Nutrition of children

1. Nutrition and nutritional need of children
Presented by : Chinju Shaji
M.Sc. Nursing 1st year
Seminar on

2. CONTENT OUTLINES
• Introduction
• Definition
• Nutritional requirement for children
• Various nutrients required for children
• Advantages of balance diet
• Disorder related with malnutrition
• Nutritional guidelines for children
• Recommended of micronutrients

3. • Exclusive breast feeding
• Changing feeding pattern
• Guiding principles for complementary feeding
• Guidelines for giving complimentary food
• Healthy eating habits
• Conclusion
• References

4. Introduction
 Growth and development is essential requirement and it
is greatly influenced by adequate nutrition.
 Healthy children makes healthy country.
 All the health care provider must know about adequate
breast feeding, weaning and balance diet for under five
children to prevent PEM, anemia, rickets and blindness
caused by nutritional deficiencies

5. Definition
NUTRITION
It is the process of nourishing or being
nourished, especially the process by which a
living organism assimilates food and uses it for
growth and replacement of tissues.

6. Present Nutritional status
 According to recent National Family Health Survey
and UNICEF Reports
 46% of preschool children and 30% of adults in India
suffer from moderate and severe grades of protein-
calorie malnutrition as judged by anthropometric
indicators

7. Nutritional requirement of children
 Currently, India is in
nutrition transition with
10% rural adults and
20% urban adults
suffering from over-
nutrition leading to an
emerging double burden
of malnutrition

8. Macronutrients
• Main source of energy in the diet
and contribute about 55-60% of
total energy intake
Carbohydrates
• Second most abundant substance in
the body.
• Required for the growth and
synthesis of tissues in the body
Proteins
• Major source of energy; carries fat
soluble vitamins like vit A,D.E and
K and precursor for biosynthesis of
prostaglandin and hormones .
Fats
Various nutrient required

9. Micronutrients
Vitamins
Vitamin
A
Vitamin
B
Vitamin
C
Vitamin
D
Vitamin
E
Vitamin
K

10. Minerals
Sixteen minerals are required to support human
biochemical processes by playing role in cell structure
and function as well as electrolytes these are calcium,
chloride, cobalt, copper, iodine, iron, magnesium,
manganese, molybdenum, phosphorus, potassium,
selenium, sodium, sulfur and zinc etc..

11. Advantages of balance diet
 A balanced diet among children is important because
they are constantly growing in body & mind.
 Making sure that children consume a sufficient amount
of calcium and vitamin D will decrease the risk of bone
related issues at a later point in life.
 It provides a strong immune system, is vital so that the
body can fight off illness and infection which is very
important for a child

12. Disorders caused by malnutrition
 Marasmus.
 Kwashiorkor
 Anemia
 Goiter.
 Pellagra.
 Scurvy
 Rickets

13. Nutritional guidelines for children
 Provide variety in meals. Avoid Monotony
 School meals and packed lunches are very important
part of daily nutritional intake
 Balance food with physical activity.

14. Nutritional guidelines for children conti…..
 Set good examples for healthy eating habit.
 Provide plenty of grains, fruits and vegetable,
low fat dairy products.
 Moderate sugars and salt.
 Involve the child in making food choices.

15. Nutritional guidelines for children Conti….
 Encourage the child to eat with family at the
dining table.
 Never skip breakfast.
 Don’t serve food in front of TV
 Avoid foods rich in saturated fats and cholesterol

16. Exclusive breast feeding and changing feeding
pattern
 Exclusive Breast feeding: Feeding the baby from the
breast for first six months exclusively with no
supplementation with any type of feeding
 Predominant breastfeeding: Main source of nutrition is
breast milk but the child is also receiving other fluids
like water or water based drinks such as juices.

17. Partial breastfeeding: Child receives
non-human milk, formula or cereal based
foods in addition to breast milk.
Exclusive breast feeding and changing feeding
pattern conti…..

18. Changing feeding pattern

19. Complementary feeding
Social or medical conditions in the mother,
complementary or sometimes total feeding with non-
human or animal milk may be required in the following
situations:
 Adopted baby
 Inadequate lactation

20. Complementary feeding conti….
 Twin or triplet babies
 Mother receiving anti-cancer drugs
 Seriously or critically sick mother
 Working mother and social constraints

21. The choice of milk
 Any liquid milk which is procured by the family for
house hold use can be given to the baby without
dilution.
 Children should be given full cream milk except when
overweight.
 Infant formulas fortified with iron and vitamins are
better.

22. The choice of milk conti……..
 For first 2 months, pure cows or buffaloes milk may be
diluted in a ratio of 3 parts of milk and one part of water
to reduce protein load to kidneys
 After 2 months full strength liquid milk can be used.
 Fresh liquid milk is suitable for feeding babies

23. How much milk to offer
 30—45 ml of milk during the first week of life.
 If babies completely empty the bottle, additional
15 ml of milk should be offered during the next
feed.
 Feeds should be gradually increased by one
ounce (30ML) after every month.

24. Feeding with a cup and spoon or paladai
To prevent risk of infection and “nipple
confusion” with bottle feeding, feeding
with a spoon or paladay is best method.
The baby should be held in the lap with
head slightly raised and edge of the
spoon or paladay is touched to the lips.
As soon as the milk touches the lips and
tongue, the baby makes swallowing
efforts to drink the milk.
This is safe but time consuming so
mother should be patient.

25. Feeding with solids
 Exclusive breast feeding is able to maintain normal growth 6
months of life.
 Infant must be gradually weaned off to take semi liquid or
semi-solid food.
 Energy needed in addition to breast milk is about 200 kcal
per day in infants 6-8 months,300kcal per day in infants 9-11
months and 550 kcal per day in children 12-23 months of
age.

26. Feeding with solids conti….
 Prolonged milk feeding without timely introduction of
weaning foods is the commonest cause of iron
deficiency anemia
 Homemade nutritious weaning foods must provided on
time to maintain growth and development

27. Guiding principles for complementary feeding
of breast feed child
 Practice exclusive breast feeding from birth to 6 months
of age, introduce complementary foods at 6months of
with breast feed.
 Continue on frequent, on demand breastfeeding until
2yrs of age.

28. Guiding principle for complimentary feeding
conti……
 Practice responsive (active) principle.
 Practice good hand hygiene and proper food handling.
 Start at 6month of age with small amount and increase
the quantity as the child gets older

29. Guiding principle for complimentary feeding
conti……
 Gradually increase food consistency and Increase the
number of times that the child is fed.
 Feed a variety of nutrient rich and energy to met all
nutrient needs.
 Use iron rich complementary foods or vitamins
mineral supplements.
 Increase fluid intake during illness , including more
frequent breast feeding.

30. Complementary feeding according to age group
• 6-8 months
Age
• 200 kcal per day
Calorie
• Start with thick porridge, well mashed
foods. Continue with mashed family foods
consistency
• 2-3 meals per day depending on the
child’s appetite, 1-2 snacks may be offered
Frequency
• Start with 2-3 tablespoonfuls per fees,
increasing gradually to 1/4of a 250 ml cup
Amount

31. Cont…
• 9-11 months
Age
• 300 kcal per day
Calorie
• Finely chopped or mashed foods and
foods that baby can pick up
consistency
• 3-4 meals per day depending on the
child’s appetite, 1-2 snacks may be offered
Frequency
• ½ of a 250 cup/bowl.
Amount

32. Contd…
• 12-23 months
Age
• 550 kcal per day
Calorie
• Family foods, chopped or mashed if
necessary
consistency
• 3-4 meals per day depending on the
child’s appetite, 1-2 snacks may be offered
Frequency
• 3/4 to full 250ml cup/bowl.
Amount

33. Healthy eating habit
 Except in preschool children, give fat free milk and
dairy products made from it.
 Avoid junk food .
 Avoid foods containing colors and preservatives.
 Avoid fried and roasted foods
 Give plenty of fresh seasonal fruits and green
vegetables.

34. Contd…
 Give foods rich in omega 3 fatty acids and DHA such as
green leafy vegetables, broccoli, kidney beans, flaxseed
or soy oil, fish and sea food, dry fruits especially
almonds and walnuts
 Water and butter milk are the best drinks, avoid cola
drinks and tinned fruit juices
 Salt and sugar should be used in moderation

35. Conclusion
 The establishment of feeding practices that are
comfortable and satisfying for both the parents and the
infant is crucial not only for the emotional well-being of
both but also for ensuring adequate nutrient intakes for
the infant. Maternal feelings are readily transmitted to
the infant. and are a major determinant of the emotional
setting in which feeding takes place

36. Conclusion conti……
 Appropriate guidance and support from an empathetic
and experienced relative, friend, or health professional
can increase such a mother's confidence, which in turn,
allows her to relax and increases the likelihood of
establishing successful feeding practices during infancy
as well as throughout childhood and beyond

39. References
 Kishore J. National Health Programmes of India. 8th edition. Century
Publications. New Delhi. 2009. Pp 141-142.
 http://www.babyfriendly.org.uk/pdfs/World_Cancer_Research_Fund
_2007-10.pdf
 Richard E Behrman Robert M Kliegman, Waldo E Nelson, Nelson
textbook of pediatrics, 14th edition WB Saunders company ,
Philadelphia, Page no—
 Singh M, Essential Pediatrics for Nurses, 2nd edition, Sagar
publications, New Delhi, Page no—104--139