1. Nutrition in Infancy, Childhood, and Adolescence 1

2.  Infancy: First year of life  Childhood: Between infancy and adolescence  -toddler 1-3  -preschool 4-5  -school age 6-12  Adolescence: Onset of puberty  Adulthood: Physical maturity. 2

3.  Kilocalories  Demand for energy is high during childhood due to rapid growth  Infancy: 98-108 cal/kg  Adulthood: 30-40 cal/kg  Carbohydrates  Main energy source  Protein  Fundamental tissue building substance of body  Protein requirements decrease as child grows 3

4.  Water  Rapid growth demands adequate fluid intake  Infants require more water than adults  Infants body = 75% water  Infant: water consumption = 10-15% body wt. (adult = 2-4%)  Calcium (bone,teeth formation )  Calcium needs are most critical during infancy & adolescence  rapid growth 4

5.  Iron (hemoglobin production)  Iron content of breast milk is fully adequate during first 6 months  Beyond age 6 mos, solid foods necessary to supply necessary iron (ie, cereals - rice)  Iron content of fortified infant formula is also adequate source 5

6.  Adequate weight  Low birth weight: <2500 g (5 lb)  Very low birth weight: <1500 g (3 lb)  Extremely low birth weight: <990 g (2 lb) **Most infants double birthweight by 6 mos. Triple by 1 year Double length by age 4 6

7.  Breastfeeding is ideal  Nutrients easily absorbed  Supports immunity – helps protect infants against infection  Allergy prevention  Mother-child bonding  **AAP recommends breastfeeding only x6 mos. 7

8.  Bottle feeding  Acceptable alternative to breastfeeding  More protein than breastmilk  Soy based formula used for milk allergies  Amino acid based formulas used for allergies to cows milk and soy formulas *Usual intake: Newborn 1-2 oz. (6-8 per day) 2 mos. 4-5 oz. (6-7 per day) 6 mos. 7-8 oz. (4-5 per day) 8

9.  Cow’s milk  Should never be fed to infants during first year (can cause GI bleeding and renal problems)  Use breast milk or formula only  Whole milk can be introduced (diluted) at 8-12 mos. Low fat milk after 1 year !  Solid food  Can be introduced at 6 months (infants GI system cannot utilize solids yet)  Introduce fortified infant cereals first, then veggies, fruits then meats Introduce each for at least 1 week 9

10.  Toddlers (1 to 3 years)  Start to eat less food, appetite less  Developing autonomy  Caloric needs vary w/ activity level  19 gm fiber per day is recommended to prevent constipation  Preschoolers (3 to 5 years)  Grow in spurts  Food “jags” are common  Group eating helps with diet (preschool)  Limit concentrated sweets  Healthy snacks: low fat yogurt, raw veggies, fresh fruits, low fat milk, graham crackers, low fat cheese 10

11.  School-age children (5-12)  Slow, irregular growth Average 7 lb. per year, may be all at once  Body changes are gradual  Girls development occurs sooner  Breakfast is important 3 meals + healthy snacks to consume enough calories  Physical activity is important 11

12.  Failure to thrive  Infants, children who do not grow & develop normally  Usually ages 1-5  May be hospitalized  Can be due to medical illness or psychosocial problems  Anemia Cereals/breads now fortified w/ iron But still common problem, especially with formula fed children (not iron fortified) or those who drink excessive amt. milk (poor iron source) Linked with delay in cognitive development 12

13. * Obesity  On the rise for children and adolescents  Factors: high-fat foods, overeating, low physical activity **supersized meals !  Leading to childhood HTN and diabetes  Lead poisoning  300,000 kids (ages 1-5)  Causes anemia, kidney damage, muscle weakness, brain damage  Lead based paint banned 1978 13

14.  Physical growth  Rapid growth during onset of puberty  Boys and girls differ in fat, muscle gain Girls: store more fat in abdomen, hip size increases to prepare for childbirth Boys: more muscle mass and long bone growth  Risk of obesity continues  Eating patterns  Influenced by rapid growth, peer pressure  Alcohol abuse, tobacco use  Pressure to be thin (anorexia, bulemia) 14

15.  Eating disorders a problem for girls and boys  Pressures to control figure  Result in “crash” diets  Self-starvation Anorexia nervosa, bulimia Youngsters see themselves as “fat” Early detection and intervention critical 15