Chapter 16

Infancy, Childhood

& Adolescence

Infants Infant’s nutrient needs – high in proportion to

body size; growth reflects nutritional well-being1. Birthweight doubles by 4-5 months;

triples by 1 yr.2. Vit. D recommendations are 10X greater/lb.

of body wt. than for adult male3. Iron recommendations are 6X greater/lb. of

body wt. than for adult male

Infants

4. Newborn requires ~650 kcal/day (~100 kcal/kg compared to adult requires ~40 kcal/kg5. Fluid needs normally met by breast

milk or formula; may need to supplement

water if hot weather, diarrhea or vomiting

Infants Breast milk – recommended the 1st yr.

1. Readily digested & absorbed and offers immunological protection; colostrum rich in antibodies 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.

Infants 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 recommended

3. Does not offer immunological protection

Infants

3. Formulas are available for infants with

special needs (premature, allergies)4. Not recommended in areas of

poverty/poor sanitation5. Nursing Bottle Tooth Decay can

develop if baby put to bed with bottle

Infants Supplemental foods – can be

introduced at 4-6 mos.

1. Infant readiness – can sit with support &

control head movement and swallow without tongue thrust

InfantsDiet Progression:4-6 mos. – iron-fortified infant cereals followed by

fruits & vegetables (no added salt or sugar) 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)

Infants

Feeding tips:1. Offer 1 new food at a time to detect allergies2. Avoid sweets, foods prepared with salt, and

honey (risk of botulism)3. Prevent choking – caution with popcorn,

grapes, nuts, hot dogs4. 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, grains Ex.: 4 Tbsp. of each for a 4 yr. old5. 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 & health1. Breakfast esp. important! – improves

school performance 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 & cereals

3. Encourage WIC program to low-income families

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 Hyperactivity

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. (Attention-

deficit 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 food2. Opportunity to play3. 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

Adolescence

Energy & Nutrient needs vary depending on:

1. Growth rate2. Body size3. Physical activity

Adolescence 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

Adolescence

1. Girls typically need less calories than boys2. Iron & calcium needs esp. high due to

menstruation & accelerated bone development.

3. Exercise & wise food choices esp. important

to avoid obesity; > 20% of teens overweight, esp. girls & African-Americans

Adolescence

4. Obesity related problems include high blood pressure, high cholesterol level, insulin resistance & diabetes mellitus-

Type 2, orthopedic problems5. Athletes vulnerable to developing

eating disorders

Adolescence Food Choices & Healthy Habits

1. Snacks & eating away from home typical2. Parents can promote good nutrition by

providing foods of high nutrient density at home

3. Marijuana enhances the “munchies”, esp.

for sweets

Adolescence

4. Cocaine stimulates the nervous system so weight loss is common

5. Alcohol & soda are “empty calorie” beverages

6. Smokers have higher nutrient needs (Vit. C)