Transcript 11 - Quia

Williams' Basic Nutrition & Diet
Therapy
14th Edition
Chapter 11
Nutrition During Infancy, Childhood,
and Adolescence
Copyright © 2013 Mosby, Inc., an imprint
of Elsevier Inc. All rights reserved.
1
Nutrition in Infancy
1. Normal growth of individual children varies
within a relatively wide range of measures.
2. Human growth and development require both
nutritional and psychosocial support.
Copyright © 2013 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.
2
Nutrition for Growth and
Development (p. 195)

Life cycle growth pattern
◦
◦
◦
◦
Infancy: first year of life
Childhood: between infancy and adolescence
Adolescence: onset of puberty
Adulthood: physical maturity
Copyright © 2013 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.
3
Measuring Childhood Growth
(p. 196)
Individual growth rates: vary widely
 Physical growth: WHO and CDC growth
charts used
 Charts use height (or length), weight, and head
circumference
 Psychosocial development: various assessments
available

Copyright © 2013 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.
4
Energy Needs (p. 196)

Energy needs in kilocalories
◦ *average 5 year old’s basal metabolic rate is
50% of his/her daily caloric intake
Needs are relatively large in childhood
 Macronutrients

◦ *Carbohydrates as main energy source
◦ *Protein for building tissue
 Sources?
◦ Fat for backup energy and essential fatty acids
Copyright © 2013 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.
5
Requirements for Water, Minerals,
and Vitamins (p. 198)


Water requirements
◦ Metabolic needs, especially during periods of
rapid growth
◦ *Infants require more water per unit of body
weight than do adults (larger proportion of the
infants total body water is in the ECF space)
◦ Table 11-2*
Minerals and vitamins
◦ Calcium: critical in early life for skeleton and
teeth
◦ Iron: essential for hemoglobin and cognitive
development in early years
Copyright © 2013 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.
6
Mineral and Vitamin Needs
Calcium
◦ Critical during the most rapid growth
periods of infancy through adolescence*
 Iron
◦ After 6 months, the infants nutrition
needs for iron exceeds that provided by
breast milk and the addition of solid
foods such as enriched cereal is
needed*

Copyright © 2013, 2009, 2005 Mosby, Inc.,
an imprint of Elsevier Inc. All rights
reserved.
Vitamin Supplements (p. 201)
Vitamin K given to nearly all infants,
critical for blood clotting
 Vitamin D drops recommended for
breast-fed infants
 Excessive amounts of vitamins A and D
over time are of concern in children and
may cause ignorance, carelessness or
misunderstanding*

Copyright © 2013 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.
8
Age Group Needs: Infancy
(p. 201)

Immature infants
◦ Weight: defined by birth weight: LBW,
VLBW, ELBW
 *Low birth weigh less than 2500g
 Gestational age: premature, small-forgestational age
◦ Type of milk: breast milk recommended
◦ Methods of feeding: nursing or bottlefeeding usually is possible with support
Copyright © 2013 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.
9
Age Group Needs: Infancy (cont’d)
(p. 203)

Term infants
◦ Better developed body systems
◦ Grow rapidly
◦ Add iron-fortified solid foods at about 6
months
Copyright © 2013 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.
10
Breast-Feeding (p. 203)
**Ideal first food for infants
 Importance of colostrum
◦ Thin yellow fluid that is first secreted by
the mammary glands a few days after
childbirth, preceding the mature breast
milk*
 Mature breast milk after 3 to 5 days

Copyright © 2013 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.
11
Bottle-Feeding (p. 203)
Follow safety precautions
 Standard commercial formulas or
formulas for infants with allergies
 Follow instructions precisely
 Positioning of baby and bottle
 Follow terminal sterilization method

Copyright © 2013 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.
12
Formula
Follow manufactures guidelines for mixing
formula
 Baby bottle tooth decay

◦ Don’t put children to sleep with a bottle of
milk or fruit juice!!*
Copyright © 2013, 2009, 2005 Mosby, Inc.,
an imprint of Elsevier Inc. All rights
reserved.
Weaning and Cow’s Milk (p. 204)
Weaning
◦ Children set own pace
◦ May need encouragement to wean
 Cow’s milk
◦ *Never in first year of life
◦ No reduced-fat cow’s milk for those less than
2 years
 Concentration may cause GI bleeding and it
provides too heavy a load of solutes for the
infants renal system

Copyright © 2013 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.
14
Solid Food Additions (p. 205)
*Not before 6 months
◦ Inability to digest
 Development of certain motor skills is signal
◦ Should be able to hold head upright*
 Possibly vegetables or meat before fruit
table 11-4
 At 6 months-iron fortified cereal*
 Foods may be homemade
◦ Do not add sugar or salt when preparing*

Copyright © 2013 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.
15
Guidelines
AAP recommendations:
 Water and juice not necessary until 6
months of life
 Allergens
◦ Wheat, egg white, citrus juice, nuts and
chocolate
 Honey
◦ Botulism risk
 Choking hazards

Copyright © 2013, 2009, 2005 Mosby, Inc.,
an imprint of Elsevier Inc. All rights
reserved.
Nutrition in Childhood and
Adolescence
1.
A variety of food patterns and habits supply the energy
and nutrient requirements of normal growth and
development, although basic nutritional needs change
with each growth period.
Copyright © 2013 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.
17
Childhood (p. 206)

Toddlers (1 to 3 years)
◦ Increase variety of foods
◦ Pleasant surroundings
◦ Limit sweets

Preschool children (3 to 5 years)
◦
◦
◦
◦
Growth and appetite continue in spurts
Patterns and attitudes form
Occasional food jags
Child-friendly version of MyPlate
Copyright © 2013 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.
18
How infants learn to eat

1-3 months
◦ Rooting, sucking and swallowing

4-6 months
◦ Munching pattern

7-9 months
◦ Pincer grasp*

10-12 months
◦ Bring bottle to mouth
Copyright © 2013, 2009, 2005 Mosby, Inc.,
an imprint of Elsevier Inc. All rights
reserved.
Feeding made simple

Toddlers
◦ Offer variety
◦ *serve small portions
 Ask for seconds if still hungry
Be patient
Copyright © 2013, 2009, 2005 Mosby, Inc.,
an imprint of Elsevier Inc. All rights
reserved.
Childhood (cont’d) (p. 209)

School-age children (5 to 12 years)
◦ Slow, irregular growth during early
years*
◦ Breakfast is important
◦ School breakfast and lunch programs
◦ Competitive foods harm nutrition
Copyright © 2013 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.
21
Common Nutrition Problems in
Childhood (p. 209)
*Failure to thrive: many possible causes,
brief hospital stay may be used to identify
etiology
◦ Do not grow and develop normally*
 Anemia: infants consuming formula or
cereal not iron-fortified
 Obesity: climbing since 1970s, parents play
important role
 Lead poisoning: from lead-based paint,
damages CNS

Copyright © 2013 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.
22
Adolescence (p. 213)

Physical growth
◦
◦
◦
◦

*Rapid growth during onset of puberty
Boys and girls differ in fat, muscle gain
Risk of obesity continues
Growth chart-can be used for any age to
determine adequate nutrition**
Eating patterns
◦ **Influenced by rapid growth, peer pressure
◦ Alcohol abuse
◦ Pressure to be thin
Copyright © 2013 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.
23
Eating Disorders (p. 214)
 Social, family, personal
pressures
 Self-imposed crash diets,
semistarvation
 Mother’s main source of pressure to
remain thin
 Fathers may be emotionally distant
 Early detection and intervention are
critical
Copyright © 2013 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.
24