Lesson 12 Chapter 16: Life Cycle Nutrition: Infancy, Ch

In the United States, the standard developed by the American Academy of Pediatrics reflects

"human milk taken from well-nourished mothers during the first or second month of lactation, when the infant's growth rate is high."

If fluoride levels are excessive, ready-to-feed formulas or formulas prepared with fluoride-free or low-fluoride water can be used. Such waters are labeled

"purified," "demineralized," "deionized," or "distilled."

Overweight children develop a characteristic set of physical traits

- . They typically begin puberty earlier and so grow taller than their peers at first -but then they stop growing at a shorter height. -They develop greater bone and muscle mass in response to the demand of having to carry more weight -appear "stocky" even when they lose their excess fat.

What should parents do when their toddler is learning to eat foods?

- Discourage unacceptable behavior, such as standing at the table or throwing food. -Let toddlers explore and enjoy food, even if this means eating with fingers for a while. - Don't force food on children. -Provide nutritious foods and let children choose which ones, and how much, they will eat. -Limit sweets. - Don't turn the dining table into a battleground.

To plot measures on a growth chart, follow these steps:

- Select the appropriate chart based on age and gender. -Locate the infant's age along the horizontal axis at the bottom of the chart - Locate the infant's weight in pounds or kilograms along the vertical axis of the chart - Mark the chart where the age and weight lines intersect (shown here with a red dot), and follow the curved line to find the percentile.

WHAT FACTORS INFLUENCES a child's eating patters?

- convenience for parents - less outdoor play - less nutritious school foods

For this reason, selective screening is recommended for children and adolescents of any age who are

- overweight or obese; -those whose parents (or grandparents) have premature heart disease (≤55 years of age for men and ≤65 years of age for women); -those whose parents have elevated blood cholesterol; -those who have other risk factors for heart disease such as hypertension, cigarette smoking, or diabetes -those whose family history is unavailable

The Academy of Nutrition and Dietetics has set nutrition standards for child-care programs. Among them, meal plans should:

-Be nutritionally adequate and consistent with the Dietary Guidelines for Americans. -Emphasize fresh fruit, fresh and frozen vegetables, whole grains, and low-fat milk and milk products. -Limit foods and beverages high in energy, added sugars, solid fats, and sodium, and low in vitamins and minerals. -Provide foods and beverages in quantities and meal patterns appropriate to ensure optimal growth and development. -Involve parents in planning. -Provide furniture and eating utensils that are age appropriate and developmentally suitable to encourage children to accept and enjoy mealtime.

Like overweight adults, overweight and obese children display a blood lipid profile indicating that

-atherosclerosis is beginning to develop—high levels of total cholesterol, triglycerides, and LDL cholesterol; -Overweight and obese children also tend to have high blood pressure; in fact, obesity is a leading cause of pediatric hypertension. -Their risks for developing type 2 diabetes and respiratory diseases (such as asthma) are also exceptionally high.

Iron-deficiency anemia is a major problem worldwide and is prevalent among US children, especially toddlers

1 to 3 years of age

The infant's length changes more slowly than weight, increasing about _______ inches from birth to 1 year.

10

soy formulas account for about ____ percent of the infant formulas sold today.

15

According to the DRI committee, children's intakes of vitamin D-fortified foods—including milk, ready-to-eat cereals, and juices—should provide

15 micrograms of vitamin D each day to maximize calcium absorption and ensure normal, healthy bone growth.

At the age of____, healthy children have attained approximately half of their adult height.

2

DRI Committee recommends a fat intake of ______ for children 4 to 18 years of age.

25 to 35 percent

DRI Committee recommends a fat intake of ____ for children 1 to 3 years of age

30 to 40 percent of energy

In addition to breast milk or formula, an infant can begin eating complementary foods between ___ and ____ months.

4 and 6

A newborn baby requires about ____ kcalories per day,

450

A healthy infant's birthweight doubles by about ____ months of age and triples by ___ year, typically reaching 20 to 25 pounds.

5 1

If fluoride levels are inadequate, formulas may need to be prepared with fluoridated bottled water once the infant is ____months of age.

6

What are the proportions of nutrition for infants?

6% protein 55% Fat 39% carb

To prevent iron deficiency, children's foods must deliver _____________ milligrams of iron per day.

7 to 10

the Child and Adult Care Food Program (CACFP), operates to school lunch and breakfast programs, and provides funds to organized child-care programs.

All eligible children, centers, and family day-care homes may participate. Sponsors are reimbursed for most meal costs and may also receive USDA commodity foods.

Orlistat is the only prescription weight-loss medication that has been approved for use in adolescents 12 years of age and older.

Alli, the over-the-counter version of orlistat, should not be given to anyone younger than age 18.

Overall, many children between the ages of 2 and 11 do not meet recommendations for fruits, vegetables, grains, and milk.

Among other nutrition concerns for US children are inadequate intakes of vitamin E, potassium, and fiber, and excessive intakes of sodium.

Iron deficiency lowers the motivation to persist in intellectually challenging tasks and impairs overall intellectual performance.

Anemic children perform poorly on tests and are disruptive in the classroom; iron supplementation improves learning and memory.

Strategies to protect against lead toxicity

Ask a pediatrician whether your child should be tested for lead poisoning. Prevent small children from putting dirty or old painted objects in their mouths, and make sure children wash their hands before eating. Similarly, keep small children from eating any nonfood items. Lead poisoning has been reported in young children who have eaten crayons or pool cue chalk. Wash floors, window sills, and other surfaces regularly. Use a mop or sponge with warm water and a general all-purpose cleaner. Wash children's bottles, pacifiers, and toys often. Feed children balanced, timely, meals with ample iron and calcium. Be aware that other countries do not have the same regulations protecting consumers against lead. Children have been poisoned by eating crayons made in China and drinking fruit juice canned in Mexico. Do not use lead-contaminated water to make infant formula. Have the water in your home tested by a competent laboratory. Use only cold water for drinking, cooking, and making formula (cold water absorbs less lead). When water has been standing in pipes for more than 2 hours, flush the cold water pipes by running water through them for 30 seconds before using it for drinking, cooking, or mixing formulas. By taking these steps, parents can protect their children from this preventable danger.

What are examples of common choking non food items?

Balloons Coins Pen tops Small balls and marbles Other items of similar size

Why can rapid fluid losses and the resulting dehydration can be life-threatening?

Because much of the fluid in an infant's body is located outside the cells—between the cells and within the blood vessels

During adolescence, these fatty streaks may begin to accumulate fibrous connective tissue.

By early adulthood, the fibrous plaques may begin to calcify and become raised lesions, especially in boys and young men.

Caregivers should reconstitute powdered or concentrated liquid formulas with optimally fluoridated water (0.7 to 1.2 parts per million).

Caregivers should let their water run for a few minutes before using in case of high lead from the pipes in the water

In most watching tv and playing on the computer and video games, use no more energy than resting, displace participation in more vigorous activities, and foster snacking on high-fat foods.

Compared to sedentary screen-time activities, playing active video games does expend a little more energy, but more research is needed to ascertain whether playing active video games increases habitual physical activity or decreases sedentary behaviors.

A woman who decides to feed her infant formula from birth, to wean to formula after less than a year of breastfeeding, or to substitute formula for breastfeeding on occasion must select an appropriate infant formula and learn to prepare it.

Cow's milk is inappropriate during the first year of life.

During the first few weeks, approximately 8 to 12 feedings a day, on demand, as soon as the infant shows early signs of hunger such as increased alertness, activity, or suckling motions.

Crying is a late indicator of hunger

Experts agree that children with high blood cholesterol should first be treated with diet ary changes. If high blood cholesterol persists despite dietary intervention in children 10 years of age and older, then drugs may be necessary to lower blood cholesterol.

Drugs can effectively lower blood cholesterol without interfering with adolescent growth or development.

Tips for Feeding Picky Eaters

Encourage children to help with meal planning. Take children grocery shopping. Ask children to help with cooking. Help children garden and harvest foods they will eat. Be Creative Try serving vegetables as finger foods with dips or spreads. Use cookie cutters to cut breads, fruits, and vegetables into fun shapes. Put healthy snacks in ice cube trays or muffin pans where children can easily reach them and graze as they play. Serve traditional meals out of order (for example, breakfast for dinner). Use healthy foods such as vegetables and whole grains in craft projects to help kids become familiar with them and encourage their interest in and enthusiasm for these foods. Enhance Favorite Recipes Include sliced or shredded vegetables in sauces, casseroles, pancakes, and muffins. Serve fruit over cereal, yogurt, or ice cream. Bake brownies with black beans or cookies with lentils as an ingredient. Model and Share Be a role model to children by eating healthy foods alongside them and offer to share your healthy snack with them. Make healthy options readily available and don't give up on repeatedly offering foods in which your child might not seem interested. Encourage your child to taste at least one bite of each food served at a meal. Respect and Relax Remember that it is not uncommon for children to eat sporadically. They have smaller stomachs, and therefore are likely to feel full faster and become hungry again not long after a snack or meal. Focus on your child's overall weekly intake of foods and nutrients rather than daily consumptions. Discuss concerns with your child's doctor. It might be helpful to maintain a 3-day food record to review at the next appointment.

What is designed to protect against hunger and improve children's health?

Food assistance programs such as the WIC program and the School Breakfast and National School Lunch Programs

For females, the iron RDA remains high into late adulthood

For males, the iron RDA returns to preadolescent values in early adulthood.

For children younger than 2 years of age, BMI values are not available.

For this age group, weight-for-height values above the 95th percentile are classified as overweight.

The American Academy of Pediatrics recommends no fruit juice in the first year and limiting juice for young children (1 to 6 years of age) to 4 to 6 ounces per day.

Fruit juices should be served in a cup, not a bottle.

What are examples of common choking food items?

Gum Hard or gel-type candies Hot dog slices Large raw apple slices Marshmallows Nuts Peanut butter Popcorn, chips, or pretzel nuggets Raw carrots Raw celery Sausage sticks or slices Whole beans Whole cherries Whole grapes

Short-term hunger, such as when a child misses a meal, impairs the child's ability to pay attention and be productive.

Hungry children are irritable, apathetic, and uninterested in their environment.

Atherosclerosis develops when regions of an artery's walls become progressively thickened with plaque

If it progresses, atherosclerosis may eventually block the flow of blood to the heart and cause a heart attack or cut off blood flow to the brain and cause a stroke

During early infancy, breast milk or infant formula normally provides enough water to replace fluid losses in a healthy infant.

If the environmental temperature is extremely high, however, infants need supplemental water.

Children with the highest risks of developing heart disease are sedentary and obese, with high blood pressure and high blood cholesterol.

In contrast, children with the lowest risks of heart disease are physically active and of normal weight, with low blood pressure and favorable lipid profiles.

In general, the adolescent growth spurt begins at age 10 to 11 for females and at 12 to 13 for males.

It lasts about 2½ years.

Recommended Eating and Physical Activity Behaviors to Prevent Obesity

Limit or avoid consumption of sugar-sweetened beverages, such as soft drinks and fruit-flavored punches. Eat the recommended amounts of fruits and vegetables every day. Learn to eat age-appropriate portions of foods. Eat foods low in energy density such as those high in fiber and/or water and modest in fat. Eat a nutritious breakfast every day. Eat foods rich in calcium every day. Choose a dietary pattern balanced in recommended proportions for carbohydrate, fat, and protein. Eat foods high in fiber every day. Eat together as a family as often as possible. Limit the frequency of restaurant meals. Limit television watching or other screen time to no more than 2 hours per day and do not have televisions or computers in bedrooms. Engage in at least 60 minutes of moderate to vigorous physical activity every day.

Unfortunately, many adolescents, especially females, have calcium intakes below recommendations.

Low calcium intakes during times of active growth, especially if paired with physical inactivity, can compromise the development of peak bone mass, which is considered the best protection against adolescent fractures and adult osteoporosis.

During adolescence, males grow an average of 8 inches taller, and females, 6 inches taller.

Males gain approximately 45 pounds, and females, about 35 pounds.

Because people frequently judge others on appearance more than on character, overweight and obese children are often victims of prejudice and bullying.

Many suffer discrimination by adults and rejection by their peers. They may have poor self-images, a sense of failure, and a passive approach to life. both normal-weight and underweight children respond unfavorably to overweight bodies.

Ingesting more than 2 -3 cups of milk a day will lead to what?

Milk anemia

When does the heart disease process begin?

Much earlier than 30

Estimated daily kcalorie needs for active and sedentary children of various ages are shown in

MyPlate online resources for preschoolers (2 to 5 years) translate the eating patterns into messages that can help parents ensure that the foods they provide meet their child's needs

At a minimum, the school breakfast must contain:

One serving of fluid milk (either unflavored low-fat or flavored or unflavored fat-free) One serving of fruit or vegetable (no more than half of the servings may be 100% full-strength juice) One to two servings of whole grains; or one serving of whole grains and one serving of meat or meat alternatives

In today's consumer-oriented society, children have greater influence over family decisions concerning food

Parental guidance in food choices is still necessary, but teaching children consumer skills to help them make informed choices is equally important

The selection criteria for surgery to treat obesity in adolescents are based on recommendations of a panel of pediatricians and surgeons and include the following:

Physically mature BMI ≥40 or BMI >35 with significant weight-related health problems Limited success in a formal, 6-month weight-loss program Capable of adhering to the long-term lifestyle changes required after surgery

Television fosters overweight and obesity because it:

Requires no energy beyond basal metabolism Replaces vigorous activities Encourages snacking Promotes a sedentary lifestyle

The RDA (or AI) for most vitamins increases during the adolescent years

Several of the vitamin recommendations for adolescents are similar to those for adults, including recommendations for vitamin D.

Many food choice problems stem from the conflict between children's developmental stages and capabilities and parents who, in attempting to do what they think is best for their children, try to control every aspect of eating.

Such conflicts can disrupt children's abilities to regulate their own food intakes and to determine their own likes and dislikes.

In greater amounts, however, caffeine can cause symptoms associated with anxiety, such as sweating, tenseness, and inability to concentrate.

Teens with certain diseases such as diabetes, heart abnormalities, and mood disorders and those taking certain medications may encounter more severe consequences when drinking caffeine such as seizures, heart failure, and death.

Because blood cholesterol in children is a good predictor of adult values, some experts recommend universal screening for all children aged 9 to 11

The US Preventive Services Task Force, however, concludes there is insufficient evidence of the benefits and harms of lipid screening in children and adolescents to make a recommendation.

A true food allergy occurs when fractions of a food protein or other large molecule are absorbed into the blood and elicit an immunologic response.

The body's immune system reacts to these large food molecules as it does to other antigens—by producing antibodies, histamines, and other defensive agents.

Foods should be warm, not hot, because a child's mouth is much more sensitive than an adult's.

The flavor should be mild because a child has more taste buds, and smooth foods such as mashed potatoes or split-pea soup should contain no lumps (a child, may wonder what the lumps might be).

Nationwide, USDA's Smart Snacks in Schools regulations now require that competitive foods and beverages, including those sold in vending machines, offer students healthier options with more fruit, vegetables, dairy products, and whole grains

The foods and beverages must also meet standards for kcalories, sodium, fat, saturated fat, trans fat, and added sugars.

The main goal of obesity treatment is to improve long-term physical health through permanent changes in lifestyle habits.

The most successful approach integrates diet, physical activity, psychological support, and behavioral changes

Among the causes may be reactions to chemicals in foods, such as the flavor enhancer monosodium glutamate (MSG), the natural laxative in prunes, or the mineral sulfur; digestive diseases, obstructions, or injuries; enzyme deficiencies, such as lactose intolerance; and even psychological aversions.

These reactions involve symptoms but no antibody production. Therefore, they are food intolerances, not allergies.

Allergies may have one or two components.

They always involve antibodies, but they may or may not involve symptoms.

Concentrated sweets, including baby food "desserts," have no place in an infant's diet because

They convey no nutrients to support growth, and the extra food energy can promote obesity.

Children say they like colorful foods, yet they most often reject green and yellow vegetables in favor of brown peanut butter and white potatoes, apple wedges, and bread.

They seem to like raw vegetables better than cooked ones, so it is wise to offer vegetables that are raw or slightly undercooked, served separately, and easy to eat.

A sedentary girl of 15 whose growth is nearly at a standstill may need fewer than 1800 kcalories a day if she is to avoid excessive weight gain.

Thus adolescent girls need to pay special attention to being physically active and selecting foods of high nutrient density

An infant's brain weight is about 12 percent of body weight, whereas an adult's brain weight is about 2 percent.

Thus, an infant's brain uses relatively more glucose—about 60 percent of the day's total energy intake.

symptoms of impending anaphylactic shock:

Tingling sensation in mouth Swelling of the tongue and throat Irritated, reddened eyes Difficulty breathing, asthma Hives, swelling, rashes Vomiting, abdominal cramps, diarrhea Drop in blood pressure Loss of consciousness

Percentile graphs divide the measures of an infant population into 100 equal divisions so that half of the population falls at or above the 50th percentile and half falls below.

Using percentiles allows for comparisons among people of the same age and gender.

A lunch consisting of a hamburger, a chocolate shake, and french fries supplies substantial quantities of many nutrients at a kcalorie cost of about 800,

When they eat this sort of lunch, teens can adjust their breakfast and dinner choices to include fruits and vegetables for vitamin A, vitamin C, folate, and fiber and lean meats and legumes for iron and zinc

In conclusion, adult heart disease is a major pediatric problem.

Without intervention, some 60 million children are destined to suffer its consequences within the next 30 years

anaphylactic shock

a life-threatening, whole-body allergic reaction to an offending substance.

alpha-lactalbumin

a major protein in human breast milk, as opposed to casein (CAY-seen), a major protein in cow's milk.

breast milk banks

a service that collects, screens, processes, and distributes donated human milk.

fatty streaks

accumulations of cholesterol and other lipids along the walls of the arteries.

Signs of protein overload include

acidosis, dehydration, diarrhea, elevated blood ammonia, elevated blood urea, and fever.

The American Academy of Pediatrics recommends a vitamin D supplement for

all infants who are breastfed exclusively and for all infants who do not receive at least 1 liter (1000 milliliters, roughly 1 quart or 32 ounces) of vitamin D-fortified formula daily.

Compared with formula-fed infants, breastfed infants have a lower incidence of

allergic reactions, such as recurrent wheezing and skin rashes.

Much of the protein in breast milk is

alpha-lactalbumin, which is efficiently digested and absorbed.

An infant receiving goat's milk is likely to develop "goat's milk anemia,"

an anemia characteristic of folate deficiency.

botulism

an often fatal food borne illness caused by the ingestion of foods containing a toxin produced by bacteria that grow without oxygen.

The American Academy of Pediatrics recommends no television viewing before 2 years of age,

and limiting daily screen time to one hour between 2 and 5 years of age and 2 hours for older children to help prevent childhood obesity

Salivary flow, which normally cleanses the mouth, diminishes

as the infant falls asleep.

Approximately half a million children between the ages of 1 and 5 in the United States have blood lead concentrations above 5 micrograms per deciliter, the level

at which the Centers for Disease Control and Prevention recommend public health actions be initiated.

Adding DHA to standard infant formulas has no adverse effects; most standard formulas are currently fortified with

both DHA and arachidonic acid.

Honey and corn syrup should never be fed to infants because of the risk of

botulism

Consequently, inadequate protein intake has widespread effects, limiting

brain function, weakening immune defenses, and disrupting digestion and absorption.

Without sterilization and refrigeration, formula is an ideal breeding ground for bacteria.

breast milk is sterile, and its antibodies enhance an infant's resistance to infections.

DHA accumulation in the brain is higher in

breastfed infants than in formula-fed infants.

You can assess the growth of infants and children by

by plotting their measurements on a percentile graph.

What minerals are in breastmilk?

calcium iron (small amounts but bioavailability is high) zinc

In addition to being easily digested, lactose enhances

calcium absorption.

Prolonged sucking on a bottle of formula, milk, or juice bathes the upper teeth in a

carbohydrate-rich fluid that nourishes decay-producing bacteria.

During the first 2 to 3 days after delivery, the breasts produce

colostrum

The high efficiency of zinc absorption during the first few moths of breast feeding does not

compensate for its low concentration over time.

A woman who breastfeeds for a year can wean her infant to

cow's milk, bypassing the need for infant formula.

Fruit juice is a good source of vitamin C, but excessive juice intake can lead to

diarrhea in infants and young children.

The maternal antibodies in the breast milk inactivate disease-causing bacteria within the infant's

digestive tract before they can start infections

By the end of the first year, infant growth slows

during the second year, an infant typically gains less than 10 pounds and grows about 5 inches in length.

mild lead toxicity has nonspecific symptoms, including diarrhea, irritability, and fatigue.

exposure to lead must stop and treatment for lead poisoning must begin

nursing bottle tooth decay

extensive tooth decay due to prolonged tooth contact with formula, milk, fruit juice, or other carbohydrate-rich liquid offered to an infant in a bottle.

The term _______________ is sometimes used to describe the many problems associated with infants and children suffering from protein deficiency.

failure to thrive

DHA accumulation in the brain is greatest during

fetal development and early infancy

For example, rice cereal is usually the

first cereal introduced because it is the least allergenic. When it is clear that rice cereal is not causing an allergy, another grain, perhaps barley or oat is introduced

Ingredients for homemade foods should be

fresh, whole foods without added salt, sugar, or seasonings.

he younger the infant, the _______ the percentage of body weight is water.

greater

Long-term hunger impairs

growth and immune defenses in children

Breast milk oligosaccharides help protect

he infant from infection by preventing the binding of pathogens to the infant's intestinal cells

The combination of obesity and insulin resistance produces a cluster of symptoms, including

high blood cholesterol and high blood pressure, which, in turn, promotes the development of atherosclerosis and the early development of heart disease.

When is reduced fat or low fat cows milk acceptable and a recommended beverage to accompany a diet that supplies 30% of kcalories from fat?

ideally by 1 year

hyperactivity

inattentive and impulsive behavior that is more frequent and severe than is typical of others a similar age; professionally called attention-deficit/hyperactivity disorder (ADHD).

Contaminated formulas may cause

infections, leading to diarrhea, dehydration, and malabsorption.

For some infants, particularly those younger than 6 months of age, cow's milk may cause

intestinal bleeding, which can lead to iron deficiency.

With respect to nutrient needs, the nutrients needed earliest are

iron and zinc, then vitamin C.

milk anemia

iron-deficiency anemia that develops when an excessive milk intake displaces iron-rich foods from the diet.

In addition to breast milk or iron-fortified formula, infants can receive iron from

iron-fortified cereals and, once they readily accept complementary foods, from meats or legumes Caregivers can enhance iron absorption from iron-fortified cereals by serving vitamin C-rich foods with meals.

Infants and young children in vegetarian families should be given

iron-fortified infant cereals well into the second year. Mashed or pureed legumes, tofu, and cooked eggs can be added to their diets in place of meats.

All formula-fed infants should be given

iron-fortified infant formulas.

To achieve this goal, snacks and meals should include

iron-rich foods, and milk intake should be reasonable so that it will not displace lean meats, fish, poultry, eggs, legumes, and whole-grain or enriched products.

Cow's milk is also a poor source of

iron. Consequently, it both causes iron loss and fails to replace iron.

Not only is breast milk sterile, but

it also actively fights disease and protects infants from illnesses.

No single nutrient is more essential to growth than protein;

it is the basic building material of the body's tissues

Wheat cereal is offered last because

it is the most common offender of allergic reaction

The amount of protein in breast milk is less than in cow's milk, but this quantity is actually beneficial because

it places less stress on the infant's immature kidneys to excrete urea, the major end product of protein metabolism

Other common problems developed from Diabetes 2 evident by early adulthood include

kidney disease, blindness, and miscarriages

The newborn infant is a

lacto-vegetarian.

Soy formulas also use cornstarch and sucrose instead of

lactose and so are recommended for infants with lactose intolerance as well.

The rate of weight gain in the fetus is greater during the _______ ______ of gestation than at any other time.

last trimester

Early lesions may either progress or regress, depending on several factors

lifestyle behaviors Smoking,

Nutrient absorption in a premature infant, especially of fat and calcium, from an immature GI tract is .

limited

As for the lipids, breast milk contains a generous proportion of the essential fatty acids

linoleic acid and linolenic acid, as well as their longer-chain derivatives arachidonic acid and DHA.

The vitamin D in breast milk is

low; vitamin D deficiency impairs bone mineralization.

Ideally, a 1-year-old will sit at the table, eat

many of the same foods everyone else eats, and drink liquids from a cup, not a bottle

In the first year, an infant's birthweight

may triple, but over the following several years, the rate of weight gain gradually diminishes.

With further exposure, the symptoms become more pronounced, and children develop learning disabilities and behavioral problems.

more severe lead toxicity can cause irreversible nerve damage, paralysis, mental impairment, and death.

New standards specify how and when manufacturers must inform the FDA about

new formulas and changes to formulas, and require testing for contamination with harmful bacteria such as Salmonella.

Vitamin D deficiency is most likely in infants who are

not exposed to sunlight daily, have darkly pigmented skin, and receive breast milk without vitamin D supplementation.

preterm, low-birthweight infants are candidates for

nutrient imbalances. Deficiencies of the fat-soluble vitamins, and the minerals calcium, iron, and zinc are common.

Infant growth directly reflects

nutrient intake and is an important factor in assessing the nutrition status of infants and children.

The last trimester of gestation is also a time of building

nutrient stores.

complementary foods

nutrient- and energy-containing solid or semisolid foods (or liquids) fed to infants in addition to breast milk or infant formula.

For older adolescents, a BMI at the 95th percentile is higher than a BMI of 30, the adult obesity cutoff point.

obesity is defined as a BMI at the 95th percentile or a BMI of 30 or greater, whichever is lower.

breast milk may offer protection against the development

of allergies.

The carbohydrate component of breast milk also contains abundant

oligosaccharides, which are present only in trace amounts in cow's milk and infant formula made from cow's milk.

An estimated ___ out of ___ pregnancies in the United States results in a preterm birth.

one out of nine

Infants at high risk—those with severe skin rash or egg allergies—need medical approval and oversight, but for most other infants,

parents may start adding peanut-containing foods such as watered down peanut butter or peanut puffs to the diet in the same way oatmeal and mashed vegetables are introduced

The breast milk from several donors is

pooled to ensure an even distribution of all components, pasteurized to destroy bacteria, checked for contamination, and frozen before being shipped overnight to hospitals, where it is dispensed by physician prescription.

An infant cannot be allowed to sleep with a bottle because of the

potential damage to developing teeth.

New guidelines recommend introducing peanut-based foods early (between 4 and 11 months), rather than later (between 12 and 36 months) to

prevent peanut allergy.

Colostrum (like breast milk) helps

protect the newborn from infections against which the mother has developed immunity.

During early lactation, preterm breast milk contains higher concentrations of

protein and is lower in volume than term breast milk.

the best sources for zinc are

protein foods such as meats, poultry, seafood, eggs, and legumes. Zinc is not as well absorbed from legumes as it is from other protein foods, however.the best sources are protein foods such as meats, poultry, seafood, eggs, and legumes. Zinc is not as well absorbed from legumes as it is from other protein foods.

Ideally, by 1 year, the infant is obtaining at least two thirds of the total daily food energy from a balanced mixture of

protein foods, cereals, vegetables, fruits, and other foods.

What should a vegan family do to ensure they are providing enough nutrients in their infant/toddler's diet?

providing more energy-dense foods, such as mashed legumes, tofu, and avocado. Using soy formulas (or milk) fortified with calcium, vitamin B12 , and vitamin D and including vitamin C-containing foods at meals to enhance iron absorption

Fats high energy density supports the

rapid growth of early infancy and the essential fatty acids needed for normal growth and development

Federal laws mandating reductions in leaded gasoline, lead-based solder, and other products over the past four decades have helped

reduce the amounts of lead in food and in the environment in the United States.

For heart health, children older than 2 years of age benefit from the same dietary pattern recommended for older individuals—that is, a diet limited IN

saturated fat, trans fat, sodium, and added sugars, while rich in nutrients and age-appropriate in kcalories

To prevent allergies and to facilitate prompt identification should they occur, experts recommend introducing

single-ingredient foods, one at a time, in small portions, and waiting 3 to 5 days before introducing the next new food.

Researchers note that many other factors—______________________________—strongly predict a child's body weight.

socioeconomic status, other infant and child feeding practices, and especially the mother's weight

Canned vegetables are also inappropriate for infants because they often contain too much

sodium

What minerals is breastmilk not a good source for?

sodium (another benefit for the infant's immature kidneys) Fluoride

What types of milk are inappropriate for infants?

soy beverages (for adults) Nutritionally incomplete goat milk (low in folate)

Most infants allergic to milk protein can drink formulas based on

soy protein.

Some infants who are allergic to cow's milk protein may also be allergic to soy protein. For these infants,

special formulas based on hydrolyzed protein are available. The protein in these formulas is a mixture of free amino acids, dipeptides, tripeptides, and short-chain peptides that do not elicit an allergic reaction in most infants.

To resolve the problems surrounding hyperactivity, physicians often recommend

specific behavioral strategies, special educational programs, and psychological counseling. If these interventions are ineffective, they may prescribe medication.

Signs of adverse reactions to foods include

stomachaches, headaches, rapid pulse rate, nausea, wheezing, hives, bronchial irritation, coughs, and other such discomforts.

Too much protein in an infant can cause

stresses the liver and kidneys, which have to metabolize and excrete the excess nitrogen.

Breastfeeding may also reduce the risk of

sudden infant death syndrome (SIDS).

The top contributors of these empty kcalories are

sugar-sweetened beverages, dairy desserts (ice cream, frozen yogurt, sorbet, sherbet, pudding, and custard), grain desserts (cakes, cookies, pies, cobblers, donuts, and granola bars), pizza, and whole milk.

Special formulas have been designed to meet

the dietary needs of infants with specific conditions such as prematurity or inherited diseases.

The main carbohydrate in breast milk (and standard infant formula) is

the disaccharide lactose.

In the United States, the two dietary practices that have the most significant effect on an infant's nutrition are

the milk the infant receives and the age at which complementary foods are introduced.

The Food and Drug Administration (FDA) mandates

the safety and nutritional quality of infant formulas.

Children's appetites begin to diminish around 1 year, consistent with

the slowing growth.

Preterm infants face physical independence from

their mothers before some of their organs and body tissues are ready.

"Health-food beverages," such as rice milk, are inappropriate choices because

they lack the protein, vitamins, and minerals infants and toddlers need; in fact, their use can lead to nutrient deficiencies.

Products containing sugar alcohols such as sorbitol should also be limited because

they may cause diarrhea.

Although soy formulas support the normal growth and development of infants, for infants who don't need them,

they offer no advantage over milk formulas.

In the absence of a mother's own breast milk, donor milk may be the life-saving solution for fragile infants, most notably

those with very low birthweight or unusual medical conditions

The main purpose of introducing complementary foods is

to provide needed nutrients that are no longer supplied adequately by breast milk or formula alone.

During the second 6 months of life, recommendations for energy nutrients reflect

typical intakes from complementary foods as well as breast milk.

Parents or caregivers should not feed directly from the jar; instead, spoon the needed portion into a dish and feed from there, leaving the leftovers in the jar

uncontaminated by a used spoon.

adverse reactions

unusual responses to food (including intolerances and allergies).

Infant formulas contain no protective antibodies for infants, but in general,

vaccinations, purified water, and clean environments in developed countries help protect infants from infections.

Infants older than about 6 months of age present a greater challenge in terms of meeting nutrient needs by way of

vegetarian and, especially, vegan diets.

Many pediatricians routinely prescribe liquid supplements containing

vitamin D, iron, and fluoride infants receive a single dose of vitamin K at birth to protect them from bleeding to death.

The growth of vegan infants slows significantly when weaning from breast milk to complementary foods. Deficiencies of

vitamin D, vitamin , iron, zinc, and calcium have been reported in infants fed vegan diets

When children are forced to try new foods, even by way of rewards, they are less likely to try those foods again than are children who are left to decide for themselves

when children are restricted from eating their favorite foods, they are more likely to want those foods.

Nutrition efforts at schools are also undermined

when students can buy what the USDA labels "competitive" or "nonreimbursable" foods—meals from fast-food restaurants or a la carte foods such as pizza or snack foods and carbonated beverages from snack bars, school stores, and vending machines. When students have access to competitive foods, participation in the school lunch program decreases, nutrient intake from lunch declines, and more food is discarded.

The exact timing of when to feed an infant foods depends on the individual infant's needs and developmental readiness

which vary from infant to infant because of differences in growth rates, activities, and environmental conditions and which vary from infant to infant because of differences in growth rates, activities, and environmental conditions

gatekeepers

with respect to nutrition, key people who control other people's access to foods and thereby exert profound impacts on their nutrition. Examples are the spouse who buys and cooks the food, the parent who feeds the children, and the caregiver in a day-care center.

Infant formulas are fortified with ________ at levels higher than those found in breast milk. Thus, breastfed infants depend more on complementary foods to provide adequate ______ intakes than formula-fed infants do.

zinc zinc