feeding & nutrition in children
TRANSCRIPT
![Page 1: Feeding & nutrition in Children](https://reader034.vdocuments.site/reader034/viewer/2022042701/55a516451a28abd77f8b461f/html5/thumbnails/1.jpg)
FEEDING & NUTRITIONIN YOUNG CHILDREN
(0-5 Yrs)
Dr Somendra ShuklaMBBS, DNB (Pediatrics), MNAMS, MRCPCH (UK),
Fellow Neonatology
Sr. Consultant Pediatrics & Neonatology
![Page 2: Feeding & nutrition in Children](https://reader034.vdocuments.site/reader034/viewer/2022042701/55a516451a28abd77f8b461f/html5/thumbnails/2.jpg)
Objectives
• To recognize the changing nutritional needs of developing children, from infancy to 5 yrs of age.
• To understand that nutritional recommendations for children vary by age, & stage of development.
• To recognize that nutritional and dietary behaviors learned in children can have a significant impact on adult health concerns such as obesity, cardiovascular disease, and osteoporosis.
![Page 3: Feeding & nutrition in Children](https://reader034.vdocuments.site/reader034/viewer/2022042701/55a516451a28abd77f8b461f/html5/thumbnails/3.jpg)
Why is Nutrition Important?
• Energy of daily living - Carbohydrate• Maintenance of all body functions- Minerals & vitamins• Vital to growth and development- Protein & fats• Therapeutic benefits
Healing - Protein
Prevention
![Page 4: Feeding & nutrition in Children](https://reader034.vdocuments.site/reader034/viewer/2022042701/55a516451a28abd77f8b461f/html5/thumbnails/4.jpg)
Growth in Infants
Rapid body growth and brain development during the first year:
• Weight increases 200%• Body length increases 55%• Head circumference increases 40%• Brain weight doubles
![Page 5: Feeding & nutrition in Children](https://reader034.vdocuments.site/reader034/viewer/2022042701/55a516451a28abd77f8b461f/html5/thumbnails/5.jpg)
Nutrition for Infants < 6 months
Breast Milk vs. FormulaConvenience vs. health
![Page 6: Feeding & nutrition in Children](https://reader034.vdocuments.site/reader034/viewer/2022042701/55a516451a28abd77f8b461f/html5/thumbnails/6.jpg)
Nutrition for Infants < 6 months
(Better Nutrition, 2000)
•Premature infants
•Long-chain polyunsaturated fatty acids
•Faster brainstem maturation
![Page 7: Feeding & nutrition in Children](https://reader034.vdocuments.site/reader034/viewer/2022042701/55a516451a28abd77f8b461f/html5/thumbnails/7.jpg)
Nutrition in young children < 6 months
(Core, 2003)
Poor nutrition = hampered mental development• Information processing• Language• Below average for age
![Page 8: Feeding & nutrition in Children](https://reader034.vdocuments.site/reader034/viewer/2022042701/55a516451a28abd77f8b461f/html5/thumbnails/8.jpg)
Feeding the Newborn
What are the options?
Breast feedingThe Indian & American
Academy of Pediatrics recommends exclusive breast feeding for 6 months.
Formula feeding
![Page 9: Feeding & nutrition in Children](https://reader034.vdocuments.site/reader034/viewer/2022042701/55a516451a28abd77f8b461f/html5/thumbnails/9.jpg)
Breast Feeding Questions
• Why should I breast feed my baby? I thought formula was the identical alternative.
• How often and for how long will my baby nurse?• How do I know if the baby is getting enough? • How many months can I breast feed the baby ?
![Page 10: Feeding & nutrition in Children](https://reader034.vdocuments.site/reader034/viewer/2022042701/55a516451a28abd77f8b461f/html5/thumbnails/10.jpg)
Breast Feeding : Advantages to Infants
• Immunologic benefits (>100 components)• Decreased incidence of ear infections, UTI, gastroenteritis,
respiratory illnesses, and bacteremia.• Convenient and ready to eat.• Reduced chance of overfeeding?• Fosters mother-infant bonding.
![Page 11: Feeding & nutrition in Children](https://reader034.vdocuments.site/reader034/viewer/2022042701/55a516451a28abd77f8b461f/html5/thumbnails/11.jpg)
Breast Feeding :Advantages to Mothers
• May delay return of ovulation.• Loss of pregnancy-associated adipose
tissue and weight gain.• Suppresses post-partum bleeding.• Decreased breast cancer rate.
![Page 12: Feeding & nutrition in Children](https://reader034.vdocuments.site/reader034/viewer/2022042701/55a516451a28abd77f8b461f/html5/thumbnails/12.jpg)
![Page 13: Feeding & nutrition in Children](https://reader034.vdocuments.site/reader034/viewer/2022042701/55a516451a28abd77f8b461f/html5/thumbnails/13.jpg)
Assessment of Breast Feeding
• Weight pattern - consistent weight gain.• Voiding - # wet diapers/day, soaked?• Stooling - generally more stools than formula.• Feed-on-demand ~ every 2-3 hours.• Duration of feedings - generally 10-20 min/side.• Need for high fat hind milk.• Activity and vigor of infant.
![Page 14: Feeding & nutrition in Children](https://reader034.vdocuments.site/reader034/viewer/2022042701/55a516451a28abd77f8b461f/html5/thumbnails/14.jpg)
![Page 15: Feeding & nutrition in Children](https://reader034.vdocuments.site/reader034/viewer/2022042701/55a516451a28abd77f8b461f/html5/thumbnails/15.jpg)
Assessing Readiness to Feed
• At what age it is best to introduce solid foods?
• How do I know if he is ready to eat?• What food should I give the baby first?
![Page 16: Feeding & nutrition in Children](https://reader034.vdocuments.site/reader034/viewer/2022042701/55a516451a28abd77f8b461f/html5/thumbnails/16.jpg)
Feeding Skills Development
5-6 mos - experience new tastes.
6-7 mos - sits with minimal support.
8-9 mos - improved pincer grasp.
10-12 mos - pulls to stand, reaches for food.
12-18 mos - increased independence.
18 mos -2 yrs - growth slows, less interest in eating.
2-3 yrs - intake varies, exerts control.
![Page 17: Feeding & nutrition in Children](https://reader034.vdocuments.site/reader034/viewer/2022042701/55a516451a28abd77f8b461f/html5/thumbnails/17.jpg)
NUTRITION 7 MONTHS ONWARDS
![Page 18: Feeding & nutrition in Children](https://reader034.vdocuments.site/reader034/viewer/2022042701/55a516451a28abd77f8b461f/html5/thumbnails/18.jpg)
![Page 19: Feeding & nutrition in Children](https://reader034.vdocuments.site/reader034/viewer/2022042701/55a516451a28abd77f8b461f/html5/thumbnails/19.jpg)
![Page 20: Feeding & nutrition in Children](https://reader034.vdocuments.site/reader034/viewer/2022042701/55a516451a28abd77f8b461f/html5/thumbnails/20.jpg)
6-7 mos - experience new tastes.
Give rice cereal .7-8 mos - sits with minimal support.
Add fruits and vegetables.8-9 mos - improved pincer grasp.
Add protein foods and finger foods.10-12 mos - pulls to stand, reaches for food.
Add soft table food, allow to self-feed.
![Page 21: Feeding & nutrition in Children](https://reader034.vdocuments.site/reader034/viewer/2022042701/55a516451a28abd77f8b461f/html5/thumbnails/21.jpg)
12-18 mos - increased independence.
Stop bottle, practice eating from a spoon.18 mos -2 yrs - growth slows, less interest in eating.
Encourage self-feeding with utensils.2-3 yrs - intake varies, exerts control.
![Page 22: Feeding & nutrition in Children](https://reader034.vdocuments.site/reader034/viewer/2022042701/55a516451a28abd77f8b461f/html5/thumbnails/22.jpg)
Pre-school (1 to 6 Years)
1-2 years: on average, grows 12 cm, gains 3.5 kg.
Rate of growth slows by 4 years.
6-8 cm/year
2-4 kg/yearBrain growth triples by 6 years.
![Page 23: Feeding & nutrition in Children](https://reader034.vdocuments.site/reader034/viewer/2022042701/55a516451a28abd77f8b461f/html5/thumbnails/23.jpg)
Common Complaints
![Page 24: Feeding & nutrition in Children](https://reader034.vdocuments.site/reader034/viewer/2022042701/55a516451a28abd77f8b461f/html5/thumbnails/24.jpg)
UNCOMMON COMPLAINT WHICH IS MORE COMMON
![Page 25: Feeding & nutrition in Children](https://reader034.vdocuments.site/reader034/viewer/2022042701/55a516451a28abd77f8b461f/html5/thumbnails/25.jpg)
Whats eating your child
![Page 26: Feeding & nutrition in Children](https://reader034.vdocuments.site/reader034/viewer/2022042701/55a516451a28abd77f8b461f/html5/thumbnails/26.jpg)
HOW TO DIAGNOSE OBESITY
![Page 27: Feeding & nutrition in Children](https://reader034.vdocuments.site/reader034/viewer/2022042701/55a516451a28abd77f8b461f/html5/thumbnails/27.jpg)
BODY MASS INDEX (BMI)
![Page 28: Feeding & nutrition in Children](https://reader034.vdocuments.site/reader034/viewer/2022042701/55a516451a28abd77f8b461f/html5/thumbnails/28.jpg)
![Page 29: Feeding & nutrition in Children](https://reader034.vdocuments.site/reader034/viewer/2022042701/55a516451a28abd77f8b461f/html5/thumbnails/29.jpg)
Meal Components
Milk (fluid)Fruits & vegetablesBreads & grains
RiceBread
Meats & meat alternates
Meat (e.g., chicken, turkey, fish)EggsCheeseBeansYogurtNuts and nut butters
![Page 30: Feeding & nutrition in Children](https://reader034.vdocuments.site/reader034/viewer/2022042701/55a516451a28abd77f8b461f/html5/thumbnails/30.jpg)
Meal Component Requirements for Children
Breakfast One serving each: • fluid milk • 100% juice, fruit, or vegetable • bread or cereal
Lunch or Supper One serving each: • fluid milk • meat or acceptable meat alternate • bread or acceptable bread alternate Plus: • two servings of fruit and/or vegetables
Snacks Total of two servings: • fluid milk • meat or acceptable meat alternate • bread or acceptable bread alternate • 100% juice, fruit, or vegetable
![Page 31: Feeding & nutrition in Children](https://reader034.vdocuments.site/reader034/viewer/2022042701/55a516451a28abd77f8b461f/html5/thumbnails/31.jpg)
Serving Sizes
Start with the recommended serving for age and food group
If children are still hungry, allow them more food
Encourage them to check in with their tummy (cues)Encourage fruits and vegetables first
Serving sizes are a min, not a max!
![Page 32: Feeding & nutrition in Children](https://reader034.vdocuments.site/reader034/viewer/2022042701/55a516451a28abd77f8b461f/html5/thumbnails/32.jpg)
Milk – Infants
Infants under 12 months should receive only breast milk or iron-fortified formula – no cow’s milk.
Whole cow’s milk does not provide enough Vitamin E, iron, and essential fatty acids for infants.
Whole cow's milk protein and fat are more difficult for an infant to digest and absorb.
![Page 33: Feeding & nutrition in Children](https://reader034.vdocuments.site/reader034/viewer/2022042701/55a516451a28abd77f8b461f/html5/thumbnails/33.jpg)
Milk served to children 12-23 months should be whole.
Milk served to children 2 years and older should be fat-free (skim) or 1% (low-fat).
Flavored milk should not be served
Milk – Children
![Page 34: Feeding & nutrition in Children](https://reader034.vdocuments.site/reader034/viewer/2022042701/55a516451a28abd77f8b461f/html5/thumbnails/34.jpg)
Rationale – Milk
Children 12 through 23 months need the fat in whole milk for healthy weight gain, growth and development.
Children 2 years and older do not need the extra fat and calories in whole milk.
![Page 35: Feeding & nutrition in Children](https://reader034.vdocuments.site/reader034/viewer/2022042701/55a516451a28abd77f8b461f/html5/thumbnails/35.jpg)
Juice – Infants
Infants should not be served juice.
![Page 36: Feeding & nutrition in Children](https://reader034.vdocuments.site/reader034/viewer/2022042701/55a516451a28abd77f8b461f/html5/thumbnails/36.jpg)
Juice – Children
Limit 100% juice to 1 serving per day in a size appropriate to age (4-6 oz.), or don’t serve at all.
All juice served should be 100% fruit or vegetable.
Non-100% juice (e.g., juice “cocktail” or juice “drink”) is a sugary beverage and should not be served at all.
![Page 37: Feeding & nutrition in Children](https://reader034.vdocuments.site/reader034/viewer/2022042701/55a516451a28abd77f8b461f/html5/thumbnails/37.jpg)
Sugary Beverages
Sugary drinks should never be offeredJuices that are not 100% juice
Fruit drinks (cocktails/-ades)
Sports drinks
Sweet tea
Soda
Energy drinks
Coffee drinks
![Page 38: Feeding & nutrition in Children](https://reader034.vdocuments.site/reader034/viewer/2022042701/55a516451a28abd77f8b461f/html5/thumbnails/38.jpg)
Rationale: Juice & Sugary Beverages
They are high in sugar and calories which can cause…
overweight/obesity
tooth decay
diarrhea
May displace healthier beverages (like milk)
Whole fruits and vegetables provide more nutrients and fiber than even 100% juice
![Page 39: Feeding & nutrition in Children](https://reader034.vdocuments.site/reader034/viewer/2022042701/55a516451a28abd77f8b461f/html5/thumbnails/39.jpg)
Fruits & Vegetables
Avoid Fried or pre-fried fruits or vegetables
French fries, tater tots, hash browns, potato chips; fried apples or okra
Serve a fruit (not juice) and/or a vegetable at every meal and snack
French fries, tator tots, and hash browns don’t count as vegetables!
![Page 40: Feeding & nutrition in Children](https://reader034.vdocuments.site/reader034/viewer/2022042701/55a516451a28abd77f8b461f/html5/thumbnails/40.jpg)
Rationale – Fruits & Vegetables
Fried or pre-fried fruits/vegetables should be avoided because…
They are high in calories and fat. Example:
VS.
57 calories, 0.06 grams fat 180 calories, 5.35 grams fat
![Page 41: Feeding & nutrition in Children](https://reader034.vdocuments.site/reader034/viewer/2022042701/55a516451a28abd77f8b461f/html5/thumbnails/41.jpg)
Fruits & Vegetables
Are rarely or never prepared with added:Meat fat
Butter
Margarine
Sugar
![Page 42: Feeding & nutrition in Children](https://reader034.vdocuments.site/reader034/viewer/2022042701/55a516451a28abd77f8b461f/html5/thumbnails/42.jpg)
Breads & Grains
Cereals should contain no more than 6 grams of sugar per serving.
At least half of grains served should be whole grains.
Serve whole grains whenever possible.
Grains high in fat or sugar should be served rarely or never.
Donuts, Danishes, cupcakes, toaster pastries, granola bars, etc.
Ingredients:WHOLE WHEAT FLOUR, WATER, SUGAR, WHEAT GLUTEN, CANE REFINERY SYRUP, YEAST, CONTAINS 2% OR LESS OF EACH OF THE FOLLOWING…
![Page 43: Feeding & nutrition in Children](https://reader034.vdocuments.site/reader034/viewer/2022042701/55a516451a28abd77f8b461f/html5/thumbnails/43.jpg)
Rationale – Breads & Grains
Whole grains are good sources of dietary fiber, several B vitamins and minerals.
Added sugars supply calories but few or no nutrients.
Fried baked goods are high in calories and fat and low in nutrients.
Example:
![Page 44: Feeding & nutrition in Children](https://reader034.vdocuments.site/reader034/viewer/2022042701/55a516451a28abd77f8b461f/html5/thumbnails/44.jpg)
Meats & Meat Alternates
Fried/pre-fried and processed meats
E.g., chicken nuggets/tenders, fish sticks, hot dogs, bologna, sausage, salami, spam
Limit to 1x per fortnight or less
Choose a variety of beans and lean meats (whitemeat/ boiled) each week
![Page 45: Feeding & nutrition in Children](https://reader034.vdocuments.site/reader034/viewer/2022042701/55a516451a28abd77f8b461f/html5/thumbnails/45.jpg)
Cheese & Other Dairy Products
Serve only real cheese – no cheese food or cheese product.(e.g., Velveeta®, Cheez Whiz®)
Serve low-fat or fat-free dairymilk, cheese, yogurt, cream
cheese, etc.
![Page 46: Feeding & nutrition in Children](https://reader034.vdocuments.site/reader034/viewer/2022042701/55a516451a28abd77f8b461f/html5/thumbnails/46.jpg)
Rationale: Meats & Cheese
Processed and fried meats and fish are typically high in total and saturated fat and sodium.
In general, cheese products contain more sodium and fewer nutrients than real cheese.
![Page 47: Feeding & nutrition in Children](https://reader034.vdocuments.site/reader034/viewer/2022042701/55a516451a28abd77f8b461f/html5/thumbnails/47.jpg)
Water
Drinking water is visible, available to children
inside and outside, available for self serve.
![Page 48: Feeding & nutrition in Children](https://reader034.vdocuments.site/reader034/viewer/2022042701/55a516451a28abd77f8b461f/html5/thumbnails/48.jpg)
Developing Healthy Habits
Offer a variety of healthy foods and snacks.Encourage fruit and vegetable intake.No junk food snacking.Limit intake of juices ( 4 oz per day).Increase intake of water (no soda).Encourage low fat dairy products (3-4 servings/ day).Make fun physical activity a habit.Limit TV to no more than 1 to 2 hours per day.Track growth and development carefully.Be a good role model.
![Page 49: Feeding & nutrition in Children](https://reader034.vdocuments.site/reader034/viewer/2022042701/55a516451a28abd77f8b461f/html5/thumbnails/49.jpg)
![Page 50: Feeding & nutrition in Children](https://reader034.vdocuments.site/reader034/viewer/2022042701/55a516451a28abd77f8b461f/html5/thumbnails/50.jpg)
JOIN my Whats app group: Parenting Tips
Whats app/ SMS request to
9818833484
![Page 51: Feeding & nutrition in Children](https://reader034.vdocuments.site/reader034/viewer/2022042701/55a516451a28abd77f8b461f/html5/thumbnails/51.jpg)
W- Hospital by PratikshaGolf course Ext RoadGurgaonPhone no.: 0124-4131000