Exam 2 - Toddler / Preschool

Question 1

Describe the growth rate of toddlers and preschoolers as compared to infants.

Answer 1

BMR for individual 1-5 yrs highest grwoth rate of entire life. Highest 0-1 decreases as you age

Question 2

What physical measurements are taken to measure growth in toddlers up to 2 years of age?

Answer 2

• Height- stadiometer, the are able to stand up straight a before two years of age they still measure “length” laying down. they measure height with stadiometer after 2 years of age.
• Weight

Question 3

What is BMI for age and how is it used?

Answer 3

t can be used continuously from 2 years of age to adulthood.

BMI-for-age provides a reference for adolescents not previously available

Question 4

Describe the dip in BMI for age growth curve from ages 2 - 4. What does this dip indicate? (Remember that BMI is an index of weight to height)

Answer 4

Period in which child is growing faster than they are gaining weight, therefore, their BMI decreases

Question 5

At ages 4 – 6 the BMI growth curve for age gradually rises from its low point. What is this rise called and why does it happen? (Remember that BMI is an index of weight to height)

Answer 5

Adiposity rebound

Question 6

What are the BMI for age categories for underweight, healthy weight, overweight and obese?

Answer 6

less than 5th percentile: underweight
5th to 85th : Healthy body weight
85th to 95th: Overweight
more than 95th: Obese

Question 7

Be able to calculate BMI and plot BMI for age (weight, height will be given to you).

Answer 7

BMI= (lbs)/(in^2)*703

Question 8

What foods should be avoided to prevent choking for toddlers up to 3 years of age?

Answer 8

grapes, nuts, peanut butter, hard candy. parent supervision required

Question 9

Toddlers have strong food preferences by age 2 to 2.5 and may not try new foods. Some toddlers are considered picky eaters. Are these children picky because they are difficult to manage or are they picky because of their taste genetics?

Answer 9

food preferences are set at this age, so it is hard to introduce foods; just let them grow out of it if their growth rate is otherwise fine; there ARE also picky eaters, but these food preferences are usually genetic

Question 10

What is a food jag?

Answer 10

Only consumes single foods or few foods for extended amount of time

Question 11

What are some good food sources for protein, fats, fiber, calcium, iron, zinc, vitamin A, vitamin C, vitamin E, and vitamin D?

Answer 11

Protein: dairy, meats & beans, eggs, fish, grains
Fat: dairy, oils / fats, meat & beans, avocado
Fiber: legumes, whole grains, vegetables, fruits
Calcium: dairy, fortified foods and juices, greens, sardines
Iron: meat & beans, fortified / whole grains, legumes, eggs, greens
Zinc: meat & beans, fortified / whole grains
Vitamin A: milk, meats, fatty fish, eggs, fruits, vegetables
Vitamin C: fruits and vegetables
Vitamin E: vegetable oils, avocados, fortified foods
Vitamin D: dairy, fatty fish, fortified foods, egg

Question 12

What foods provide docosahexanoic acid (DHA). Why is this lipid important in growth of toddlers?

Answer 12

Brain, eye, nervous system.

DHA is found in safe-to-savor coldwater, fatty fishes such as salmon (always choose wild when you can) and cod. DHA-rich eggs, sometimes called omega-3 eggs. algae is an all-natural plant source of DHA, anchoives, herring, sardines, trout, other oily fish, nuts, seeds, wholegrains and dark green, leafy vegetables.

Question 13

What are the appropriate portion sizes for grains, fruits, and vegetables in toddlers?

Answer 13

Meal planning; 3 meals+2-3 snacks.

Small portion size; milk-0.5 cup, meat/cheese -1oz, bread/small roll-0.5 item, vegetables & fruits & grains – 1Tbsp/yr of age.

My plate for 2yrs; make half your grains whole, & vary your veggies.

Question 14

Describe a healthy eating environment for a toddler and preschooler. (foods and feeding behavior and surroundings, social / emotional)

Answer 14

Family Dinners, calm enviroment without any distractions

Healthy feeding relationship; encouraging self-feeding, allowing self-regulation of food intake, offering a variety of foods & textures, recognition of developmental abilities, response to hunger & satiety cues, & be a good role model

Question 15

At what age is it appropriate to serve low-fat or fat-free cow’s milk? Why?

Answer 15

1- 2 years old = whole milk
2+ = skim-2% milk

because the fat is needed for proper brain development

Question 16

Many toddlers and preschoolers do not meet recommendations for iron, vitamin D and calcium. Describe diseases / symptoms associated with these nutrient deficiencies.

Answer 16

Iron- Iron deficient anemia

Vitamin D- rickets, poor bone formation very weak bones

Question 17

In what ethnic populations do we see vitamin D deficiency in young children?

Answer 17

Black and Hispanic

Question 18

A child can meet his/her vitamin D needs by means other than foods or supplements. How?

Answer 18

Sitting in the sun

Question 19

Compare the protein recommendations of infant, toddlers and preschoolers.

Answer 19

Infants: 1.5 g/kg of body weight
Toddlers: 1.1 g/kg of body weight
Preschoolers: 0.95 g/kg body weight
Adults: 0.8 g/kg body weight

Question 20

What variables are used to calculate the energy needs (Estimated Energy Requirement - DRI) for preschool children?

Answer 20

Height, weight, age, gender, activity level & CHO, F, P, vitamins and minerals, fiber & fluids.

Question 21

According to the American Academy of Pediatrics, what is the recommended fiber intake for a toddler who is 30 pounds and 2 years old? (2.2 pounds = 1 kilogram)

Answer 21

Ideal- 19g this is the DRI. steiman said to was AAP (which is .5g/kg body weight)
Minimum- Age +5g she said this was a good estimate

Question 22

What are the risk factors for lead poisoning? What are some sources of lead in the environment and how is lead poisoning prevented?

Answer 22

2.2% of children age 1-5 have high blood levels of lead. Ingestion of lead is caused by contamination in environment (canned goods, some ceramic dinnerware, dirt) as well as iron and calcium deficiency (lead binds to same proteins in iron and calcium). Lead poisoning leads to lower IQ, decreased growth and kidney disease later in life. Treatment for lead poisoning is to get lead out of the environment and a routine screening.

Question 23

What are food allergies? Name 8 common food allergens. Describe common and life threatening symptoms/signs associated with food allergies.

Answer 23

When the body makes antibodies to an allergen and is related to the immune system. Allergies can be antibody mediated or immediated. Making antibodies to proteins found in food and won’t break them down but absorb whole proteins instead.

Common Food Allergies:
animal – fish, shellfish, milk, egg*most common
plant – soy, wheat, peanut, treenuts
Most will grow out of milk, egg, and soy

Symptoms
skin and gastrointestinal tract problems –skin, diarrhea, airway block
respiratory shock - treat by epinephrine (epi-pens)
Life-threatening allergies – peanuts, treenuts, shellfish

Treatment
Follow children and make aware of allergy everywhere child goes (daycare, friends, restaurants, etc.)
Government requires any food allergen foods to be labeled! (Label law)

Question 24

Describe the difference between food allergies and food intolerances. What are some food agents that can cause food intolerances?

Answer 24

Differences between food intolerances and food allergies is food intolerances are delayed, do not involve antibodies and affect the GI tract. Food allergies are immediate, antibody mediate and involve an airway, the GI tract and the skin. Some common food agents that cause food intolerances are lactose food ((most common and affects among 10% of Americans. Lactase isn’t present to break down lactose)), additives like sulfites ((they add sulfites to maintain the color of the foods. Sulfites are also found in wine, monosodium glutamate (MSG) [an additive that is added to a of Asian foods. Sulfites are also found in dry foods since they slow down the browning.)); Salicyates ((aspirin found in beer, coffee and wine. Salicylates include peptobismol, noxzema))

Question 25

According to the FITS 2008 Study, preschoolers are not consuming enough of what food groups? (MyPlate)

Answer 25

Fruits, Vegetables and Whole Grains

Question 26

What are some common causes of dental caries in toddlers and preschoolers?

Answer 26

carbohydrate rich foods
Juice/ milk in a bottle
sticky and sweet foods like raisins and bananas

Question 27

What populations of children are susceptible to iron deficiency? What are some common causes of iron deficiency in young children? What foods are high in iron? How does vitamin C intake affect iron absorption?

Answer 27

7% of toddlers; population at risk is low income toddlers and preschoolers, as high as 17% in Hispanic population and then African Americans have 2nd highest rate. Common causes include a lack of access to iron containing foods, kids drinking lots of milk (this causes them to develop milk anemia from iron deficiency). Symptoms and signs are decreased academic performance, memory and behavioral problems. Prevention is consumption of iron containing foods (plants, legumes, eggs, foods high in Vitamin C) Some iron deficient kids will be put on iron supplements. Vitamin C enhances iron absorption in non heme iron by binding to non-heme iron and allowing it to travel to the intestines. Vitamin C, as an ascorbic acid, increases the stability of nonheme iron, which increases solubility and lets non heme iron be more readily absorbed through the mucous membranes of the intestine

Question 28

What do the Food Allergen Labeling and Consumer Protection Act of 2004 require?

Answer 28

Gov’t requires foods to be labelled, saying they have allergens, even if there is just one allergen.

Question 29

At what age do children pay more attention to external cues with regard to food intake? What are some external cues that influence food behavior and intake?

Answer 29

Children start paying attention to external cues at age 5. Some of these external cues include food rewards/restrictions (don’t make food a reward or punishment), size of portions and advertising (children don’t know difference between fantasy and reality sadly). Ultimately parents decide when child eats and what child eats, but child decides how much to eat and whether or not to eat it.

Question 30

What is encopresis? How is it treated?

Answer 30

Holding in stool, treated with cleaning colon methods and high fiber foods and fluids

clear colon by lactulose & enema, high fiber foods, & fluids.

Question 31

What are the nutrient deficiency risks in children raised on a vegan diet?

Answer 31

B vitamins, vitamin D, zinc and calcium, kcal, and essential fatty acids

Question 32

Describe the food borne illnesses resulting from infection by:
Campylobacter jejuni, salmonella, e.coli

Answer 32

o Campylobacter jejuni - second most common food borne illness. infection from poultry.
o Salmonella sp. - most common. from raw eggs usually. causes nausea, vomiting, headaches
o E.coli 0157:H7 - opportunistic pathogen in GI tract. from undercooked meats, unpasteurized juices, and “pre-washed” spinach. so always wash your own fruits and veggies

Question 33

What are the recommended food preparation methods for preventing food borne illness?

Answer 33

Clean, Cook, Separate, Chill

Question 34

What percentage of toddlers / preschool children are obese in this country?

Answer 34

10%

Question 35

What is food insecurity?

Answer 35

11-12% of US households are food insecure, and about 1/3 of them are children. In ATX, about 1/5 children are food insecure. Food insecurity, however, is when you are lacking the resources to buy enough food or you are lacking the resources to buy foods that are healthy. A lot of these children are obese. Food security is important for young children. Children may be nutrient deficient, have social behavioral problems, physical illness

Question 36

What populations of children are at risk for food insecurity?

Answer 36

Obese children, as stated earlier. But we see food insecurity more in Native Americans, African Americans and Hispanic populations. Single women with children are also at risk populations. Low income households are also very susceptible to food insecurity.

Question 37

Describe available food assistance programs for low-income families.

Answer 37

1) WIC: Woman, Infants and children: big federal program that assists women at or below poverty level. Usually helps women with children and/or pregnant. There are food vouchers that include all the different food groups
2) Head Start: for children from 0-5 years of age; pregnant women can participate. It is for families with small children. The goal for this program is to increase school readiness. Also they provide different types of services: dental, etc. They also teach parents how to become better parents.
3) Food Stamps/Snap: Supplemental Nutrition Assistance Program: these are for individuals struggling financially and there are certain types of foods that you can buy. You can’t buy alcohol, but you still can buy sodas and other junk food
4) Federal Lunch Program: Families with low income. Children will receive a free lunch or a reduced lunch. There are some students that are provided with lunch and breakfast, and this will be paid by the nutritional government, and most schools have it. 62% of students in ATX are eligible for free or reduced lunch.

Question 38

What are appropriate treatments for weight management in children who are overweight, obese (with no complications), and obese (with complications)?

Answer 38

Overweight and obese with no complications weight maintenance. Obese with complications should also be weight maintenance and then weight loss. Weight loss should not be more than 1 pound per month. Weight maintenance = maintain body weight while increasing in height.