CHILDREN CHILDREN NUTRITIONNUTRITION(0-7 YRS)(0-7 YRS)

Dr. Ayman Balla MustafaDr. Ayman Balla Mustafa

Therapeutical Nutrition DepartmentTherapeutical Nutrition DepartmentMisurata University, LibyaMisurata University, Libya

Children categories

1) Exclusive Bre a s tfe e d ing ba by (0 -6 m o nths a g o )

2 ) Bre a s tfe e d ing ba by o ve r 6 th m o nths .

3 ) To ddle rs Nutritio n (1 -4)4) Childre n in Pre cho o l

a nd Scho o l a g e s (4-7 )

0-6th month

Exclusive breastfeeding

Means an infant receives o nly breastmilk from the mother or a wet nurse, or expressed breastmilk,

No other liquids Solids except drops or

syrups consisting of vitamins, mineral supplements or medicines.

Most babies should breastfeed exclusively for six months because

Breastmilk contains all the nutrients a full-term baby needs for the first six months of life.

It provides enough water even in hot weather and is the safest source of water.

Exclusive breastfeeding reduces the risk of diarrhoea and other infections.

Giving any other food or drink increases the risk of diarrhea.

Ways encourage exclusive breastfeeding include:

The baby start suckling within one hour of birth.

Colostrum contains high levels of vitamin A and anti-infective factors that protect newborns from disease.

Giving colostrum is like giving a first immunization.

If a family has a wrong belief about colostrum (e.g. it is dirty), help them to understand it is safe.

Advising the mother to feed ‘on demand’ (when the baby wants to feed) at least 8-10 times over 24 hours, and let the baby suckle for as long as he or she wants day and night;

Dealing with breastfeeding problems (e.g. sore nipples, engorged breasts, thrush in baby’s mouth) promptly;

When she wants to stop breastfeeding, she should do this when the family is able to give suitable replacement feeds;

Iron fortified formula is an acceptable substitute for those families who have decided that breastfeeding is not an option.

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Infant NutritionFrom 6th month to 1 Year

‘weaning’ some confusion about its meaning.‘the period during which the child changed from having only breastmilk to only family foods’.

“continued breastfeeding plus complementary foods”.

the term ‘complementary feeding’ should avoid this confusion and ensure that the recommended feeding for children aged over six months

Weigh the baby at least monthly to monitor his or her growth.

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When to start complementary feeding?

when they are six months old, due to:

breast milk alone cannot supply all the nutrients needed for growth;

children are able to eat and digest other foods.

Breastfeeding on demand should continue until a child is 2 years old.

As children grow, increasing amounts of complementary foods are needed to fill the gap between the nutrients supplied by breastmilk and children’s nutrient needs.

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Prepare complementary foods hygienically

Rich in energy, protein and micronutrients, especially iron (not watery).

Foods are easy to eat and digest. Foods are hygienically prepared and

fed. contain no bones or hard pieces that

might cause choking; Foods are not too spicy or salty. Too much salt is bad for children. Some fat-rich foods to increase the

energy content; fresh fruits and vegetables, especially

ones rich in vitamins A and C;

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Food made with germinated or fermented flours

Young children need foods rich in energy and nutrients because their stomachs are small.

Porridge made from fermented flour is easier to digest and safer because germs cannot grow easily in fermented porridge.

The iron is better absorbed

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Optimal nutrition is extremely important during the first year, as the baby’s organs and nervous system continue to develop and mature and as the baby grows physically.

In fact, use length and weight measurements as the main tools for assessing an infant’s nutritional status.

Infant Nutrition:From Birth to 1 Year

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In the first year of life, an infant generally grows about 10 inches in length and triples in weight.

Energy needs are very high because the basal metabolic rates of babies are high.

Still, the limited physical activity of a baby keeps total energy expenditure relatively low.

Infant Growth and Activity

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Dietary requirements

protein for infants 0 to 6 months of age is 9 g/day or about 1.5 g/kg body weight per day.

Formula-fed infants typically consume higher amounts of protein compared with breastfed infants; however, the proteins in commercial formulas are less efficiently digested and absorbed.

The protein guideline for infants 7 to 12 months of age is 9.9 g/day or 1.1 g/kg body weight per day.

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Breast milk and commercial formulas are both high in fat (about 50% of total energy).

Specific fatty acids are essential for the rapid brain growth, maturation of the retina of the eye, and nervous system development that happens in the first 1 to 2 years of life.

infants one year, omega-6 fatty acids is 4.6 g/day, about 6% to 8% of total calories, omega-3 fatty acids is 0.5 g/day.

Dietary fat

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The recommended carbohydrate intake for infants is based on the lactose content of human milk.

60-95 g/day of carbohydrate for infants 6 and 12 months of age reflects the intake of human milk and complementary foods.

Dietary carbohydrate

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An infant’s micronutrient needs high due to rapid growth and development.

Micronutrients include iron, vitamin D, zinc, fluoride, and, for infants of breastfeeding vegans, vitamin B12.

Fortunately, breast milk and commercial formulas provide most of the micronutrients needed for infant growth and development.

In addition, all infants are routinely given an injection of vitamin K shortly after birth. until the infant’s intestine can develop its own healthful bacteria.

Micronutrient Needs of Infants

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Fluid is critical for everyone, but for infants the balance is more delicate for two reasons.

First, they lose more water through evaporation from the skin surface area than adults.

Second, their kidneys are immature and unable to concentrate urine. Hence, they are at even greater risk of dehydration.

An infant needs about 2 oz of fluid per pound of body weight.

Fluid Recommendations for Infants

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Certain conditions, such as diarrhea, vomiting, fever, or extreme hot weather, can accelerate fluid loss.

Parents should avoid giving breastfed or formula-fed infants sugar water, fruit juices, or sweetened beverages in a bottle, especially at bedtime, as the practice can cause decay of developing teeth.

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NUTRITION FOR TODDLERS

Nutrient needs increase as a child progresses from infancy to toddlerhood.

Although their rate of growth has slowed,’ increased nutrient needs are based on their larger body size and activity

toddlers attending day care centre may be exposed to foods that may be more or less nutritious than the foods served at home.

Nutrition for Toddlers (1-4 yrs)

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Healthy toddlers of appropriate body weight need to consume 30% to 40% of their total daily energy intake as fat.

This is important for toddlers, especially those have little appetite. Fat is also necessary during the toddler years to support the continuously developing nervous system.

Toddlers’ fat needs

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Toddlers’ protein needs increase because they weigh more than infants and are still growing rapidly.

The protein for toddlers is 1.1 g/kg BW per day, or13 g of protein daily.

the 2 cups of milk alone provide 16 g of protein; this enough to meet their protein needs.

Toddlers’ protein needs

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The carbohydrate for toddlers is 130 g/day, Adequate fiber is important for toddlers.

Many fruit juices are nutritious sources of carbohydrates that can be included.

Keep in mind, however, that too much fruit juice can displace other foods and nutrients and can cause diarrhea.

Carbohydrate for toddlers

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Adequate intakes of the micronutrients associated with fruits and vegetables.

The calcium and iron as “priority nutrients” for children 2 to 4 years.

Calcium is necessary for children to promote optimal bone mass, which continues to accumulate until early adulthood.

Dairy products are excellent sources of calcium

Micronutrient Recommendations for Toddlers

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Toddlers can be well nourished by consuming a balanced, varied diet.

The child’s physician may recommend a multivitamin and mineral supplement as a precaution against deficiencies.

The toddler’s physician or dentist may also prescribe a fluoride supplement, if the community water supply is not fluoridated.

Supplements should also be considered for children in vegan families.

Do Toddlers Need Nutritional Supplements?

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Toddlers’ stomachs are still very small, and they cannot consume all of the energy they need in three meals.

They need small meals, nutritious snacks, every 2 to 3 hours.

A positive environment helps toddlers develop good mealtime habits as well.

Foods prepared for toddlers should also be fun.

Cont.

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NUTRITION FOR PRESCHOOL AND SCHOOL-AGE CHILDREN

(LECT. 10)

The nutrient needs of young boys do not differ from those of girls; because of this, macronutrients, fiber, and micronutrients are grouped together for boys and girls aged 4 to 8 years.

Total energy requirements continue to increase throughout childhood because of increasing body size and higher levels of physical activity.

Appropriate physical activity while minimizing risk of excess weight gain.

What Are a Child’s Nutrient Needs

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Start reducing dietary fat is to slowly introduce lower-fat dairy products such as 2% or 1% milk, low-fat yogurt.

Children who fail to consume the recommended amount of fruits and vegetables each day may become deficient in vitamins A, C, and E.

Low-fat milk, yogurt are child-friendly and convenient sources of calcium.

Fat Needs

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Low-fat milk, yogurt, cheese, and fortified fruit juices are child-friendly and convenient sources of calcium.

The problem of “milk displacement,” when children stop drinking milk in favor of soda, energy drinks, and juice, is a recognized factor in low calcium intake.

Diets that are low in calcium also tend to be low in other nutrients, so attention to calcium intake can help ensure a more healthful overall diet for children.

Ca requirement

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The children aged 4 to 8 years for iron and zinc increase slightly to 10 mg/day and 5 mg/day, respectively.

These based on the assumption that most girls do not begin menstruation until after age 13.

legumes offer a fiber-rich that will also add iron and zinc to the diet.

Iron requirements

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Overweight and obesity of old children

Among children and youths are becoming problems in some places, especially urban areas.

Children, like adults, are at risk of becoming overweight or obese if they eat too much, especially energy-rich food (e.g. fatty and/or sugary foods), and consume too many fizzy drinks, and are not physically active.

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Overweight and obesity of old children

Feeding older children

The risk of tooth decay is greatest when foods contain large amounts of sugars and starch that stick to the teeth, and when oral hygiene is poor (no or insufficient tooth brushing).

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