4

NUTRITION

Learning Objective

The objective in this section is for you to explain how nutrition influences growth and development This meets the NAEYC Standard 1b, 6b and the MA Core Competency 1.A.2 @ Initial & 8.D. 12@Initial level.

 Interesting Facts

Globally, an estimated 43 million preschool children were overweight or obese in 2010, a 60% increase since 1990. (National Resource Center for Health and Safety in Child Care and Early Education, University of Colorado Denver. National Resource Center for Health and Safety in Child Care and Early Education: Achieving a State of Healthy Weight: A National Assessment of Obesity Prevention Terminology in Child Care Regulations 2010. Aurora, CO; 2011.)

  • Models for healthy behavior are early educators as 75 % of children spend time in child care.
  • Children who are overweight or obese are at increased risk for health and socio-emotional problems.
  • Being overweight in the preschool years is highly predictive of being overweight later in childhood.
  • Overweight children are more likely than their peers to develop cardiovascular disease, type-2 diabetes, liver disease, sleep apnea, high cholesterol, and asthma.
  • Food insecurity is associated with children’s greater risk for being overweight.
  • Shared mealtimes are associated with a number of benefits such as increased vocabulary and exposure to a wider variety of foods that may result in healthier eating habits.
  • Research suggests that having a television on during mealtimes may promote unhealthy eating.

The Harvard School of Public Health asserts that childhood is a critical time for obesity prevention because children are develop taste preferences and physical skills, as well as imitate healthy and unhealthy behaviors of caregivers. Children’s early-life experiences, such as bottle feeding, too little sleep, and too much television can increase the risk of obesity later in life.

Inadequate food intake in children is associated with a number of serious health, behavior, and cognitive deficits. Children who are food  insecure are in poorer health than children who are in food secure households with higher rates of hospitalization, iron deficiency anemia, and chronic health conditions.  As you can see the factor of nutrition impacts all developmental domain.

Developmental Considerations

Infants

In your work with infants and toddlers and their families, you will likely hear about the Women, Infants, and Children (WIC) program.  WIC’s mission is to safeguard the health of low-income women, infants, and children up to age 5 who are at nutrition risk by providing nutritious foods to supplement diets, information on healthy eating, and referrals to health care. Delivering high quality nutrition services is essential in not only carrying out this mission, but also ensuring that WIC continues to be the premiere national public health nutrition program.  A resource that is useful to you as a caregiver is the Infant Nutrition and Feeding: A Guide for Use in the WIC and CSF Programs (2009) The guide provides nutrition education to help you inform families of  infants.

Another useful resources is the Stanford Children’s Health website .    The Infant Feeding Guide offers guidance for appropriate and healthy feeding of an infant during the first year of life.  Here are tips from their website:

Don’t give solid foods unless your baby’s health care provider advises you to do so. Solid foods shouldn’t be started for infants younger than age 4 months for the following reasons:

  • Breast milk or formula provides your baby all the nutrients that are needed to grow.
  • Your baby isn’t physically developed enough to eat solid food from a spoon.
  • Feeding your baby solid food too early may lead to overfeeding and being overweight.
  • As a general rule, solid foods don’t help babies sleep through the night.

Guide for formula feeding (0 to 5 months)

Age Amount of formula per feeding Number of feedings per 24 Hours
1 month 2 to 4 ounces 6 to 8 times
2 months 5 to 6 ounces 5 to 6 times
3 to 5 months 6 to 7 ounces 5 to 6 times

Feeding tips for infants after 4-6 months

  • When starting solid foods, offer one new food at a time—not mixtures like cereal and fruit or meat dinners. Give the new food for two to three days before adding another new food. This way you can tell what foods an infant may be allergic to or can’t tolerate.
  • Begin with small amounts of new solid foods—a teaspoon at first and slowly increase to a tablespoon.
  • There are no strict rules about the order in which you should give different foods in. Many people start with an infant cereal and gradually add fruits, vegetables, and proteins.
  • Don’t use salt or sugar when making homemade baby foods. Also, avoid feeding homemade spinach, beets, green beans, squash, and carrots for infants younger than age 6 months because of the risk for methemoglobinemia, a blood disorder that can interfere with oxygen delivery in the blood, due to high concentration of nitrates. Canned foods may contain large amounts of salt and sugar and shouldn’t be used for baby food. Always wash and peel fruits and vegetables and remove seeds or pits. Take special care with fruits and vegetables that come into contact with the ground. They may contain botulism spores that cause food poisoning.
  • Cow’s milk shouldn’t be added to the diet until the baby is age 12 months. Cow’s milk doesn’t provide the right nutrients for an infant.
  • Limit fruit juice without sugar o a maximum of 4 to 6 ounces daily when the infant is able to drink from a cup (around age 6 months or older). Whole fruits and vegetables are a much healthier option.
  • Feed all foods with a spoon. Your baby needs to learn to eat from a spoon.  Only formula and water should go into the bottle.
  • Expect a smaller and pickier appetite as the baby’s growth rate slows around age 1.
  • Once an infant is taking solids, offer sips of water.
  • Offer a wide variety of foods early to develop good eating habits later.

Toddlers

The following list is from the North Carolina Division of Child Development: Infant Toddler Foundations (2008).  The list is useful in understand what to expect from toddlers

Young toddlers may begin to:

  • Want to feed themselves.
  • Eagerly participate in snacks and mealtimes.
  • Bite, chew, and swallow soft food smoothly.
  • Show interest in many types of food and no interest in other foods.
  • Eat inconsistently (eat a lot at one meal and little at the next, be too busy playing to eat).
  • Ask for food when hungry or accept food when offered.
  • Be willing to try new foods.

Older toddlers may begin to:

  • Enjoy helping with meal and snack routines (set table, wash hands, throw away trash).
  • Bite and chew solid food more easily.
  • Accept or refuse food depending on their appetite and interest.
  • Notice and talk about food textures, temperatures, and tastes (crunchy crackers, warm soup, sweet apples).
  •  Understand that some foods are good for them (fresh fruits, vegetables, milk) and some are not very healthy (potato chips, soda).

 

A resource to review

Skim the publication American Academy for Pediatrics. (2011) Bright Futures: Nutrition, 3rd Edition. Washington, DC: Author. The introduction provides information on promoting good nutrition and physical activity as essential components of a healthy lifestyle; establishing a framework for understanding how culture affects food choices and nutrition; and building partnerships among health professionals, families, and communities to improve the nutrition status of infants and toddlers.

In the nutrition supervision section you will examine nutrition issues for infants and toddlers, an overview of the development, nutrition supervision information, desired health and nutrition outcomes, and a list of frequently asked questions with answers that can be used as a handout for families.

In the nutrition tools section includes a questionnaire to help you promote the nutrition status of infants and toddlers.  As you explore consider

What do families need to do to promote the nutrition status of infants and toddlers?

✦How can you become more effective in promoting the nutrition status of infants and toddlers?

 

Legal Responsibilities

Are you aware of the MA licensing regulations regarding Nutrition and Food Service? The regulations from the Standards for the Licensure or Approval of Family Child Care; Small Group and School Age and Large Group and School Age Child Care Programs state in section 7.12 the following requirements apply to all delivery models of childcare.  I included the most relevant for you to read that is why the numbers and letters skip.

(1) The program must design and implement a nutrition program that meets the U.S.D.A. guidelines for the nutritional and dietary needs and feeding requirements of each child, including those of children with disabilities.

(2) All educators must receive basic training in the following (See below for training options):

(a) in USDA recognized nutrition requirements for the healthy growth and development of children; and

(b) in food choking hazards.

(3) Educators must follow parents’ or physicians’ orders in the preparation and feeding of special diets to children.

(4) Educators must follow the directions of the parents and /or the child’s physician regarding any food allergies of a child.

(6) The program must have a method of providing nutritious meals and snacks to children whose parents fail to send meals and/or snacks from home.

(7) If the program provides meals and snacks for children:

(a)  the nutrition program must serve a variety of nutritious foods;

(b)  the program must ensure that snacks and meals are prepared and served in a safe and sanitary manner;

(8) The program must provide refrigeration and storage for food at not less than 32° F, nor more than 40° F for all food requiring refrigeration. Meals and snacks provided by parents must be stored safely. Thermometers verifying temperatures must be maintained in all refrigerators.

(10) Meal schedules must be appropriate to the ages of the children served.

  • In programs serving infants and toddlers:
    • A current feeding schedule must be maintained, documenting use of either breast milk or formula, if applicable, new foods introduced, food intolerances and preferences, voiding patterns, and observations related to developmental changes in feeding and nutrition.
    • Infants and toddlers must be fed according to their individual feeding schedules or needs.
      3. Infants must be held while fed a bottle.
    • The program must offer a nutritious substitute to a child who misses a meal or snack due to deviations from his regular schedule (such as arriving late or leaving early).

(11)  During meal and snack times educators must:

(a) be present interacting with and assisting children;
(b) allow children to eat at a reasonable, leisurely rate;
(c) encourage children to serve themselves, when appropriate;
(d) ensure that each child receives an adequate amount and variety of food;

(e) help children with disabilities to participate in meal and snack times with their peers;
(f) encourage children to eat a well-balanced diet;
(g) offer alternative activities for children who have finished their snack or meal.

(12)  Educators must dispose of, or return to the parent, milk, formula or food unfinished by a child, as directed by the parent.

(13) The program must provide a source of sanitary drinking water located in or convenient to rooms occupied by children.

(14) Educators must offer water to children at frequent intervals and upon request by children.

Training Options

  1. The United States Department of Agriculture (USDA) has compiled food safety and general nutrition information targeted at Child Care Educators
  2. Menu Planning for Child Care 
  3. Choking Prevention

What did you discover about your responsibilities as an educator for nutrition by reviewing the regulations and exploring the resources?

 

Let’s Move

Explore Let’s Move! Child Care a part of the initiative launched by Michelle Obama dedicated to solving the obesity problem. Let’s Move! is about putting children on the path to a healthy future during their earliest months and years. What idea might you use from Let’s Move Childcare?

 

Read and Participate

After reading Chapters 3 and 4 about the influences of culture and nutrition.  Use the reflection form below as you complete the readings and/or watch the videos as a note taking method. Using your notes as recorded on the table, write out 3 paragraphs to summarize your ideas.   Share your connections, extensions, and curiosities either in the Blackboard discussion or during a class discussion.

CRITERIA NOTES EXAMPLES FROM WEEKLY CONTENT
Connections

Relate ideas from the reading to learning in other courses or life experience.

Implementation

What strategies or methods have you used in the past, or will use in the future to support what you have learned from the weekly content?

Curiosities

What are you still curious about?  What do you want to explore further?   Why?

Additional Online Resource(s) to Share

 

 

 

 

 

License

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Infant and Toddler Education and Care Copyright © 2017 by Dr. Susan Eliason is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License, except where otherwise noted.

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