NUTRITION FOR HEALTHY GROWTH IN CHILDREN.

Dr Zubeda TumbiClinical Nutritionist and Dietician

Health Watch ClinicPh No. : 022-6331498/9820401253/9930244548

Email ID: zubedatumbi12@gmail.com / zubedatumbi@yahoo.com

Website: www.healthwatch.co.in

Nutrition during infancy

• Nutrition in the first year most imp as Growth and Development most rapid.

• Birthweight doubles at 6 mths & triples at 1yr.• Height ↑from 50 cm at birth- 70-75cm at1 yr.• Body composition changes; body water ↓ from 75to 60% Body fat ↑from12 to 24%

• Childhood Nutrition has a lifelong impact on growth , productivity, and quality of life .

Nutritional Considerations

• First 5 years period of rapid growth.• Energy req-80-90 cal \kg body wt per day.• Protein -1.6g\kg body wt per day.• 40 % of energy from fat . • Calcium req- 500mg per day.• Phosphorus-750mg per day (Ca:P)ratio1:1.5• Iron-87 mcg\kg body wt per day.• Iodine-30mcg\kg body wt per day .• Vit A 350 mcg\day.• Vit C- 25 mg\day.• Folate- 25 mcg\ day.

• National Health Survey 3 (2005-06)for INDIAAverage rate of malnutrition – 47% Anaemia – 70%Every second child under 5 yrs age malnourished8.1 Million seriously malnourishedStunted growth 48% Underweight 43%

Protein Energy Malnutrition• PEM – highest incidents in young children

between 6months – 2years• Impairment in brain development and future

productivity is irreversible when malnutrition occurs in pregnancy or in early formative years.

• Females are highly marginalised in health nutrition and medical status.

PEM Causes• Inadequate or unbalanced diet• Problems with digestion or absorption• Certain medical conditions like tuberculosis,

HIV, chronic diarrhoea, frequent illness like cold.

• Deficiency of protein and energy rich foods

General Symptoms of Malnutrition in Children

• Failure to grow at expected rate, both in terms of weight and height

• Changes in behaviour (irritable, sluggish, apathetic)

• Changes in hair and skin colour• Protuberant abdomen• Swelling of legs, abdomen and whole body

Rickets – Vitamin D Deficiency• Disorder of a growing child• Caused due to lack of vitamin D• Leads to softening and weakening of bones• Occurs in children during periods of rapid

growth at age 6-24 months.

Causes of Rickets• Vitamin D is a fat soluble vitamin• Regulates calcium and phosphate levels• Absorbed from food or produced by skin when

exposed to sunlight• Hydroxylated first in liver and then in kidney

into the active form

Sources of Vitamin D

• Fish, liver, egg, yolk, milk and milk products as well as oil are good sources

• 20mins of exposure to ultraviolet band of sunlight

Calcium: Nutrient for Bone Health

most abundant mineral in the body, maximizes bone growth and skeleton during childhood and beyond. Small amt of calcium in the bloodstream is needed for a

normal heartbeat, bloodclotting, and muscle function. The body withdraws the calcium it needs from bones to

maintain blood levels, which is why children need adequate calcium every day.

Many kids don't get enough for their nutritional needs.

Vitamin A from Foods

• Its important for growth • Immunity especially for chest infections• Helps good eyesight, skin and hair.

Dietary Guidelines• First 4-6 months : exclusive breast feeding with start of colostrum .• Breast milk has high level of whey protein lactalbumin which is easy to digest .• High Taurine and lactose in breast milk helps in brain development also

promotes gut bacteria.• Better absorption of iron calcium and zinc from breast milk.• Immunoglobulins in breast milk improve immunity.• Beyond 4-6 mths : supplement breast milk with cereal ,protein ,fruits, vegetables, fats and sugar.• Germination and Malting of cereals starch becomes easy to digest .

Weaning food concepts• Combination of cereals and pulses with fats like

butter, coconut oil, cow ghee , nuts and sugar or jaggery ensures adequate

calories and high quality proteins.• Weaning foods shd be easy to digest.• Weaning should have proper • consistency & texture.• Hygienic and lightly seasoned.

Balanced formula for healthy recipe

• A) Carbohydrate- cereals , millets ,ARF, sugar

• B) Protein food –pulses, milk,curds,egg, nuts • C) Fruits & Vegetables:

Green leafy vegetables used alternatively, use of orange or yellow vegetable fruit.

• D) Oil/Nuts/Oilseeds or Jaggery

Some easy nutritious recipes• Orange juice , mashed boiled apple\mashed

chikkoo .• Banana smoothie \apple milk shake• Green pea\palak soup with white sauce • Curd rice• Rice kheer\rava kheer\dahlia kheer\ragi kheer• Khichdi, soft veg pulao, upma , pohe aloo.

Nutri rich Recipes for 2-5 yr olds

• Vegetable soups • Spinach rice• Fruit custards• Pancakes made with moong, oats, rava, ragi, banana flour.• Dosas & idli• With curd or coconut chutney and light sambhar• Veg sandwiches

Guidelines for feeding practices.

• Introduce one food at a time in small quantity.• Start with soft mushy foods &• Move to semi solid foods.• Be patient; allow the baby to learn the art of eating & enjoy the

eating process.• Avoid too many choices at a meal to avoid confusion.• Avoid artificial colours ,preservatives n processed foods• Use boiling ,steaming, braising & baking ; avoid frying.• Reduce volume of food, making food nutrient dense as child cant

eat large amounts.

Guidelines for feeding practices.

• Avoid microwaving baby foods; as temperature inside food higher may burn baby mouth.

• Never criticize food; leaves a negative impact.• Attractive spoons and bowls motivate child to

eat.• Healthy eating habits in infancy helps prevent

childhood obesity ,high blood pressure and diabetes as child grows.

Finger foods

• Finger foods are directly eaten without any spoon, fork or knife.

• Introduce when the child starts holding objects with fingers and thumb; signals start of self feeding.

• Allow child to indulge in the eating process but prevent choking by cutting in pieces less than half an inch in size.

Feeding guidelines for 2-5 years• Encourage the child to eat family meals• Avoid bulky food in one serving size with less nutrient

density, e.g. kurmura, bhel• Never bribe a child to eat a particular food/meal

• Train children to distinguish between unhealthy or healthy foods

• Schedule meal time before the child is very hungry. Let meal time be family meal time.

• Avoid chocolates, soft drinks, refined and sticky foods that could increase the risk of dental caries.

• Children should not be allowed to watch TV while eating or be left unsupervised.

• Preschool children attracted by commercials on TV often remember and want advertised items.

• Reduce TV time as it encourages inactivity – excess weight gain, dental caries as sugar laden foods are often preferred while TV viewing.

Physical Activity in children

• Regular physical activity improves strength, endurance, enhances self esteem, and prevents obesity in children.

• Children should be made to play actively for 60 min a day.(IOM-1997)

Wishing you happy meal times Thank You!!!