Infant and Childhood Nutrition

Feeding changes during childhood (6)

-A three year old child needs 1,400 calories •Infants need to eat 35-50 calories per pound but toddlers need to eat 35-40 calories per pound •3 years old= 35 pounds x 40 calories/pound = 1,400 calories •Growth slows by 30% after the first year -For children, it is their foundational years of eating -Their appetites and attitudes will wax and wane -Meal planning is important -Avoid power struggles •Both the parent and the child play an important role -According to the Feeding Infants and Toddlers Study, 1/4 children do not get enough fruits and vegetables

Allergies (2)

-Allergies can be hereditary •If the mother is allergic, she should ensure that there is no cross contamination of foods she is consuming with foods that she is allergic to because antibodies can be transferred from the mother to the baby -Most kids will grow out of food allergies

WC goods and services (4)

-Checks to buy healthy foods -Education sessions -Breastfeeding help -Referrals •To medical providers for pediatric and perinatal services •To community services, such as food banks, legal services, substance abuse treatments, shelters

Effects of TV on children's eating habits (2)

-Children watch an average of three hours of advertisements per week -Children from families with a high television use have altered diets •They consume an average of 6% more of their total daily energy intake from meats •5% more from pizza, salty snacks and sodas •5% less of their energy intake from fruits, vegetables, juices compared to families with low television use

WIC foods (3)

-Classified based on their nutrient contents -Provide: protein, vitamin a, vitamin c, calcium, iron. These nutrients are needed by pregnant women and young children -WIC foods are intended to supplement the participant's diet, not meet all of his or her daily requirements

WIC coverage (2)

-Covers: women who are pregnant, breastfeeding, or postpartum but not breastfeeding; infants under 12 months old; children under five years of age -WIC serves low and moderate income families •Income less than 185% •Families with parents who work may be eligible •Immigration status is not considered when determining WIC eligibility

Tips for picky eaters (5)

-Get kids involved Ex: food naming, cookie cutter shapes, "try a new food" charts and games -Know when to try new foods Ex: beginning of a meal, limited pressure, role modeling, neophobia -Give choices, within reason -Bring kids shopping and allow them to select foods from the store -Family meals

Best part of community nutrition and breastfeeding

-Helping people feel empowered is a successful facet of community nutrition -The mother feels empowered because her ability to feed her child enables her to quell a screaming kid

Human milk vs. iron supplementation (4)

-Human milk is the preferred source of food for infants up to 6 months -Infant formulas have more iron than breast milk but by using breast milk with less bioavailability of iron, infants will improve their ferritin receptors in the small intestine and improve their ability to extract iron from food on their own -Hematocrit is the measure for iron supplement -WIC may or may not advise iron supplementation based on whether or not the nutritionist is up to date on the most recent research

Signs and symptoms of insufficient milk supply (5)

-Infant lethargy and/or irritability -Jaundice -Infrequent defecating or urinating -Failure to gain weight -Excessive weight loss (7-10% of birth weight)

Introduction of solid foods info (3)

-Introduction of solid foods is for exposure and developing the palate. It is not for caloric substitution -Aids in the prevention of allergies -The introduction of grain cereal first is popular in the U.S. but there has been a shift away from this because of lead and arsenic related recall problems

When should parents introduce solid foods to the child? (4)

-Parents should wait until child is six months old to introduce solid foods Infants are physically ready for solid foods when: -Their birth weight has doubled -They can sit with support and movements -Their tongue thrust is diminished The tongue thrust reflex prevents children from choking. When a substance is placed on the tongue, it automatically extends outwards rather than backwards into the mouth. This is a breastfeeding response because the tongue extends out toward the nipple

When does planning for breastfeeding begin? (4)

-Planning for breast feeding begins in the delivery room -Immediate skin to skin contact between the mother and child is important because it stimulates prolactin to produce colostrum (pre-milk) -The infant needs breastfeeding immediately because it is tired from travel to the outside world •Also, the infant will want to sleep approximately 30 mins after being born so that will delay the next chance to breast feed by several hours -Non-white mothers are more likely to initiate and continue breastfeeding

Introduction to infant growth and nutrition (6)

-Rapid growth and development •Growth is an indication that children, especially infants, have exceptionally high nutrient needs •Normal growth is a strong indicator of nutritional adequacy and overall health of an infant -Weight doubles by 4-6 months and triples by 12 months -Height increases 50% in one year -Head circumference increases by 30% -Length and head circumference are more sensitive measures than weight for assessing a baby's growth and nutritional status -Infants need more of almost everything compared to adults in terms of ratio to body weight •Vitamin D recommendations for an infant are almost seven times greater per pound of body weight than those for an adult male •Pound for pound, niacin recommendations for an infant and adult male are similar

Goals of healthy people 2020 for children and adolescents (4)

-Reduce the number of C-sections among low-risk women -Reduce the rate of fetal deaths at 20 or more weeks gestation -Reduce the occurrence of FAS -Increase the portion of adolescents that had a wellness checkup in the past 12 months

Challenges to implementing quality school nutrition programs (5)

-Students have developed a preference for soft drinks, fast foods, and salty snacks -Mixed messages are sent by school personnel -There are limitations to school food preparation and serving space -Inadequate meal periods -Lack of education and standards for school service directors

Teen food choices (4)

-Teens eat more meals and snacks away from home •Energy dense foods •Fast food visits account for 31% of all food eaten away from home and make up 83% of their visits to restaurants -Snacks provide 1/4 of their daily energy •Skip meals -Highly influenced by peers -There are several common concerns •Obesity •Fad diets •Anemia •Eating disorders •Substance abuse

Mother's nutritional needs during lactation (4)

-The diet should supply at least 1,800kcal per day •Milk production requires 800kcal per day -Based on an average milk secretion of 750-800mL/day, the nursing mother needs 640kcals/day extra the first six months and 501kcals/day extra the second six months -The recommendation is 500kcals/day extra to promote loss of fat from pregnancy •Weight loss of 1 to 4 lbs. per month in the lactating mother is appropriate -An intake of less than 1,500kcals per day will inhibit milk production

Childhood obesity (6)

-The number of overweight children has dramatically increased -Overweight-Above the 85th percentile -Obesity-Above the 95th percentile -Severe Obesity-Above the 99th percentile -There are a characteristic set of physical traits related to growth •Begin puberty earlier •Stop growing at a shorter height than peers •Greater bone and muscle mass -There are other physical health signs •Blood lipid profile •Type II diabetes •Respiratory diseases

Community programs for childhood nutrition (2:5,1)

1) Black Panthers Free Breakfast Program -Began in 1969 in Oakland, California with 11 children -The rationale for beginning it was community improvement -There was a research link between poor nutrition and poor scholastic performance -It grew in popularity -Served as the foundation for the National School Breakfast Program 2) Action for Healthy Kids: Provide all children PK-12 with culturally sensitive physical activity and healthy eating education programs

Community nutrition programs to support lactation (2:3,3)

1) Commodity supplemental food program -Supplements the diets of pregnant and breastfeeding women, infants and children up to age 6 -Utilizes commodity foods in the form of food packages -Available to state agencies and Indian Tribal Organizations 2) WIC -Established as a pilot program in 1972 and made permanent in 1974 -It is an extension/supplemental program to SNAP -The Food and Nutrition Service of the USDA administers WIC at the federal level

Nutrition related health concerns during infancy (3:3,2,5)

1) Feeding bottle tooth decay -Clean the infant's gums twice a day using a washcloth on the gums and a soft toothbrush with water on the teeth -Introduce a drinking cup at 6 months, and provide juice in a cup instead of a bottle. -Limit juice to 4-6 oz. per day 2) Iron deficiency anemia -Caused by inadequate dietary iron intake, not enough iron fortified solid foods, too much milk feeding -There is mandatory federal testing for anemia at 1 yrs. old 3) Failure to thrive -This is a term used when a decrease or low physical growth is observed over time using a national standard growth chart -Generally diagnosed when growth is less than the 5th percentile -There are different classifications of failure to thrive -Organic-Diagnosed medical illness is the basis -Non Organic-Not based on medical illness. This is a behavior-based problem that is usually related to neglect of the child -Mixed =Poor feeding or feeding skills disorder Dysfunctional family interactions and difficult parent-child interactions Lack of preparation for parenting and/or no support Ex: MSPI + parent just switches kid to water (behavior)

School meal programs for children (6:6,5,2,1,3,3)

1) National School Lunch Program -1946, USDA -Cash subsidies and commodities are provided to schools -Schools must serve meals that meet specified nutritional guidelines and must offer free or reduced price meals to eligible students -< or equal to 130% of poverty guidelines = no cost 130-185% of poverty guidelines = reduced price -SNAP families automatically eligible -In 2007, 30.5 million children participated 2) National School Breakfast Program -1966, USDA -Cash subsidies are provided to school -< or equal to 130% of poverty guidelines = no cost 130-185% of poverty guidelines = reduced price -10.1 million children participate each school day Over 1.7 billion meals served in 2007 -Development of this program was spearheaded by the Black Panther Party 3)After School Snack Program -Gives children nutritional enhancement and encourages them to participate in supervised activities filled with learning opportunities -The USDA reimburses the schools for the snacks 4) Special Milk Program -Provides milk to children in schools, childcare institutions, and eligible camps that do not participate in other federal child nutrition meal service programs 5)Summer Food Service Program for Children -Provides meals to all eligible participants, which are those below 185% of the poverty guidelines and children up to 18 years over the summer -Can provide two meals daily -Weaknesses: cold bagged lunches with lots of cheese; children must obtain transportation to the school to receive the lunch; most schools only offer lunch programs over the summer not breakfast 6) Child and Adult Care Food Program -Serves nutritious meals and snacks to eligible children and adults who are enrolled at participating childcare centers, daycare homes, and adult daycare centers -CACFP is administered through state grants by USDA's Food and Nutrition Service (FNS) -Participant eligibility for free or reduced price meals must be determined by the institution

Why are BMI charts downward sloping?

BMI charts for child growth slopes downwards because between the ages 2-5, children grow taller and become relatively leaner. Overall, BMI decreases during preschool years

Why is supplementation bad?

If the mother has a deficiency but does not supplement, she will feed her baby every two hours, which stimulates the production of more milk. If the mother supplements, the mother will only feed every six hours because she is supplementing so her production will decrease

What palates do children develop first?

Infants develop their sweet palates first. There is a natural preference for sugar Infants are usually eating to be eating solid foods because eating is a novelty to them. They can be fed band foods and vegetables and will eat it

Major strength of WIC

WIC is community oriented and can immediately adjust for needs of the community