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NUFS 356 > L12 Toddler and Preschooler Development > Flashcards

L12 Toddler and Preschooler Development Flashcards

1
Q

What are the ages of a toddler and preschooler and what is their average growth?

A

Toddler: 1-2
- gain 2.8kg and 12cm/year
Preschooler: 3-5
- gain 2kg and 7 cm/year

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2
Q

Explain the patterns of growth rates and appetite for toddlers and preschoolers.

A
  • Growth rates progressively decrease compared to infancy resulting in a decrease in appetite
  • Growth spurts occur periodically and growth rates and appetite increase to accommodate
  • Height increases before weight
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3
Q

When assessing the growth of children, what are the age and measurement guidelines used?

A

Up to 2 years:

  • weight for age, and length for age
  • and weight for length

Over 2:

  • weight for age (only for 10 and under), and weight for height
  • BMI for age

WHO standard for age is only used from 0-5years

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4
Q

At what age can the adults BMI classification system be used and why?

A

Above 18 years old.
In adults the BMI changes because of the changes in body fat and lean muscle mass but during development it represents changes in body fat, lean muscle mass, organ growth, bone density, etc.

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5
Q

What are the general trends in the growth of toddlers and preschoolers between the ages of 2-6?

A

There is a general decrease in BMI from 2 to about 6 years old compared to infancy. This is not due to a decrease in body fat, rather it is a greater increase in lean tissue and height gains.

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6
Q

What are the WHO growth chart classifications for the severely underweight for 0 -24 months and 2 -5 years old?

A

0-24 months and 2 - 5 years: weight for age is less than the 0.1st percentile

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7
Q

What are the WHO growth chart classifications for the underweight for 0 - 24 months and 2 - 5 years old?

A

weight for age is less than the 3rd percentile

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8
Q

What are the WHO growth chart classifications for being at risk of being overweight for 0 - 24 months and 2 - 5 years old?

A

0 - 24 months weight for length is more than the 85th percentile.
2 - 5 years: BMI for age is greater than the 85th percentile

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9
Q

What are the WHO growth chart classifications for being overweight for 0-24 months and 2 - 5 years old?

A

0 -24 months: weight for length is more than the 97th percentile
2-5 years: BMI for age is more than the 97th persentile

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10
Q

What are the WHO growth chart classifications for obesity for 0-24 months and 2 - 5 years old?

A

0 - 24 months: weight for length is greater than the 99th percentile
2 - 5 years: BMI for age is greater than the 99th percentile.

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11
Q

What are the WHO growth chart classifications for being severely obese for 0-24 months and 2 - 5 years old?

A

There are no known classifications bc it is very rare (Prader Willi Syndrome) to see is under 5 years of age and no standards are set.

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12
Q

What are some example of the progressions of motor skill development through the ages of 1 - 3 years old.
ie. at what ages are they walking, crawling up stairs, running, walking stairs, riding a tricycle?

A 
12 months - walking 
15 months - crawling up stairs 
18 months - running 
24 months - walking up stairs 
36 months - pedaling on a tricycle
  • by about 5 there is a greater ability of motor skills like kicking and throwing a ball
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13
Q

What are some of the motor skills developed for feeding in a toddler?

A
  • self-feeding using a cup
  • hand feeding (use of fork or spoon is beginning but not easily done yet)
  • chewing ability is enhanced (moving tongue side to side, rotary jaw movement rather than just side to side)
  • can begin to eat more difficult textures
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14
Q

What are some of the motor skills developed for feeding a preschooler (about 3)?

A
  • use of fork and spoon (cutting and spreading with a knife but requires supervision)
  • participating in meal prepping (age appropriate tasks)
  • choking hazards are still a concern
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15
Q

What are 6 cognitive and social developments of toddlers? x6

A
  • new found independence, more interactive, and broader social interactions
  • observing and imitating others
  • learning family customs
  • developing fears
  • expression of wills (ie. temper tantrums, negativism)
  • language skills (from 10 words at 18 months to over 100 at 24 months)
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16
Q

What are 4 cognitive and social developments of preschoolers?

A
  • egocentrism (an inability to understand a perspective other than one’s own) and magical thinking
  • increasing social interactions and cooperative play
  • external behavioural limits become internal limits?
  • testing of limits (ie. too much parental control can result in lack of self-confidence. For example, not using internal satiety cues. Too little parental control can result in anxiety or eating too much salty or sweet foods.)
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17
Q

Why is early childhood a sensitive period to establish food preferences? x5

A
  • Familiar food flavours and textures are preferred (about 10 - 30 exposures of a food are needed to become a preference).
  • Children may fear or dislike the unfamiliar. Exposure to a VARIETY of textures and flavours is important in early childhood.
  • Even in breastfeeding. Mother’s diet reflects the flavours of the milk. Exposure to a variety is important.
  • Desire sweet and salty (umami)
  • Dislike sour and bitter
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18
Q

At what age should most of the energy should come from food?

A

Over 1 year old almost 100% of energy should be from food. Breastfeeding is still encouraged but formula over 1 year is not necessary.

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19
Q

Types of foods and eating patterns are learned from the family in early childhood. What type of learning is this?

A

Observational learning. It is a significant method of learning

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20
Q

How do traditional early feeding practices in combination with the current obesogenic environment contribute to the development of poor eating habits?

A

Traditionally early feeding practices encourage children to eat all their food bc of undernutrition concerns. This combined with the obesogenic environment of increased availability of inexpensive, ultra-processed foods and the innate preference for these foods contributes to unhealthy eating patterns.

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21
Q

How much do ultra-processed foods contribute to the average Canadian diet for 2-13 years old?

A

Over 50%

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22
Q

What does the high consumption of ultra-processed foods have on nutrient consumption (higher of what and lower of what?

A

Higher intake of energy, CHO, sugar, fat (total and saturated), salt, and some B vitamins

Lower intake of protein, fibre, potassium, phosphorous, zinc, magnesium, vitamin A, riboflavin, B6, B12, and C

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23
Q

The estimated energy expenditure for a toddler is based on what criteria?

A

Based on weight, height, age, and physical activity. Is enough energy to meet the needs for growth, maintenance, and activity.
There is a separate formula for boys and girls.

24
Q

What % of 4-8 years old’s are overweight and obese?

A

overweight - 14.6 %

obese 7.6%

25
Q

What are the Canadian 24-hour movements guidelines for 0-4-year-olds?

A

Sit: no sitting for more than 1 hour. If they are less than 2 years old, no screen time. If they are over 2 years old, no more than 1 hour of screen time is recommended.

Sleep: For the first 3 months, 14 - 17 hours. 3 - 4 years old’s should get 10 - 13 hours a day.

Move: less than 1 year, several play times per day. 1-2 years old 180 min any intensity. 3-4 years old need 180 min activity with 60 min high energy.

*sleep goes down with age and energy intensity increases

26
Q

What are the recommended DRI’s for macro’s, omega 3’s and 6’s, and water for a 1 - 3-year-old?

A 
CHO 130g
Fibre 19g
Linolenic 0.7g
Linoleic 7g 
Protein 1.05 g/kg 
Water 1.3L
27
Q

What are the recommended DRI’s for macro’s, omega 3’s and 6’s, and water for a 4 - 8-year-old?

A 
CHO 130g
Fibre 25g
Linolenic 0.9g
Linoleic 10g 
Protein 0.95 g/kg
Water 1.7L
28
Q

According to the CCHS (Canadian Community Health Survey) what is the median fibre intake for 1-3-year-olds and 4-8-year-olds compared to the recommended fibre intake?

A

1-3-year-old median intake is 9.9g of fibre. 4-8-year-old median intake is 13.4g of fibre. They are both below the recommended 19g and 25g respectively.

29
Q

What are the AMDR’s for 1-3-year-olds?

A

CHO 45-65%
Fat 30-40%
Protein 5-20%

30
Q

What are the AMDR’s for 4-8-year-olds?

A

CHO 45-65%
Fat 25-35%
Protein 10-30%

31
Q

What % 1-3-year-olds and 4-8-year-olds are meeting the recommended fat intake?

A

1-3-year-olds, 47% are below and 3% are above.
4-8-year-olds, 5.5% is below and 6.8% are above the recommended.
Possibly because parents perceive low fat to be healthier.

32
Q

What are the micronutrients of concern for toddlers?

A

Iron (deficiency), calcium (deficiency), vitamin D (deficiency), sodium (too high), potassium (too low)

33
Q

What is the most common micronutrient deficiency?

A

Iron

34
Q

What % of 4-8-year-olds have calcium below EAR?

A

23%

35
Q

What % of 1-3-year-olds and 4-8-year-olds have a vitamin D intake below EAR?

A

1-3-year-olds 86%

4-8-year-olds 93%

36
Q

What % of 1-3-year-olds and 4-8-year-olds have a sodium intake above UL?

A

1-3-year-olds 77%

4-8-year-olds 93%

37
Q

Explain potassium intake of 1-8-year-olds?

A

Median intake is below the AI

38
Q

Should toddlers have a vegetarian diet?
What are some nutrients of concern?
What is recommended?

A

Yes, it is healthy but it is difficult to get the adequate energy and fat intake below 2 years old without animal products.
Nutrients of concern are protein, vitamin D, B12, zinc, iron, calcium, and omega-3’s.
Recommend fortified cereals and soy-based follow up formulas.

39
Q

What are the goals for toddler and preschooler feeding (X4)?

A
  • To have adequate but not excessive energy and nutrient intake
  • To help support normal development (motor, cognitive, growth, and social)
  • Establish healthy eating patterns and behaviors (family influenced)
  • Support self-regulation of energy intake
40
Q

What is the division of responsibility in feeding toddlers?

A

Parents decide what, when, and where to eat

Children decide how much and whether or not to eat.

41
Q

What are 8 tips for helping toddlers and preschoolers develop healthy eating behaviors? x8

A

1) Role modeling (types of foods, eating patterns, attitudes, activity, screen time, sleep)
2) Foods available and accessible
3) Food preparation
4) Consistent eating schedule
5) Remove distractions
6) Exposure to variety (foods, textures). May take 15+ exposures to be accepted.
7) Introduce new foods with known and preferred foods
8) Encourage self-feeding regardless of messiness (confidence, motor skill development)

42
Q

How do you develop a consistent eating schedule with toddlers and preschoolers?

A
  • plan meal and snack times
  • 3 meals and 2-3 snack (2-3 hours between)
  • water in between meals and snacks
43
Q

What are 4 common feeding concerns?

A
  • lack of interest in foods: growth rate decreases after infancy and occurs in spurts and leads to concerns from parents
  • unpredictable amounts are eaten (changes in growth rates changes energy needs)
  • reluctance to try new foods
  • picky eating and food jags
44
Q

What is neophobia?

A

fear of something new

45
Q

What types foods should you offer a toddler and preschooler and some tips on choosing them (x8)?

A
  • a formula is not needed after 12 months (can continue BF)
  • supplement with vitamin D up to 2 years
  • variety of foods (all food groups)
  • emphasize minimally or unprocessed
  • processed in moderation and ultra is not necessary
  • limit beverages other than water (some milk, no sweetened beverages)
  • milk should be whole fat
  • soy and plant-based milk are not recommended bc not enough fat (soy until 2 if no breast milk or animal milks)
46
Q

What food can increase the risk of iron deficiency?

A

Too much animal milk. Fill up on that and not enough food.

47
Q

What are some common causes of dental canaries in young children?

A
  • Use of bottle or sippy cup at night or throughout the day because of the constant exposure to CHO
  • sticky foods

*simply CHO is used by bacteria in the mouth to produce acid which erodes enamel

48
Q

How much do you offer a toddler or preschooler as far as serving sizes?

A
  • number of servings are ok to use but not the amounts
  • offer small amounts (0.25, 0.5 servings) at first and then more if not full
  • progress to self-serving from what is offered
  • the toddler decides if to eat and how much to promote independence of energy regulation and regulation of appetite
49
Q

What regulates the self-regulation of energy intake?

What are the responses to hunger and satiety?

A
  • the hypothalamus regulates hunger and satiety
  • internal cues are also from hormones, nervous system, and blood nutrient levels
  • also external cues
  • hunger is a response to low glucose, ghrelin, and other hormones
  • satiety is a response to stretching in the GI tract, CCK, leptin, and other hormones
50
Q

What are some external cues that stimulate energy intake?

A
  • sight, smell, taste
  • advertising
  • habits, social situations
  • portion sizes
  • parental and peer modeling
  • pressure and incentives to eat more
  • using food as a reward
51
Q

What did a 6-day food record in 2 -5-year-olds reveal in variability in energy consumption?

A

There is more variability in energy intake between meals than between days.

52
Q

What were the results of the fat substitution study?

*foods were replaced with a no energy fat substitute

A

Lower fat intake resulted in increased food intake proving that internal cues regulated energy consumption.
*why concerns about meal-time energy consumption variability should not be a concern (generally)

53
Q

What did a study say about parental behavior and food acceptance?

A
  • Foods offered with praise or encouragement were consumed less the second time
54
Q

What did a study say about portion control in 3.5 years and 5 years old?

A

When portion sizes are increased, the 3.5-year-olds decreased the consumption of foods.
When portion sizes are increased, the 5-year-olds consumed the same amount of food.
*at some point portion sizes influence consumption and internal cues become less influential

55
Q

Summary of regulation of toddler and preschooler energy intake

A

They are responsive to internal cues. Energy intake varies with energy density. Eat more if less energy dense.

Begin to be sensitive to external cues. Praise and rewards have negative effect on food intake.
Portion sizes impact food consumption but are less influential as they get older.
Peers influence food choices and preference.

NUFS 356 (24 decks)

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