Lecture 6 Flashcards
What age are toddlers and preschoolers?
Toddlers: 1-3 yrs
Preschool: 3-5
What are eating patterns that can be established at a young age?
Learning food preferences
Developing feeding skills
Developing eating habits
Innate ability to self regulate
When do energy and nutrient needs decrease?
Around 12 months
When does food intake increase for toddlers/preschoolers?
Increase food intake during periods of rapid growth
-appatite varies (ups and downs)
What varies more, daily energy intake or meal intake?
Meal intake
- Kid has smaller appetite as they progress past that first year of life
- Theres a difference in day to day in how much a toddler will eat, some a lot others less
How much milk should kids be getting/day?
Over 2yrs no more than 16oz/day
What are the energy needs of toddlers/preschoolers?
Individual needs vary widely
-based on growth physical activity
Total needs increase with age
Need/kgBW decrease gradually
What are the AMDRs for toddlers/preschoolers?
Fat:
30-40%(1-3yrs)
25-35%(3-5yrs)
Carb:
45-65%
Protein:
5-20%(1-3yrs)
10-30%(3-5yrs)
What do we need to consider interns of protein for toddlers/preschoolers?
Quality of protein consumed (eat high quality)
Decrease amount of total protein needed in the diet to provide essential amino acids
What is the amount of protein based on need/kgBW for toddlers/preschoolers?
RDA 1-3yrs: 1.1g/kgBW/day (13g/day)
RDA 4-8: 0.95g/kgBW/day (19g/day)
Why shouldn’t we restrict fat in young children?
Important source of energy and essential nutrients
Provides essential fatty acids for Brian development
-oils, avocados, nut, seed butter
What kind of milk should kids get if they are 12-24months and not nursing?
Whole milk
Why isn’t skim, 1% 2% and milk alternatives not appropriate for kids?
Not appropriate for <2 years because there is not enough fat
Why are kids constipated?
High cheese intake
Low intake of fiibre
Low intake of water
Stool holding
What is stool holding?
Chiild doesn’t completely empty bowl=over distension, large fecal mass in belly, painful to have BM=more stool holding
What are the problems with too much fibre?
May displace other energy dense food
May decrease bioavailability of some minerals
Diarrhea
How do you determine how much fluid a child should get?
<10kg: 100ml/kg
10-20kg: 1000ml+50ml/kg
20gk+: 1500ml+20ml/kg
What are the key nutrients of children?
Fe Ca Zn Vitamin D -need increase with age
What nutrient does a healthy balanced diet lack?
Fe
- diet has to be really well planned
- Fe demand coupled with growth rate can lead to anemia if not adequate intake
How should children get enough Fe?
Meals/snack should be Fe rich
- meats
- cereals
- green peas
- rasisn/dried apricots
- beans
Consume less than 24oz
What is the most common deficiency?
Fe deficiency anemia
- more common in low income kids
- associated with longterm delays in cognitive development and behavioural disturbances
How much Fe, Zn and Ca should a toddler 1-3yrs get?
Fe 7mg
Zn 3mg
Ca 700mg
How much Fe, Zn and Ca should a kid 4-8yrs get?
Fe 10mg
Zn 5mg
Ca 1000mg
What do kids multivitamins look like?
Contain Fe, Zn, Ca Fruit flavoured Chewable Cartoon snapped Extra colours and sugars
Who should use multivitamins?
Deprived families Malnourished Anoorexic/poor eating habits Vegetarian diets without adequate intake of dairy Chronic diseases
Is there a danger to taking vitamins?
Fe Poisoning
Who does not require multivitamin supplementation?
Most children consuming a variety of basic foods
-supplementation is unnecessary
What is the UL for Fe?
0-13yrs= 40mg/d
-max quantity safe for most children
What are the symptoms of mild Fe overdose?
Nausea and vomitting
Diarrhea
Gastrointestinal bleeding
What are the symptoms of a severe Fe overdose?
Shock
Liver damage
Coma
Death
Where do most kids get ttheir Fluoride?
Water
Toothpaste
What is the purpose of fluoride?
Mineralizes enamel to harden and protect teeth
Should you supplement fluoride?
For children not receiving fluoridated water
- only available via prescription
- too much leads to fluorosis
How much does infant wt increase in first year?
triples
Doubles by 5-6months
When do kids start to slow in growth?
Toddlers and preschoolers slow in this growth velocity resulting in a decr4ease in appetite and food intake
-decrease is normal
How much do toddlers hight an weight increase?
0.4inches (1cm)/month
8oz (0.23kg)/month
How much do preschoolers height and weight increase?
2.75inch (7cm)/yr
- 4lbs(2kg)/yrs
- both until adolescence
What happens to bones then kids grow?
Increase bone mass and densidt
How do we measure height in kids?
Length: age 0-2yrs
-length board
Height: 2+
-stadiometer
Based on CDC chart which % are kids overweight and obese?
Overweight: BMI between 85th%-95th%
Obesity: greater than 95th%
What do the WHO growth charts describe?
How children should grow under optimal environmental conditions regardless of SES or ethnicity
-all babies are breastfed exclusively for 6 months
What happens to a 2% shift on a growth chart?
We are concerned, 1% we want to check
-can indicate FTT (down) or go up
When looking at a growth chart what can we see when there is a low ht for age and appropriate wt for ht?
Child is stunted
- implies long term malnutrition
- longterm malnutrition
When looking at a growth chart what can we see when there is a normal ht for age and low wt for ht?
Child is wasted, implies recent or continuing wt loss
-more acute low intake
When looking at a growth chart what can we see when there is a high wt for ht/BMI and high wt for age?
Child is gaining excess wt relative to ht
-child overweight
When looking at a growth chart what can we see when there is a low wt for age?
Child is FTT
How many children are obese in the US?
1/10 ages 2-5
-not all food related but screen time, less activity and genetics
How do we prevent obesity in kids?
Comes back to how food was delt with in the home before the age of 8
What % of kids at age 4 and 10 are overweight or obese?
Age 4: 15% overweight
Ahe 4: 5% obese
Age 10: 20% overweight
Age10: 6% obese
How serious is childhood obesity?
American children may be the first generation in modern history to live shorter lives than their parents
- 16-40% of elementary school kids are overweight/obese
- top public health problem
What is the cycle of childhood obesity?
Healthy child starts to increase screen time, and continuing to eat some calories. These build up due to lack of physical activity and child notices they cant do some things that their peers can do. They stop trying to do those things. They continue to do less activity and keep gaining wt into adulthood and now you have an overweight adult
What do kids learn how to do in terms of development in year one?
Drink from cup Chew foods Pincer grasp Stand and toddle(no sense of danger) Growth slows Brian and CNS maturation
What do kids learn how to do in terms of development in year 2?
Can eat different textures cause more teeth
More effective use of cup/utensils
Walk and run
Psychological development
What kind of psychological development do we see in toddlers 18-36months?
Not willing to taste anything and everything anymore
Assertive/selective in how and what they eat
Show independence by saying NO
What are the eating patterns of toddlers?
Eat less as growth rate slows
Quantity of food eaten varies based on activity level and growth spurts
Fav food and sudden changes in likes/dislikes
Experimentation
Strive for independence and control
Short attention span
Need for security (schedule)
How long does it take a toddler to eat?
30 mins for a full mealtime
-give time and opportunity to play and experiment with their food
What should you do for toddlers to help the develop proper mealtime behaviours?
Model healthy behaviours No force feeding Dont offer junk as a reward Minimize distraction Have their own seat Allow to practice self feeding Introduce new food and texture
What re some tips for toddler nutrition?
Offer variety 3 meals and 2 snacks (healthy) -snacks should not replace meals Water or milk at mealtime Whole milk until 2 yrs Limit fruit juice (1x/day) Avoid sweet and sticky foods Limit foods high in salt sugar caffeine and excess fat
what are the recommended max caffeine intakes?
4-6yrs: 45mg/d 1 can of cola
7-9: 62.5/d 1.5 can of cola
10-12: 88mg/d 2 cans
What are the tips for feeding toddlers?
Eat with your child Teach by example Offer simple moist easy to chew foods Dont force to eat or clean plate Do not make sweets/ dessert a reward
What are some of the reasons why toddlers might bite?
Teething Need for autonomy and control Exploration Cause and effect Attention Frustration Anxiety
Why do we need parental supervision over kids?
Risk of choking
Have no sense of danger
Might walk with food in mouth
What development do we see in preschoolers?
Can use utensils and cup effectively Climb and jump Develop fine motor skills Language develops rapidly -especially if they are in preschool/kinder-garden
How is mealtime with toddlers similar to preschoolers?
Minimize distractions
Model healthy behaviours
Offer new foods with familiar foods
How is the appetite of preschoolers?
Variable because it can increase before a growthspurt
Why is it important for preschoolers to be involved in food prep/selection?
Parents decides what to offer, and when to offer it
Child decides what to eat and how much-great ability to self regulate
Why should we offer smaller servings for preschoolers?
So they will ask for more and wills top eating when they are full
How can preschoolers learn healthy eating habits?
Develop sense of test, acceptance and enjoyment of different foods
Instill attitudes and practices for lifelong healthy eating
Can be fussy and that’s okay
Prevent chocking
Let them help in kitchen
What kinds of physical activity should preschoolers participate in?
Participate in structured and unstructured activities
Many active periods with rest in between
Avoid long periods of inactivity
Teach basic movement skills first
Have safe indoor and outdoor play areas
Provide opportunities for active play
What are sedentary behaviours?
Thos involving every little physical movement while kids are awake
What are the guidelines for sedentary behaviour?
Keep prolonged periods of inactivity to <1hr
TV/games not recommended for less than 2 yrs
Screen time 2-4 <1hr/day
Limit playpen use
Play with your kids
