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Nutrition in Toddlers

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Essential Nutrition for growing child,
How to calculate calorie need,

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Nutrition in Toddlers

  1. 1. Nutrition in Toddlers Dr. Nyi Nyi Kyaw M.B,B.S (Ygn) M.Sc (Nutrition & Dietetics) (Bedfordshire, UK) Member of Nutrition Society (UK)
  2. 2. Introduction • The toddler (ages 1 to 3) phase can often be challenging when it comes to feeding. • Several developmental changes occur at this time. • Toddlers are striving for independence and control. • Their growth rate slows down and with this comes a decrease in appetite.
  3. 3. Calorie Needs • Depending on their age, size, and activity level, toddlers need about 1,000–1,400 calories a day. • Calorie Requirement (1989, RDA) - 1-3 year - 102 kcal/kg - 4-6 year - 90 kcal/kg - 7-10 year - 70 kcal/kg Example - 2 years old child with 10 kg needs 1020 kcal per day.
  4. 4. Method For Calorie Calculation • Schofield Energy Equation formula (for BMR) Boy Girl Age Equation (kcal/day) SEE < 3 59.512 × W - 30.4 70 3–10 22.706 × W + 504.3 67 Age Equation (kcal/day) SEE < 3 58.317 × W - 31.1 59 3–10 20.315 × W + 485.9 70
  5. 5. Activity Factors (AF, Thermogenesis) • Bedbound, immobile + 10% of BMR • Bedbound, mobile or sitting + 15-20% of BMR • Mobile, on ward + 25 % of BMR
  6. 6. Stress Factors (Disease Factors) Todorovic & Micklewright 2004 • Brain Injury 0-50% of BMR • Cerebral Haem 30% • CVA 5% • COPD 15-20% • Infection 25-45% • IBD 0-10% • ICU 0-60% • Leukemia 25-34% • Lymphoma 0-25% • Pancreatitis 3-10% • Sepsis / Abscess 20% • Solid Tumors 0-20% • Transplantation 20% • Surgery 5-40%
  7. 7. •TEE (Total Energy Expendicture) = BMR + AF + SF
  8. 8. HOLIDAY-SEGAR METHOD (Fluid Maintenance ) First 10kg = 100ml per kg in 24 hrs Second 10kg = 50ml per kg in 24hrs Other kg (or remaining kg) = 20ml per kg in 24 hrs.
  9. 9. Calorie Distribution • Carbohydrate - 45-65 % of total calorie intake • Protein - 10-35 % of total calorie intake • Fat - 20-35 % of total calorie intake To achieve the BALANCE DIET
  10. 10. Macronutrient Distribution
  11. 11. Protein Requirement for Toddler • Protein Distribution is 10-35% of total calorie requirement • Easy way to Calculate protein requirement - 1-3 years - 1.05 g/kg/day - 4-13 years – 0.95 g/kg/day (2005, RDA) Example – 15 kg, 2 years old child needs 15.75 grams of protein per day
  12. 12. Protein source • Whey Protein (predominant protein in Human Milk) • Egg • Fish • Milk and Dairy Products • Beef • Chicken • Soy • Legumes
  13. 13. Protein Ranking From Highest to Lowest quality of protein
  14. 14. Serving size Animal Protein (Meat and Fish) contain 7 grams of protein in following serving - 1 ounce (or) 30 grams (or) 2 ticals
  15. 15. Serving Size • Plant protein (soy bean and legumes) yield 7 grams of protein in ½ cup. (cooked)
  16. 16. Serving Size • Milk and Dairy products provide 8 grams of protein in following serving size. - Milk - 240 ml (1 glass) - Yogurt - 160 ml - 1/3 cup shredded cheese - 1 cup pudding made from milk - 1 cup of soy milk
  17. 17. Essential Fatty Acid The Essential Fats are a group of fatty acids that are essential to human health. • Omega-3 (ω3) – Linolenic acid • Omega-6 (ω6) – Linoleic acid
  18. 18. Omega 3 Source • Walnuts • Wheat germ oil • Flaxseed oil • canola oil • Fish liver oils • Fish, eggs, Human Milk • Seafood, Fatty fish • Tuna • Mackerel • Salmon • Sardines
  19. 19. Omega 6 Source • Corn oil • Peanut oil • Cottonseed oil • Soybean oil • Many plant oils
  20. 20. Different Source of Omega 3 and 6
  21. 21. Serving Size for Essential Fatty Acid
  22. 22. DHA • Docosahexaenoic acid (DHA) is an omega-3 essential fatty acid • DHA is an important constituent of the brain cell membrane, which have a role in neurotransmission • Benefits in vision and brain function
  23. 23. DHA is one of the primary structural component of brain tissue and retina
  24. 24. Recommended food intake according to Age and Gender
  25. 25. Micronutrients • Zinc • Iron • Calcium • Vitamin D
  26. 26. Zinc • Recommended Daily Allowance (RDA) - 3-5 milligrams per day • Zinc deficiency can occur if there is not a high enough consumption from diet • Deficiency can lead to growth impediments and increased risk of infection. • During pregnancy and lactation, women may need extra zinc.
  27. 27. Benefits of Zinc • Zinc and regulating immune function – need to activate T cell • Zinc for treating diarrhea • Zinc effects on learning and memory • Zinc to treat the common cold
  28. 28. Source of Zinc • Beans • Beef (lean) • Lobster, Oyster, Crab • Pork loin (lean) • Rice • Peas • Yogurt • Pecans, Peanuts
  29. 29. Iron • Recommended Daily Allowance (RDA) – 7-10 mg per day • In iron deficiency - Slow weight gain. - Pale skin. - No appetite. - Irritability (cranky, fussy).
  30. 30. Iron Rich Food • Meats: Beef, lamb, pork, veal, liver, chicken, turkey. • Fish • Eggs • Grains and cereals: Iron-fortified cereals, whole grain breads, enriched bread, pasta and rice. • Legumes: chick peas, lentils, dried peas and beans. • Vegetables: spinach, broccoli, watergrass
  31. 31. • To help prevent iron deficiency: • Limit your child's milk intake to about 16–24 ounces a day (2 to 3 cups). • Serve more iron-rich foods • When serving iron-rich meals, include foods that contain vitamin C (like tomatoes, broccoli, oranges, and strawberries), which improve the body's iron absorption. • Continue serving iron-fortified rice and cereal until your child is 18–24 months old
  32. 32. Calcium • Recommended Daily Allowance (RDA) - 700 mg per day
  33. 33. Calcium Rich Food • Two servings of dairy will easily add up to the 500 milligram daily goal of calcium for toddlers. Each of the following counts as one serving: • 1 cup of milk • 1 cup of yogurt • 1½ ounces of natural cheese, like cheddar or Swiss • 2 ounces of American cheese • 1 cup of ice cream or frozen yogurt
  34. 34. Vitamin D • Recommended Daily Requirement – 10 umg or 400 IU per day • Food Source – egg yolk, Organ meat, Red Meat and Oily Fish, fortified products • Sunlight exposure – 5-10 min per day (between 10 am to 3 pm)
  35. 35. • Avoid battles over food and meals. • Provide regular meals and snacks. • Be flexible with food acceptance • Be realistic about food amounts. Portion size should be about one- fourth the size of an adult portion. • Limit juice intake; encourage whole fruit instead. • Dessert should not be used as a reward.
  36. 36. Make the food easy for your toddler to eat: • Cut food into bite-size pieces. • Make some foods soft and moist. • Serve foods near room temperature. • Use ground meat instead of steak or chops. • Use a child-size spoon and fork with dull prongs. • Seat your child at a comfortable height in a secure chair.
  37. 37. Prevent choking by: • Slowly adding more difficult-to-chew foods. • Avoiding foods that are hard to chew and/or swallow such as nuts, raw carrots, gum drops, jelly beans, and peanut butter (by itself). • Modifying high-risk foods: cut hot dogs in quarters, cut grapes in quarters, and cook carrots until soft. • Always supervising your child when he or she is eating. • Keeping your child seated while eating.
  38. 38. Take Home Message • Calorie Requirement according to age • Protein Requirement according to age • RDA for Zinc - 3-5 mg • RDA for Iron - 7-10 mg • RDA for Calcium - 700 mg • RDA for Vitamin D - 10 umg or 400 IU • How to prevent choking
  39. 39. Thank You

Editor's Notes

  • Mothers are facing such a problem about feeding difficulities.
  • 100 gram of meat does not contain 100 gram of protein
  • T cells help the body in two ways:
    controlling and regulating immune responses
    attacking infected or cancerous cells

    2. 10-day course of zinc tablets is effective at treating diarrhea and also helps prevent future bouts of the condition.
    3. Research conducted at the University of Toronto and published in the journal Neuron suggested that zinc has a crucial role in regulating how neurons communicate with one another, affecting how memories are formed and how we learn.
    4. Zinc lozenges were found to shorten the duration of common cold episodes by up to 40 percent in a study published in the Open Respiratory Medicine Journal.
    In addition, a Cochrane review concluded that taking "zinc (lozenges or syrup) is beneficial in reducing the duration and severity of the common cold in healthy people, when taken within 24 hours of onset of symptoms."

  • Babies younger than 6 months old need 200 mg of calcium a day.
    Babies 6 to 11 months old need 260 mg of calcium a day.

    he percentage of fat in milk and other dairy foods doesn't affect their calcium content — skim, 1%, 2%, or whole all have about the same amount of calcium. Your health care provider will let you know which type of milk is right for your child.
  • calcium and vitamin D to prevent a disease called rickets. Rickets softens the bones and causes bow legs, stunted growth, and sometimes sore or weak muscles.
  • 3. as toddlers are often reluctant to try new things. If your toddler refuses a food, don't make a big deal out of it, and try again in a few days or weeks.
    6. Try serving it with the rest of the food.
  • ×