Growing
Strong.

Growth slows in toddlerhood and appetite naturally varies — this is normal, not a problem. Offer 3 meals plus 2–3 snacks daily. Food neophobia (fear of new foods) peaks around age 2; repeated exposure (10–15 times) is usually needed before a new food is accepted. Iron deficiency remains common — include iron-rich foods (meat, beans, fortified cereals) with vitamin C.

Limit milk to ~500 ml/day (excess reduces appetite and iron absorption). Avoid sugary drinks entirely; limit juice to <120 ml/day of 100% juice. Watch for choking (cut grapes, avoid whole nuts, hard lumps). In South Africa, sugary drink consumption is rising in young children, contributing to high dental caries and early obesity. Water and milk are the only drinks toddlers need.

Sources: 1. SASO. Infant and young child feeding guidelines. 2023. 2. Vorster HH, et al. SA food-based dietary guidelines. S Afr J Clin Nutr. 2013. 3. AAP. Toddler nutrition. Pediatrics. 2020;146(5):e20200071.

School-age children thrive on the balanced plate: half vegetables and fruit, a quarter whole grains, a quarter lean protein. Calcium (700–1,300 mg) builds bones; iron supports cognition (deficiency impairs learning and concentration). Limit sugary drinks, ultra-processed snacks, and screen-time eating.

In South Africa, 1 in 3 children is stunted or overweight, and school tuck shops are dominated by junk food. Healthy lunchboxes are achievable on a budget: wholewheat sandwich with peanut butter or egg, a piece of fruit, plain yoghurt, and water. Breakfast improves school performance. Water should be the default drink; one sugary drink per week is plenty.

Sources: 1. Vorster HH, et al. SA food-based dietary guidelines. S Afr J Clin Nutr. 2013. 2. Cochrane Review. School-based nutrition interventions. 2018. 3. Shisana O, et al. SANHANES-1. HSRC Press; 2013.

Growth is monitored in South Africa via the Road to Health card at clinic visits — weight-for-age, height-for-age and BMI-for-age track development. South Africa faces a "double burden": stunting (chronic undernutrition, ~27%) and childhood obesity coexist, often in the same communities. Both impair health and development.

Adequate protein and zinc support linear growth; vitamin A supplementation is provided per SA DOH protocol. 60 minutes of daily physical activity and limited sedentary screen time (<2 hours) are essential. Both undernutrition and overnutrition require attention — a child can be stunted and overweight simultaneously. Regular growth monitoring catches problems early.

Sources: 1. SA Department of Health. Road to Health Booklet. 2018. 2. Shisana O, et al. SANHANES-1. HSRC Press; 2013. 3. WHO. Guiding principles for complementary feeding. Geneva: WHO; 2020.