Course Module

NCM 105
Nutrition and Diet Therapy
 Lesson Module 10
NUTRITION ACROSS THE
LIFESPAN: INFANCY,
CHILDHOOD AND
ADOLESCENCE

Alicia Lonzame-Lopena, RN MAN

Maria Seniz Calma, RN MAN
Lesson Module Content
1. Life cycle growth pattern.
2. Nutrition requirements for growth.
3. Specific age group needs.
a. Infancy
b. Childhood
c. Adolescence
4. Common nutrition problems
during childhood and adolescence
 Lesson Module Objectives
At the end of the lesson, the following objectives should be
attained:
1. List the following general stages of overall growth and
variation along the way
2. Discuss how individual growth is measured
3. Explain the different nutritional requirements for
growth for infants, children and adolescents
4. Enumerate common nutritional problems during
childhood
 Life Cycle Growth Pattern
Infancy Childhood
• Growth is rapid during the • Between infancy and
first year of life. adolescence, the childhood
• Most infants double their growth rate slows and
birth weight by the time becomes irregular.
that they are 6 months old,
• Appetites usually taper off
and they triple it between
12 and 15 months of age. during periodic plateaus.
• Infants generally increase
their birth length by 50%
during the first year and
double it by 4 years of age.
Adolescence Adulthood
• Growth hormone and sex • Physical growth levels off
hormones rise, which brings during adulthood and then
multiple and often gradually declines during
bewildering body changes old age. However, mental
to young adolescents. and psychosocial
• During this period, long development lasts a
bones grow quickly, sex lifetime.
characteristics develop, fat
and muscle mass increase.
 Measuring Childhood Growth
Physical Growth
• The current recommendation is for clinicians to use
the WHO growth charts for infants who are up to 2
years old and the CDC growth charts for children who
are older than 2 years old.
• The combined use of the WHO and CDC growth charts
allows practitioners to plot the growth patterns for
height, weight, and head circumference from birth to
the age of 20 years.
• Special growth charts are available for several diseases
or conditions that affect childhood growth.
WHO and CDC Growth Chart
Psychosocial Development
• Various assessments can be used to measure
mental, emotional, social, and cultural growth
and development. Food is intimately related to
these aspects of psychosocial development as
well as to physical growth.
• The growing child does not learn food attitudes
and habits in a vacuum but rather as a part of
close personal and social relationships.
Nutritional Requirements For Growth
Energy Needs
• Kilocalories
 First 3 years of life, children need
somewhere between 80 and 120
kcal/kg body weight per day.
 Adult needs of 30 to 40 kcal/kg
per day
 Premature infants are highly
variable and not well defined,
they are thought to range from
110 to 130 kcal/kg per day.
• Macronutrients
Protein Needs
• Water requirements
 Water is an essential nutrient
that is second only to oxygen for
life.
 Infants require more water per
unit of body weight than adults
for three reasons:
1) a greater percentage of the
infant’s total body weight is
composed of water;
2) a larger proportion of the infant’s
total body water is in the
extracellular spaces; and
3) infants have a larger proportional
body surface area and metabolic
rate compared with adults.
 Approximate Daily Fluid Needs During Growth Years
Age Males and Age Males (L/day) Females
Females (L/day)
(L/day)
0 to 6 months 0.7 9 to 13 years 2.4 2.1

7 to 12 0.8 14 to 18 years 3.3 2.3

months
1 to 3 years 1.3 > 19 years 3.7 2.7
4 to 8 years 1.7
 Mineral and Vitamin Needs

• Calcium • Iron
 Approximately 40% of adult  Essential for hemoglobin
peak bone mineral density formation and cognitive
is deposited during the development during the
short period of early years of life.
adolescence.  Infants who are not breast-
 To reduce the risk for fed need iron-fortified
fractures and osteoporosis, infant formula.
weight-bearing activity and
appropriate calcium must
be emphasized during
adolescence more so than
at any other time
throughout the life span.
 Vitamin Supplements
• The American Academy of Pediatrics
recognizes only two vitamins that are
potentially needed in supplemental form:
vitamins K and D.
• Excess amounts of vitamins A and D
(hypervitaminosis) are of special concern in
children. Excess intake may occur over
prolonged periods as a result of ignorance,
carelessness, or misunderstanding.
 Age-group Needs
Infancy
• Immature Infants
Immature infants are subject to problems with growth
and nutrition.
 Weight- as defined by birth weight, low birth weight
infants weigh less than 2500g (5lb 8 oz); very low birth
weight infants weigh less than 1500g (3lb 5 oz);
extremely low birth weight babies weigh less than
990g (2 lb 3 oz).
 Gestational Age- premature infants are born preterm
at less than 270 days’ gestation and weigh less than
2500g (5lb 8 oz)
o Type of milk- normal feeding of breast milk
o Methods of Feeding- tube feeding and
peripheral vein feeding are used in special
cases, but both carry hazards and are to be
avoided if possible.
• Term Infants
Mature newborns have more finely developed
body systems and grow rapidly; they gain
approximately 168g (6oz) per week during the
first 6 months.
 Breast-feeding

 Human milk is the ideal first food for infants.

 During pregnancy, the breasts prepare for
lactation; toward term they produce colostrum.
 Mature breast milk comes in 3 to 5 days after
delivery.
 Foremilk-first mature milk to let down, lowest in
fat content
 Midmilk- has progressively more fat content
 Hindmilk- the milk that comes at the end of the
feeding, has the highest fat content.
 Bottle-feeding
• Choosing a formula
• Preparing the formula
• Feeding the formula
• Cleaning bottles and nipples
 Baby bottle tooth decay- the decay of the baby
teeth as a result of inappropriate feeding practices
such as putting an infant to bed with a bottle; also
called nursing bottle caries, bottle mouth, and bottle
caries.
 Cow’s Milk

• An infant should never be fed cow’s milk

during the first year of life.
• Unmodified cow’s milk is not suitable for
infants; its concentration may cause
gastrointestinal bleeding, and it provides too
heavy a load of solutes for the infant’s renal
system.
• Infants and toddlers who are younger than 2
years old should also not be fed reduced-fat
cow’s milk (e.g., skim or low-fat milk).
 Solid Food Additions
• When to introduce: Avoid solid foods and cow’s
milk for at least 4 to 6 months after birth.
• What to introduce: When solid foods are started,
no specific sequence of food additions must be
followed. Introduce foods one at a time (starting
with iron-fortified cereal) and in small amounts
so that, if an adverse reaction occurs, the
offending food can be easily identified.
 Guideline for Adding Solid Foods to an Infant’s Diet During The
First Year
When to Add Food Added*6 months
6 months Iron-fortified infant cereal made from rice,
barley, or oats (these are offered one at a time)
Pureed baby food (vegetables or strained fruit)
8 months Whole-milk yogurt
Pureed baby food (meats)
8 to 10 months Introduce more grain products one at a time,
including wheat, various crackers and breads,
pasta, and cereal
Add more vegetables and fruits in various
textures (e.g., chopped, mashed, cooked, raw)
Egg yolk, beans, and additional types of pureed
meats
Cottage cheese and hard cheeses (e.g.,
cheddar, Colby Jack)

10 to 12 months Infants should be able to tolerate a large

variety of grain products and textures
Chopped fruits and vegetables
Finger foods
12 months Whole eggs
Whole milk
 Childhood
• Toddlers (1 to 3 years old)
 Increasing the variety of foods available helps
children to develop good food habits
 Energy and protein needs are still high per each
kilogram of body weight compared with adult
needs.
 Toddlers have a wide range of energy needs
during this time, and these are directly related to
their level of physical activity.
 DRI of 19g of fiber to prevent constipation and to
promote a healthy gastrointestinal tract.
• Preschool-Aged Children (3 to 5 years old)
 Children continue to form patterns, attitudes,
and basic eating habits as a result of social and
emotional experiences.
 Food preferences grow according to what the
group is eating.
• School-Aged Children (5 to 12 years old)
 School-aged children are increasingly exposed to new stimuli,
including television, which is correlated to long-term negative
influences on food habits.
 Breakfast as a particularly important meal for school-aged children.

 School breakfast and lunch programs-federally assisted meal

programs that operate in public and nonprofit private schools and
residential child-care instructions.
 Competitive foods- any food or beverage that is served outside of a
federal meal program in a food-program setting, regardless of
nutritional value.
 Common Nutrition Problems During
Childhood
• Failure To Thrive- infants, children, or
adolescents who do not grow and develop
normally. Most commonly affects young children
between the ages of 1 to 5 years of both sexes.
 The ff. factors may be involved:
 Clinical disease
 Neuromotor problems
 Dietary practice
 Unusual nutrient needs or losses
 Psychosocial problems
 Anemia
 Children who are most often
deficient in overall iron stores
are formula-fed infants who
are not receiving iron-fortified
formula and older infants who
are not consuming iron-
fortified cereals and foods.
 Milk anemia- toddlers who
excessively consume cow’s
milk.
 Iron-deficiency anemia has
been linked to delayed
cognitive development in
children, and it can have
irreversible long-term effects.
 Obesity
 Some factors during
gestation and early
infancy that significantly
increase the risk for
childhood obesity
include maternal over
nourishment or
undernourishment,
gestational diabetes,
maternal smoking, and
formula feeding.
 Lead Poisoning
 Lead poisoning in children
can be extremely damaging
to the central nervous
system, and it can
negatively alter both
cognitive and motor skills.
 Approximately 70% of lead
exposure among children is
the result of lead-based
paint.
 One of the Healthy People
2020 targets is the
complete elimination of
lead exposure in children.
 Adolescence (12 to 18 years old)
• Physical Growth
 Girls store more subcutaneous
fat in the abdominal area.
 At first a boy’s growth spurt is
slower than that of a girl, but
he soon surpasses her in both
weight and height.
 Girls who reach sexual
maturation early are more
likely to become overweight
or obese than girls who do not
mature until later.
 Boys who mature earlier are
more likely to be thinner than
their counterparts.
• Eating Patterns • Eating disorders
 Teenagers tend to skip lunch  Self-starvation occurs, and
more often than breakfast, to complex eating disorders such
derive a great deal of their as anorexia nervosa and
energy from snacks to eat any bulimia nervosa may develop.
kind of food at any time of  Disordered eating often begins
day. during the early adolescent
 Boys usually fare better than years.
girls
 Girls may tend to restrict their
food and have an inadequate
nutrient intake because they
are under a greater social
pressure for thinness.
 Anorexia Nervosa

• An eating disorder
characterized by weight loss
(or lack of appropriate
weight gain in growing
children); difficulties
maintaining an appropriate
body weight for height, age,
and stature; and, in many
individuals, distorted body
image. People with
anorexia generally restrict
the number of calories and
the types of food they eat.
 Bulimia Nervosa
•  Binge eating followed
by purging. Binge eating
refers to eating a large
amount of food in a
short amount of time.
Purging refers to the
attempts to get rid of
the food consumed.
This may be done
by vomiting or
taking laxatives.
ADULHOOD AND OLDER ADULTHOOD
 SUMMARY
To end today’s lesson, let us summarize some
important key points and concepts:
1. Growth and development of healthy children depend on
optimal and nutrition support
2. From birth, the nutrition needs of children change with each
unique growth period
3. Infants experience rapid growth
4. Human milk is the natural first food
5. Toddlers, preschoolers and school-aged children experience
slow and irregular growth
6. Adolescents undergo a large growth spurt before adulthood.
7. Social and cultural factors influence the developing habits of
all children
LEARNING ACTIVITIES
1.Explain Why Immature infants have special dietary
needs.
2.Why is breastfeeding the preferred method of
feeding infants

(Date and Link for submission, To be announced)

WATCH:
https://www.youtube.com/watch?v=UdmU-Xo_RC
c
NEXT LESSON MODULE
Lesson Module 11
Nutrition across the lifespan:
Early, Middle and Late adulthood
 ASSESSMENT

A summative assessment test

will be posted in the Google
classroom. This can be availed
on (-Date-) at (-time-)
Always check your Google
classroom for messages and
announcements.
REFERENCES / RESOURCES
• Nix, S. Williams Basic Nutrition and
Diet Therapy. 14th Ed.
• Available:
https://evolve.Elsevier.com/Williams/
basic/
• Youtube:
https://www.youtube.com/watch?v=
UdmU-Xo_RCc