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Nutrition of infants, children & adolescents. Dr . Ali M. Bakheit. I ntroduction. Childhood nutrition influence adult health. Intrauterine nutrition influence adult morbidity & mortality. Child nutrition should be taken seriously.
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Nutrition of infants, children & adolescents • Dr . Ali M. Bakheit
Introduction • Childhood nutrition influence adult health. • Intrauterine nutrition influence adult morbidity & mortality. • Child nutrition should be taken seriously. • Good dietary habits & adequate physical activity.
Infants nutrition • Totally dependant on others. • Very rapid growth. • High nutritional needs. • Children with special needs fed with minor adjustments.
Infants growth • Weight doubled in 4-6/12, trebles in 1 year, at 5 years =2 x wt at 1 year. • Standard growth curves. • Poor nutrition affect brain growth. • Emotional factors & stress affect growth.
Nutrition and development • Mother milk provides nourishment, immune protection and developmental stimuli. • Formula milk ? • At 5-6/12 infant can bite. • At 6-7/12 can chew some food. • At 1 year has 8 teeth can eat.
Nutritional needs of infants • For a fully breast-fed infant mother milk is sufficient. • Calculations are for formula-fed infants. • Energy determined by size & activity. • Protein needs more than adult for growth.
Nutritional needs • Fats 30-50 % of energy in take, important for development of the brain, retina & vascular system. • Carbohydrates 40 % of energy { lactose}. • Lactose glucose + galactose {brain & nervous system development}. • Fermented lactose lactic acid protective against bacterial growth.
Fluids • Small total body water. • Large surface area/weight ratio. • Minimum 75-100 ml /kg/day. Best is 150 ml. • Provided by milk up to 4-6/12, no need for water. • Avoid dehydration from any cause.
Minerals • Calcium, phosphorus & magnesium for bone. • Iron & copper for RBCs maturation. • Iron stores depleted by 4-6/12. • Zink for cell division and growth.
vitamins • Milk is adequate of vitamins except D & K. • Vitamin D supplements for lactating mother. • Vitamin K an oral dose at early days as a routine practice.
Breast feeding & formula feeding • Comparison ?
weaning • To accustom to the new foods. • Age 4-6/12. • Weaning provide certain nutrients e.g. energy, protein, iron, zinc, vitamins A & D. • Milk remains the main constituent of diet.
Weaning…cont. • Important recommendations: • sugar and salt not added to food. • food not heavily spiced . • drinks should be diluted & unsweetened. • at 1 year solid food several times a day.
Children 1-5 years • Move from milk centered to family diet. • Food habits develop and continue for life. • Child develop independence in relation to food conflict. • Family should avail food at home.
Children 1-5…. • Growth is slower than in first year but activity increases. • Full dentition by 2 years. • 3 meals and snacks in between. • Dense food + 250 ml of milk. • Low sugar, more fruits & vegetables, iron intake. • Food refusal ?
School children and adolescents • Autonomous ? • Growth is slow preadolescent, rapid at adolescence. • Activity ? • Societal pressure increases with age, food advertisement & fashion.
Adults • Energy requirements is difficult to measure {age, climate, work…etc.} • From 20-39 years unchanged. • 40- 59 decreases by 5%. • 60-69 decreases by 10%. • Then by 10 % every 10 years. • Protein 0.5 - o.6 gm/kg/day is a safe level.
