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can eat later.” If she’s otherwise occupied, she may see no need to stop what she’s doing for a meal.
    So a drop in appetite now is not only no cause for alarm; it’s perfectlynormal. Study after study has found that healthy toddlers who aren’t pushed or coerced into eating consume enough food for normal growth and development. Children who are force-fed, on the other hand, tend to develop chronic eating problems.
    Typically, normal appetites vary from meal to meal, day to day, week to week, month to month. Some children will eat one hearty meal a day and nibble at the rest, other children will satisfy their body’s requirements by “grazing” throughout the day. Interest in eating may pick up during a growth spurt, slow down at teething time or with a cold or the flu. Yet calculated over the weeks, the intake of food almost invariably balances out.
    To test this theory, keep a record of your child’s food intake over a two- or three-week period. Then compare it with the Toddler Diet requirements (see page 504). If you’re conscientious about recording every bite and about providing only healthy bites (no junk food), you’ll probably be surprised to discover how well your toddler is actually eating.
    Keep in mind that your toddler’s rejection of food is not a rejection of you or a reflection on your parenting skills. You can make the most of what appetite she has by making certain to follow the recommendations for feeding the finicky eater (see page 517).
    Sometimes a poor appetite is temporary and related to changes in a child’s life or to a cold or other illness. If your toddler isn’t gaining weight or seems otherwise out of sorts, discuss your concerns with her doctor or nurse-practitioner.
M ILK ALLERGY
    “Our toddler, who recently was weaned from the breast to cow’s milk, has suddenly started having diarrhea off and on, plus she makes sort of a wheezing sound when she breathes, and has a runny nose all the time. She doesn’t seem sick, and has no fever. Should I check with the doctor?”
    Any symptom, or group of symptoms, that arrives on the scene suddenly calls for a call to the doctor. Your child may be the victim of a virus, but it’s more likely she’s developed an allergy to cow’s milk.
    The symptoms of milk allergy include those your toddler has exhibited (diarrhea, asthma, runny nose) as well as eczema, constipation, irritability, poor appetite, and fatigue. Even the smallest quantity of milk in any form can trigger one or more of these symptoms.
    Milk allergy is usually apparent early in the first year if an infant is taking a milk-based formula (and sometimes if a breast-feeding mother is consuming a lot of dairy products). But it often does not show up in a breastfed child or one who has been on a soy or hydrolysate formula until cow’s milk is added to the diet at a year.
    Milk allergy, which seems to affect about 12% of infants, is usually outgrown by the end of the second year, though a small percentage of children continue to have trouble with milk beyond that time. Children who are allergic to milk generally cannot tolerate
any
milk or milk products. They nevertheless require the calcium that milk provides for healthy growth. This calcium can come from a soy milk that is fortified with calcium or from calcium-fortified orange juice. Goat’s milk may also work for a child who is allergic to cow’s milk. And there are a variety of other calcium-rich foods (see page 506) that can supplement your toddler’s diet. Discuss the options with her doctor so that together you can make certain that your toddler’s diet isn’t deficient in calcium or in milk’s other major nutrients, including protein, phosphorus, vitamin D, and riboflavin. Also see page 355.
F OOD THROWING
    “After just a few bites or sips, my toddler invariably throws her bowl on the floor or turns her glass over. I can’t stand the mess anymore.”
    The only sure way to avoid a toddler’s mealtime mess is to