chapter 16 infancy, childhood & adolescence. infants infant’s nutrient needs – high in...
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Chapter 16
Infancy, Childhood
& Adolescence
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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
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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
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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.
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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
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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
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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
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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)
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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
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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
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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
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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)
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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)
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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
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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
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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
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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
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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
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Adolescence
Energy & Nutrient needs vary depending on:
1. Growth rate2. Body size3. Physical activity
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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
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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
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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
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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
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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)