Toddler Nutrition Flashcards
Life cycle stage
toddlers 1-3
Characterised by rapid increase in gross and fine motor skills and language skills
Pre school 3-5
Characterised by increasing autonomy, broader social circumstances, increasing language skills and expanding self control
Importance of nutrition status
During toddler and preschool years, adequate nutrition is required to achieve full growth and development
Undernutrition impairs cognition and availing to explore environment and thus development
17% of children live in poverty, 19% single parent families
Normal growth and development
From birth to 1 year, average infant triples his birth weight
Toddlers gain 200g and grow 1cm per month (approx 12cm from 1-2yo)
Preschoolers gain approx 2kg and grow 7 cm per year
Decrease in growth rate is accompanied by a reduced appetite and food intake
Monitoring children’s growth
Use calibrated scales and height board
Toddlers under 2- weighed without clothes or diaper, determine recumbent length
Over age 2- weighed with light clothing, measure stature with no shoes
Recumbent length- <24 months are measured in the recumbent position
Growth charts used to compare development and growth to other healthy children of same age and gender
0-24: head circ, wt, ht
2-18: wt, ht, BMI
Growth charts
Percentiles drawn- lines represent 5th, 10th, 25th, 75yh, 90th and 97th percentiles for weight, height and head circumference
Most babies weight and length fall somewhere between the 5th and 97th, if baby in 5th, 95% of babies are taller and heavier than she is. Appropriate percentiles may be different for Asians or babies with downs
<5th- healthy weight/ underweight. Low body fat, low level of health risk
5th-85th- healthy weight. Appropriate fat. Lowest health risk.
85th-95th- risk of overweight or is overweight. Raised body fat and health risk.
>85th- overweight/ obese. High body fat, high level of health risk.
Common problems with measuring and plotting growth data
Error in measuring may result in errors in health status assessment.
Use of calibrated equipment and plotting accuracy are vital
Not choosing appropriate chart.
Cognitive development of toddlers
Orbit around parents Transition from self centred to more interactive Vocabulary expands- 10-15 words at 18months 100 at 2 years 3 word sentences by 3 years
Temper tantrums common- learning about selves and ability to control environment
Development of feeding skills and behaviours of preschool age children
Can use a fork, spoon and cup well
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 and preparation eg shopping, peeling, cleaning or cutting
Energy intake in preschool age children
Adjust energy intake to meet energy needs
I ate ability to self regulate food intake
Avoid encouraging child to clean your plate and using food as a reward
Parents need to provide a selection of healthy and nutritious foods and let child decide how much to eat
Healthful eating habits must be learned
Appetite
Prefer familiar food, strong flavours may not be accepted
Serve child sized portions and make food attractive.
Control amount eaten between meals to ensure appetite for basic foods
Consumption of foods high in sugar and fat before meals decreases intake of basic foods
Offering large portions increases food intake and may promote obesity
Restriction of palatable foods increases preference for the foods
Food preference development
Intitially tend to reject new foods
May need 8-10 exposures before accepting
Food intake related to parents preference
Prefer sweet and salt, reject sour and bitter
Preference for energy dense foods- pleasant feeling of satiety, associated with special occasions, used as a reward, media/advertising
Feeding relationship
Parent or caretaker responsible for:
What children are offered
Environment it is served (when and where)
Respond to child’s hunger and satiety cues
Child responsible for:
How much they eat
Whether they eat a particular meal or snack
Fussy eating
Limited intake of food groups Food fads Rejection of foods Reluctance to try new foods Extreme likes and dislikes Concern- significant changes in growth pattern, one major food group rejected for a long period of time, fussy eaters at higher risk of iron, zinc B13 and fibre deficiencies
Management Repeated exposure Limited choices Positive language and role modelling Routines Fluids Screen time Don't bribe Meal prep involvement Limit duration of meal times
Energy needs
Estimated requirements-
Toddlers up to 2 years considers age, gender, weight, length and growth factor
Above 2 years- recommended to calculate BMR and to apply appropriate OAL
Cereal and dairy are a significant source of energy
Protein:
1-3: RDI 1.08g/kg
4-8: RDI 0.91g/kg
Fat:
Support growth, provide EFAs and fat soluble vitamins
<2 years- full fat dairy and 40% e from fat
2-5 years- low fat fairy and 30% e from fat
Vitamins and minerals
Nutrients of particular importance - b group vitamins - iron - calcium - vit D Most toddlers and preschool age children have adequate vitamin and mineral consumption except iron, calcium and zinc
Common nutrition problems - iron deficiency
Iron deficiency anaemia
- 19% toddlers with depleted iron stores
- 4% iron deficiency anaemia
May cause delays in cognitive development and behavioural disturbances
Prevention:
- limit milk consumption to 500-700ml/d since milk is poor source if iron and may displace better options
- infants at risk should be tested 9-12 motnsh, 6 months later and annually aged 2-5
- educate caregivers on appropriate food choices
Intervention
- iron supplements
- counselling with parents in adequate diets and repeat screening 4 weeks later
Diet:
- meat and meat alternatives
- prepare far rich foods in diff ways
- but C sources at mealtimes
Common nutrition problems - dental caries
Prevalence - 1-3 children aged 4-6 in Aus Causes - bedtime bottle with juice or milk - streptococcus mutans - sticky carbohydrate foods - sugar containing beverages
Prevention
- Fluoride supplemental amounts vary by age and fluoride content of water supply
- brush teeth twice per day
- reduce grazing during the day
Common nutrition problems - constipation and diarrhoea
Constipation
Hard, dry stools associated with painful bowel movements
Causes: stool holding and diet
Prevention: consume adequate fibre and water
Excessive milk may be linked to consummation- usually because milk displaces fibre containing foods
Diarrhoea
Large amounts of fruit juice may reduce the guts ability to absorb water
Issue tends to resolve around three or four years of age and may be related to hit immaturity in absorbing water
Food security
Poor access to foods at all times, insecurity common in minority populations, low income families and single parent families
Concern for child growth and development
Food safety
Young children vulnerable to food poisoning
Food safety practices:
- clean hands and surfaces
- separate foods
- cook to proper room temp
- refrigerate foods promptly
