Infant, Child and Adolescent Nutrition: A Practical Handbook

Cover
Half Title
Title Page
Copyright Page
Contents
Preface
Author Bio
Section 1: Nutritional requirements and healthy eating
1. Nutritional requirements
Water
Energy
Nutrients
Protein
Carbohydrate
Starch
Sugars
Fibre
Prebiotics
Fat
Saturated fat
Trans fats
Unsaturated fats - monounsaturated and polyunsaturated
Essential fats: omega 3 and omega 6 fats
Balancing omega 3 and omega 6 fats in diets
Vitamins
Vitamin A
B vitamins
Vitamin C
Vitamin D
Vitamin E
Vitamin K
Minerals
Other beneficial components in food
Phytochemicals
Probiotics
Dietary requirements
Macronutrients
Micronutrient requirements
Ensuring adequate energy and nutrient intakes
References and further reading
2. Principles of a balanced nutritious diet for children over 1 year
Balanced nutritious diet
Drinks
Pictorial guides for food groups
Portion sizes
Vegetarian diets
Vegan diets
More restricted diets
Free sugars and dental health
Brushing teeth
Sugar-containing medicines
Salt
Saturated fat
Caffeine
Colours and preservatives in food and drinks
Meals and snack routines
Snacks
Daily meal plans combining the food groups
Example eating plan 1
Example eating plan 2
Meal planner for a vegetarian diet
Assessing nutritional adequacy using the food groups
References and further reading
Reduced growth in vegan children
3. Social and cultural influences on food choices
Cultural food traditions
Religious food traditions
Fasting
Religious festivals
Socio-economic factors influencing food choice
Healthy Start Scheme
Cultural variations in feeding practices
Cutlery
Eating environment
Self-feeding by infants and toddlers
Mealtime routines
Marketing and media influences on food choices
Food fashions
Recent positive food fashions
Recent food fashions with a negative effect for children
Influence of family feeding practices and parenting skills
Family meals
Parenting styles
Using food and drinks as rewards, treats or for comfort
Advantages of a meal and snack routine
Social and cultural influences on infant feeding choices
Breastfeeding vs. formula feeding
References and further reading
Resources
Section 2: Assessment of growth and nutritional intake
4. Measuring and assessing growth
Biological drivers of growth
Growth rates throughout childhood
Anthropometric measurement
Assessing growth and body mass index on centile charts
Recommendations for measuring children
Frequency of measuring infants and children
Clothing
Measuring equipment
Growth charts
Growth charts recommended for use in the UK
Plotting on growth charts
Age correction for preterm babies
Normal growth patterns
Weight loss after birth
Birthweight centile does not always predict the weight centile later in infancy
Weight gain in infancy
Following length centiles in the first 2 years
BMI and body fat differences in girls and boys
Crossing centiles during adolescence
Abnormal growth
Faltering growth in infancy
Faltering growth in children
Weight monitoring
Acknowledgements
References and further reading
Resources
5. Assessing nutritional intake
Assessing nutritional adequacy of a child's diet with a recorded food intake
Assessing nutritional adequacy using the food groups
Using computer software
Nutritional assessments for epidemiological data
Biochemical measures used for nutritional assessment
References and further reading
Resources
Section 3: Prenatal nutrition
6. Preconception and fertility
Nutritional advice preconception
Optimizing body weight
Women with diabetes
Improving fertility and the chance of conception
Body weight
Overweight and obesity with or without polycystic ovary syndrome
Excessive body fat especially central obesity
Underweight
Weight loss and undernutrition
Eating disorders
Extreme levels of exercise
Poor iron stores
Alcohol, smoking and drug misuse
Male infertility
References and further reading
Resources
7. Pregnancy
Healthy eating for pregnancy
Key nutrients during pregnancy
Folate, folic acid and neural tube defects
Dietary folates
Vitamin D
Iron
Iodine
Omega 3 fats
Calcium
Supplements for pregnant women
Appropriate weight gain during pregnancy
Overweight and obese women
Underweight women
Women at increased nutritional risk during pregnancy
Women with pre-existing medical conditions
Diabetes
Gestational diabetes
Adolescents
Vegetarian and vegan women
Women who have previously had a low-birthweight baby
Women who are homeless, living in bed and breakfast accommodation or on low incomes
Recent immigrants
Women with alcohol or drug problems or eating disorders
Food, drinks and supplements to avoid or limit
Vitamin A
Oily fish
Alcohol
Caffeine
Food safety
Allergy prevention advice
Common dietary problems during pregnancy
Nausea and vomiting
Cravings and taste changes
Heartburn/oesophageal reflux
Constipation
Promoting breastfeeding antenatally
References and further reading
Section 4: Infants: 0-12 months
8. Milk feeding
Nutritional requirements of infants 0-6 months
Choice of milk feeding
Milk feeding choices for mothers with HIV
Breastfeeding
Benefits of breast milk for the infants and their mothers
Stages of breast milk
Colostrum
Transitional milk
Mature milk
Vitamin D supplementation
Supporting mothers to start and continue breastfeeding
Example of a feeding session routine
Positioning and Attachment
Positioning
Attaching onto the breast
Indicators of good attachment
Indicators of poor attachment
Progression of a breastfeed
Breastfeeding twins and multiples
Monitoring breastfed infants
Overcoming breastfeeding problems and difficulties
Sore or cracked nipples
Engorgement
Blocked ducts
Mastitis
Breast abscess
Inadequate milk supply
Tongue-tie
Mixed breast and bottle feeding
Expressing breast milk
Using a breast pump
Expressing milk for new-born infants
Storing expressed breast milk (EBM)
In a fridge
In a freezer
In hospital
Thawing frozen breast milk
Continuing breastfeeding when returning to work
Infants reluctant to take a bottle
Introducing a cup or beaker
Nutritional needs for breastfeeding mothers
Foods to limit
Food hypersensitivity
Formula milks for infants
Choosing an infant formula suitable from birth
Infant and follow on formulas based on cow or goat milk protein
Differences between and within brands
Soya-based infant formula
Specialised infant formulas
Making up and storing infant formula
Warming refrigerated feeds
Making up formula feeds while travelling or on holiday outside the United Kingdom
Bottle feeding infants
Extra fluid
Introducing a cup
Vitamin D supplementation for formula-fed infants
References and further reading
Resources
9. Complementary feeding
Terminology
Why begin complementary feeding?
When to begin
Nutrient and energy density of complementary foods
Milk feeding 6-12 months
Suitable drinking cups
Vitamin D supplement
Foods to avoid until 12 months of age
Acquiring feeding skills in a positive feeding environment with responsive feeding
Following infant cues
Satiety cues
Learning to like new tastes
Learning to cope with new textures
Progressing through the feeding stages
Stage 1: Beginning CFs
Texture of foods
Foods to offer
Infants at high risk of developing food allergies
Menu planners
First meals
More nutritious first meals as the infant begins to eat more than 1-2 teaspoons
Stage 2: 6-9 months
Texture
Foods to offer
Drinks with meals
Menu planner for 6-7 months
Menu planner for 7-9 months
Stage 3: 9-12 months
Foods to offer
Texture
Menu planner for 9-12 months
Vegetarian diets in infancy
Dental care
Commercial baby foods
Food safety
Preventing choking
Hygiene
Foods to limit and avoid
References and further reading
Resources
10. Common feeding problems in infancy
Slow development of feeding skills and oromotor delay
Unsettled infants/colic
Posseting and gastro-oesophageal reflux
Diarrhoea and gastroenteritis
Constipation
Management of constipation
Dietary factors which can cause or exacerbate constipation:
During breastfeeding
During infant formula feeding
When complementary feeding begins
Dietary management of constipation
In formula-fed infants
During complementary feeding
Food hypersensitivity (food allergy and food intolerance)
Symptoms
Diagnosis
Faltering growth
Management of faltering growth in breastfed infants
Management of faltering growth in formula-fed infants
Vitamin D deficiency
Specialist infant formulas
References and further reading
Resources
11. Preterm infants
Classification of preterm and small-for-gestational-age infants
Growth charts for classification and assessment
Nutritional requirements
Feeding routes for preterm infants in the neonatal unit
Parenteral nutrition
Trophic feeds or minimal enteral feeding
Enteral nutrition
Breast milk
Expressing breast milk for preterm infants
Nutrient content of preterm breast milk
Energy
Protein
Calcium and phosphorus
Vitamins and iron
Supplements for breast milk
Oral feeding
Breastfeeding
Bottle feeding
Formula milks for preterm infants
Preterm formulas
Nutrient-enriched post-discharge formula
Discharge home from the neonatal unit
Beginning complementary feeding
Acknowledgements
References and further reading
Resources
Section 5: Preschool children: 1-4 years
12. Preschool children: 1-4 years
Achieving nutrient and energy requirements
Combining the food groups
Food group 1: Bread, rice, potatoes, pasta and other starchy foods
Food group 2: Fruit and vegetables
Food group 3: Milk, cheese and yogurt
Food group 4: Meat, fish, eggs, nuts and pulses
Food group 5: Oils, butter and fat spreads
Extra food groups 6, 7 & 8 includng foods high in free sugars
Vitamin and mineral supplementation
Portion sizes for children 1-4 years
Drinks
Meal and snack routines
Meal plans
Meal plan for spring
Meal plan for summer
Meal plan for autumn
Nutritious snacks
Meal plan for winter
Nutrients at risk
Vegetarian and vegan diets
Meal plans for a vegetarian diet with high-iron and high-vitamin C foods
Vegan diets
Dental health
Food safety
Choking
Faddy eating, selective eating and food refusal
Food neophobia
References and further reading
Resources
13. Common nutritional problems in preschool children
Dental decay
Prevention
Iron-deficiency anaemia
Obesity
Constipation
Treatment
Dietary changes to suggest
Diarrhoea
Gastro-oesophageal reflux disease
Selective eating and avoidant restrictive food intake disorder (ARFID)
Management of selective eating behaviour
Faltering growth
Specialist feeding clinics
Vitamin D deficiency and rickets
References and further reading
Resources
14. Feeding preschool children in childcare settings
Opportunities and challenges for children eating in childcare settings
Nutritional standards for food and drinks offered in childcare settings
Nutritional guidance available for nurseries
Food for celebrations at nurseries
Packed lunches
Sandwich fillings for sliced bread, bread rolls, bagels, pitta bread or wraps
Dips to go with breadsticks or vegetable sticks
Salads
Pudding or second course
Promoting healthy lifestyles and healthy eating habits in childcare settings
Reference
Section 6: School-age children
15. Primary school-age children 5-11 years
Influences on food tastes and preferences
Energy and nutrient intakes of children 5-10 years
Portion sizes
Malnutrition in school children
Underweight or faltering growth
Inappropriate dieting among children
Dental caries
Anaemia
Low vitamin D levels
School food and drinks
School food standards
Popular school lunches
Changing school meals
Packed lunches
School breakfasts
The National Fruit and Veg Scheme
Subsidized school milk
References and further reading
Resources
16. Nutrition for adolescents
Physical development
Emotional changes and food choices
Nutritional requirements in adolescence
Vitamins
Minerals
Calcium and phosphorus
Iron
Healthy eating
Nutritional intakes and status as reported in surveys
Food choices
Further causes of malnutrition
Vegetarianism
Inappropriate slimming
Disordered eating
Alcohol
Conditions that increase nutritional requirements
Physical training for sport
Pregnancy
Cooking and food preparation skills
References and further reading
Resources
Section 7: Nutrition for chronic conditions
17. Food hypersensitivity - food allergies and intolerances
Prevention in children
Classification of food hypersensitivity
Food allergy
IgE-mediated food allergy
Non IgE-mediated food allergy
Food Intolerance - non-allergic food hypersensitivity
Coeliac disease
How common are food allergies?
Diagnosing food allergies and intolerances
Managing diagnosed food hypersensitivity
Exclusion diets
Cutting out eggs
Cutting out peanuts and tree nuts
Cutting out sesame
Cutting out milk
Cutting out wheat
Cutting out soya
Reintroduction of excluded foods to test whether a food allergy has been out-grown
Food labels
'Free-from' foods and lists
Adapting family foods for a food allergy or intolerance
Eating outside the home
At nursery and school
Travel to non-English-speaking countries
References and further reading
Resources
18. Childhood obesity
Definitions of overweight and obesity in children
Clinical definitions of overweight and obesity in the United Kingdom
Definitions of overweight and obesity for national statistics
Assessing overweight or obesity
Prevalence of childhood obesity in the United Kingdom
Factors associated with childhood obesity
Parental obesity
Rapid weight gain in infancy
Adiposity rebound
Consequences of obesity
Preventing obesity
Portion sizes of food and drinks
Physical activity
Children under 5 years:
Children 5-18 years:
Limiting sedentary behaviour
Getting enough sleep
Childcare settings
Treating obesity
Engaging parents
Supporting parents to make lifestyle changes
Stimulus control
Goal setting
Self-monitoring
Reward systems
Problem solving
Other solutions
Support for parents who are not ready to make lifestyle changes
Acknowledgements
References and further reading
Physical Activity and Health
Resources
19. Nutrition for children with chronic diseases and syndromes
Medical conditions requiring dietary modifications
Considerations when advising and supporting parents and carers
Nutritional support for children with an inadequate appetite to satisfy their energy and nutrient requirements
Increasing the energy density of the normal diet by adding extra carbohydrate and/or fat
Prescribable high-energy drinks or sip feeds
Tube feeding
Nasogastric tube feeding
Orogastric tube feeding
Gastrostomy feeding
Feeds available for tube feeding
Blended diets for gastrostomy feeding
Selecting a feed and feeding regimen
Considerations when initiating tube feeding
Support for home tube feeding
Parenteral feeding for critically ill children with poor gut function
Common medical conditions requiring dietary modifications
Autistic spectrum disorders, including attention deficit hyperactivity disorder (ADHD) and Asperger's syndrome
Cancer
Considerations for nutritional support
Coeliac disease
Food Labelling Regulations on gluten free and low gluten foods
Prescribable gluten-free foods
Cystic fibrosis
Diabetes
Type 1 diabetes
Glycaemic index
Hypoglycaemia
Coping with food refusal in children with diabetes
Type 2 diabetes
Inflammatory bowel diseases - Crohn's disease
Neurological disabilities - cerebral palsy, Down's syndrome, muscular dystrophy and degenerative disorders
Down's syndrome
Acknowledgements
References and further reading
Resources
Answers to activities
Chapter 3
Activity 3
Activity 4
Activity 5
Activity 6
Activity 7
Activity 8
Activity 9
Activity 10
Chapter 6
Activity 1
Activity 2
Chapter 7
Activity 1
Activity 2
Activity 3
Chapter 11
Activity 1
Chapter 12
Activity
Chapter 15
Activity 2
Chapter 18
Activity 1
Appendix 1: Function and Food Sources of Nutrients
Appendix 2: Growth Charts
Appendix 3: BMI and Waist Circumference Charts
Glossary
Index