Infancy/Childhood/Adolescence Flashcards
Describe patterns of growth in weight, length, and head circumference during the first year of life
- Weight doubles at 5 months, triples at 12 months
- Length increases by half at 12 months
- Head circumference increases by 1/3 at 12 months
Outline the recommendations for protein, calcium, iron, fluoride, and vitamin D in the diet of infants.
- Water: no additional for 6 months
- Protein: breast-fed need more after 6 months (note: histidine is essential for infants)
- Calcium: breast-fed or formula infants need more after 6 months
- Fluoride: supplement at 6 months if water not fluoridated
- Vitamin D: breast fed infants need supplements throughout first year
- Iron: supplement at 4-6 months
Compare and contrast the use of breast milk and formula for infant nutrition.
Breast milk
Advantages:
• Warm, sterile, hypoallergenic, prevents infection
• Contains growth factors for GI tract maturation
• Better fatty acid profile → may promote brain development
• May improve long-term motor and cognitive abilities, reduce risk of chronic diseases (obesity, overweight) as an adult
• Less expensive
• Promotes infant-maternal bonding, may decrease risk of maternal breast cancer
Disadvantages
• Lower in protein, calcium, phosphorus, Vitamin D
• Drugs/toxins may pass into breast milk
• Contraindicated: HIV/AIDs, TB, syphilis, inborn errors of metablism
Formula
Advantages
• Able to adjust concentrations to provide adequate calories
• Special formulas available (soy, lactose-free)
Outline the rationale and recommended procedures and progression for introduction of complementary foods in the infant diet.
• 4-6 months: infant able to transfer food to back of mouth (developmentally ready)
• If introduce foods before 4 months → increases risk of allergies (since GI tract is immature)
• At 6 months:
o Need protein and iron since stores are depleted
• Pureed meat/fortified infant cereal with breast milk
o Add vegetables and fruits gradually (5-8 months)
• Wait 3-4 days between new foods
• May need >10 exposures to establish a new food
o Initial portions are small (1-2 tbsp, gradually increase)
o Feed with spoon (not bottle) to learn feeding skills
List foods that should not be included in the infant’s diet during the first year
- Honey and corn syrup (potential botulism contamination)
- Allergenic foods: fish, wheat, egg white, peanut butter
- Beware of choking hazards
- No cow’s milk before age one
- If giving juice: only 100% juice from a cup after 6 months (limit to 3 oz initially)
Outline recommendations and concerns about the use of cow’s milk or goat’s milk during the first year.
• Lower in iron, linoleic acid, vitamin E
• Higher calcium and casein content → reduced iron absorption
• Higher amounts of sodium, potassium, protein → higher renal solute load, increases chance of dehydration during illness
• Causes microscopic GI bleeding in about ½ of infants
• Can give whole milk after 1 year
o Reduced fat (2%) given if infant is at risk of being overweight, has family history of high cholesterol, obesity or heart disease
o After age 2: infants can drink 1% or skim milk
Describe recommendations for assessing growth in childhood and identify changes that would be a cause for concern.
• Weight and height charted on growth chart
• CDC charts: based on children in US
o Used after 2 years
• WHO charts: bases on how children grow with optimal conditions
o Used from birth to 2 years
• BMI evaluated as a percentile
• Children generally follow growth percentiles
Discuss nutrients of special concern during childhood.
• Iron
o Deficiency affects development and behavior
o 55-60% not receive enough iron
o Deficiency develops soon, but anemia develops more slowly
o Universal screening at 9-12 months and 6 months later
• Calcium: bone growth
o Supplement if not drink milk
• Vitamin D
o Supplement if diet/sun exposure inadequate
• Zinc
o Deficiency results in growth failure, poor appetite, decreased taste acuity
o Low in processed foods
List characteristics of children most likely to benefit from vitamin and mineral supplementation.
- From economically limited families
- With anorexia, poor appetites, poor eating habits
- Chronic diseases
- Enrolled in weight loss programs
- Consuming vegetarian diets without adequate dairy products
Describe characteristics of effective, high quality feeding interactions for children
Preschool children (1-6 years)
o Offer reasonable choices, expose to variety of foods
o Present in neutral environment without excessive pressure
o Regular eating items
o Importance of taste, odor, temperature, presentation
o Model health behaviors
o Parents must acknowledge and respect child’s autonomy
o Goal to help children learn eating skills and positive eating behaviors, be able to recognize hunger and fullness cues
School-aged child (6-12 years)
o Difficulties because more food consumed at school, less time to eat lunch
o Greater distractions/ peer pressure and advertising influences
List BMI percentile definitions for overweight and obesity in children and adolescents. *
- Normal BMI <95th percentile
* Obese: ≥95th percentile
Describe potential areas of improvement to help the typical adolescent achieve healthy weight and quality nutrition.
- Family meals: better mental health and eating habits
- Family routines (regular mealtimes and bedtimes): linked to academic achievement, self-esteem, psychosocial adjustment
- Time spent interacting with parents: affects health and well-being
- Away from home eating: increases caloric consumption, decreases dietary quality
- Snacking: more snacking decreases overall quality of diet (snacks usually contain more sugar, saturated fats and fewer vitamins, minerals)
- Regular breakfast: less likely to be overweight and more attentive in school
Discuss risk factors for developing an eating disorder.
- Participation in activities that promote thinness (ex. Dancing, gymnastics)
- Certain personality traits: low-self esteem, difficulty expressing negative emotions, difficulty resolving conflict, being a perfectionist
Outline potential nutritional concerns of adolescent athletes.
- Fluid needs to replace water and electrolytes
- Increases appetite (so usually adequate calories, nutrients)
- Iron status
- Monitor supplements/performance enhancing substances
