Download Infancy, Childhood, and Adolescence

Infancy, Childhood, and Adolescence
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Chapter 11:
Infancy, Childhood,
and Adolescence
J
Pistack MS/Ed
Growth
Infants usually double their weight by 4-6
months
 They triple their weight by 1 year
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Development
Development - changing from a simple to
more complex organism
 A psychological development is trust –
need consistent handling
 Failure to thrive (FTT) term of inadequate
growth
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Nutritional Needs of the Term
Infant
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The American Academy of Pediatrics
recommends exclusive breastfeeding the
first 6 months of life
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Prevents against infectious disease
Decreases allergic responses
May decrease chances for later obesity
Infants are often developmentally ready for
complementary foods at 4 to 6 months of age
Nutritional Advantages of Breast
Milk
Infection-fighting agents—
immunoglobulin A (IgA) and leukocytes
 Allergy prevention—correct proteins,
which are hydrolyzed that are less likely
cause allergic response
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◦ An infant can absorb whole proteins but that
is what causes the allergic reaction
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Obesity—evidence suggest decreased
obesity later in breastfed infants
Formula-Fed Infants
Breastfeeding may not be possible for all
mothers
 Formulas are regulated in the United
States
 Do contain more protein than breast milk
 Come in many concentrations—powder,
mix, ready to feed
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Formula Preparations
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Directions for preparing the formula
◦ Cleanliness/sterility of equipment
◦ Water to use for dilution
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Sterility
Fluoride content
Possible lead contamination
Safe storage
Use of correct strength formula
Safe heating of the formula before feeding the infant
Discard prepared bottles of formula that are
unrefrigerated for 1 hour or partially
consumed
Soy Protein Formulas
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Free of cow’s milk protein and lactose and
iron-fortified
The American Academy of Pediatrics
recommends using soy protein–based
formulas in term infants for:
◦ Galactosemia and hereditary lactase deficiency disease in which the transformation of galactose
to glucose is blocked, allowing galactose to
increase to toxic levels in the body.
◦ Those whose parents desire a vegetarian diet
◦ Secondary lactose intolerance following acute
gastroenteritis
Soy Formulas (Continued)
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The Academy does not recommend soy
protein–based formula under the
following circumstances:
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Preterm infants
Cow’s milk allergy
Routine treatment of colic
Healthy or high-risk infants to prevent atopic
disease
Providing Nutrition to Preterm
Infants
Human milk from the infant’s mother is
the gold standard
 Special formulas for premature infants
 May need calcium, phosphorus, and
sodium supplements
 Greater risk for iron deficient anemia due
to smaller iron stores—may need iron
supplementation
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Necrotizing Enterocolitis (NEC)
The most serious gastrointestinal
disorder of neonates
 Acquired injury to the bowel
 Inflammatory bowel disease results in
inflammation and bacterial colonization of
the bowel wall
 Causes significant morbidity and mortality
in preterm infants
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Nutritional Problems in Infancy
Colic: cause unknown, spasms of colon,
“Rule of 3”—crying 3 hours/day, 3
days/week, 3 weeks
 Diarrhea: rotavirus, enteritis, or food
intolerance—more than three watery
stools per day; hydration is key; monitor
signs and symptoms of dehydration
 Allergies: hypersensitivity to a food;
some severe; treatment is avoidance of
allergen
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Food Allergies in Infancy
Most common protein foods: milk, eggs,
peanuts, tree nuts, fish, crustacean
shellfish, soy, wheat
 Diagnosis: allow time between food
introduction to locate source
 Anaphylactic reactions to food (e.g.,
peanuts)— emergency!
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Nutrition of the Toddler (1–3 Years
Old)
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Foods not recommended until after age 1;
gradually introduce if allergies are not a
concern
Foods include:
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Unmodified cow’s milk
Egg white
Wheat
Citrus fruits
Seafood
Chocolate
Nut butters
Nutrition of Preschool Child
(3–6 Years Old)
Adequate dentition and good nutrition
are mutually supportive
 The American Dietetic Association has
addressed meeting children’s nutrition
and nutrition education needs while in
child care
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Child Care Recommendations
Eight hours or less: should be offered one
meal and two snacks or two snacks and
one meal
 Eight or more hours: offer two meals and
two snacks or three snacks and one meal
 Serve fruits and vegetables high in vitamin
C daily
 High in vitamin A at least three times a
week
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Child Care Recommendations
(Continued)
Caregivers should not add extra salt or
sugar to food
 Good institutional food management
practices should be implemented
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◦ Good hand washing
◦ Adequate refrigeration
◦ Proper storage of supplies
Nutrition of School-Age Child
(6–12 Years Old)
A balanced diet suitable for healthy adults
will also be good for a school-age child
 Exercise can help growth and
development by stimulating osteoblasts
and expending energy to control weight
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Nutrition in Adolescence
Do not meet the daily recommendation for
fruits, vegetables, and whole grains
 Exceed the daily recommended amount of
sodium
 Drink more full-calorie soda per day than
milk (Centers for Disease Control and
Prevention, 2013)
 Peak growth spurt is known to take place
between ages 10 ~14 for girls and 12~16
for boys
 During the peak growth spurt, the mineral
and protein content of the body is increased
so healthy nutrition intake is important
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Concerns Regarding Adolescent
Nutrition
Diet lacks calcium and iron—some
correlation to fractures in this age-group
 Skipping breakfast
 Overemphasis on weight
 Acne—linked or not to food
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The Growing Concern About
Overweight Children
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Pediatricians treating diseases of aging
◦ Hypertension
◦ High blood cholesterol
◦ Non–insulin-dependent diabetes mellitus
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Contributing factors
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Genetics
Food environment
Sedentary lifestyle
Internal cues of hunger and satiety extinguished
Lack of recognition of problem by adults
Prevention and Early Diagnosis
Plot yearly body mass index on CDC
growth charts
 Encourage healthy diets
 Low-fat dairy after age 2
 Fruit and vegetable intake
 Promote physical activity
 Limit screen time to 2 hours per day
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