Toddler nutrition 2 Flashcards
Overweight and obesity
BMI lowest aged 4-6
Adiposity rebound- normally increased in BMI threat occurs after BMI declines
Best treatment is allowing child to grow into his or her height
Reducing weight may be associated with a reduction in intake of nutrients for adequate growth
Prevention of overweight and obesity
Limit sugar sweet beverages Encourage fruits and veg Limit tv Daily breakfast Limit fast foods Limit portions Calcium rich diets Diets high in fibre Follow the NRVs for carbs, protein and fat Promote physical activity Limit energy dense foods
Prevention of CVD
Limit dairy saturated fats, trans fat and cholesterol
Acceptable total fat intake:
1-4: 30-40%
4-18: 25-35%
For children at high risk of CVD, limit day fat to <7% of calories and cholesterol <200mg
Maintain healthy weight
Daily physical activity
Reduced screen time
Healthy eating patterns according to Australian DGs
Vitamin and mineral supplements
Varied diet provides all minerals and vitamins needed
Supplements may be required for people with anorexia, poor appetites or poor diets, or a dietary program for weight management, severe fussy eaters, vegetarian and vegans, people with chronic disease
Recommended vs actual intake
2/3 children at 1 serve of fruit per day and 5% at 2+ serves
50% 2 year olds consuming >EER
Toddler age group- milk, milk products and cereal based products provided almost 50% of E needs
De intakes in 3 year olds lower than RDI (9mg)
Refined CHO (sugar) contributed 24-26% of E intake
Vegetarian diet
Vegan and macrobiotic diet children tend to have lower growth rates but remain within the normal ranges
Staple foods eg. Legumes and wholegrains can be bulky and may be difficult for small children with small appetites to consume enough
Guidelines:
- several meals/ day (3 w 2 snacks)
- avoid excessive bulky foods
- include energy dense foods (cheese, avocado, but butters)
- omega 3 fatty acid sources (canola, soybean oil, walnuts)
- sources of Zn, Fe, B12, vit D and Ca should be included or supplemented or consumed in fortified foods
- iron intake needs to be approx 80% more than the NRV if derived for vego diet
- include but C rich foods
Nutrition in childcare
Nearly half of preschool age children attend a child care program
Long day care may consume >50% of daily intake whilst in care
Nutrition quality framework for early childhood education and care
Offer food at intervals not less than 2 hours and no more than 3 hours
Issues childcare face- accesssing nutrition training, providing nutrition menu with budget constraints, food safety
Concern for physical activity
Recommendation for toddlers and pre- schoolers:
- phys active for 3 hours per day
- not inactive for >1 hour at a time (except sleeping)
- <2 yo no screen time
- > 2yo limit 1 hour per day
With chronic conditions - higher caloric needs: Cystic fibrosis Renal disease Ambulatory children with diplegia Pediatric AIDS Bronchopulmonary dysplasia
Lower caloric needs Downs Spina bifida Nonambulatory children with diplegia Leader Willi syndrome Nonambulatory children with short stature
Growth assessment
Nutrition assessment should be first step to determine if nutrition services are needed for those with chronic conditions
- is child’s growth on track
- is child’s diet adequate
- are feeding or eating skills age appropriate
- does diagnosis affect nutritional needs
Feeding problems
Children with special health need may have feeding problems:
Low interest in eating
Long mealtimes (30mins)
Preferring liquids over solids
Food refusals
Foods that are preferred by younger children (soft texture, mild tasting)
Chewing and swallowing difficulties due to poor muscle control
Failure to thrive
Inadequate ht or wt gain with growth decline more than 2 growth percentiles
May result from
- digestive problems (eg GORD, coealiac)
- asthma or breathing problems
- neurological conditions such as seizures
- paediatric aids
Recovery can include accelerated catch up growth if E is provided at higher levels than for a typically growing child
Coeliac disease
May result in diarrhoea and caused by sensitivity to the protein gluten found in wheat and other grains
Digestive symptoms usually develop by 2 years of age
Nutrition intervention- strict gluten avoidance, nutrients of concern (Ca, VitD, B12, Fe, folic acid)
Autism
Symptoms apparent before 3 years of age
Sensitive to sensory information which can result in rigid, self restricted range of food choice
No scientifically proven diet is recommended for prevention or treatment
Gluten free and Caesein free diets have been recommended via internet and support groups but have no scientific evidence
Muscle coordination problems and cerebral palsy
Group of disorders characterised by impaired muscle activity and coordination present at birth and developed during early childhood
Reduced dietary intake results from child easily become tired while eating
Difficulties with coordinating muscles for chewing/ swallowing and using utensils well
Food allergies
Seen in approx 2-8% of children Milk Eggs Wheat Peanuts Walnuts Soy Fish Complete avoidance of food required Ensure adequate nutrition and food substitutes Can affect the whole family
