling with sickness?

Keep a normal feeding routine and rely on your child’s internal body signals. 

Their appetite cues probably give us the clearest picture of what and when they should eat when they get sick. The thing is…toddlers especially won’t always know to ask to eat (babies will cry for milk), or they will ask when they’ve reached a point of super hunger. Hand down, the #1 best thing to do not only for nutrition during an illness but also for maintaining nutrition and decreasing pickiness after an illness is to keep your normal feeding routine as much as possible!

Now… that doesn’t mean they will take food every time you offer it. KNOW THIS AHEAD OF TIME and adjust your expectations. That’s perfectly fine… remember… their appetites lead the way here and always. You just be the reliable source to offer food at set intervals whether they ask for it or not, and trust their body and instincts to do the rest in terms of whether food is accepted or how much is accepted. 

If they ask for food outside of set meal and snack times, it’s ok to give it to them for a couple of days while things are really bad. Again, appetites may be sporadic and it can be hard to predict when those opportunities to get some calories may come around. Try to come back around to your regular routine as soon as you can though.

Focus on hydration

Since appetite may be down and risk for dehydration through fever or diarrhea may be up, focusing on hydration during this time is key! For babies under 1 year, the best thing to do is offer breastmilk/formula frequently to drink, especially when they’ve refused solid food meals. Keep offering those meals if they’ve started solids, but let milk take over for hydration since they may not get enough if you are too focused on solids.

For toddlers, you can offer:

• Breastmilk
• Cow’s milk/kefir
• Plant based milk/kefir
• Coconut water (diluted 1:1 ratio with water) (offered occasionally)
• Smoothies (include one of my favourite protein powders for added nutrition)
• Fruit juice (diluted 1:1 ratio with water) (offered occasionally, do not offer if experiencing diarrhea)
• Non-caffeinated tea in small amounts (¼ cup offered occasionally) like decaf green tea, ginger tea, lemon, echinacea, fennel, chamomile

In addition to offering more beverages, make sure to offer lots of hydrating foods at meal and snack times as well.

Examples of hydrating foods include: 

• Broths and soups (homemade using real chicken broth…not from a can/package)
• Popsicles
• Applesauce
• Yogurt
• Cucumber
• Iceberg lettuce
• Tomatoes
• Zucchini
• Watermelon
• Cantaloupe
• Melon
• Oranges
• Pineapple
• Apples
• Spinach
• Grapes

Offer immunity fighting foods

Garlic – without a doubt, garlic is nature’s antibiotic. It’s known to have immense health properties, and has positive (though still very preliminary) research showing that it can treat/reduce the duration of the common cold. Although we can’t recommend a therapeutic dose yet, consuming lots of garlic (in a garlic dip is my favourite) is a great practice to get into, especially when sick to naturally fight off microbes.

Honey (over age 1 only) –  100% pure honey is also antimicrobial/antibacterial and there have been studies that show its successful effect as a cough remedy. Try offering your toddler 1.5-2 tsp of honey before bedtime, maybe diluted in a cup of warm water, drizzled onto toast or in a smoothie.

Elderberry – These have antiviral properties and are loaded with phytonutrients to strengthen the immune system as well as has compounds that can directly block a virus’s entry and replication in the body. A few small studies have found the elderberry extract reduces the duration of colds and other upper respiratory tract infections. Although they haven’t been conducted on children and more research is warranted, things look promising for it. It’s best to take it within 24 hours of onset of a cold/flu. You can find my favourite elderberry (and other!) supplements in my amazon shop for you to easily find and see my recommendations.

Avoid large portions and excessive catering

It’s understandable during this time that they may not be able to stomach certain foods, or large amounts. What I suggest is to offer smaller portions of food initially so as not to turn off your baby/toddler upon first sight, especially if they have very little appetite. Sometimes if they get the impression that they have to eat all of the food on their plate, and may refuse it altogether. You can always replenish their plate with more food once they finish what was there. 

I also don’t recommend full on catering to your child’s request for food …yes even when they’re sick! I know that it’s hard when they’re sick and only feeling like eating one specific thing to want to offer that over and over again. It’s ok to do it once or twice…but keep it at bay and instead focus on being considerate rather than catering. Sometimes they don’t want to chew or it takes too much energy to eat…soft and easy to eat foods like mashed potatoes, yogurt, oatmeal, crackers and even puree pouches can be helpful and good choices. But if you know that they prefer to eat these foods during this time…choose to offer it to them before they ask for it, alongside other foods, and make sure to vary things so you’re not re-offering that exact same food next meal. 

This is just in both of your best interests for afterward this is all over. When they’re sick, it’s so easy to create a habit that they expect to continue afterwards. Toddlers especially won’t be able to understand why it was ok to get the food they asked for one day and then the next be expected to eat what the rest of the family is eating. There may be a day or two of pushing boundaries once they are healthy again to see if you will give in to their requests, but set those clear limits and they will fall into a state of comfort again with the regular routine.

What about the B.R.A.T Diet? 

There is no good evidence indicating that there is a need to feed your child food bland foods like banana, rice, applesauce and toast (B.R.A.T.) during bouts of diarrhea. There may be a benefit to including foods like rice and green bananas to help absorb some water and reduce stool volume, but children on the BRAT diet are more likely to experience important deficiencies in calories, protein, fat, fiber, and several critical micronutrients. It’s best to focus on what they can personally handle and stomach. If they can eat a curry when they’re sick…go for it! If all they can stomach is toast and rice, then go for it. Just try to get variety in the diet as soon as possible.

Doesn’t milk and dairy increase mucus production?

Contrary to what many think, milk and dairy doesn’t actually increase mucus (phlegm) production. It may however make it more noticeable/thicker, so that may cause discomfort to your little one. Take on an individual basis – if you notice your child is bothered by it, you can go ahead and remove it from their diet until they are healthy again.

How do you get your baby/toddler back on track after they’re healthy again?

Once they are healthy again, you can expect their appetite to come back slowly. Sometimes it may look like they’re healthy (energy is back, no more symptoms, etc.) but it can take a few days to even a week for their appetite to return. Keep calm and don’t stress about this or pressure them to eat. 

I’ve already alluded to this, but the best advice I have for you to get things back to normal if they went off track while they were sick is to make sure to go back to the same variety and strategies and feeding schedule I teach in my Feeding Toddlers online course no matter what once they are healthy again. It may take a few days of consistency, but keep at it and you’ll have your little one back to eating happily and healthily. 

If you haven’t taken my Feeding Toddlers course, it’s here to help you find the stability and confidence you need in knowing what and how to feed your toddler so that you can have an adventurous and happy eater. It takes you through all the things you didn’t know you needed to know…all the factors you can influence that take meal times from stressful to stress-free. The mealtime set up, the schedule, what to serve, how to serve it, what to say, how to handle all the one-off situations and extreme picky eating and more. 

Good luck and sending you all the love as you care for your sick little one!

References: 

1. Garlic for the common cold.
2. Effect of honey, dextromethorphan, and no treatment on nocturnal cough and sleep quality for coughing children and their parents. 
3. A comparison of the effect of honey, dextromethorphan, and diphenhydramine on nightly cough and sleep quality in children and their parents. 
4. Effect of honey on nocturnal cough and sleep quality: double-blind a. randomized, placebo-controlled study. 
5. A spoonful of honey helps a coughing child sleep
6. Randomized study of the efficacy and safety of oral elderberry extract in the treatment of influenza A and B virus infections.
7. Elderberry Supplementation Reduces Cold Duration and Symptoms in Air-Travellers: A Randomized, Double-Blind Placebo-Controlled Clinical Trial
8. MISTAKEN BELIEFS AND THE FACTS ABOUT MILK AND DAIRY FOODS | Request PDF
9. Milk consumption and mucus production in children with asthma
10. Milk, mucus and myths 
11. Safety and efficacy of a premixed, rice-based oral rehydration solution.
12. Managing Acute Gastroenteritis Among Children: Oral Rehydration, Maintenance, and Nutritional Therapy
13. Hypocaloric oral therapy during an episode of diarrhea and vomiting can lead to severe malnutrition.

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