Download NUTRITION FROM INFANCY THROUGH ADOLESCENCE

Nutrition from Infancy Through
Adolescence
Chapter 18
BIOL1400
Dr. Mohamad H. Termos
Infant growth and nutrition needs
The growing infant
- Infant weight doubles within
6 months of age and triples
within the first year of age.
- This rapid growth requires a
very high amount of
nutrients because otherwise
growth would slows or
cease
Infant growth and nutrition needs
Under-nutrition
- Half of the world's children
short and underweight for
age because of poor
nutrition
- Child does not receive
breast milk, instead high
carbohydrate, low protein
and other nutrients
- The best indicator of
nutritional status is
growth
Infant growth and nutrition needs
Infant growth and development
can be assessed using growth
charts which give ratios of
weight Vs height, height Vs
age, weight Vs age.
- 10th percentile means a child is
smaller than 90 out of 100
Infant growth and nutrition needs
Adipose (fat) tissue growth
- It is very unwise to greatly
restrict diet and fat intake
before age 2. This is because
restricting fat cells
development would mean a
reduction in energy intake
which would affect growth of
other organ systems.
- Effects of overfeeding in
infancy are speculative. Most
overweight infants become
normal-weight preschoolers
without excessive diet
restrition.
Infant nutritional needs
1.
a.
b.
c.
d.
2.
a.
b.
c.
3.
a.
b.
c.
Calorie or Energy needs:
0 - 3 months: (89 Kcal x wt in kg) + 75
4 - 6 months: (89 Kcal x wt in kg) + 44
7 - 12 months: (89 Kcal x wt in kg) - 78
Human milk and formula provide about 640
kcalories / quart
Carbohydrates:
0 - 6 months: 60 grams/day
7 - 12 months: 95 g/day
These goals are easily met by proper diet
Protein:
0 - 6 months: 9 grams/day
7 - 12 months: 14 g/day
These goals are easily met by breast milk or
formula
Infant nutritional needs
4. Fat:
a. 30 g/day with 15% (~5g) of total kcal
as essential fatty acids
b. Essential fatty acids (DHA and AA)
are vital to the development of the
eyes and nervous system
5. Vitamins of special interest:
a. Vitamin K given by injection to all
newborns
b. Breastfed infants need Vitamin D
supplementation until they are
weaned.
c. Vitamin B12 supplement if
breastfeeding mother is vegan
Infant nutritional needs
6. Minerals of special interest:
a. Iron
- Stores generally depleted by age 4 to 6 months
- Infant > 6 months need dietary iron source
b. Iodine and zinc generally met if energy needs
met
c. Fluoride supplement if water not fluoridated
7. Water:
a. 700-800 ml (3 c) needed per day
b. Human milk and formula usually meet this
need
c. More required in hot, humid weather or with
vomiting, diarrhea, fever
d. Limit supplemental fluids to 4 ounces per day.
Excessive fluid can be harmful especially to the
brain
Formula feeding for infants
Formula composition
- Carbohydrate: generally lactose or
sucrose
- Protein: heat-protein from cow's milk
- Fat: vegetable oils
- Soybean-based for lactose or cows
milk intolerant
- Predigested (hydrolyzed) protein:
protein easier to digest
Formula feeding for infants
Formula preparation
- Use clean bottles and mixing utensils
- Mix formula with clean, cool water as hot
water may contain more lead from
pipes
- Boiled, cooled well-water is OK if it has
been tested for contaminates like
nitrates
- Prepared formula can be kept in
refrigerator for 1 day.
- Do not use microwave to heat as hot
spots can occur
- Discard formula left over from a feeding
(might be contaminated by saliva
bacteria and enzymes
Formula feeding for infants
Feeding technique
- Burp infants during feeding every 1 to
2 ounces or every 10 minutes
- Burp again at end of feeding
- Stop feeding when infant indicates
he/she is full
- Place infants to sleep on their back
- Time on stomach while awake to
prevent flattening of the head
- Sleeping on stomach linked to
sudden death syndrome (SIDS)
Expanding the infants mealtime
choices
- By about 6 months infants
are ready to begin eating
solids
- By 1 year infants consume a
variety of meat, grain, fruit
and vegetable
- Respond to infant cues of
hunger and satiety
Expanding the infants mealtime
choices
- Until 6 mo nutrient needs met by
breast milk or formula
- Other nutrients and additional kcal
needed after 6 months
- Iron stores depleted by 6 mo
Physiological capabilities of infant:
- Ability to digest starch after 3 months
- At about 4 to 6 months the following
develop:
A) Tongue thrust control
B) Head and neck control
C)Ability to sit with support
Infant growth and nutrition needs
Foods to match needs and developmental ability
during the first year:
- < 6 months, primary goal meet iron needs
- Start with tsp serving of single food, gradually
increase portion size
- Feed same food for 1 week then add another food
- Introduce vegetables before fruits
- One food at a time helps identify possible allergies
- Common allergy-causing foods to avoid during
infancy: Egg whites, Chocolate, Nuts, Cow’s milk
Infant growth and nutrition needs
By 9-10 months
- Infants explore, experience, and play
with food
- Present new food for several
consecutive days to aid acceptance
of the food
By 1 year
- Finger feeding is more efficient
- Give baby sized spoon
- Breast and bottle feed in more upright
position for easier swallowing
- Maintain calm and casual tone during
mealtimes
- Infant may take only 2 or three bits at
some meals
Weaning from breast to bottle
- Sippy cup can be introduced
at 6 months
- Drinking from cup not bottle
helps prevent early childhood
carries
- Continual bottle-feeding baths
teeth in carbohydrate rich
fluid. Ideal growth medium for
bacteria that make acid that
decays teeth
- Wean night feedings by giving
pacifier or water
Dietary Guidelines for Infant Feeding
Statements from American Academy of Pediatrics
- Include variety of foods
- Pay attention to signs of hunger and satiety
- Infants need fat in the diet
- Include fruits, vegetables and grains but not too
much fiber
- Avoid artificial sweeteners, include natural sugars
for calories
- Include foods containing zinc, iron and calcium
Food Allergies and Intolerances
Allergies and intolerances broadly
defined as adverse reactions to
foods. Symptoms Include:
1. Sneezing
2. Coughing
3. Nausea or vomiting
4. Diarrhea
5. Hives, other rashes
Food Allergies
- Immune system response,
occurs when the body
mistakes an ingredient in
food as harmful and creates
a defense system to fight.
- Symptoms develop after
interaction between our
antibodies and the food
(mostly proteins)
Food Allergies
Types of reactions:
- Itching, asthma, and swelling
- Nausea, diarrhea, and
indigestion
- Headache and skin reactions
- Anything milder than the
above symptoms is called a
"food sensitivity"
Food Intolerances
Food Intolerances:
- Adverse reactions not involving
allergic mechanism
- Digestive system response, occurs
when a constituent in food irritates
the digestive system.
- Other causes include: Certain
synthetic compounds added to foods,
Food contaminants, Toxic
contaminants, Deficiencies in
digestive enzymes
Treatment: Avoidance or consume
smaller amounts
Preschool children: Nutrition concerns
- Between 2 - 5 years old growth rate slows, average
weight gain is 4.5 - 6.6 pounds per year, and average
height gain is 3" to 4"
- Rapid development of food habits and development of
life- long eating patterns
- Decreased appetite associated with decreased growth
rate
- Emphasize fruit, vegetables and whole grains and limit
fatty and sweet foods choices
Preschool children: Nutrition concerns
Nutritional problems in preschool children
1- Iron-deficiency anemia
- Occurrence most likely from 6 to 24 mo
- Decreased stamina and learning ability
- Emphasize sources of iron in the diet
with vitamin C sources
2- Constipation
- Can be associated with more serious
condition
- Eat more dietary fiber, fruits,
vegetables, whole-grain breads and
cereals, and beans
Preschool children: Nutrition
concerns
3- Dental caries
- Begin oral hygiene when teeth
appear
- Seek early pediatric dental care
- Drink fluoridated water
- Use small amounts of fluoridated
toothpaste twice daily
- Avoid sticky, high-sugar snacks
4- Vegetarianism in Childhood:
Risks include:
a. Iron deficiency
b. B-12 deficiency
c. Vitamin D deficiency
School-age children
- Generally, nutritional concerns and
goals are the same as
preschoolers
- Serving size increases as energy
needs increase
- Children who eat breakfast are more
likely to meet their daily nutritional
needs than children who do not
eat breakfast
- Areas of diet needing improvement:
increase fruit, vegetable, wholegrain, and dairy choices and
reduced soda consumption
School-age children
Type 2 diabetes
1. Primarily due to obesity coupled with
inactivity
2. Blood glucose screening in at risk
children every 2 years starting at age 10
3. Intervention: proper diet and physical
activity
4. Medications may be necessary
School-age children
Obesity
- In the US, 15% of school-age children are
overweight.
Effects: Cardiovascular disease, type 2
diabetes, hypertension in adulthood
- 40% of obese children become obese adults
- Potential causes: Heredity, diet, and
inactivity
Treatment:
- 60 minutes or more of planned physical
activity per day
- Moderate energy intake
The teenage years
Rapid growth spurt
Age:
- Girls: 10 to 13; Boys: 12 to 15
Height gains:
Girls: gain 10 inches, Boys: gain 12 inches
Body composition
- Girls gain fat and lean tissue
- Boys gain mostly lean tissue
- During growth spurts teenagers eat more
- Chose nutritious food to meet nutrient needs
The teenage years
Nutritional problems and concerns of
teens
1. Anorexia and bulimia
2. Sodium intake often high
3. Iron-deficiency anemia