Nutritional Consideration of Infants, Young Children and Adolescents

Question 1

Why are nutrients required?

Answer 1

• Essential nutrients replace losses and are inv. with growth of new tissues
• Energy to permit metabolic functions
• Maintenance, growth and development
• Develop immunity

Question 2

Phases of child growth?

Answer 2

ICP model of growth:
• Infant (nutrient-led)
• Child (growth hormone-led)
• Pubertal (sex steroid-led)

Question 3

Define dietary reference values?

Answer 3

Estimated Average Requirement (EAR) - used for energy requirements of a population; 1/2 will require more than the EAR and 1/2 will require less

Reference Nutrient Intake (RNI) - a requirement that is sufficient for 97% of the population

Lower Reference Nutrient Intake (LRNI) - a requirement that is sufficient for the 3% of the population that have the lowest needs

Question 4

Difference between the EAR and the LRNI and RNI?

Answer 4

LRNI is -2 SD from the EAR

RNI is +2 SD from the EAR

Question 5

RNI for vitamin A?

Answer 5

350-400 μg/day

Dietary sources include cheese, eggs and yoghurt

Intake is usually excessive

Question 6

RNI for vitamin C?

Answer 6

25-30 μg/day

Dietary sources include oranges, blackcurrants and potatoes

Intake is usually excessive

Question 7

RNI for vitamin D?

Answer 7

7-8.5 μg/day

Main source is sunlight; small amounts available from oily fish and eggs

Breastfed and non-breast-fed infants tend to be low

Question 8

Recommendations for vitamin supplementation in children?

Answer 8

From 6 months, all children consuming <500 mls/d of infant formula should take vitamin A, C & D supplements

Breastfeeding mothers should take vitamin D supplements of 10 µg per day

Question 9

RNI for sodium in children?

Answer 9

280mg, 320mg, 350mg and 500mg per day for children aged 4-6, 7-9, 10-11 and 12-18 months, respectively

Intake tends to be excessive in most people

Question 10

Physical activity guidelines for infants not yet walking?

Answer 10

Encourage from birth

Floor based & water-based activities in safe environments

Minimise time spent sedentary for extended periods (except sleeping)

Question 11

Physical activity guidelines for children capable of walking?

Answer 11

180 minutes throughout the day

Minimise time spent sedentary for extended periods (except sleeping)

Question 12

Physical activity guidelines for those ages 5-18?

Answer 12

≥ 60 minutes/day of moderate to vigorous intensity physical activity

3 days/week - vigorous intensity activities

Minimal time being sedentary (sitting)

Question 13

Guidelines for milk-feeding?

Answer 13

Exclusive breastfeeding is recommended for the 1st 6 months of an infant’s life

Question 14

Definition of weaning?

Answer 14

Process of introducing foods with an increase in variety of texture, flavour, aroma & appearance

Question 15

Guidelines for when complementary feeding (weaning) should be started?

Answer 15

Start at ~6 months of age and not before 4 months; breast milk should be the main type of milk consumed

Question 16

Guidelines for types of complementary foods?

Answer 16

First foods should be gluten free and introduce foods that cause allergies one at a time; sugar and salt should not be added

Question 17

Consequences of late weaning?

Answer 17

Inadequate provision of energy and nutrients from breast milk alone; leads to growth faltering and malnutrition

Micronutrient deficiencies

Lack of development of motor skills

Question 18

Key vulnerabilities in school-aged children?

Answer 18

Chronic disease

Disordered eating patterns, e.g: faddism

Supply/demand imbalance, e.g: obesity

Question 19

Key vulnerabilities in adolescence?

Answer 19

Eating disorders

Obesity

Early pregnancy

Question 20

Advantages of breastfeeding?

Answer 20

Greater likelihood of higher IQ

Lower obesity risk for baby in later life

Lower maternal breast cancer risk

Question 21

Guidelines for dental health in children?

Answer 21

Introduced to drinking from cups or beakers from about six months of age

Tooth brushing should begin as soon as teeth begin to appear

Question 22

Social and cultural factors that may affect weaning practices and food choices?

Answer 22

Living in a deprived area

Opinions of the infant’s maternal grandmother

Personal disagreement with advice to wait until baby was 4 months

Lack of encouragement from friends to wait until baby was 4 months

Being in receipt of free samples of manufactured food

Question 23

Examples of public health nutrition interventions?

Answer 23

Healthy start (welfare food scheme)

Childsmile (dental programme)