Young children’s first experiences with food and mealtimes can shape their life long food preferences and relationship with food. Introducing foods and planning healthy meals for a growing toddler can be a daunting experience for any parent and a diagnosis of type 1 diabetes during this time can seem overwhelming. We are here to support you to ensure diabetes doesn’t interfere with building your child’s healthy relationship with food.
- The nutritional needs of young children with diabetes are no different from those without diabetes.
- Eating well keeps their bodies healthy, as well as helping to manage blood glucose levels.
- Children grow rapidly in the first few years of life. Nutrition and normal blood glucose levels are essential to support this growth.
However, food means much more to us all than just fuel and nutrients, food is also about fun, enjoyment, family time, social and special occasions. It is important that diabetes doesn’t get in the way of any of this.
There is no one essential food that your child must eat and there is no need to avoid any food or food group. There are lots of ways to achieve a healthy diet with different combinations of foods.
The key is variety; include some foods from every food group every day. A high quality, nutritious diet is based on plenty of wholegrain low GI carbohydrates and fruits and vegetables and low in unhealthy fats, added sugars and salt. If you make healthier choices for your child most of the time, it is fine to have less healthy foods sometimes, without any guilt. The most important thing is you and your child enjoy food and eating together. Establishing healthy habits from a young age leads to healthy adult lifestyles.
Our top tips for parents of young children
- Keep to three main meals at regular times and up to 2-3 small snacks between meals. Limit mealtimes to a maximum of 30 minutes.
- Leave a gap of at least an hour between snacks and meals.
- Avoid continual grazing between meals, this is associated with higher blood glucose levels and refusing to eat at mealtimes.
- Young children are very good at regulating their own appetites; you may find their appetite varies from day to day. All young children have 2-3 days a week when they eat less food than other days. As long as you are happy with their overall variety of foods across the week, this is fine.
- Learning to recognise feelings of hunger and fullness is an important skill, forcing children to eat more or less than they want to can over-ride these feelings and lead to difficulties recognising these feelings later in life.
- Start by offering small portions, large portions can be off-putting, and allow them to finish when they have had enough. Signs that young children have had enough include turning their head away, closing their mouth and pushing the plate away.
- Snacks can help to provide additional nutrients. Keep snacks to 5-7g carbohydrate, once between each meal. Limit drinks, such as milk, and low carbohydrate snack foods as they can also fill children up.
- The table below shows average estimated carbohydrate requirements for toddlers. This will vary depending on their size and activity levels. The Infant and Toddler forum also have some great online resources showing suitable portion sizes and snack ideas for toddlers.
| Age | Average estimated carbohydrate requirements | Average estimated carbohydrate per meal |
|---|---|---|
| 6 months | 70-75g/day | 15-25g |
| 1 year | 85-95g/day | 20-30g |
| 2 years | 115-125g/day | 30-40g |
| 3-4 years | 135-150g/day | 40-45g |
- Insulin should always be given before eating, ideally 10-15 minutes before. Giving insulin after eating leads to large rises in blood glucose levels.
- Provide small portions, carbohydrate count these portions and bolus insulin before the meal. If your child eats more you can give additional insulin for the extra food.
- If you are worried that your child will not finish the meal give insulin for half of the carbohydrate and top up with additional insulin if they eat more.
- Do not worry if you have given more insulin in comparison to the food eaten, if the difference is 5-10g carbohydrate this won’t matter. If the difference is larger, due to the action of the insulin, it will take two hours for the blood glucose levels to drop. If using a closed-loop system you may find the system is able to prevent a low level by reducing the automated basal rate or you will have time for your child to eat a little more to make up the difference.
- Avoid forcing your child to eat when they don’t want to and avoid making up the difference with ‘treat’ foods like sweets.
- Young children can pick up on their parents stress and worry about eating and learn that they can use their diabetes to refuse a meal and get to eat the foods they want. Avoid using food as rewards and ensure that everyone involved in childcare is consistent with these messages.
- There are many myths in the media about foods people with diabetes should not eat, in reality there is no need to avoid any foods.
- Restricting foods often leads to unhealthy relationships with food, where certain foods are seen as ‘good’ or ‘bad’ or associated with guilt.
- If there are any particular meals or foods you find increase or decrease blood glucose levels and are tricky to manage discuss with the team about strategies for dealing with these foods, rather than avoiding them. Meals that are higher in protein or fat may cause high blood glucose levels 3-5 hours after eating. A closed loop system should help to deal with this rise.
- A normal part of the development of young children involves food refusal, dislike of new foods and frequently changing food preferences and appetite as they seek to gain independence.
- Children learn from older children and adults. Eating meals together, where possible, is important.
- There’s no reason why your child with diabetes should eat any differently to any other follow the same healthy diet and talk positively about the food you are eating, so they can learn from you.
- Get young children involved with food and messy play and start to get them involved in simple food preparation as soon as possible.
- Even young children can pick up on things adults around them say. Talking about food and nutrition can’t be avoided when managing diabetes, but the way we talk about food is important.
- Avoid talking about weight and diets, instead talk about healthy bodies that are growing and strong. Talk about how food and activity builds strong bodies and how foods have ‘magical powers’, for example to build strong bones, help you run, help your brain think and stop you becoming unwell.
- Talk about how healthy bodies can be different shapes and sizes.
- Avoid using food as a reward, labelling foods as ‘good’ or ‘bad’ and associating guilt with any food.
- Establish a regular routine of breast feeds or formula feeds.
- Breastmilk contains 7g carbohydrate per 100ml, therefore for babies from six months of age you can safely bolus for 7g carbohydrate before feeds. Babies from six months will generally have around 200mls per feed.
- Treat hypos with 1-2g fast acting glucose for under 2 year olds and 2-5g for 2-5 year olds. Less hypo treatment is usually needed if using a closed-loop system.
- Avoid using sweets to treat hypos to avoid children wanting to have hypos so they can have sweets. Glucose gel, glucose juice and glucose tablets are good options.
- Speak to your team about suitable hypo treatments for babies.
- Breastfed babies and children up to four years of age having less than 500ml of infant formula per day should take vitamin drops containing vitamins A, C and D.
- All young children, with and without diabetes, should be active for at least three hours every day. Inactive time, in pushchairs, watching TV and other screen-time should be limited. Diabetes shouldn’t get in the way of being active.
- Most of the activity young children do tends to be unstructured play. This makes establishing which activities will impact the blood glucose levels of young children tricky.
- Use the activity mode or increase the blood glucose target to prevent low levels with closed-loop systems.
- Speak to the team about managing more structured activities likes swimming lessons.
Most importantly, have fun! Exploring food and mealtimes with your young child is such an exciting time and builds the foundations for a healthy lifestyle. Think picnics or an ice cream on a sunny day, holidays learning about other cuisines and specific meals or foods associated with religious holidays or festivities. Diabetes won’t stop your child being involved in these occasions. If diabetes means food or mealtimes are no longer fun or becoming stressful, please speak to the team for support.
Speak to the Children's Diabetes Dietitians for individual advice or further information can be found at:
Includes information for parents on healthy eating for babies and toddlers, suitable portion sizes, meal planning advice, meal ideas and tips on managing fussy eating.
A practical recipe guide and portion sizes for 1-4 year olds.
Includes an age specific area for under 5’s, as well as breakfast and meal ideas and managing activity in this age group.
Contact Details
You can contact the Children's Diabetes Dietitians on uclh.
Page last updated: 14 November 2024
Review due: 01 November 2026