Child and adolescent nutrition 1. Introduction To develop to their optimal potential, it is vital that children are provided with nutritionally sound diets.
Diet and exercise patterns during childhood and adolescence may spell the difference between health and risk of disease in later years.
Different stages of the life cycle dictate differing nutrient needs.
2. What are the most important nutritional considerations in the first year of life? In the first 12 months of life a baby will triple its weight and increase its length by 50 per cent. These gains in weight and height are the primary indices of nutritional status and their accurate measure at regular intervals are compared with standard growth charts. These measurements are important tools for monitoring a child's progress particularly during the first 6 to 12 months of life. Breast-feeding on demand remains the ideal form of feeding for healthy babies who are born at term. Human milk provides optimum nutritional needs for growth and development.
The first 4-6 months are a period of very rapid growth, particularly for the brain, and the amino acid and fatty acid composition of breast milk is ideally suited to meet those needs.
Breast milk also contains anti-bacterial and anti-infection agents, including immunoglobulins, which have an important role to play in boosting immune function.
The colostrum, which is the fluid produced by the mammary gland during the first few days after birth, is rich in protein and has high levels of minerals and vitamins.
Colostrum also contains antibodies, anti-infection agents, anti-inflammatory factors, growth factors, enzymes and hormones, which are beneficial for growth and development. Breast-feeding is strongly advocated for physiological, psychological and emotional reasons. There is no reason why breastfeeding should not continue for as long as it is nutritionally satisfactory for mother and child up to 2 years.
However, with changing lifestyles and the availability of commercially prepared formulae, prepared formulae is generally safe provided that an approved infant formula is used under strict hygiene conditions.
The infant formulae attempt to mimic as far as possible the composition of human milk and their use must comply with guidelines laid down by the European Union and the World Health Organization.
Formula-fed infants also need to be demand fed and the formulae must be made up exactly according to the manufacturer's instructions for optimal growth.
Special attention has to be taken to sterilise all the feeding equipment to reduce the potential risk of contamination, because formula fed babies do not have the same degree of immunological protection as breastfed babies. When should solid foods be introduced? Introduction of complementary solid food is usually a gradual process over several weeks or months, starting at about 6 months of age.
The exact timing is determined by the individual infant and mother, and reflects the fact that breast milk will suffice in those first months but will no longer be able to provide adequate nutrition by itself as the baby grows.
The introduction of complementary foods by about 6 months is important to ensure normal chewing and speech development The quality, number and variety of solid feeds can be increased gradually at a pace that will be generally dictated by the child.
Cereals are generally the first foods that are introduced into the infant's diet (mixed with a little breast milk or formula), with purées of vegetables and fruits and meats to follow.
By exclusive breast feeding up to 4 to 6 months of age, the likelihood of allergies is lessened. Foods that are more likely to cause allergic reactions in sensitive children, such as egg whites and fish, are generally introduced after 12 months of age. To know more about food allergy. With present changes in lifestyle, commercially available baby food play a growing role in the diet of children and should therefore meet strict standards of quality and safety.
The convenience and variety of foods available make them a good option to use to complement home prepared foods.
Commercial baby foods are prepared from fresh fruits, vegetables and meat with no added preservatives and must meet very strict standards. An important consideration in the first year of life is the amount of iron supplied in the diet and iron deficiency anaemia is routinely screened for during infancy.
The use of an iron fortified formula or cereal, and the provision of iron-rich foods such as pureed meats can help to prevent this problem.
Bibliography * Calvo, E. B.; Galindo, A. C.; Aspres, N. B. (1992). Iron status in exclusively breast-fed infants. Pediatrics, 90(3):375-379.
* Department of Health and Social Security (1988). Present day practice in infant feeding: 3rd Report. Report on Health and Social Subjects 32. HMSO, London.
* EEC Commission Directive on infant's formulae and follow-on formulae (1991). Official J. European Communities No. L175/35-/49.
* Freedman, D. S.; Dietz, W. H.; Srinivasan, S. R.; Berenson, G. S. (1999). The relation of overweight to cardiovascular risk factors among children and adolescents to cardiovascular risk factors among children and adolescents: the Bogalusa Heart Study. Pediatrics, 103:1175-1182.
* Gregory, J.; Lowe, S.; Bates, C. J., Prentice, A., Jackson, L.V., Smithers, G., Wenlock, R., Farron, M., (2000). National Diet and Nutrition Survey: young people aged 4-18 years, vol. 1. Report of the Diet and Nutrition Survey, TSO, London.
* International Life Sciences Institute (2000). Overweight and Obesity in European Children and Adolescents. Causes and consequences-prevention and treatment. pp. 1-22. ILSI Europe, Brussels, Belgium.
* James, J. (1991). Iron deficiency in toddlers. Maternal and Child Health, 16:309-315.
* Stordy, B. J.; Redfern, A. M.; Morgan, J. B. (1995). Healthy eating for infants-mothers' actions. Acta Paed, 84:733-741.
* Walter, T., Dallman, P.R., Pizarro, F., Velozo, L., Pena, G., Bartholmey, S.J., Hertrampf, E., Olivares, M., Letelier, A., Arredondo, M., (1993). Effectiveness of iron-fortified infant cereal in the prevention of iron deficiency anaemia. Pediatrics, 91(5):976-982.
* Wardley, B. L.; Puntis, J. W. L.; Taitz, L. S. (1997). Handbook of Child Nutrition. 2nd Edition. Oxford University Press, Oxford.
* Weaver, C. M. (2000). The growing years and prevention of osteoporosis in later life. Proceedings of the Nutrition Society, 59:303-306.
* World Health Organisation (1990). Prevention in childhood and youth of adult cardiovascular disease: time for action. WHO, Geneva.
References: European Food Information Council (EUFIC) Date last updated: 17 November 2006