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Barbara Robinson, MPH, RD, CNSC
Johnson and Wales University
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Length of gestation, other!s "re#"regnan$y %eight, health and si&e of the"la$enta in'(en$e infant!s birth %eight
)fter birth, the infant!s gro%th is in'(en$edby geneti$s and no(rishent
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Infancy Rapid growth:
~9 in. in first year
Fetal growthfactors- likehormones
Childhood Slow but steady growth
(2-3 in./year)
Growth hormone
dolescence Pubertal growth spurt -peak elocity:
!oys: ~4." in.#yr
$irls: ~% in.#yr
&e' hormones(testosterone andestrogen) * growthhormone
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*nfants ad+(st intae to eet energy needs
Sensitivity to h(nger and satiety $(es
Monitor gains in %eight and length over tie
-or(la#fed infants $ons(e ore $als than
breast#fed infants
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Higher "er g %eight than for ad(lts be$a(seof ra"id gro%th DR*. /01g2g2day
Re$oendations based on $o"osition ofh(an il
H(an il or infant for(la3 s(""leental"rotein so(r$es beginning age 456 onths
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47#178 of $alories
9ssential fatty a$ids :9-); in h(an il vs0infant for(la. linolei$ and linoleni$ a$ids
9-) re8 of total $als
Long#$hain "oly(nsat(rated fatty a$ids3
vis(al a$(ity and ne(ral develo"ent0)ra$hidoni$ and Do$osahe?aenoi$ a$ids:)R),DH);
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Maternal reserves gone in ter infants by 4 os0
*nfant iron de@$ien$y $oon $ognitiveeAe$ts
S(""leent %2 iron#forti@ed $ereal
or forti@ed for(la by 4 to 6 onths
))P. Revised re$s. feed
eat earlier. by 1# os0
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Mineral Requirements
Zinc: Like Iron, is found in meats
Infants often deficient
tandard M!I does not contain minerals
"alcium: more is retained from #reastmilk t$an from infant formula
%#ioa&aila#ilit'(
)
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-ood of $hoi$e for infants
)""ro"riate energy n(trients :e?$e"tions;
Contains i(ne fa$tors Hel"s "revents diarrhea and otitis edia
)llergies to h(an il "rotein are rare##$aveat. other!s diet
DH)
)tta$hent and bonding
Maternal health bene@ts
1*
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Se$retory i(noglob(lin ). an antibodythat "lays a$riti$al role in ($osal i(nity
La$toferrin @ghts against E* infe$tions.
Liits availability of iron in theintestine for ba$teria to feed on
Lyso&yes. 9?ert strong in'(en$e on ty"e of ba$teria%hi$h inhabit the intestinal tra$t
Lactobacillus bifdus. Hel"s ae B vitains, andinhibits gro%th of ba$teria, in$l(ding ore "athogeni$$olon ba$teria, s($h as salonella0
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http://en.wikipedia.org/wiki/Antibodyhttp://en.wikipedia.org/wiki/Antibody7/25/2019 Lifespan Infancy
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DHA levels o breast milk vary with thediet o the breasteeding mother0
*n a Danish st(dy, eating @sh2@sh oilin$reased the ao(nt of DH) in breast il0
Fhe il of Nigerian %oen, %hose diet
is ri$h in n(ts, has a high oega#> fat$ontent0
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Bene@ts. $ognitive develo"ent, gi i(nity"revention of astha and over%eight# aybe
))P s(""orts e?$l(sive breast#feeding for 6onths and breast#feeding "l(s solid foods forthe ne?t 6 onths
Ne% resear$h on allergy "revention ight leadto $hange in re$oendations
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Protein. ty"e aAe$ts digestibility.
567.47 ratio of %hey to $asein5G7.7 ratio of %hey to $asein for $o%!s il
Whey fors softer $(rd, is digested ore
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Based on $o%!s il protein Co% il "rotein is heat treated
Soy alternatives not (sed as often as "revio(sly
Reg(lated by -D) thro(gh the *nfant -or(la)$t, /I1
De$rease in aneia %ith (se of iron#forti@edfor(las
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Co%!s il and iitation ils notre$oended before age / year :$aveat;
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Cereal forti@ed %2 ele$trolyti$ally red($ed iron
Jars for fr(its and vegetables "rovide$arbohydrates and vitains ) and C
htt".22%%%0nydailyne%s0$o2life#style2health2baby#food#gro$ery#store#good#infants#re$oended#daily#s(""ly#inerals#st(dy#arti$le#/0/7667II
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*ss(es %ith i?ed foods and desserts
Hoe#"re"ared infant food. avoid addedsalt and s(gar (nder age 5 /7 onths
Kal(e of 'avors in foods# s"i$es, et$0
htt".22"ediatri$s0abo(t0$o2$s2agesstages2a2nineonths0ht
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9arly feeding "atterns. *nitially every Gho(rsBy G#4 onths . 4 o(n$es every 4 ho(rs
and no night feed
Satiety C(es
Develo"ent of feeding sills.
Paler and "in$er gras"U" and do%n (n$hing at 4#6onthsRotary $he%ing at #I onths
1)
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+,2*
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)ddition of foods. Solids, Co"leentary foods, S"oon feedings,Beiost :foods other than il or for(la;, *nfant foods
WeaningO breast or bottle to $("
Preventing $aries :$avities;
-eeding older infants. ty"e of food, serving si&e,for$ed feeding, environent
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Weight
Length
Head Cir$(feren$e
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+%Q/>1S76>
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+4Q/>1S761
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Lo% %eight and noral height
a$(te n(tritional de@$ien$y
Lo% height for age $hroni$
n(tritional de@$ien$y
Wasting vs. stunting
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*naderd"er$entile for age or
$rossing do%n%ard t%o "er$entiles onthe gro%th $hart %ithin si? onths orless
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Ero%th fail(re
Develo"ental delay
De$reased $ognitive ability
)"athy, irritability :learning, eating
De$reased strength and "hysi$al a
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Fo $o"ensate. need to "rootea$$elerated gro%th velo$ity
in$reased $alories and
"rotein for anabolis
in$reased i$ron(trients s($h as$al$i( :bone;, iron, :blood
vol(e; &in$ :DN) synthesis; 28
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*nade
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Se$ondary Maln(trition
D(e to disease or disability
%,
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*"aired ability to ingest.$he%ing or s%allo%ing
*"aired digestion2absor"tion
Chroni$ illness
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Norative data is available and sho(ld be(tili&ed0
Data is only (sef(l %hen a$$(ratelyobtained (sing re$oended ethodology
S($$essive eas(res of %eight and height"lotted on a gro%th $(rve have far oreval(e than a single eas(re
%+
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%%Q/>1S76>
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%4
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Preat(re *nfants.
Chronologi$al )ge #N(ber of WeesPreat(re Corre$ted )geO
Do%n Syndroe
F(rner Syndroe
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Re$(bent length. eas(red for @rst >years on a length board
Standing height on stadioeter
thereafter
%
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o S(""leent all
o infants %2 477 i( Kit D
o Breast feed to /G onthso )fter breastil, iron#forti@ed
for(la
o *ron#enri$hed foods by :4#6 os;
3)
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Aer eats earlier
*nfants 6onths don!t need %ater, +(i$e
No lo% fat il age t%o0
Liit +(i$e to 4# 6 o(n$es# oAer only in$(", not bottle
+*
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htt".22%%%0$olbertnation0$o2the#$olbert#re"ort#videos2>/7/I2+an(ary#/>#G7//2tho(ght#for#food###fr(it#"o($h##doritos#ad###s("er#big#g(l"
+1
http://www.colbertnation.com/the-colbert-report-videos/371019/january-13-2011/thought-for-food---fruit-pouch--doritos-ad---super-big-gulphttp://www.colbertnation.com/the-colbert-report-videos/371019/january-13-2011/thought-for-food---fruit-pouch--doritos-ad---super-big-gulphttp://www.colbertnation.com/the-colbert-report-videos/371019/january-13-2011/thought-for-food---fruit-pouch--doritos-ad---super-big-gulphttp://www.colbertnation.com/the-colbert-report-videos/371019/january-13-2011/thought-for-food---fruit-pouch--doritos-ad---super-big-gulphttp://www.colbertnation.com/the-colbert-report-videos/371019/january-13-2011/thought-for-food---fruit-pouch--doritos-ad---super-big-gulphttp://www.colbertnation.com/the-colbert-report-videos/371019/january-13-2011/thought-for-food---fruit-pouch--doritos-ad---super-big-gulphttp://www.colbertnation.com/the-colbert-report-videos/371019/january-13-2011/thought-for-food---fruit-pouch--doritos-ad---super-big-gulphttp://www.colbertnation.com/the-colbert-report-videos/371019/january-13-2011/thought-for-food---fruit-pouch--doritos-ad---super-big-gulp7/25/2019 Lifespan Infancy
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Kitain D. S(""leents re$oended forALLALL infants, es"e$ially those %ith dar sin and es"0 "reat(re infants
))P in$reased re$oendation to 477
Kitain Q. Heorrhagi$ disease of the ne%born3"reventive in+e$tion at birth for all ne%borns
+3
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*N-)NF C)S9 SFUDT
++
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Breast#feeding.
/0 9?"oses infants to variety of'avors that re'e$t aternal diet
G0 )llo%s infant to $hoose o%n"ortion si&es
+5
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Casein hydrolysates N(traigen
Pregestiil
)lient(
)ino )$id#Based
Neo$ate 9le$are
N(traigen ))
+6
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Faes (" soe of $hild!s tie and attention
B(t ee"s it!s "la$e as one i"ortant area in life
-ood "referen$es area #learned$ behavior.
Children are able to accept a wide variety offoods with familiarity being a majordeterminant of food preferences. Satter
Birch L. !evelopment of food acceptance.!ev."sych. #$$%&'(&)#)
4
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9ating is a LearnedO Behavior
Learning %hat to eat is a develo"ental"ro$ess and o$$(rs in $onte?t of a failyenvironent
9ating . a$tivity that is re"eated over and overagain
-eeding behaviors and "referen$es are sha"ed
thro(gh this re"etition
+8
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D(ring the early years, failiesestablish feeding and "arenting"atterns that "ersist thro(gh the
$hild!s gro%ing (" years0
0
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Adults are responsible for
what when and where achild eats but ultimatelythe child is responsible for
how much and whetherhe*she eats at all
5*
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Parents are a $hild!s @rst tea$hersO
Windo% of o""ort(nity in develo"ent ofinfant and $hild food "referen$es
9Ae$tive "arenting in early years .
"ositive i"a$t later on
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-ood "referen$es re"etition Child initially dislies healthy foods Parent sho(ld
not be dis$o(raged
Contin(e to oAer healthy food in $onte?t of "leasantfeeding e?"erien$e
higher n(ber of food e?"os(res ne$essary in$hildren aged 4 to 1 years than in $hildrenaged G years
5+
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Can Parents Fae )dvantage of Fhis
No g(arantee a $hild %ill lie a given food
B(t, early, $onsistent e?"os(re to a variety ofhealthy foods a""ears to be a $riti$al fa$tor infostering "referen$e
Fae hoe essage. Proote and e?"ose the$hild to healthy eating in the 9)RLT stages ofdevelo"ent
Birch and Marlin, 1982
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Parental odeling. Siblings2"eers2"arents role odels
en$o(rage tasting ne% foods
Prote$tive -a$tors. eating 6V faily dinners"er %ee, eating breafast :all age gro("s;
R9M9MB9R. $hildren are (nable to eat
foods not available to the
Rosenran&, Ri$hard R Model of the hoe food environentand $hildhood obesity0O +utrition ,eviews0 Kol0 66:>;0 :G77;.
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When given the o"tion, the $hildoften $hoose the L9SS healthy one 9?a"les.
)""le vs0 a""le Po" Fart
Mil vs0 sodaTog(rt vs0 +ello
lo% fat "o"$orn vs0 "otato $hi"s Baed S%eet "otato vs0 fren$h fries
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"/
)nte$edents to eating behaviors in$hildhood
More food e?"os(res needed at 4#1 yrs ofage than at G yrs of age.
To(nger $hildren are ore liely to a$$e"t ne% 'avorsBirch and -arlin #$'. / don0t li1e it / never tried it&e2ects of e3posure on two
year old children0s food preferences. Appetite 4)454(%.
G77G st(dy. year#old $hildren "referred thesae foods that they lied at age 4.
S(ggests food "referen$es are ore diX$(lt to $hange as$hildren be$oe older# d(rability
61inner Carruth Bounds and 7eigler '%%'. 0
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;oddlers have poor eating habits
St(dy "o"(lation. >,777 /#G year olds
I#// os0 of age. I8 daily fren$h fries/I#G4 os0. G78 daily fren$h fries
5>78 of $hildren G4 os. no fr(its or
vegs
!evaney B et al.
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0,
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/8 had +(i$e before 6 os0
=>78 of ids /1 G4 os had a s(gary fr(itdrin ea$h day and 5 /78 had soda
Children aged /#G years re
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/0 )(thoritative. sensitivity, eotional %arth,
involveent and e?"e$tations for self $ontrol anddis$i"line
Eive and tae bet%een "arent and $hild. higher a$adei$a$hieveent, in$reased self#reg(latory ability, ore
ada"table
G0 )(thoritarian. high deands for self#$ontrol, lo% levelsof sensitivity, inial eotional s(""ort
)sso$iated %ith "oorer o(t$oes 62
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>0 Perissive. lo% e?"e$tations for self#$ontrol2dis$i"line, high sensitivity2%arth Children ore self#$on@dent b(t lo%er
levels of self#$ontrol
40 Negle$tf(l. lo% e?"e$tations for self#$ontrol2dis$i"line, lo% sensitivity2%arth Unfavorable $hild o(t$oes, higher rates
of de"ression2soing2"oor s$hoola$hieveent
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) $obination of sensitivity ande?"e$tations for self#$ontrol see to$reate an o"tial environent for $hildren%ith res"e$t to liiting over%eight ris
Parent#$hild $oo"eration and "arental%arth in$reased $hildren!s ability toreg(late negative eotions
9n$o(rage listening to internal h(nger$(es and "roote nat(ral desire to
e?er$ise 6+
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68 > yrs03 (" to I78 in soe Head StartProgras
))P . no% lo$al '(oride $on$entrations Karying re$oendations for
6 os > yr >#6 yr
6 yr0 /6 yr0No '(oride 6 os0
Baby bottle tooth de$ay. "rolonged $onta$t ofbottle ni""le to o(th, li
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Recommended dietary fluoride supplement* for agFluoride concentration in community drinking water
0.6 ppm
ge*-6 mont$s .one .one .one
6 mont$s-3 'ears */25 m0da' .one .one
3-6 'ears */5* m0da' */25 m0da' .one
6-16 'ears 1/* m0da' */5* m0da' .one
luoride
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Fhe (se of foods and li
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Fhan yo(
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