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TRANSCRIPT
Toddler and Early
Childhood Nutrition
(Ages 1-5 years)KIM-ASHLEIGH MOSTERT
Learning Objectives
When asked by the presenter, participants will be able to identify
three community programs available to toddlers and
preschoolers
Given a scenario, participants will be able
to recognize three appropriate eating behaviors for toddlers.
Given a scenario, participants will be able
to determine one nutrition intervention to increase the number of
foods a young child will eat.
Toddler and Preschooler Characteristics
Toddler: Ages 1-3 years
Characterizations:
rapid development of gross and
fine motor skills
Increased ability to explore their
environment and language
Increasing independence
Preschooler: Ages 3-5 years
Characterizations:
Increasing autonomy
Experiencing broader social
circumstances
Increasing language skills
Expanding ability to control behavior
1 1
DRIs
Nutrition is key
during these years
to ensure full
growth and
development
potential
2
1
Growth Charts
Heights and weights are plotted
in gender-specific charts
Used to portray a pattern rather
than specific measurements
Identifies any deviations in growth
3
1, 3
Development of Skills - Toddlers
Decreased growth and appetite
Weaning
Internal hunger/fullness cues
Development ability to chew foods of different
textures
Learn to move tongue laterally and chew with rotary movements
12-18 months: can handle soft or chopped foods
18-24 months: can handle meat, raw
fruits/vegetables and multiple texture foods
1
1
Development of Skills - Toddlers
Intense need for independence
Self-feeding begins
Preferences and dislikes develop
Toddler sized
Portions
Snacks
1
1
Development of Skills - Preschoolers
Can now use forks, spoons and cups well
Spills and mess still occurs but not
intentionally
Good age to begin teaching about food,
food selection and preparation
Allow children to be involved
Reinforce good eating habits
Parents as role models
Image courtesy of Donnie Ray Jones at flickr.com
1
1, 4, 5
Development of Skills - Preschoolers
Children have an innate ability to self-regulate
caloric intake
No inborn mechanism to consume a well-balanced
diet
Food preferences, appetite and satiety develop
“picky” eaters
Preference for sweet and slightly salty taste, reject
sour or bitter taste
Image courtesy of Julian King at flickr.com
1
1, 4, 5
Temperament
Temperament: How the child tends to behave
“easy” ~40%
Adapts well, tires new foods
“difficult” ~10%
Irregular preferences, resistant
“slow to warm-up” ~15%
Slow to adapt
1
Food-Related Parenting Styles
Permissive: child eats what he wants
Authoritarian: control child’s intake via commands,
instructions, coercion
Authoritative: uses questions and reasoning in
attempt to shape and guide a child’s behavior 5
5
5
Common Nutrition Problems
Dental caries
Sleeping with a bottle
Constipation
Vitamin D Deficiency
Calcium deficiency
Iron deficiency9,10
6
1
7,8
Common Nutrition Problems
Food security
Children have a high nutrient need
Very vulnerable
Food safety
Foodborne illnesses
USDA guidelines for children
Obesity
1
1
Image courtesy of Merelize at Stockvault.net
Early Childhood Obesity
Early intervention is important
Overweight toddlers overweight adults
Prevention policies:
Growth monitoring
Physical activity
Healthy eating
Marketing and screen time
Sleep Image courtesy of Jack Moreh at Stockvault.net
11
12
“Adult” Diseases on the Rise
Type II Diabetes
Hypertension/Prehypertension
Underdiagnosed in toddlers/preschoolers
Cardiac problems
13,14
13,14
Nutrition Related Programs
Head Start
Early Head start
Child and Adult Care Food Program (CACFP)
Women, Infants, Children (WIC)
First 5 California
15,16
17
18,19
20
Head Start Programs
Administered by the Administration for Children and Families (ACF)
Within the Department of Health and Human Services (HHS)
Edibility usually based on income at or below the poverty line
Support children’s growth and development through:
Early learning
Health
nutrition
Family well-being
Child and Adult Care Food Program (CACFP)
Funded via grants to States
Located at various locations
Child care centers
Day care homes
Afterschool programs
Eligibility/pricing
<130% poverty line – free meals
130%-185% - reduced price meals
>185% - full price
Women, Infants, Children (WIC)
Supplemental program
Provides food, health care, nutrition education
Eligibility based on income
Must be pregnant, breastfeeding, or just had a
baby
Infants and children up to age 5
First 5 California
All children ages 0-5years are eligible
Various programs and resources throughout the community
Health
Oral health
Nutrition and Physical Activity
Quality early care and education
School readiness
Effective parenting
Case Study
Ava is a 2-year old living with her parents in low-income housing. During the week
Ava’s parents work full-time so Ava stays at a child care center where she usually
eats mac and cheese or PB&J for lunch. On the weekends, her parents enjoy
spending time with Ava but much of the time is spent running errands and catching
up on tasks around the house. Partly to appease Ava, her parents allow her to have
as much of her favorite snacks, apple juice from a sippy cup, crackers, and cookies, as she wants between meals. When the family sits down to have a meal together,
Ava usually doesn’t eat much and plays with her food. She complains of not liking
the food and wants something different. Ava becomes very fussy and wants to leave
the table. In an attempt to keep Ava at the table with them, her parents turn on the
TV and if that doesn’t quiet Ava, her mother offers to make another meal of Ava’s choice
adapted from Case Study 10.1 Nutrition through the Lifecycle p.2731
Questions?
References
1. Brown J, Isaacs J, Krinke UB, et al. Nutrition through the Lifecycle. 4th ed. Belmont, CA: Cengage Learning; 2011.
2. DRI Tables and Application Reports | Food and Nutrition Information Center. https://fnic.nal.usda.gov/dietary-guidance/dietary-reference-intakes/dri-tables-and-application-reports. Published 2011. Accessed September 20, 2016.
3. Growth Charts - Clinical Growth Charts. http://www.cdc.gov/growthcharts/clinical_charts.htm. Accessed September 20, 2016.
4. Nicklas T a, Baranowski T, Baranowski JC, Cullen K, Rittenberry L, Olvera N. Family and child-care provider influences on preschool children’s fruit, juice, and vegetable consumption. Nutr Rev. 2001;59(7):224-235. doi:10.1111/j.1753-4887.2001.tb07014.x
5. Patrick H, Nicklas TA. A Review of Family and Social Determinants of Children’s Eating Patterns and Diet Quality. J Am Coll Nutr. 2005;24(2):83-92. doi:10.1080/07315724.2005.10719448.
6. Voskuijl WP. Paediatric constipation and functional non-retentive faecal soiling. 2005. http://dare.uva.nl/record/1/239374. Accessed September 18, 2016.
7. Gartner L, Greer F. Prevention of Rickets and Vitamin D Deficiency: New Guidelines for Vitamin D Intake. Pediatrics. 2003;111:908-910.
8. Gordon CM, Feldman HA, Sinclair L, et al. Prevalence of Vitamin D Deficiency Among Healthy Infants and Toddlers. Arch PediatrAdolesc Med. 2008;162(6):505. doi:10.1001/archpedi.162.6.505.
9. Baker RD, Greer FR. Diagnosis and Prevention of Iron Deficiency and Iron-Deficiency Anemia in Infants and Young Children (0–3 Years of Age). Pediatrics. 2010;126(5).
10. Lozoff B, Jimenez E, Hagen J, Mollen E, Wolf A. Poorer Behavioral and Developmental Outcome More than 10 Years After Treatment for Iron Deficiency in Infancy. Pediatrics. 2006;105.
References
11. Paul IM, Bartok CJ, Downs DS, Stifter CA, Ventura AK, Birch LL. Opportunities for the primary prevention of obesity during infancy. AdvPediatr. 2009;56(1):107-133. doi:10.1016/j.yapd.2009.08.012.
12. Early Childhood Obesity Prevention Policies: Goals, Recommendations, and Potential Actions. Washington, DC; 2011.
13. Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents.; 2005. https://www.nhlbi.nih.gov/files/docs/resources/heart/hbp_ped.pdf. Accessed September 20, 2016.
14. Hansen ML, Gunn PW, Kaelber DC, et al. Underdiagnosis of Hypertension in Children and Adolescents. JAMA. 2007;298(8):874. doi:10.1001/jama.298.8.874.
15. Early Childhood Health and Wellness: Nutrition. https://eclkc.ohs.acf.hhs.gov/hslc/tta-system/health/nutrition. Published 2016. Accessed September 24, 2016.
16. Head Start Program Facts Fiscal Year 2015. https://eclkc.ohs.acf.hhs.gov/hslc/data/factsheets/docs/head-start-fact-sheet-fy-2015.pdf. Published 2016. Accessed September 24, 2016.
17. Child and Adult Care Food Program (CACFP). http://www.fns.usda.gov/cacfp/why-cacfp-important.
18. Women, Infants and Children Program. http://www.cdph.ca.gov/programs/wicworks/Pages/default.aspx/. Published 2016. Accessed September 24, 2016.
19. About WIC | Food and Nutrition Service. http://www.fns.usda.gov/wic/about-wic.
20. First 5 California. http://www.ccfc.ca.gov/.