Infant, Child, and Adolescence

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Transcript Infant, Child, and Adolescence

Chapter 16
Infancy, Childhood
& Adolescence
Infant’s nutrient needs – high in proportion to
body size; growth reflects nutritional well-being
1. Birthweight doubles by 4-5 months;
triples by 1 yr.
2. Vit. D recommendations are 10X greater/lb.
of body wt. than for adult male
3. Iron recommendations are 6X greater/lb. of
body wt. than for adult male
4. Newborn requires ~650 kcal/day
(~100 kcal/kg compared to adult
requires ~40 kcal/kg
5. Fluid needs normally met by breast milk
or formula; may need to supplement
water if hot weather, diarrhea or vomiting
 Breast milk – recommended the 1st yr.
1. Readily digested & absorbed and offers
immunological protection; colostrum rich in
2. Provides the right balance of nutrients,
except Vit. D; supplements may be Rx’d
during birth-6 mos. if insufficient exposure
to sunlight
3. Fluoride & iron supplements recommended
>6 mos.
Infant formula – the only alternative to
breast milk the 1st yr.
1. No cow’s milk until > 1 yr. (induces GI
blood loss)
2. Meets strict nutrition standards –
prepared to provide similar nutrient
content as human milk; iron-fortified
3. Does not offer immunological protection
3. Formulas are available for infants with
special needs (premature, allergies)
4. Not recommended in areas of
poverty/poor sanitation
5. Nursing Bottle Tooth Decay can develop if
baby put to bed with bottle
Supplemental foods – can be introduced
at 4-6 mos.
1. Infant readiness – can sit with support &
control head movement and swallow
without tongue thrust
Diet Progression:
4-6 mos. – iron-fortified infant cereals followed by
fruits & vegetables (no added salt or
6-8 mos. – infant breads & crackers; offer juices
diluted in a cup
8-10 mos. – meats, egg yolk (no whites), legumes,
cheese, yogurt, “finger foods”
>12 mos. – whole cow’s milk (2-3 ½ cups/day)
Feeding tips:
1. Offer 1 new food at a time to detect allergies
2. Avoid sweets, foods prepared with salt, and
honey (risk of botulism)
3. Prevent choking – caution with popcorn,
grapes, nuts, hot dogs
4. Allow child to explore food without forcing to
eat/finish food or use food to reward/punish
Early & Middle Childhood
Energy & nutrient needs
1. By age 1, growth rate slows; appetite
varies with growth phases
2. Energy - ~1000 kcals + 100 kcals/yr.
(ie. 3 yr. old needs ~1300 kcals/day)
3. Nutrients – need steadily increases
Early & Middle Childhood
4. Food portions adjusted to age: ~1
Tbsp./yr. for meats, fruits/vegetables,
Ex.: 4 Tbsp. of each for a 4 yr. old
5. Limit sweets – large intakes can lead
to nutrient deficiencies & obesity
Early & Middle Childhood
Malnutrition in Children
1. Associated with poverty, esp.
children of large families or with
single mothers and inappropriate
diets (very low fat)
Early & Middle Childhood
Malnutrition affects behavior & health
1. Breakfast esp. important! – improves school
2. Children need to eat every 4-6 hrs. to
maintain blood glucose
3. Encourage WIC & National School
Breakfast/Lunch programs to those in
need (breakfast provides ¼ & lunches 1/3
of the RDA)
Early & Middle Childhood
Iron deficiency – the most common nutrient
deficiency in the U.S.
A. Affects energy, behavior, mood, attention
span & learning ability
B. Prevention:
1. Limit milk to 3-4 c./day
2. Encourage lean meats, eggs, legumes,
whole grain & iron-fortified breads &
3. Encourage WIC program to low-income
Early & Middle Childhood
Lead poisoning in children
1. Widespread in children <6 yrs.
2. Affects learning abilities & behavior; may
cause irreversible brain damage (neurological
symptoms include impaired concentration &
reaction time, poor coordination, seizures)
3. Causes: “hand to mouth” – ingesting tainted
dirt, debris, old paint, lead-contaminated
water from pipes
4. May coincide with iron deficiency
Early & Middle Childhood
Food allergies
1. Adverse reaction to food involving an
immune response
2. Symptoms: N/V, skin rash,
inflammation of nasal passages or
lungs, asthma
3. ~75% of all food allergies due to:
eggs, peanuts, milk
4. Food allergies tend to decline with age
Early & Middle Childhood
1. Caffeine – may cause sleeplessness,
restlessness, irregular heartbeats
2. Other causes: desire for attention, lack of
sleep, over stimulation, too much T.V. or too
little exercise
3. ~5% of children have A.D.H.D. (Attentiondeficit hyperactivity disorder) & may require
drug therapy
4. Dietary changes, such as eliminating sugar or
food additives, will not solve problem
Early & Middle Childhood
Food Choices & Eating Habits
A. Nutrition at home – parents are “gatekeepers”
who can foster a child’s growth with:
1. Nourishing food
2. Opportunity to play
3. A nurturing environment
B. Habits established in childhood can help prevent
obesity & chronic diseases
C. If child already obese, goal is to prevent further
weight gain until height catches up
Energy & Nutrient needs vary
depending on:
1. Growth rate
2. Body size
3. Physical activity
Pubertal Growth Spurt
Girls: Growth spurt begins at 10-11 yrs.,
peaks at age 12-14 due to increase
in body fat & start menstruating
Boys: Growth spurt begins at 12-13 yrs.,
peaks at age 14-16 due to increase
in muscle and bone
1. Girls typically need less calories than boys
2. Iron & calcium needs esp. high due to
menstruation & accelerated bone
3. Exercise & wise food choices esp. important
to avoid obesity; > 20% of teens
overweight, esp. girls & African-Americans
4. Obesity related problems include high
blood pressure, high cholesterol level,
insulin resistance & diabetes mellitusType 2, orthopedic problems
5. Athletes vulnerable to developing
eating disorders
Food Choices & Healthy Habits
1. Snacks & eating away from home typical
2. Parents can promote good nutrition by
providing foods of high nutrient density
at home
3. Marijuana enhances the “munchies”, esp.
for sweets
4. Cocaine stimulates the nervous system
so weight loss is common
5. Alcohol & soda are “empty calorie”
6. Smokers have higher nutrient needs
(Vit. C)