Nutrition From Infancy Through Adolescence

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Nutrition From Infancy Through Adolescence
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Infant Growth

• Rapid growth rate
• Weight doubles by 4-6 month of age
• Weight triples by 1 year
• Length is increased 50 by the 1st year
• Nutrients needed to support proper growth
• Inadequate nutrition (including fat) can inhibit
  growth

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Effects of Undernutrition

• Hampers cell division
• Adequate nutrition will not make up for loss
  growth
• Body bone size is set by 20 years of age
• Growth charts and the percentiles
• Overfeeding may increase number of fat cells
• Underfeeding will affect growth and development

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Failure To Thrive

• Usually due to poor parent-infant interaction
• Infant need physical contact and eye contact
• Diet restriction not recommended
• Infant are dependent on others for nutrition

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Infants Nutritional Needs

• Energy 45-50 kcal / pound body wt
• Protein 0.7 - 1 g / pound body wt
• Protein should focus on essential AA
• Can be obtained from breast milk or formula
• Fat 40 of total kcal

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Vitamin Needs

• Vitamin K injection at birth
• Vitamin D or sunlight
• B-12 if mom is a vegan

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Mineral Needs

• Iron store depleted by 4-6 month of age
• Change to iron-fortified formula for bottle fed
  infants
• Possible iron supplementation for breastfed
  infants
• Introduction of iron-fortified solid foods
• Adequate zinc and iodide
• Fluoride supplement after 6 month of age for
  tooth development

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Water Needs

• Most fluid needs will be met via breast milk or
  formula
• Supplemental water may be necessary in hot
  climate
• Diarrhea, vomiting will require additional fluids
• Babies are easily dehydrated and can damage
  kidneys
• Under normal condition, additional water is not
  necessary

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Formula Feeding

• Lacks long chain fatty acids--omega-3 (found in
  breast milk)
• Cows milk base usually contain lactose/sucrose,
  casein, whey, and vegetable oils
• Soy base contains soy protein
• Fortified with vitamins and minerals (except
  fluoride)

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Bottle Preparation, Storage and Feeding

• Monitor safety and cleanliness
• Boil cold water (hot tap not recommended due to
  risk of lead)
• Prepared bottles can be stored for 24 hours
• Left over bottles should be discarded
• Burp baby every 10 minutes
• Monitor for babys signal for satiety

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Feeding Skills

• 4-6 months begin solid foods
• Start with cereals (rice)
• By 6-7 months, infant able to grab objects
• Teething begins
• Food play and Drinking from a cup
• By 10 months may be ready for finger foods
• Begin to wean from BF, Intro whole milk(soy?)

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Introduction of Solid Foods

• Replete iron store
• Need for vitamin D and fluoride
• Introduction to flavors and tastes
• Develop eating habits

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When To Introduce Solids

• Immature GI prevents starch digestion until the
  age of 3 months
• Limited kidney function until 4-6 months of age
• Limited ability to excrete high protein or
  mineral from diet
• Physical abilities
• Prevent allergies
• Introduce solids at 6 month of age

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First Foods

• Iron-fortified cereals--rice cereal
• Introduce one food at a time
• Wait a week before introducing a new food
• Strained foods and meats
• Introduce vegetable before fruit
• Do not introduce mixed food
• Offer juice in a sippy cup (prevent
  nursing-bottle syndrome)
• No cows milk until 1 year of age

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Allergy Causing Foods

• Egg whites
• Chocolate
• Nuts
• Cows milk

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What Not to Feed An Infant

• Allergenic foods
• Honey or corn syrup (contains Clostridium
  botulinum)
• Highly seasoned foods
• Excessive formula or breast milk
• Choking potential foods
• Cows milk
• Excessive apple or pear juice

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Dietary Guidelines For Infants

• Build to a variety of foods
• Pay attention to infants appetite to avoid
  overfeeding
• Infant needs fat
• Choose fruits, vegetables, grains but limit
  high-fiber foods
• Sugar in moderation
• Sodium in moderation
• Choose foods containing iron, zinc, and calcium

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Milk Allergy

• Cows milk contains 40 different proteins that
  can cause allergic reactions
• Causes vomiting, diarrhea, blood in the stool,
  constipation
• Switch to soy base, or pre-digested protein
  formula
• May want to limit cows milk from mom if breast
  feeding

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Iron-Deficiency Anemia

• Occurs in older infants consuming too few solid
  foods
• Cows milk is a poor source of iron
• Feed iron-fortified formula
• Feed iron-fortified cereals/meats
• May need iron supplement

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Children
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Preschool Children (age 2 - 5)

• Average weight gain 4.5 - 6.6 lb. per year
• Average height gain is 3-4 inches per year
• Tapering of growth rate
• Reduction in appetite

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Encourage Nutritious Foods

• Serve new foods and repeat exposure
• Preschooler has sensitive taste buds and will be
  wary of new foods
• Prefer crisp texture and mild flavor
• Parents/caregivers must teach by example
• Offer finger foods
• Meal time should be a happy time

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Feeding Problems

• Tension between parents and/or children
• High expectations from parents
• Change in appetite
• Six small meals Vs. 3 bigger meals

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Not eating as much as he use to

• Drop in growth rate
• Loss of appetite
• Typical serving size 1 tablespoon per year of
  age

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Always snacking and never finishing meals

• Six small meals Vs. three large meals
• Smaller stomach capacity
• Foster good eating habits with good food choices
• Children will not starve

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Never eats vegetables

• Introduce one at a time and repeatedly
• Good role model
• Allow child to help in preparation
• Raw or blanched may be better tolerated
• Serve with nutritious dip

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Is he eating healthfully?

• Compare to Food Guide Pyramid
• Vitamin and mineral supplements are not necessary
  But ARE they?
• Focus on good food choices vs. supplements
• Low-fat diets not recommended for children under
  2 years of age
• Limit childs exposure to saturated fats and
  sedentary lifestyle

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Iron-Deficient Anemia

• Most likely occur at 6-12 months of age
• Poor oxygen supply to cells
• Compromised learning abilities
• Iron-fortify cereals, lean meats
• WIC

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Constipation

• Dietary fiber age 5 (for ages 3-18)
• Fluid
• 5 cups per day for toddlers
• 9 cups for older children

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Reduce Risk of Heart Disease

• Atherosclerosis begins in childhood
• After the age of 2, follow the National
  Cholesterol Education Program
• The American Academy of Pediatrics, reduce fat to
  lt30 by age 5
• Gradually decrease fat until growth ceases (age
  16-18)

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Low-Sodium

• Role in hypertension?
• Builds good health habits
• Better calcium retention

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School-Age Childrens Meals

• Importance of breakfast
• Steer towards healthful foods
• Diets of school-age kids are inadequate

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3Obesity and Childhood

• 32-3 of Caucasian kids ages 2-19 are overweight
• 30-40 of African American kids are overweight
• 32-41 of Hispanic kids are overweight
• 40 of obese children become obese adults

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How to Correct this EPIDEMIC?

• Encourage physical activity daily
• Moderate kcal intake
• Limit high fat foods
• Set a GOOD example
• Weight loss diet is not necessary

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The Teenager

• Rapid growth spurt between age 10-13 in girls
• Rapid growth spurt between age 12-15 in boys
• Girls gain 10 inches
• Boys gain 12 inches
• Increase in appetite/decrease in nutrition

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Nutritional Problems of Teens

• Anorexia nervosa and bulimia nervosa
• Poor food choices
• High fat intake
• High sodium intake
• Girls stop drinking milk
• Iron-deficiency anemia in menstruating girls
• No link between food and acne

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Diets of Teenage Girls

• Adoption of fad diets
• Increase meals away from home
• Missed meals
• Limited food choices
• Increase snacking
• 44 are trying to lose weight
• Diet commonly low in iron, calcium, zinc,
  vitamins folate, A and C

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Results of Obesity in Adolescence
Decreased bone growth - shorter Menstruate
earlier/Larger breasts incr. Risk of female
cancers Social problems - Ridiculed, isolation,
poor self-esteem 80 chance of remaining
overweight into adulthood!
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Getting Teens to Eat Right

• Teens unaware of long-term affect on health
• Recommend smaller portions of high fat/sugar
  foods
• Larger servings of low-fat dairy, lean meats,
  vegetables, fruits, and grains
• Stress the importance of nutrition and physical
  performance and fitness

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Snacking

• 1/4-1/3 of energy needs are met via snacking
• Snacking mostly on chips, candies, cola, ice
  cream
• Snacking for socialization reason, not hunger
• Poor dietary habits will be continue into
  adulthood
• Increase risk for chronic diseases