Ideally, children should be offered 3 meals and 2 – 3 planned snacks per day, to ensure they meet their caloric and general nutrient requirements. Planned meals and snacks help to prevent grazing (constant picking at food), as the toddler learns to eat when the food is given to them. This teaches the toddler “I am hungry, and so must eat enough at my meal”, and also “I am full, I will stop eating now.”

The amount a child eats may vary from day to day, and even meal to meal, but overall, it should even itself out over the day or week. Suggested portion sizes can help to guide amounts served, but considering your child’s appetite, which is driven by their growth and weight gain, is very important. Let your child be the judge of how much food they eat, listen, and look out for cues that indicate they have eaten enough. Ask your child, “Have you had enough?” or “Do you want anymore?” If they indicate to you that they are full, stop pushing food at this mealtime, even if your child has not finished everything presented. Do not continue to push them to eat more against their will, this hinders the learning of hunger and satiety.

Taller, more active children will usually eat larger portions than smaller, less active children. However, be careful to not compare your child’s intake to another’s, especially if the other child does not have PKU; their intake is different and needs to be. A child growing well is a firm indication that they are eating enough food (calories). Your child’s growth is carefully monitored by your metabolic clinic. Your metabolic dietitian is the best person to discuss your child’s food intake, feeding behaviours, growth, and any questions and concerns you may have concerning their diet.

The ‘Australian Guide to Healthy Eating” is a food selection guide.  It presents foods, as food groups, in the proportion they are recommended, on a daily basis. This guide is for the general population and not for people who require a low protein diet for treatment of PKU.   However, with a few adaptions, the Australian Guide to Healthy Eating, can still help to guide a child with PKU.  

View information on the Australian Guide to Healthy Eating

However, a few vegetables need to be weighed and their protein content counted as part of your child’s total protein allowance. Children need to eat a variety of vegetables daily, including different colours helps to achieve a broad range. Offer vegetables at most meals, including lunch and dinner, ideally offering at least 5 different types over the day.  

Legumes and beans are usually too high in protein for the low protein diet for PKU, and therefore are not to be eaten.  

Some supermarket breads, cereals, pasta, and rice may be appropriate in very small amounts, but their protein content needs to be counted as part of your child’s total protein allowance. Using a variety of the lowest protein options is important as these are generally needed to satisfy your child’s hunger. If foods, such as bread and cereal, contains protein, the amount consumed needs to be limited and your child may lack much needed calories. These foods make up at least 1/3 of the plate and are recommended at each (most) meal, and some snacks.

The protein substitute your child consumes several times throughout the day, is a replacement for these foods; it provides essential protein, some calories, and vitamins and minerals. Your dietitian will recommend how much protein substitute your child requires each day.   

There are several low protein dairy alternatives that may be included in the PKU diet. These include some low protein, non-dairy “cheeses”, non-dairy “yoghurts”, and non-dairy “milks”. Labels need to be carefully read and their protein content counted as required. Incorporating these options into the diet can greatly help to increase overall variety.

However, a few fruits do need to be weighed and their protein content counted as part of your child’s total protein allowance.   Children need to eat a variety of fruit daily, including different colours which helps to achieve a broad range. Offer fruit approx. 3 times per day. Young children will often not eat a whole piece of fruit in one sitting so offering small amounts at regular times over the day helps to increase overall intake. It is recommended for children to eat the equivalent of at least 2 pieces of fruit per day, and more if hungry. 

• Drink plenty of water,
• Use fats and oils in small amounts,
• High sugar, high fat, “low nutrition” foods should be eaten in small amounts i.e., low protein biscuits, cakes, sweet drinks (cordials, carbonated soft drinks), cream, confectionary.

NOTE - The information provided here should be used as a guide only and every child’s appetite, whether they have PKU or not, will be unique to them.  Offer your child realistic food serving sizes and allow them to ask for more if they are still hungry.  The best advice you will receive on the types of food and the amount your child should be eating will come from your metabolic dietitian.