Life Cycle: From Childhood through Adulthood

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Objectives

1. Understand the stages of growth and development during infancy and the effect of nutrition on these stages

2. Explain feeding techniques along with introduction of solids and possible feeding problems during infancy

3. Comprehend the importance of proper nutrition and nutritional concerns during childhood and adolescence

4. Understand the physiological and dietary changes that take place during older adulthood through the elder years

5. Recognize the nutrient needs and nutrition-related concerns for mature adults

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The Infant’s Birthweight

• Low birth weight– less than 5.5 lbs (2500 g) at birth– classified according to their gestational age

• SGA– SGA is Small for Gestational Age– AGA is Appropriate for Gestational Age

• Normal birth weight– 6.5 to 8.75 lbs (3000-4000 g) for full term

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• Infant growth and development– Growth best marker of nutritional status

• Evaluated using growth charts– Weight gain

• Double birth weight by 5 (4-6) months• Triple birth weight by 12 months

– Length gain• Increase length by 50% by 12 months

– Head circumference– Growth Charts

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• Energy and nutrient needs of infancy

– Requirements based on composition of breast milk– Energy

• Highest needs of any life stage ~ 100 kcals/kg/day

– Protein• Highest needs of any life stage ~ 2 g/kg/day

– Carbohydrate and fat• Fat major energy source• Carbohydrates as simple sugars

– Water

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Vitamins and Minerals for Infants• Vitamin D

– concern if no sunlight; dark skin; mom is deficient– at risk infants---supplement

• Vitamin K– single dose at birth

• Vitamin B-12– breastfed by a vegan mom may need supplement

• Iron– breastfed OK for 6 months; formula-include iron

• Fluoride– supplement at 6 months if no fluoride in water

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Newborn Breastfeeding• Ideal method of feeding

• Newborns show signs of hunger: feed!– Rooting: turning head when stroked on the cheek– every 2-3 hours– 10-15 minutes per breast

• Latch– nipple and areola

• Lactation Consultants

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Infant Formulas

• Standard Infant Formulas– cow’s milk as a base;

• Soy-Based Formulas– if milk based develop vomiting, diarrhea, constipation,

abdominal pain, or colic• Other Types of Formula

– for premature; rare defects; allergic to both cow’s milk and soy

• Formula Preparation– ready-to-feed; concentrate; powdered;

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• Loving and warm environment

• hold baby close; make eye contact

• don’t prop bottle

• burping

• watch for cues of fullness

Feeding Technique

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How much to feed newborn?

•Breastfeed: 8-12 x/day

•Wet at least 6 diapers

•Have at least 3 loose stools per day

•Regain birth weight within the first 2 weeks

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• Readiness for Solid Foods• Increased digestive enzymes

– so solid foods can be digested with ease

• Loss of extrusion reflex– infant’s tongue pushes the spoon and food back

out– need to be able to transfer food from front of

mouth to the back

• Able to sit without support• Purposefully bring hand to mouth• Age of about 4-6 months

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Feeding schedule• Baby rice cereal

• iron-fortified; hypoallergenic• mix with breast milk or formula

• Add one food at a time• see how tolerates foods and watch for allergic reactions

• Strained vegetables, fruits, meats• 6-7 months: infant spoon and cup with spout lid• 8 months: pick up small pieces of food• 9-12 months: soft foods; table foods• NO cow’s milk, egg whites, ?wheat?

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Infants: Foods to Avoid

• Avoid Honey and Corn Syrup– contain spores of Clostridium botulinum, in

infants can cause botulism, a deadly food borne illness

• Avoid high risk choking foods– hotdogs, nuts, raw carrots, raisins, apple

chunks, popcorn, hard candy, gum, hard pretzels, grapes, plain peanut butter,

• Don’t leave baby along during feeding

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Infancy

• Feeding problems during infancy– Colic– Baby bottle tooth decay– Iron-deficiency anemia– Gastroesophageal reflux– Diarrhea– Failure to thrive– Fruit Juices and Drinks

• 3-6 ounces per day; avoid putting in a bottle

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EWU:figure 12.21

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Childhood: age 1 to beginning of adolescence

• Energy and nutrient needs during childhood– Energy and protein

• Kcal and grams protein per kg decrease from infancy

– 1-3 year old: 1,300 kcals/day– 4-6 year old: 1,800 kcals/day– 7-10 year old: 2,000 kcals/day

– Vitamins and minerals• Variety of foods needed• Need for supplements?

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Common Food Habits of Toddlers• Playing with food

– discover texture, smell, taste

• Food jags– continue to offer new foods

• Food protests– caregiver model positive, corrective behavior

• Irregular eating patterns– growth has slowed; may skip meals but

continue to offer regular meals and snacks

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Influences on Childhood Food Habits and Intake

• Advertisements– sweetened cereal; fast food; candy

• Social events and parties– pizza; soft drinks;

• Popular snacks and beverages– “fruit snacks”; cookies; ice cream; soda

• 2 parents working• Unscheduled meals and snacks

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Nutritional Concerns of Childhood– Malnutrition and hunger

• School Lunch, Breakfast, and Summer Food Service programs

– Food and behavior• No scientific link between diet and hyperactivity

– Nutrition and chronic disease• Gradually phase in lower-fat, higher-fiber diet

– Childhood obesity• Increasing incidence• Focus on growth

– Lead toxicity– Vegetarianism

24EWU: Figure 13.4

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Adolescence• Physical growth and development

– Adolescent growth spurt• Boys: begins between 12-13 years

– Gain about 8 inches in height, 45 pounds in weight

• Girls: begins between 10-11 years– Gain about 6 inches in height, 35 pounds in

weight• Change in body composition• Changes in emotional maturity

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Nutrient Needs of Adolescents– Energy and protein

• Highest total calories and protein grams per day

– Vitamins and minerals of concern• Vitamin A• Iron• Calcium

• Influences on food intake– Social factors– Income – Individuality

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Nutrition-Related Concerns of Adolescents– Fitness and sports

– Acne

– Eating disorders

– Obesity

– Tobacco, alcohol, recreational drugs

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Staying Young While Growing Older• Age-related changes

– Weight and body composition• Add fat, lose lean body mass

– Mobility• Reduced muscle and skeletal strength

– Immunity• Decline in defense mechanism

– Taste and smell• Decline in ability

– Gastrointestinal changes• Reduced acid secretion, reduced motility

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Especially Physical Activity

• Weigh less

• Greater flexibility

• More endurance

• Better balance

• Better health

• Strengthen muscles---less falls

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Nutrient Needs of the Mature Adult• Energy

– Reduced needs • Decreased activity, decreased lean body mass

• Protein– Same needs per kg body weight as younger adults

• Carbohydrate– More likely to be lactose intolerant

• Fat– Maintain moderate-low fat diet

• Water– Reduced thirst response

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Nutrient Needs of the Mature Adult

• Vitamins of concern– Vitamin D

• Needed for bone health, calcium balance• Reduced skin synthesis, activation• Higher needs

– B vitamins• Reduced ability to absorb vitamin B12

• Folate, B6, B12 may help reduce heart disease risk

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Nutrient Needs of the Mature Adult• Minerals of concern

– Calcium• Bone health• Reduced ability to absorb calcium

– Zinc• Marginal deficiencies likely• May compromise immunity, wound healing

– Magnesium– Iron

• Elders may have limited intake

• Need for supplements

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Nutrition-Related Concerns of Mature Adults

• Drug-drug and drug-nutrient interactions– Can affect use of drugs or nutrients

• Depression– May reduce food intake– Alcoholism can interfere with nutrient use

• Anorexia of aging– Loss of appetite with illness– Can lead to protein-energy malnutrition

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• Arthritis– May interfere with food preparation and eating– Dietary changes may improve symptoms

• Bowel and bladder regulation– Increased risk of urinary tract infection– Chronic constipation more common with age

• Need for increased fluids, fiber

• Dental health– May interfere with eating ability, food choices

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• Vision problems– Can affect ability to shop, cook– Antioxidants may reduce macular degeneration

• Osteoporosis– Common in elders, especially women– Maintain calcium, vitamin D, exercise

• Alzheimer’s disease– Affects ability to function– Reduced taste, smell– Risk for weight loss, malnutrition

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Meal Management for Mature Adults

• Managing independently– Services for elders

• Meals on Wheels• Elderly Nutrition Program• Food Stamp Program

• Wise eating for one or two

• Finding community resources

Queries???

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