• It provides infants with most of the nutrients they need

Pediatric nutrition                                                                  • Thiamine (vitamin B1) for infants 0...
9 kg (20 lb): 850 kcal/d; children 1–3 years with a

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Pediatric Nutrition_Gale Encyclopedia of Nursing_2002


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  1. 1. • It provides infants with most of the nutrients they need Pediatric nutrition Pediatric nutrition for growth and is a readily available energy source. • It contains large amounts of vitamin E, which may help Definition prevent anemia. Additionally, vitamin E is an important Pediatric nutrition considers the dietary needs of antioxidant. infants to support growth and development, including • It is compatible with infants’ enzymes. changes in organ function and body composition. • Unlike cow’s milk, it has an optimum calcium to phosphorus ratio of 2:1. Purpose • Breastfeeding transfers antibodies from mothers to Decisions parents make about nutrition and feeding infants. their infants have short- and long-term effects on the • All infectious diseases occur less frequently in infants babies’ subsequent growth and development. Infectious who are breastfed rather than bottle fed. disease and chronic digestive disease can be reduced • It favorably changes the pH of stools and the intestinal with good nutrition choices such as breastfeeding. flora, thus protecting against bacterial diarrheas. Breastfed infants have better overall health, so choices about pediatric nutrition are important considerations. Formula feeding There are a number of commercially prepared infant Precautions formulas on the market available in powder, concentrat- Infants consume small amounts of food at a time, but ed liquid, and pre-diluted liquid forms. The American they should not be fed directly from the jar because bac- Academy of Pediatrics advises that whole cow’s milk teria is introduced into a jar from the babies’ mouth. If should not be given to a child during the first year of life. It also recommends iron-fortified formula for all infants uneaten food is then put into the refrigerator, bacteria will on formula. Infant formula has more protein and more likely grow and may cause diarrhea, vomiting, or other iron than human milk, but lacks antibodies. signs of food-borne illness. In order to prevent food sen- sitivities, some foods such as wheat, eggs, and chocolate Introduction of solid foods should be avoided until the child is one year of age. The age to start solid foods depends on infants’ Ensuring adequate water intake, which can be needs and readiness, but they do not need solid food derived solely through milk, is critical to maintain elec- before six months of age, particularly breastfed infants. trolyte balance and therefore the overall health of Tongue and mouth movement is usually adequate by four infants and young children. months. If infants are force-fed early, some will rebel and develop feeding problems. Weaning of a breastfed infant Description depends on the preferences and needs of the mother and Breastfeeding for optimum health infant. Weaning gradually over weeks or months is easi- est. When the infant is about seven months old, breast- There are several advantages that breastfeeding pro- feeding once a day should be replaced by a bottle or cup vides compared to bottle-feeding. Breast milk imparts of modified formula or fruit juice. By 10 months, the superior nutritional, immunological, and psychological infant may be weaned to a cup. Thereafter, one or two benefits to infants. Breastfeeding is also much more eco- feedings daily can be continued until age 18 to 24 nomical, and no preparation is required. The American months. A full diet of solid foods and fluids by cup Dietetic Association advocates breastfeeding exclusively should be given to infants who are nursed even longer. for four to six months, and breastfeeding with weaning To determine an infant’s tolerance, solid foods foods for at least 12 months. The American Academy of should be offered by spoon and introduced one flavor at Pediatrics also advocates breastfeeding, stating, a time. Many commercial baby foods (desserts and soup “Exclusive breastfeeding is ideal nutrition and sufficient mixtures, in particular) are high in starch, calories, have to support optimal growth and development for approxi- no or little vitamin or mineral value, and are high in cel- mately the first six months after birth...It is recommend- lulose, which is poorly digested by infants. Commercial ed that breastfeeding continue for at least 12 months, and baby foods with high sodium content, more than 200 thereafter for as long as mutually desired.” mg/jar, should be avoided. The daily sodium requirement Breast milk’s nutritional advantages are: is 17.6 mg/kilogram. Pureed home foods will suffice. 1849 G A L E E N C Y C L O P E D I A O F N U R S I N G A N D A L L I E D H E A LT H
  2. 2. Pediatric nutrition • Thiamine (vitamin B1) for infants 0–6 months: 0.2 mil- ligrams/day (mg/d); 7–12 months: 0.3 mg/d; children KEY TERMS 1–3 years: 0.5 mg/d. Anemia—A decrease in the number of red blood • Riboflavin (vitamin B2) for infants 0–6 months: 0.3 cells in the bloodstream, characterized by pallor, mg/d; 7–12 months: 0.4 mg/d; children 1–3 years: 0.5 loss of energy, and generalized weakness. mg/d. Cystic fibrosis—A hereditary genetic disorder that • Niacin for infants 0–6 months: 2 mg/d; 7–12 months: 4 occurs most often in Caucasians. Thick, sticky mg/d; children 1–3 years: 6 mg/d. secretions from mucus-producing glands cause • Vitamin B6 for infants 0–6 months: 0.1 mg/d; 7–12 blockages in the pancreatic ducts and the airways. months: 0.3 mg/d; children 1–3 years: 0.5 mg/d. Dietary reference intakes (DRI)—This standard • Vitamin B12 for infants 0–6 months: 0.4 mcg/d; 7–12 recommends the daily amounts of energy, protein, months: 0.5 mcg/d; children 1–3 years: 0.9 mcg/d. minerals, and fat-soluble and water-soluble vita- mins needed by healthy males and females, from • Pantothenic acid for infants 0–6 months: 1.7 mg/d; infancy to old age. 7–12 months: 1.8 mg/d; children 1–3 years: 2.0 mg/d. Electrolytes—Any of the various ions such as • Biotin for infants 0–6 months: 5 mcg/d; 7–12 months: sodium, potassium, or chloride required by cells 6 mcg/d; children 1–3 years: 8 mcg/d. to regulate the electric charge and flow of water • Folate for infants 0–6 months: 65 mcg/d; 7–12 months: molecules across the cell membrane. 80 mcg/d; children 1–3 years: 150 mcg/d. Gluten enteropathy—A hereditary malabsorption • Vitamin C (ascorbic acid) for infants 0–6 months: 40 disorder caused by sensitivity to gluten, a protein mg/d; 7–12 months: 50 mg/d; children 1–3 years: 15 found in wheat, rye, barley, and oats. Also called mg/d. non-tropical sprue or celiac disease. • Vitamin D (in the absence of adequate sunlight) for Recommended dietary allowance (RDA)—The infants 0–6 months: 5 mg/d; 7–12 months: 5 mg/d; chil- recommended dietary allowances are the quanti- ties of nutrients in the diet that are needed for dren 1–3 years: 5 mg/d. good health. • Vitamin E for infants 0–6 months: 4 mg/d; 7–12 months: 5 mg/d; children 1–3 years: 6 mg/d. • Vitamin K for infants 0–6 months: 2.0 mcg/d; 7–12 Meat should be preferentially introduced to high-carbo- months: 2.5 mcg/d; children 1–3 years: 30 mcg/d. hydrate foods; however, because infants often reject • Calcium for infants 0–6 months: 210 mg/d; 7–12 meat, it must be introduced patiently and carefully. months: 270 mg/d; children 1–3 years: 500 mg/d. To ensure infants eat enough fat when weaning from • Phosphorus for infants 0–6 months: 100 mg/d; 7–12 breast milk or formula, choose whole milk up to two months: 275 mg/d; children 1–3 years: 460 mg/d. years of age. Two good sources of protein and fat that • Magnesium for infants 0–6 months: 30 mg/d; 7–12 infants enjoy are peanut butter and cheese. If there are months: 75 mg/d; children 1–3 years: 80 mg/d. concerns about obesity, lean protein choices provide the fat and protein. Adequate intakes of grains, fruits, and • Selenium for infants 0–6 months: 15 mcg/d; 7–12 vegetables will ensure that infants receive all the neces- months: 20 mcg/d; children 1–3 years: 20 mcg/d. sary vitamins and minerals. • Zinc for infants 0–6 months: 2 mg/d; 7–12 months: 3 mg/d; children 1–3 years: 3 mg/d. Preparation • Iron for infants 0–6 months: 0.27 mg/d; 7–12 months: 11 mg/d; children 1–3 years: 7 mg/d. In order to make appropriate choices about pediatric nutrition, it is important to be aware of the nutritional The following is the recommended dietary needs of infants. The following are the recommended vita- allowance for energy and protein intakes for infants and min and mineral intakes for infants and young children: young children: • Vitamin A for infants 0–6 months: 400 micrograms/day • Energy (calories) for infants 0–6 months, with a weight (mcg/d); 7–12 months: 500 mcg/d; children 1–3 years: of approximately 6 kg (13 lb): 650 kilocalories per day 300 mcg/d. (kcal/d); 6–12 months with a weight of approximately G A L E E N C Y C L O P E D I A O F N U R S I N G A N D A L L I E D H E A LT H 1850
  3. 3. 9 kg (20 lb): 850 kcal/d; children 1–3 years with a Pediatric physical therapy PERIODICALS weight of approximately 13 kg (28 lb): 1300 kcal/d. Azais-Braesco, V., and G. Pascal. “Vitamin A in Pregnancy: Requirements and Safety Limits.” American Journal of • Protein for infants 0–6 months: 13 grams per day (g/d); Clinical Nutrition 71 (2000): 1325S-33. 6–12 months: 14 g/d; children 1–3 years: 16 g/d. Mills, J. L. “Fortification of Foods with Folic Acid—How Breastfed infants need 400 international units (IU) of Much is Enough?” New England Journal of Medicine vitamin D and 0.25 mg of fluoride daily. 342 (2000): 1442-45. Traber, Maret G. “Vitamin E: Too Much or Not Enough?” Breastfeeding does not require any preparation, but American Journal of Clinical Nutrition 73 (2001): bottle feeding requires some preparation such as ensuring 997-98. the milk is the right temperature and the nipples are ster- ORGANIZATIONS ilized, if sterilized disposable nipples are not used. American Dietetic Association. 216 W. Jackson Blvd., Chicago, IL 60606-6995. (312) 899-0040. Complications <http://www.eatright.org/>. Food and Nutrition Information Center Agricultural Research Obesity may start with excessive eating in infancy. If Service, USDA. National Agricultural Library, Room an infant has two obese parents, it is particularly impor- 304, 10301 Baltimore Avenue, Beltsville, MD 20705- tant to monitor and control weight gain. With two obese 2351. (301) 504-5719. (301) 504-6409. parents, an infant has an 80% chance of becoming obese. <http://www.nal.usda.gov/fnic/>. fnic@nal.usda.gov. Diarrhea may be caused by conditions such as celiac Food and Nutrition Professionals Network. disease (gluten enteropathy), cystic fibrosis, and sugar <http://nutrition.cos.com/>. (lactose) intolerance. La Leche League International. 1400 N. Meacham Road, Schaumburg, IL 60168-4079. (847) 519-7730. <http://www.lalecheleague.org/>. Results OTHER Infants should be closely monitored for proper Women, Infants, and Children. The Food and Nutrition weight gain to ensure they are receiving adequate nutri- Service Headquarters. 3101 Park Center Drive, tion. Resources such as the National Center for Health Alexandria, VA 22302. (703) 305-2746. Statistics growth charts can be used as a guide. Crystal Heather Kaczkowski, M.Sc. Health care team roles Breastfeeding education efforts are important steps for health care teams. They should encourage a longer duration of breastfeeding to achieve maximum nutrition- Pediatric physical therapy al benefits for infants. A dietitian can assist in providing advice regarding pediatric nutrition feeding decisions. Definition Resources Pediatric physical therapy is concerned with the examination, evaluation, diagnosis, prognosis, and inter- BOOKS vention of children, aged birth through adolescence, who Baker Jr., Robert D. Pediatric Parental Nutrition, 1sted. are experiencing functional limitations or disability due Gaithersburg, MD: Aspen Publishers, Inc., 2001. to trauma, a disorder, or disease process. Hendricks, Kristy M., et al. Manual of Pediatric Nutrition, 3rd ed. Hamilton, Canada: B. C. Decker Inc., 2000. Purpose Institute of Medicine. Dietary Reference Intakes: Applications in Dietary Assessment. Washington, D.C.: National Pediatric physical therapy is indicated when a child Academy Press, 2001. has a pathology or suffers a trauma which results in an Mindell, Earl, and Hester Mundis. Earl Mindell’s Vitamin impairment leading to the loss of function and/or societal Bible for the 21st Century. London, UK: Warner Books, disability. Pathologies may include non-progressive neu- 1999. rological disorders such as cerebral palsy, which results Rodwell-Williams, Sue. Essentials of Nutrition and Diet from trauma to the brain during or shortly after birth. Therapy. London: Mosby-Year Book, 1999. Children born with genetic syndromes, heart and/or lung Samour, Patricia Q., et al. Handbook of Pediatric Nutrition, defects, hydrocephalus, spina bifida, fetal alcohol syn- 2nd ed. Gaithersburg, MD: Aspen Publishers, Inc., 1999. 1851 G A L E E N C Y C L O P E D I A O F N U R S I N G A N D A L L I E D H E A LT H