Infant, Child and Adolescent Nutrition

A Practical Handbook

Judy More

• Publisher: CRC Press
• Year: 2021
• ISBN:
  9781000369755
• Edition: 2
• Topic: Médecine
• Subtopic: Nutrition, diététique et bariatrie

Infant, Child and Adolescent Nutrition: A Practical Guide, Second Edition, is an evidence-based, practical guide introducing readers to the theory behind optimal child nutrition. Containing practical advice on how to put that theory into practice, this new edition facilitates learning through case studies, key points, and learning activities. Divided into seven sections, chapters cover prenatal nutrition and nutrition throughout childhood from preterm babies to adolescents up to the age of 18.

Sections throughout focus on topics ranging from nutrient requirements, balanced eating patterns and common problems to cultural influences on food choices and guidelines on assessing growth and dietary intakes. Prevention and management of obesity and allergies are covered in separate chapters. The first 1000 days are given particular consideration with chapters on diets for preconception, pregnancy, milk feeding and complementary feeding during infancy. The chapter on nutritional treatments covers common conditions such as diabetes and Crohn's disease, as well as more intricate feeding regimes and tube feeding required for children with rarer diseases and syndromes.

New in this second edition are:

· Changes in in food allergy prevention and oral immunotherapy treatments.

· Causes and management strategies to deal with fussy and selective eating in toddlers.

· The importance of iodine in diets before and during pregnancy to improve children's cognitive abilities.

· Updated recommendations on vitamin D supplementation.

This second edition is an essential reading for students taking courses in nutrition and paediatric healthcare. It serves as a useful reference for individuals responsible for the nutritional intakes of children in primary care and community settings including early years practitioners, midwives, health visitors, school nurses and governors, social workers, paediatricians and general practitioners.

About the Author

Judy More BSc, RD, RN is a Paediatric Dietitian, Honorary Lecturer at the University of Plymouth, UK and Director of Child-nutrition.co.uk Ltd, London, UK.

Section 1

Nutritional requirements and healthy eating

1 Nutritional Requirements

2 Principles of a Balanced Nutritious Diet for Children Over 1 Year

3 Social and Cultural Influences on Food Choices

1

Nutritional requirements

Summary

• Nutritional requirements increase as children grow and are theoretically defined for different age groups of children.

• Reference Nutrient Intakes (RNIs) are used to define the average daily amount of protein and each essential micronutrient that different age groups of children need.

• Energy requirements depend on weight and activity and are theoretically defined by Estimated Average Requirements (EARs) for each age group.

• There are no set fluid requirements for children over 1 year of age as the kidney functions well and can cope with varying amounts of fluid intake; however, dehydration should be avoided by offering 6–8 drinks per day.

• Different nutrients have different functions in the body and a combination of all the nutrients is required to maintain health and sustain growth and development.

Food and drinks provide water, energy and nutrients that are required for growth, development, health and a strong immune system to fight infection. When a diet is balanced and nutritious, it provides adequate amounts of water, energy and all the nutrients.

In general, energy and nutrient requirements increase with age as children grow, but to support rapid rates of growth in infancy, there are some exceptions: daily calcium, iron and phosphorus requirements are higher in infancy than in the following 3 years.

Water

Water makes up about 75 per cent of a newborn infant’s body weight and about 70 per cent of that of a toddler. Throughout childhood, this percentage slowly decreases to about 60 per cent of an adolescent. Infants and young children have a larger skin area in relation to their size than older children and can dehydrate very quickly, and, so, need regular fluid intakes throughout the day.

Infant milk feeds are about 90 per cent water and a young infant’s water intake can come entirely from milk feeds. Once solid food is introduced, some water will be obtained from food as well as drinks. Older children obtain about 60 per cent of their water intake from food and the remaining 40 per cent is from drinks. The kidneys can cope well with small or large intakes of fluid from around 4–6 months of age so there are no set fluid intakes but as a guide:

Daily average fluid requirements for infants and children advised by Dietetic Department Great Ormond Street Hospital for Children NHS Trust 2018 are:

• 0–6 months: 150 mls/kg body weight;

• 7–12 months: 120 mls/kg body weight;

• Children over 10 kg: 100 mls/kg for first 10 kg, +50 mls/kg for next 10 kg, + 20 mls/kg thereafter – up to about 2.5 L/day maximum.

Energy

Energy requirements in children must provide for (Wiskin et al. 2011):

• basal metabolic rate, which is around 60–70 per cent of energy expenditure;

• physical activity, which varies considerably and can be up to 30–40 per cent of energy expenditure;

• growth – the energy required varies throughout childhood as the rate of growth changes, as described in Chapter 4.

Throughout childhood, energy requirements increase as weight increases and individual requirements vary specifically with activity levels and growth rate. Estimated average energy re...