Lecture 14: Toddler and Preschool Nutrition Flashcards
What are toddlers defined as?
Children between the ages of 1 and 3 years
What happens to growth velocity in toddlers?
It slows
What happens to appetite in toddlers?
Decrease in appetite coinciding with slowing growth
What 5 things increase in toddlers?
- Gross motor skills
- Fine motor skills
- Independence
- Exploration
- Language
What are gross motor skills?
Use of large muscle groups exhibited as walking along, running, walking up stairs, hopping, skipping
What are fine motor skills?
Smaller muscle groups demonstrated by stacking objects, scribbling and copying shapes
When does dramatic development in language occur?
18 to 24 months
What is preschool age?
3-5 years
What is pre-school age characterised by?
Increasing autonomy
- Need for rituals/regularity
Broader social circumstances
Expanding ability to control behaviour
What do feeding skills look like in toddlers and pre-schoolers (>12 months)?
Increased fine motor skills and visual coordination:
- Use of cups and utensils
- Prefer to eat with their hands
- Happy self-feeding and exploring new tastes
What are some food items prohibited from pre-school lunches?
- Nuts and seeds
- Crisps, popcorn and rice crackers
- Hard or chewy sweets
- Sausages and saveloys
- Dried Fruit
How do we manage toddler appetite?
- Routine and regular meals are important
- Parents often overestimate portion sizes (start with small portions)
- Offer a variety of foods
- Allow children to ask for more of something on offer
Why do we not want to serve large plates to toddlers?
Full plate can be overwhelming:
- Better to start with smaller amounts, they are more accepting of this
- From there, the child will then be able to ask for more
- Continue to offer the foods they are eating and want more of
What are the MOH recommended servings for toddlers?
Veges = 2-3
Fruit = 1/2
Grains = 4
Legumes = 1
Milk products = 1-1.5
For toddlers its not about being strict about servings, its about…
Variety
How is cows milk beneficial as a food for toddlers?
Provides energy, protein, calcium, riboflavin and vitamin B12
What type of milk is recommended for toddlers?
Whole (dark blue) milk
- Reduced fat milks should not be used before 2 years of age due to child’s high energy requirement
What is the maximum amount of milk that should be drunk per day for toddlers?
No more than 350mL
Why no more than 350mL of cows milk?
- Low in iron
- Displaces nutrient rich food in the diet
What are toddlers milks? What are they fortified with?
Cows milk based drinks that are fortified with minerals and vitamins such as iron, iodine, vitamin D and vitamin C
What is toddlers milk promoted as?
‘Alternatives’ to cows milk (“nutritionally superior”) for infants over the age of 12 months
Are toddler milks recommended by MOH?
No!
Why are toddler milks not recommended by MOH?
- Can continue a child’s preference for milk (limits variety in foods)
- Achieving optimal nutrition from a variety of healthy foods is important to set up healthy eating behaviours
- They are expensive
What percent of total energy was found to come from toddlers milk in Australian toddlers (12-24 months)?
22%
- This is problematic because could be replacing other important nutrients
What are the recommendations for juice intake?
- Should not be sipped throughout the day
- Should not be used as a means to calm an upset child
- No more than 120mL/day
What are the main characteristics of toddler behaviour? (6)
- Strong independence (emergence of ‘no’)
- Easily distracted
- Learning to self regulate
- Overstimulation
- Shyness and fear of strangers
- Biting, pinching and hair pulling
New independence and ability to self-regulate can develop into….
Fussiness
- It is very normal for toddlers to go through a period of fussy eating - reassure parents
Why is it common for toddlers to develop fussiness?
- Could be drive to be independent
- Could be an inbuilt protective mechanism, safety thing
The period for how long this fussiness phase lasts will depend on…
How the family react and respond to their child
We want to ensure we are creating a ??? eater
Confident eater
What is responsive feeding?
Letting your child guide you about how much they eat, encourage but DON’T force them
Why is responsive feeding important?
- Helps with ability to self-regulate
- Relaxed positive mealtimes creates positive attitudes towards foods
- Older family members role model healthy eating and social interaction leads to positive mealtime behaviour
What is the division of responsibility?
a feeding approach developed by Ellyn Satter that defines distinct roles for both parents and children in the feeding process
What is the parents role in the divison of responsibility?
- What
- When
- Where
the child eats
What is the child’s role in the divison of responsibility?
- Whether
- How much
they eat
What is family mealtime?
A social and cultural occasion where at least one adult eats, and interacts, with a child or children who is also present at the meal
What are some tips to prevent fussy eating?
- Ensure they are hungry
- Provide small portions with variety
- Provide plenty of opportunities to try foods
- Avoid pressure
- Have adults role model and talk positively
When should the last snack be offered before meal time?
90 minutes - this is variable as some toddlers will find this too long, they might need a little bit of energy to actually eat the dinner
How should toddlers be rewarded regarding food?
- Praise child when they try a new food or eat a food they ‘dislike’
- Never reward with food
Resist the temptation to replace the offered food with…
A favourite food
How long should a meal last?
End the meal within a reasonable time (for example, 30 minutes) and clear away the plate without comment
How should new foods be introduced to selective eaters?
- Offer new foods with accepted foods
- Repeated exposure
Food rewards are typically….
Energy dense and nutrient poor
- Puts more of a preference on the reward food
Why should food not be eaten in front of screens?
Makes it difficult for young children to recognise their fullness cues and can lead to overeating
- We want children to focus on eating during mealtimes
When should the transition from a high chair to normal chair be made?
- No set period but anywhere between 18 mo and 3 y
- When they are steady enough to keep upright for longer periods
What did OzFITS find about toddlers consuming foods from all core food groups?
Good variety
- Slightly lower in veges
What percent of toddlers consumed discretionary foods? (OzFITS)
9/10 (13%)
- Displacing nearly 15% of their diet from foods that could contribute well to their nutrient intake
What are discretionary foods?
High in energy, saturated fat and/or sugar - have little nutritional value
What are the main drinks for toddlers 12-24mo (most to least consumed)?
- Breastmilk
- Formula
- Cow’s milk
- Sweetened beverages
What percent of toddlers consumed over the UL of sodium intake (1000mg/day)?
1/3
What was the average sodium intake/day?
878 +- 12.4mg/day
Why is high sodium intake for toddlers concerning?
- May influence preferences for salty foods into adulthood
- Risk factor for CVD
What are the top 5 sources of sodium in toddlers (12-24mo)?
- Regular breads and rolls
- Cheese
- Dairy Milk
- Mixed dishes (cereal based)
- Processed meats
What are the top discretionary sources of sodium in toddlers (12-24mo)?
- Processed meats
- Sauces and condiments
- Savoury biscuits
- Yeast extracts (vegemite)
- Cakes, muffins, scones
