Nutritional Considerations of Infants, Young children and Adolescents

Question 1

Why is nutrition required?

Answer 1

Essential nutrients to replace losses and to grown new tissues
Energy to permit metabolic function
Maintenance, growth and development
Develop immunity

Question 2

What are the different phases of child growth?

Answer 2

Infant (nutrient led)
Child (growth hormone led)
Pubertal (sex steroid led)

Question 3

What does the reference nutrient intake for protein range from?

Answer 3

12.7g-14.5g for infants aged 4 to 18 months

Question 4

What is the RNI for vitamin A and what are good dietary sources?

Answer 4

350-400 micrograms a day

Cheese, eggs, yoghurt

Question 5

What is the RNI for vitamin C and what are good dietary sources?

Answer 5

25-30 mg/d

Oranges, blackcurrents, potatoes

Question 6

What is the RNI for vitamin D and what are good sources of it?

Answer 6

7-8.5 micrograms/day

Sunlight, oily fish and egs

Question 7

What vitamin supplements should be given to infants from 6 months?

Answer 7

All children consuming less than 500mls/d of infant formula should take vitamins A, C and D

Question 8

What vitamin supplements should babies at 2 weeks have?

Answer 8

Brestfed babies should be given a supplement of 8.5-10mg of vitamin D a day
Breasfeeding mother should take take vitamin D supplements

Question 9

What are the recommendations regarding breastfeeding?

Answer 9

Exclusive breastfeeding is recommended for the first 6 months of life

Question 10

What is infant formula?

Answer 10

Modified cow’s milk
Whey or casein based formula
No antimicrobial or bioactive substances from breast milk
Whey based formula recommeded for first year

Question 11

When should weaning begin?

Answer 11

About 6 months but can begin as early as 4 months

Question 12

What does weaning consts of?

Answer 12

Process of introducing foods with an increase in variety of texture, flavour, aroma and appearance
Low energy foods can limit energy intake

Question 13

When can infants begin to drink full fat unmodified cows milk?

Answer 13

Small amounts of cooking from 6-9 months
Gradually introduced as a drink from 12 months
Semi-skimmed milk not before 2 years
Skimmed milk not before 5 years

Question 14

What should the first food given to babies be?

Answer 14

Gluten free if before 6 months e.g. baby rice, cooked and mashed fruits and veggies, peeled and mashed banana
Sugar and salt should not be added
Give foods rich in absorbable iron e.g. red meat, canned fish, well cooked eggs
Avoid whole nuts and seeds until 5 years
Avoid adding sugar to foods
Frequent intake of foods and drinks high in sugar should be limited

Question 15

What are the advantages to complimentary feeding?

Answer 15

Gross motor development
Fine motor/vision development
Oral motor development/ speech
Psychosocial: infant-carer relationship

Question 16

What are the consequences of late weaning?

Answer 16

Inadequate provision of energy and nutrients from breast milk alone may lead to growth faltering and malnutrition
Micronutrient deficiencies, esp of iron and zinc may develop owin to the inability of breast milk to meet requirements
Optimal development of motor skills such as chewing and acceptance of new tastes and textures may not be ensured

Question 17

What skills do children learn at school age regarding food?

Answer 17

Learning to be independent
Developing eating patterns
Developing behaviour patterns

Question 18

What are key vulnerabilities with children at school age?

Answer 18

Chronic disease
Disordered eating pattern (faddism)
Supply/demand imbalance (obesity)

Question 19

What skills do adolescents gain regarding food?

Answer 19

Attaining independence and ability to parent

Accelerated growth meaning increased demand

Question 20

What are the key vulnerabilities with adolescents?

Answer 20

Eating disorder
Obesity
Early pregnancy

Question 21

Why does WHO reccommend exclusive breast feeding for the first 6 months of life?

Answer 21

Immunoloical features
Anti-infective agents
Growth factors
Modulators of intestinal growth 
Reduction in diarrhoea
Colonic function 
Reduction in resp infection 
Reduction in atopic disease
Greater likelihood of higher IQ at 7 1/2 years
Lower obesity risk 
Lower maternal breast cancer risk

Question 22

What can be done to allow for optimal dental health in children?

Answer 22

Introduced to drinking from cups or beakers from about 6 months and tooth brushing should begin as soon as teeth begin to appear

Question 23

What has convincing evidence to reduce the risk of dental caries?

Answer 23

Fluoride exposure in toothpaste

Question 24

What has associations with obesity?

Answer 24

Maternal obesity
Early weaning
Rapid weight gain in first 2 years

Question 25

What influences the timing of solid food to infants?

Answer 25

Living in a deprived area
Opinions of the infant’s maternal grandmother
Personal disagreement with advice to wait until baby 4 months
Lack of encouragement from friends to wait until baby 4 months
Being in receipt of free samples of manufactured food