Chapter 10: Toddler and Preschooler Nutrition Flashcards
Obesity Treatment in Young Children
- Focus on a healthy family lifestyle.
- “Grow into wt” can be good advice.
- Avoid overemphasis on weight.
- Treatment warranted when complications related to obesity exist.
Obesity
BMIFA greater than or equal to the 95th percentile.
Toddler Development: Appetite/Intake
Reduced appetite vs. infancy; snacks should be nutrient dense and planned to avoid displacement of valuable nutrients; increase in self-feeding.
Calcium Intake in Young Children
Vital for bone mass accrual, weight management, BP control and more.
Toddler Development: Cognitive
Sense of self develops, onset of fears, rituals and imitation common, great deal of language development; solitary play.
Age 1-3: 30-40%
Age 4 & up: 25-35%
In cases of documented hyperlipidemia or familial heart disease, TLC guidelines can be used with caution.
Recommended Fat Intake for Young Children
Growth Velocity
The rate of growth over time.
Further solidification of toddler skills.
Preschooler Development: Milestones
Trend for decreased appetite (growth spurts occur, though); Ideal time to involve child in food selection and prep.
Preschooler Development: Feeding
Iron Needs in Young Children
Age 1-3: 7 mg/day
Age 4-8: 10 mg/day
Vitamin Supplementation
Children likely to benefit from supplements are the least likely to receive them. Avoid >100% DRI.
Preschooler Development: Cognitive
Internal behavior control; magical and egocentric thought; cooperative play; speech in complete sentences with dramatic increase in vocabulary.
Hemolytic Uremic Syndrome (HUS)
A serious, sometimes fatal complication associated with illness caused by E. coli, which occurs primarily in children under the age of 10 years. HUS is characterized by renal failure, hemolytic anemia, and a severe decrease in platelet count.
Fine Motor Skills
Development and use of smaller muscle groups demonstrated by:
- Stacking objects
- Scribbling
- Copying a circle or square.
Preschooler Development: Energy Regulation
Caloric intake controlled by internal cues, but health behaviors must be learned.
Familiar foods can be comforting; child may use food as a means of control; preferences for plain (vs. mixed) foods and possibly bland foods.
Preschooler Development: Food Intake
Protein Needs in Young Children
Age 1-3: 1.1 g/kg/day
Age 4-8: .95 g/kg/day
Macrobiotic Diet
This diet falls between semi-vegetarian and vegan diets and includes foods such as brown rice, other grains, vegetables, fruits, dried beans, and spices.
Gains in fine/gross motor skills, independence and language.
Toddler Hallmarks
Fluoride Sources
- Tap water
- Some bottled water
- Some toothpastes
Lead Poisoning
Affects about 2% of children age 1-5 and causes adverse changes in the brain, blood, kidneys, IQ, and growth. Sources of lead are: lead-based paint, lead-soldered water pipes, eating dirt, and iron deficiency can increase the absorption of lead.
Age 1-3: 19 g/day
Age 4-8: 25 g/day
Caution- excessive fiber may cause diarrhea, lead to inadequate kcal intake, or reduce mineral bioavailability.
Fiber Needs in Young Children
Gross Motor Skills
Development and use of large muscle groups as exhibited by:
- Walking alone
- Running
- Walking up stairs
- Riding a tricycle
- Hopping
- Skipping.
Adiposity or BMI Rebound
A normal increase in BMI that occurs after BMI declines and reaches to its lowest point at 4 to 6 years of age. Early adiposity rebound associated with increased risk for obesity in adulthood.
Reduced appetite vs. infancy; snacks should be nutrient dense and planned to avoid displacement of valuable nutrients; increase in self-feeding.
Toddler Development: Appetite/Intake
Recumbent Length
Measurement of length while the child is lying down. Recumbent length is used to measure toddlers
Age 12-35 mths:
(89 x wt - 100) + 20 kcals (for energy deposition)
Age 3-5 years:
Calculation that includes gender, age, ht, wt, and physical activity.
Energy Needs in Young Children
Recommended Fat Intake for Young Children
Age 1-3: 30-40%
Age 4 & up: 25-35%
In cases of documented hyperlipidemia or familial heart disease, TLC guidelines can be used with caution.
Age 1-3: 1.1 g/kg/day
Age 4-8: .95 g/kg/day
Protein Needs in Young Children
Preloads
Beverages or food such as yogurt in which the energy/macronutrient content has been varied by the use of various carbohydrate and fat sources. The preload is given before a meal or snack and subsequent intake is monitored.
Fluorosis
Permanent white or brownish staining of the enamel of teeth caused by excessive ingestion of fluoride before teeth have erupted.
Energy Needs in Young Children
Age 12-35 mths:
(89 x wt - 100) + 20 kcals (for energy deposition)
Age 3-5 years:
Calculation that includes gender, age, ht, wt, and physical activity.
Sense of self develops, onset of fears, rituals and imitation common, great deal of language development; solitary play.
Toddler Development: Cognitive
Caloric intake controlled by internal cues, but health behaviors must be learned.
Preschooler Development: Energy Regulation
Internal behavior control; magical and egocentric thought; cooperative play; speech in complete sentences with dramatic increase in vocabulary.
Preschooler Development: Cognitive
Young children that are more likely to have iron deficiency anemia:
Low SES <130% of poverty and African American and Mexican American kids.
Preschooler Development: Food Intake
Familiar foods can be comforting; child may use food as a means of control; preferences for plain (vs. mixed) foods and possibly bland foods.
Stature
Standing height.
Walking, other gross motor skills refined; no understanding of safety vs. danger.
Toddler Development: Milestones
Weaning usually complete during this stage; chopped soft table food can be eaten; beginning to use utensils; choking risk is high; onset of food jags.
Toddler Development: Feeding Skills/Behaviors
Toddlers
Children between the ages of 1 and 3 years.
Foods that offer protection against dental caries:
- Milk and Cheese: casein, Ca++, PO4-
- Unrefined Plant Foods: PO4-, phytates
- Green and Black Teas
Age 1-3: 3 mg/day
Age 4-8: 5 mg/day
Zinc Needs in Young Children
Gains in autonomy, language, behavior and behavior control. Their social circle expands.
Preschooler Hallmarks
Ellyn Satter Pearls
- Keep meals, snacks, and the eating environment safe
- Meals should be pleasant and relatively free of distractions
- Avoid the “clean your plate” mentality
- Meal time is a time for learning social skills
Preschooler
Age 3-5 years; not in kindergarten.
Division of Responsibility
Developed by Ellyn Satter, a dietitian, social worker, and well-known infant/child/family nutrition advisor. “Division” basics is that the parent is responsible for the “what, when and where” of meals and snacks. Child is responsible for the “how much and whether or not” of meals and snacks.
Preschooler Hallmarks
Gains in autonomy, language, behavior and behavior control. Their social circle expands.
Dental Caries Prevention
- Avoid behavior that promotes BBTD
- Sticky sweats in moderation
- Good oral hygiene and dental care
- Defined meals/snacks vs. grazing
Food Insecurity
“Regular” food insecurity experiences in children linked to behavior problems, as well as academic and emotional troubles.
Preschooler Development: Feeding
Trend for decreased appetite (growth spurts occur, though); Ideal time to involve child in food selection and prep.
Age 1-3: 7 mg/day
Age 4-8: 10 mg/day
Iron Needs in Young Children
Toddler Development: Feeding Skills/Behaviors
Weaning usually complete during this stage; chopped soft table food can be eaten; beginning to use utensils; choking risk is high; onset of food jags.
Fiber Needs in Young Children
Age 1-3: 19 g/day
Age 4-8: 25 g/day
Caution- excessive fiber may cause diarrhea, lead to inadequate kcal intake, or reduce mineral bioavailability.
Age 1-3: 700 mg/day
Age 4-8: 1,000 mg/day
Calcium Needs in Young Children
Fluoride
Needed for healthy tooth enamel. If too little, the result is increase in tooth decay. If too much, result is fluorosis which is permanent tooth enamel staining. Supplements by prescription only. Indicated when water supply is not fluoridated. Screen carefully to assess need and be aware of all fluoride sources.
Toddler Hallmarks
Gains in fine/gross motor skills, independence and language.
Early Childhood Caries
The presence of one or more decayed (noncavitated or cavitated lesions), missing (due to caries), or filled tooth surfaces in any primary tooth in a child 71 months (~6 years) of age or younger.
Iron Deficiency Anemia Treatment in Young Children
Iron drops (3 mg/kg/day) and dietary counseling. Follow-up and further testing.
Overweight
BMIFA between the 85th and 94th percentiles.
Preschooler Development: Milestones
Further solidification of toddler skills.
Preschool-Age Children
Children between the ages of 3 and 5 years who are not yet attending kindergarten.
Calcium Needs in Young Children
Age 1-3: 700 mg/day
Age 4-8: 1,000 mg/day
Preventing Iron Deficiency in Young Children
Counsel parents on appropriate milk intake & early detection of low iron levels.
Zinc Needs in Young Children
Age 1-3: 3 mg/day
Age 4-8: 5 mg/day
Toddler Development: Milestones
Walking, other gross motor skills refined; no understanding of safety vs. danger.
Toddler Serving
1 tablespoon of each food per age in years of the child.
CVD
Initiation/progression of CVD may begin in early childhood. Children at risk for dyslipidemia: kids with familial hyperlipidemia, who are obese, and who eat an atherogenic diet.
Iron Intake in Young Children
Often deficient in children because of rapid growth and a diet poor in iron.
Physical Activity Recommendations for Young Children
60 minutes per day of active play. Parental involvement and careful supervision of sedentary activities.
Vegetarianism
As long as the caregivers are educated, children can thrive. Nutrients of concern are B12, vitamin D, Ca, n-3 fatty acids, and possibly iron and zinc.
