1 Nutrition
Chapter Objectives
After this chapter you should be able to:
- Explain developmental considerations when feeding infants.
- Describe feeding tips for infants.
- Explain upcoming emerging skills for toddlers.
Interesting Facts
Globally, an estimated 43 million preschool children were overweight or obese in 2010, a 60% increase since 1990. [1]
- Models for healthy behaviour are early educators as 75 % of children spend time in child care.
- Children who are overweight or obese are at increased risk for health and socio-emotional problems.
- Being overweight in the preschool years is highly predictive of being overweight later in childhood.
- Overweight children are more likely than their peers to develop cardiovascular disease, type-2 diabetes, liver disease, sleep apnea, high cholesterol, and asthma.
- Food insecurity is associated with children’s greater risk for being overweight.
- Shared mealtimes are associated with a number of benefits such as increased vocabulary and exposure to a wider variety of foods that may result in healthier eating habits.
- Research suggests that having a television on during mealtimes may promote unhealthy eating.
The Harvard School of Public Health asserts that childhood is a critical time for obesity prevention because children are develop taste preferences and physical skills, as well as imitate healthy and unhealthy behaviours of caregivers. Children’s early-life experiences, such as bottle feeding, too little sleep, and too much television can increase the risk of obesity later in life.
Inadequate food intake in children is associated with a number of serious health, behaviour, and cognitive deficits. Children who are food insecure are in poorer health than children who are in food secure households with higher rates of hospitalization, iron deficiency anemia, and chronic health conditions. As you can see the factor of nutrition impacts all developmental domain.
Developmental Considerations
Infants
In your work with infants and toddlers and their families, you will likely hear about the Women, Infants, and Children (WIC) program. WIC’s mission is to safeguard the health of low-income women, infants, and children up to age 5 who are at nutrition risk by providing nutritious foods to supplement diets, information on healthy eating, and referrals to health care. Delivering high quality nutrition services is essential in not only carrying out this mission, but also ensuring that WIC continues to be the premiere national public health nutrition program.
Resources to Explore
- Stanford University Infant Feeding Guide: Guidance for appropriate and healthy feeding of an infant during the first year of life.
Don’t give solid foods unless your baby’s health care provider advises you to do so. Solid foods shouldn’t be started for infants younger than age 4 months for the following reasons:
- Breast milk or formula provides your baby all the nutrients that are needed to grow.
- Your baby isn’t physically developed enough to eat solid food from a spoon.
- Feeding your baby solid food too early may lead to overfeeding and being overweight.
- As a general rule, solid foods don’t help babies sleep through the night.
| Guide for formula feeding (0 to 5 months) | ||
|---|---|---|
| Age | Amount of formula per feeding | Number of feedings per 24 Hours |
| 1 month | 2 to 4 ounces | 6 to 8 times |
| 2 months | 5 to 6 ounces | 5 to 6 times |
| 3 to 5 months | 6 to 7 ounces | 5 to 6 times |
Feeding tips for infants after 4-6 months
- When starting solid foods, offer one new food at a time—not mixtures like cereal and fruit or meat dinners. Give the new food for two to three days before adding another new food. This way you can tell what foods an infant may be allergic to or can’t tolerate.
- Begin with small amounts of new solid foods—a teaspoon at first and slowly increase to a tablespoon.
- There are no strict rules about the order in which you should give different foods in. Many people start with an infant cereal and gradually add fruits, vegetables, and proteins.
- Don’t use salt or sugar when making homemade baby foods. Also, avoid feeding homemade spinach, beets, green beans, squash, and carrots for infants younger than age 6 months because of the risk for methemoglobinemia, a blood disorder that can interfere with oxygen delivery in the blood, due to high concentration of nitrates. Canned foods may contain large amounts of salt and sugar and shouldn’t be used for baby food. Always wash and peel fruits and vegetables and remove seeds or pits. Take special care with fruits and vegetables that come into contact with the ground. They may contain botulism spores that cause food poisoning.
- Cow’s milk shouldn’t be added to the diet until the baby is age 12 months. Cow’s milk doesn’t provide the right nutrients for an infant.
- Limit fruit juice without sugar o a maximum of 4 to 6 ounces daily when the infant is able to drink from a cup (around age 6 months or older). Whole fruits and vegetables are a much healthier option.
- Feed all foods with a spoon. Your baby needs to learn to eat from a spoon. Only formula and water should go into the bottle.
- Expect a smaller and pickier appetite as the baby’s growth rate slows around age one.
- Once an infant is taking solids, offer sips of water.
- Offer a wide variety of foods early to develop good eating habits later.
Toddlers
The list is useful in understand what to expect from toddlers[2]
Young toddlers may begin to:
- Want to feed themselves.
- Eagerly participate in snacks and mealtimes.
- Bite, chew, and swallow soft food smoothly.
- Show interest in many types of food and no interest in other foods.
- Eat inconsistently (eat a lot at one meal and little at the next, be too busy playing to eat).
- Ask for food when hungry or accept food when offered.
- Be willing to try new foods.
Older toddlers may begin to:
- Enjoy helping with meal and snack routines (set table, wash hands, throw away trash).
- Bite and chew solid food more easily.
- Accept or refuse food depending on their appetite and interest.
- Notice and talk about food textures, temperatures, and tastes (crunchy crackers, warm soup, sweet apples).
- Understand that some foods are good for them (fresh fruits, vegetables, milk) and some are not very healthy (potato chips, soda).
Chapter Attribution
Chapter adapted from Nutrition in Infant and Toddler Education and Care by Susan Eliason, CC BY-NC-SA.
- National Resource Center for Health and Safety in Child Care and Early Education, University of Colorado Denver. (2011). Achieving a State of Healthy Weight: A National Assessment of Obesity Prevention Terminology in Child Care Regulations. https://nrckids.org/files/regulations_report_2010.pdf ↵
- North Carolina Division of Child Development. (2008). Health and physical development. https://ncchildcare.ncdhhs.gov/Portals/0/documents/pdf/D/dcd_infant_toddler_health_physical_development.pdf ↵
