Nutrition in the LifeCycle 2 Flashcards
Toddler
- children between the ages of 1 and 3
- stage of development characterized by rapid increase in gross and fine motor skills with subsequent increase in independence, exploration of the environment, and language skills
Preschool
- children between the ages of 3 and 5
- stage of development characterized by increasing autonomy, experiencing broader social circumstances, such as attending preschool, or staying with friends and relatives; increasing language skills, and expanding ability to control behavior
What is normal weight gain in toddlers and preschoolers respectively,
toddlers: 3-5 lbs a year, mostly in gut
preschoolers 4 lbs a year
How is growth monitored in toddlers? preschoolers?
Use calibrated scales & height board Toddlers under age 2 years -Weighed without clothes or diaper -Determine recumbent length Children over age 2 years -Weighed with light clothing -Measure stature with no shoes Recumbent length -The length of toddlers < 24 months are measured in the recumbent position Common problems: -Error in measuring may result in errors in health status assessment -Use of calibrated equipment and plotting accuracy are vital
Physiological and Cognitive Developmental Milestones in Toddlers
walking progress by month -15mo: crawl upstairs -18mo: run stiffly -24mo: walk up stairs one foot at a time -30mo: alternate feet going up stairs -36mo: ride a tricycle cognitive -toddlers "orbit" around parents -transitions from self-centered to more interactive -vocabulary expands *10-15 words at 18mo *100 words at 2 years *3 word sentences by 3 years -temper tantrums common
Cognitive Development of Preschool age children
- egocentric: cannot accept another’s point of view
- learning to set limits for himself
- cooperative & organized group play
- vocabulary expands to >200 words
- begin using complete sentences
Development of feeding skills in Toddlers
gross and fine motor development improved
-9-10 months weaning bottle begins
-12-14 months completely weaned
-12 months refined pincer
-18-24 months able to use tongue to clean lips and has developed rotary chewing
Adults supervision vital to prevent choking
Feeding Behaviors in Toddlers
- rituals in feeding are common
- may have strong preferences & dislikes
- food jags common (child eats the same thing for a long period of time and then won’t eat it at all)
- serve new foods with familiar foods & when child is hungry
- toddlers imitate parents & older siblings
What is a toddler’s appetite? What are appropriate portion sizes for toddler’s?
- Slowing growth results in decreased appetite
- Nutrient-dense snacks needed but avoid grazing on sugary foods that limit appetite for basic foods at meals
- Toddler-sized portions average 1 tablespoon per year of age
Feeding Behaviors and Appeitite in Preschoolers
- can use fork, spoon, & cup
- spills occur less frequently
- foods should be cut into bite-size pieces
- adult supervision still required
- appetite related to growth
- appetite increases prior to the “spurts” of growth
- include child in meal selection & preparation
- portions?
- Control amount eaten between meals to ensure appetite for basic foods
Temperament Theory
Temperament is defined as the behavioral style of the child, or the “how” of the behavior
Three temperamental clusters
-“easy”-adapts to regular schedules & accepts new foods
-“intermediate”/”slow-to-warm-up”-slow adaptability, negative to new foods, but can learn to accept new foods
-“difficult”-slow to warm up and may be negative to new foods; may have to give more exposures, have more patience
-“intermediate low” and “intermediate high”-a mixture of behaviors
Appetite and Satiety
- consumption of foods high in sugar and/or fat before meals decreases intake of basic foods
- offering large portions increases food intake and may promote obesity
- restriction of palatable food increases preferences for the foods
Parent Child Feeding relationship
Parent or caretaker responsibilities:
-“What” children are offered to eat
-The environment in which food is served including -“when” & “where” foods are offered
Child’s responsibilities:
-“How much” they eat
-“Whether” they eat a particular meal or snack
Common micronutrient deficiencies in toddler’s and preschoolers
iron, calcium, zinc RDA 1-3yrs iron: 7mg calcium: 500mg zinc: 3mg RDA 4-8yrs iron: 10mg calcium: 800mg zinc: 5mg
Common Nutritional Problems in toddlers and preschoolers
Iron-deficiency anemia Dental caries Constipation Lead poisoning Food security Food safety
Prevention and Intervention of Iron-Deficiency Anemia in Toddlers
Preventing Iron Deficiency:
-Nutrition-Limit milk consumption to 24 oz/d since milk is a poor source of iron
-Infants at risk should be tested at 9 to 12 months, -6 months later, and annually from ages 2 to 5
Intervention for Iron Deficiency
-Iron supplements
-Counseling with parents
-Repeat screening
Dental Caries in Toddlers
Prevalence: -1 in 5 children ages 2 to 4 Causes: -Bedtime bottle with juice or milk -Streptococcus mutans -Sticky carbohydrate foods Prevention: -Fluoride—supplemental amounts vary by age & fluoride content of water supply
Constipation in Toddlers
Definition: Hard, dry stools associated with painful bowel movements
Causes: “Stool holding” and diet
Prevention: Adequate fiber
AI for fiber ages 1-3: 19g/d; 4-8: 25g/d
Lead Poisoning in Toddlers
- Seen in ~2.2% of children ages 1-5
- Low levels of lead exposure linked to lower IQ & behavioral problems
- High blood lead levels may decrease growth
- Reduce lead poisoning by eliminating sources of lead
Nutrition and Prevention of cardiovascular disease
in toddlers and preschoolers
Limit dietary saturated fats, trans fat & cholesterol
Acceptable total fat intake ranges:
-2 to 3 years—30 to 35% of calories
-4 to 18 years—25 to 35% of calories
For children at high risk of CVD limit saturated fat to < 7% of calories & cholesterol to < 200 mg
Vitamin and Mineral Supplements for prevention of nutritional deficiencies
A varied diet provides all vitamins & minerals needed
AAP recommends supplements for certain groups of children:
-From deprived families
-With anorexia, poor appetites or poor diets, or a -dietary program for wt mgmt
-Who consume only a few types of foods
-Vegetarians without dairy products
Vitamin D deficiency
-consequences: rickets
Dietary and PA guidelines for Toddlers and Preschoolers
Dietary guidelines
- Offer a variety of foods, limiting foods high in fat & sugar
- No specific # minutes of PA for kids 2-5, active play several times each day, developmentally appropriate and fun with variety
- 60 minutes of vigorous physical activity each day (6-17 year olds)
- MyPlate developed by the USDA for young children
Recommended v. Actual Intake for Toddlers and Preschoolers
Recommended
-Iron- meats, fortified cereal, dried beans and peas
-Fiber- fruits, vegetables, whole grains
-Fat- follow food guide pyramid
-Calcium- dairy, canned fish with soft bones, green -leafy vegetables, calcium-fortified beverages
-Fluids- beverages, foods and sips of water
Dietary intake of children ages 2-5
-Energy exceeded by 31%
-Consistently low “mean” intakes of zinc, folic acid, Vit D and Vit E
-Total fat is 31% of calories
-Sodium intake is 2150-2400 mg (rec 2300 mg)
Nutrition Intervention for Risk Reduction for T/P
Model program Bright Futures in Practice: Nutrition -Public food and nutrition programs WIC -WIC’s Farmers’ Market Nutrition Program -Head Start and Early Head Start *Breakfast, lunch and snack *Monthly nutrition information *Funding from USDA and meals in compliance with federal requirements -Supplemental Nutrition Assistance Program (formerly Food Stamps)
Definition of Middle Childhood
between the age of 5-10
also part of school-age
Definition of pre-adolescence
for girls: ages 9-11
for boys: ages 10-12
also part of school aged
How is tanner staging determined
girls: breast buds and pubic hair
interval between breast budding and menarche is usually 2.25 years but can be as long as 6 years
boys: testes size and pubic hair
Normal growth development in childhood
Measurement techniques
- Growth velocity will slow down during the school-age years
- Should continue to monitor growth periodically
- Weight and height should be plotted on the appropriate growth chart (charts for boys and girls)
Physiological development of school-aged children
- Muscular strength, motor coordination, & stamina increase
- In early childhood, body fat reaches a minimum then increases in preparation for adolescent growth spurt
- Boys have more lean tissue than girls
Psychosocial issues in school-aged children
- caregiver/peer interactions
- body image
- media influence
- dieting behaviors (parents/peers)
