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Nutrition: Infancy to Preschool

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Shannon Bishir

on 25 April 2011

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Transcript of Nutrition: Infancy to Preschool

Infancy to Preschool Years When looking at infant nutrition, breast fed is best fed Here's how it works Breast milk can be fed directly through the breast, or can be pumped and fed through a bottle. Feeding directly from the breast is convenient because there is no bottle to prepare, warm up, clean, etc... However, pumping makes it possible for working mothers to resume their careers after their maternity leave is up. Most mothers use both methods, as dictated by their schedule. An infant's birth weight is expected to double by 4-6 months of age, and triple by age one.
An infant's length is expected to double by one year of age.
Infants need more energy and nutrition per pound than older kids and adults. To fuel this rapid growth, nutritional needs must be met.
Without proper nutrition, growth may slow or even stop.
The rapid growth rate that characterizes the first 12 months tapers off quickly during the preschool years.
An average three year old weighs about 32 pounds and is about three feet tall. Breast feeding and lactation Infant growth In the American population, breastfed infants have a lower mortality rate than their non breast fed counterparts Interesting fact:

Breast feeding provides optimal nutrition and
time for baby and mom to bond
It takes about 800 additional calories per day to produce milk, however, the lactating woman can meet these energy needs by adding 300-400 calories a day to her pre pregnancy caloric needs.
No special foods are needed for lactation, but hydration is essential.
Healthy snacks can be decided on by following MyPyramid guidelines.
The lactating woman should drink something when nursing to maintain milk volume and keep well hydrated.
The lactating woman should avoid alcohol and caffeine for as long as she is breast feeding, as these drugs are excreted in breast milk.
The lactating woman should check with her doctor before taking any prescription, over the counter, or herbal medications, because any of these meds may be harmful to baby Lactation Diet When to quit It is recommended that babies be breastfed exclusively for the first six months of life
At six months of age, infants can be given appropriate foods, but breastfeeding should still continue until the child's first birthday.
Although breastfeeding can continue past the first year, it is uncommon in the United States. After birth, the breasts produce a yellow tinged liquid known as colostrum.
Colostrum is a very important first food because it contains various antibodies, immune system cells, and a substance that helps the body to produce a beneficial bacteria that is needed in the GI tract.
About a week into lactation, colostrum becomes mature milk.
Mature milk may have a bluish color in comparison to cow's milk.
Breast milk is rich in lipids including AA (arachidonic acid) and DHA (docosahexaenoic acid), fatty acids that an infant's nervous system, especially the brain and eyes, rely upon.
The fat content of breast milk changes during each feeding; at the beginning of a nursing session, the milk (foremilk) is low in fat, but as the feeding goes on, the fat content increases. The high fat milk at the end of the feeding (hind milk) may leave the infant feeling satisfied, causing him/her to stop the feeding session

Failure to empty breasts completely will cause milk supply to dwindle, and eventually stop all together. This often occurs when feedings are supplemented with formula and/or baby food, reducing baby's need to suckle.
Constant nursing and pumping can make nipples sore, raw, and cracked. Using lanolin helps to relieve these discomforts, increasing chances of continued breast feeding.
Breast feeding doesn't always come easy to mom or baby; Time is needed to master the techniques that make for successful breast feeding; it may be difficult to get started, but the benefits are well worth the effort.
Vegetarian women who do not take B-12 supplements may need to give the infant B-12 supplements to meet his/her needs.
At about six months, the infant should be consuming iron rich solids because the iron in breast milk may no longer meet the infant's needs.
Flouride supplements may also be needed for breast fed infants. Breast size has no bearing on whether or not a woman can produce milk. Interesting fact: Helpful Hints If mom is worried that baby is not getting enough milk, She should watch baby for signs that he/she is full, such as disinterest in nursing, turning away, etc...
While nursing, listen for the baby's suck and swallow. This indicates that baby is getting milk.
A well nourished baby should gain weight normally, have six or more wet diapers and one to two stools each day.
Mom should have a support system to help her to continue on breast feeding. New mothers are unlikely to breast feed without partner support, so it's important that her partner support and appreciate that breast milk is is nearly perfect nutrition for their infant.
Lactation consultants are available at the hospital for support.
The La Leche league is an international organization dedicated to the education and support of breast feeding women. Their phone number is 1-877-4-LALECHE, and their website is www.llliorg.
For more breast feeding info go to www.cdc.gov/breastfeeding/ and/or visit www.womenshealth.gov/breastfeeding/. The fat in breast milk helps to supply the energy needed for proper growth.
Emotional and physical upset, such as stress, pain, fatigue, and tension may impede the let-down reflex, a reflex that causes milk to be released when baby suckles.
Breast milk is nutritious, but it's not always a complete food for all infants. Breast milk may not have sufficient amounts of vitamins D and B-12, or the minerals iron and flouride. It is therefore advised that all breast fed infants be given a supplement that supplies 400 IU per day until he/she can obtain the vitamin through diet. Sun may supply part of the infant's vitamin D needs.
Breast milk is produced on a supply and demand basis; the more baby suckles, the more milk is produced.
Certain surgical procedures involving the breasts can disrupt nerves and tissues in the breasts. Post-surgically a woman may be able to produce milk, but their infant's growth should monitored to make sure that baby is getting enough milk. Infant Formula Feeding and cow's milk Not all women want to breast feed, so infant formula is a safe and adequate source of nutrients for a growing baby.
Infant formula is made by altering cows milk to improve its digestibility and nutrient content.
Infant formulas generally contain heat treated proteinsfrom cow's milk, lactose and/or sucrose, and vegetable oil.
Infant formulas generally lack cholesterol, but some formulas have the fatty acids DHA and AA added to them.
Vitamins are added to infant formulas, and sometimes formulas have more micronutrients than human milk.
The composition of formula is different than human milk, and manufacturers have been unable to duplicate the human antibodies and other unique immune system factors that are present in breast milk.
The overall energy content in formula is about the same as in human milk.
The caregiver is in control of how much he/she feeds the infant, which often leads to overfeeding.
It is recommended that parents choose an iron fortified formula for babies that aren't breast fed.
For babies who are allergic to formulas that are made using cow's milk protiens, similar products made with soy or other proteins are available.
Do not microwave formula as hot spots may scald the infant.
Concentrated infant formulas perish quickly. Once a container is opened, it must be used within one day.
Any formula left in the bottle after a feeding must be discarded because it will have been contaminated by the bacteria in the infant's saliva. Formula & Feeding MyPyramid guidelines for breast feeding moms Cow's Milk Cow's milk is too high in minerals and protein, and doesn't have enough carbohydrate content to meet an infant's needs. In addition, it is difficult for infants to digest caesin, the major protein in cow's milk.
Infants should not be fed cow's milk until one year of age, at which time he/she should be given whole milk until age two.
After age two, milk can be gradually changed from whole, to 2%, to 1%, and finally to skim if desired. Allergies Allergies are an immune response to foreign substances in the body.
Formula fed infants are more likely to develop allergies than breast fed infants.
A woman with a family disposition to allergies can help prevent them in her child by breast feeding exclusively for six months.
Infants rarely develop allergic reactions to food proteins that enter breast milk through the mother's bloodstream.
Some children outgrow allergies during childhood, but some remain allergic to the food for their entire adult life.
Allergies to proteins in food, especially cow's milk proteins, often begin in infancy and may persist through childhood.
Signs and symptoms of allergies may include, but are not limited to the following: GI symptoms- Vomiting, diarrhea, intestinal gas and pain, bloating, and constipation. Integumentary symptoms- Itchy, swollen, or reddened skin. Respiratory symptoms- Runny nose and brathing difficulties such as asthma. Introducing Solid Foods An infant is not physically mature enough to eat solids before four to six months of age.
An infant's digestive tract is not able to readily digest starches prior to three months of age.
An infant's nutritional needs can be met with breast milk or formula until about six months of age, at which point more calories and iron are needed in the diet.
Solids can be added to an infant's diet at six months of age, but the foundation of his/her diet should still be breast milk or formula for the first year.
Many caregiers are anxious to start solids because they feel that it helps infants sleep through the night, however, sleeping through the night is a milestone that generally occurs at about three to four months of age regardless of what the infant is eating.
Infants have an extrusion reflex, which is an involuntary response to solid or semi-solid objects being placed in the mouth. This reflex causes the baby to push things out of his/her mouth, making feeding messy and sometimes frustrating.
Liquids such as formula and breast milk do not elicit the extrusion reflex, which is why infants are able to swallow fluids.
At about four to six months, the extrusion reflex disappears, and the child develops the ability to digest, metabolize, and excrete a wider range of foods.
By six months an infant has gained the ability to sit with back support and has gained muscular contro; over his/her neck and mouth movements. These signs indicate that the infant is physically ready to eat solids, is less likely to choke on foods, and can turn his/her head when full. When to start solids First solids It is recommended that the first solid given be a rice cereal. A commercial brand is best as they are least likely to trigger an allergic response.
The caregiver should wait two to four days in between trying new foods so that if an allergic response occurs, there is no confusion as to which food was the culprit.
If rice cereal is tolerated, a new cereal or a strained vegetable can be given.
Foods that most often cause allergic response in infants include: Egg whites, chocolate, nuts, and cow's milk, therefore these foods shouldn't be given to babies.
Avoid giving mixed foods, commercially prepared dinners, and/or casseroles since it would be difficult to determine the cause if an allergic response occurred.
After the infant has eaten each food on its own, he/she can eat mixtures.
Single food items such as peas and carrots are more nutrient dense choices than mixed dinners and desserts.
Many of these foods are commercially available at the grocery store, but the caregiver can puree fresh fruits and veggies, put them in an ice cube tray and freeze. This way, an ice cube sized portion can be popped from the tray, heated, and served at feeding times.
By about eight to twelve months of a baby can use a pincer grasp to eat finger foods such as crackers, toast, and cooked string beans. At this age, babies can also hold his/her own bottle, and are beginning to practice drinking from a sippy cup.
Babies need to practice self feeding even if it is a messy endeavor.
By about ten months, babies are mastering self-feeding, and are transitioning to eating foods that the rest of the family eats. Nutrition and dentition At about six to eight months of age, baby's first set of teeth, known as primary dentition, begin to appear.
Teeth are important to nutrition because they help the baby to bite and chew food.
Weaning is a gradual process of shifting an infant from breastfeeding or bottle-feeding to drinking breast milk or formula from a cup and eating solid foods from a spoon. This is extremely important to dental health.
Caregivers often place babies in their cribs with a bottle eat bedtime. This practice is discouraged because sleepy infants suck slowly, allowing carbohydrate-containing fluids to bathe the teeth, providing a nutrient source for bacteria that stick to teeth. These bacteria produce acids that dissolve tooth enamel, causing cavities to form on the teeth. If baby needs to have a bottle at bedtime, give him/her a bottle of water.
Cavities that occur from bottle feeding are known by dentists as baby bottle caries, or to the lay person as baby bottle rot. Helpful Hints When feeding solid foods to an infant:
Use a baby sized spoon- a small spoon with a broad handle.
For breast feeding or bottle feeding, hold the infant comfortably on your lap with baby's body in a more upright position to ease swallowing.
Add some breast milk or formula to the infant cereal, and place a small dab of the semi-solid food on the tip of the spoon. Gently place the spoon on the infant's tongue, tilting it so that the cereal slides off of the spoon and on to the infant's tongue.
Expect messes thanks to the extrusion reflex, however, if an infant repeatedly spits out his/her food, or looks away when the spoon nears his/her mouth, discontinue the feeding.
Expect the infant to take only two or three bites during these early feeding sessions. What not to feed an infant Although an infant should be consuming a variety of foods, certain foods and beverages are not appropriate. Avoid feeding infants the following items:
Honey- this product may contain spores of Clostridium botulinum, a bacteria that can produce a botulism toxin that can be fatal to infants under one year old.
Excessive infant formula or human milk- Depending on age, most infants need less than thirty ounces of human milk or infant formula per day. Too much formula or breast milk may decrease hunger, causing the infant to refuse the solid foods that contain the necessary nutrients that are not found in human milk or infant formula.
Semisolid baby cereal in a baby bottle that has an enlarged nipple opening- This contributes to overfeeding, and doesn't facilitate self feeding skills.
Candy, flavored gelatin water, or soft drinks- These items provide few micronutrients.
Small pieces of hard or coarse foods- Foods such as hot dogs, nuts, grapes, pieces of cooked meats, raw carrots, popcorn, and peanut butter can cause choking. Also, caregivers should watch during feedings so that the child doesn't stuff to much food in his/her mouth.
Excessive amounts of apple and/or pear juice- These juices contain fructose and sorbital,a sugar alcohol, that can cause diarrhea. Also, when the infant consumes these juices, it replaces space that would normally be filled by breast milk or formula, which may cause the infant to take in less calcium and other essential minerals.
Unpasturized (raw) milk- Raw milk may be contaminated by bacteria and/or viruses.
Goat's milk- Goat's milk is low in iron, folate, and vitamins C and D. Well baby checkups Well child exams typically occur at 2, 4, 6, 9, 12, 18, and 24 months, and annually thereafter.
During well baby exams,a health professional usually measures the infant's weight, length, and head circumference.
Head circumference measures brain growth, which occurs at a rapid rate in the first eighteen months of an infant's life.
The three values are then compared on charts that indicate the typical growth of an infant. These charts are available at the Centers for Disease Control and Prevention website- www.cdc.gov/growthcharts/.
The growth charts display percntile divisions; a percentile ranks the child's size among other children who are the same age and gender.
If an infant boy is in the 90th percentile for length, it means that he is the same length or longer than 90% of boys his age, and that he is the same length or shorter than 10% of boys his age.
If an infant's growth slows down too much, the child's physician should investigate to determine if a medical condition is responsible for the unusual measurements.
The preferred growth standard for children between the ages of two and twenty is the BMI, or body mass index for age, a chart that assigns a number based on the child's height and weight.
BMI-for-age charts for children are both gender and age specific.
An overweight child has a BMI-for-age that is at or above the 85th percentile, below the 95th percentile for children of same age and same sex.
An obese child has a BMI-for-age that is at or above the 95th percentile for children of the same age and sex. Interesting fact: If an average infant's growth rate didn't slow down, he/she may weigh about 190 pounds and be about 5'7" tall by three years of age Nutrition During The Preschool Years As the growth rate slows down after infancy, preschoolers' appetites decrease becasue they do not need as much food, and they do not have the stomach capacity to eat adult sized portions.
Parents must understand that it is normal if their p rescholer isn't eating as eagerly as he/she did as an infant.
Caregivers should serve nutrient dense foods for meals and snacks, especially for those who eat a relatively small amount of food. Some examples of nutrient dense foods are: Lean meats, low fat milk products, whole grain cereals, fruits, nuts, and vegetables.
It is not necessary to eliminate cereals that are sweetened with sugar, but caregivers should read labels, and try to buy varieties with less added sugars.
Caregivers should monitor and limit a child's intake of sweets, because these simple sugars may crowd more nutritious foods out of the child's diet.
Fish should be included in a child's diet on a regular basis, especially those high in omega 3 fatty acids, such as salmon.
Although fish is recommended, comercially fried fish, including fish sticks, should be avoided because of their high fat content.
Vegetarian diets for children must be carefully planned to meet a growing child's needs or deficiencies may develop. Diet and appetite Snacks Snacking is not necessarily a bad habit, especially if snacks are nutrient dense and fit into the child's overall diet.
Preschool children have small stomachs, so snacks can be offered midmorning or midafternoon, at a time when the child is most likely to be hungry between meals.
A four to five year old child can safely eat raw vegetables without fear of choking, so raw carrots, broccoli floweretes, cauliflower, sliced peppers, mushrooms and more may be accepted.
Healthy dips may make raw vegetables more appealing to children. Chapter 13 recipe for healthy living features a yogurt dip for vegetables that children may enjoy.
By 4 to 5 years old, skim milk is acceptable. Fostering positive eating behaviors Children can be picky eaters, and may go on food jags. Food jags are periods where the child wont eat foods they liked in the past, or they want to eat one particular food all the time.
Food jags and picky eating may be a child's way of expressing independence.
Caregivers should aid nagging, forcing , and bribing their children to eat.
Offer a variety of healthy foods so that the child can choose which items, and how much, to eat.
Preschool children often refuse new foods; texture, temperature, appearance, and taste all influence whether or not a child will try a new food. Children may resist mixed foods, such as in casseroles and stews, even if the child likes each food seperately.
Vegetables with strong odors can be upsetting and unappealing to preschool children, but eating vegetables becomes more appealing when children help to plant, grow, and harvest them from a home garden. If it isn't feasible to plant a home garden, allowing the child to help to select and prepare vegetables as snacks may make the snack more exciting to eat.
Caregivers should try to understand that all people have the right to like or dislike certain foods.
Try to make sure that the dinner table is a place where the family can be social while enjoying healthy foods together.
Avoid making statements like: "You can just sit here until your plate is clean", or "you can have a cupcake if you finish your peas". These statements can make meal times miserable, and as a result destroy a child's appetite entirely.
When a child refuses to eat, have him/her sit at the table a bit longer, and if he/she is still disinterested, take the food away and wait until the next scheduled meal or snack time.
Healthy children are not in danger of starving if they miss a meal, but if a lack of appetite persists, caretakers should consult a physician to have illness ruled out. Common Food Related Concerns
Decreased physical stamina
decreased learning abilities
decreased resistance to infection
Foods such as lean meat, and enriched breads and cereals
Milk and milk products are poor sources of iron, so these should be limited. Preschool children need 2 cups per day of fat free or low fat milk or equivalent milk products. Iron Deficiency Dental Caries Allergies Obesity Many preschool children have had one or more dental caries by the time they enter school.
If dental caries are left untreated, pain, gum infection, and tooth loss may occur.
Brush twice daily using a pea sized amount of flouride toothpaste if child spits well, but if he/she swallows toothpaste, non-flouride toothpaste should be used.
Provide flouridated drinking water, tap water is fine.
Provide and promote regular pediatric dental care beginning at age two, or sooner if necessary.
Avoid pop and sticky, sugary snacks, especially between meals.
If a preschooler is a gum chewer, provide him/her with gum that is sugar free. Although any foods can trigger an allergy, the most common food allergens are: Peanuts, tree nuts (walnuts and pecans), fish, shellfish, milk, eggs, soybeans, and wheat.
A child who is extremely allergic to a food may have a severe reaction just by being in the area where the food is being cooked or eaten. Avoiding foods that cause an allergic response can, for some children, be a matter of life or death.
Avoid exposure to problem foods.
Pay attention to nutrition labels to be sure that the food doesn't have things in it that an allergic child should avoid.
Caregivers must inform others who have contact with the child of the need to avoid certain foods.
A registered dietician can help plan menus that meet the allergic child's needs. Theprevalence of preschool obesity increased from 5% in 1976-1980 to over 12% in 2003-2006.
Obesity among preschoolers is a major public health concern.
Childhood obesity is an early risk factor for type two diabetes, hypertension, and obesity later in life.
Approximately 20% of obese four year old children mature into obese adults.
There is n one cause for excess body fat in children, but researchers have identified some factors that are associated with the development of the condition. These factors include: Family history of excess body fat, high birth weight, and obese family members.
Children who eat too many fried foods, drink too many sugar sweetened drinks, and spend much of their time at sedentary activities such as T.V., video games, and computers have a greater risk of gaining excess body fat in childhood.
Promotion of healthy eating practices for all family members.
Promotion of daily physical activities for all family members.
Be a good role model,; monkey see, monkey do. In Closing My precious lil' angel Violet Marie :) Children are our worlds most valuable resource, so we should provide them with the best nutrition possible My Goofy Girl Gracie My littlt big girl Nevaeh My Araya who now thinks she is too cool to smile :o : _ - - ) Like many others, my family means the world to me, so I always do my best to provide them with wholesome foods that give them the nutrients they need to grow into happy, healthy, successful, and strong adults. Learning about nutrition has helped me to understand how to promote healthy eating habits, as well as create balanced meals and healthy snacks that children enjoy. All in all, I believe that educating yourself about nutrition is one of the single most important things that you can do for yourself and your family.
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