NUTRITION

IN EARLY
CHILDHOOD

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Protein-energy malnutrition

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OUTLINE
I. Definition
II. Characteristics
III. Nutritional Requirements
IV. Transitional Foods
V. Food preferences
VI. Feeding Problems
VII. Feeding Tips
VIII.Signs of Good Nutrition
IX.Nutritional Assessment
X. Signs of Poor Nutrition
XI.Common Problems and
Disorders

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 Early Childhood Definition

Defined as the period between 1 to 6 years old. Toddler period - increase in gross and fine motor
skills; increase in independence; exploration of the
One to three years: toddler period environment; language skills.
Four to six years: pre-school period Pre-school period - increasing autonomy;
experiencing broader social circumstances;
Children start to have self-regulated food intake. increasing language skills; and expanding ability to
control behavior.

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Characteristics Characteristics of the

Growth and Development in Early Preschool Period
Childhood: B. Changes in fat, muscles, and bone tissues
Body fat decreases. More muscle and bones
A. Weight and height - steady, slow among boys and more body fat tissues among
growth rate, with more or less equal to girls. Cartilage Internal system and tissues -
a yearly gain of 2 to 3 kg. The rate of body system slows and stabilizes.
Early childhood through the teen years is the main
Average height increase by 2-3
bone-building phase of your child's life.
inches per year
This is when your child's body adds the most
calcium to their bones to help them become
denser and stronger.

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 Characteristics of the Characteristics of the
Preschool Period Preschool Period
D. Brain growth - rapid during the first 3-4 years.
C. Brain reaches 75% of its adult size by age 2 and
90% at age 4-6 years
Adult chest breathing movements
New cells are formed, existing cells become more
Larger bladder, thus longer time between
complex. Myelination continues.
bathroom trips and so child’s sleep is less
interrupted Hand preferences are established by age 4

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MYELINATION Characteristics of the

Myelin forms around the axons in what is often called
the myelin sheath. ... Myelin enables nerve cells to
Preschool Period
transmit information faster and allows for more complex E.Changes in gastrointestinal tract:
brain processes. The myelination process is By 1 year, the digestive system, liver and kidneys are
vitally important to healthy central nervous system
able to cope with normal family meals although GIT
functioning.
may still be sensitive.

Increased stomach capacity - 1/2 of adult stomach

capacity

Taste buds sensitive to hot and cold foods as well as

strong flavors

Twenty baby teeth come out by age 2 1/2 to 3

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 Characteristics of the Characteristics of the
Preschool Period Preschool Period
F. Developmental milestones cont…

Progression of fine motor coordination. Increased curiosity and interest in environment

Fast rate of intellectual, social, and emotional Aroused by visual, audio and sensory stimuli;
development ® formative years: most receptive shows preference for certain colors;
to learning especially by imitation rather than
Greater interest in surrounding environment , but
reason or logic
may distract the child during mealtime

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Development of Feeding Development of Feeding

Skills Skills
12 months: refined pincer grasp that enables them to
12 to 18 months: able to move the tongue from pick up small objects, such as cooked peas and carrots,
side to side (or laterally) and learn to chew food and put them into their mouths.
with rotary, rather than just up and down, able to use a spoon around this age, but not very well.
movements.
18 to 24 months: able to use the tongue to clean the lips
can now handle chopped or soft table food. and have well-developed rotary chewing movements.

can handle meats, raw fruits and vegetables, and

multiple food textures.

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 TABLES

NUTRITIONAL
REQUIREMENTS OF
PRE-SCHOOL
CHILDREN

REGIDOR, CM // 040216

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TABLES
Energy
Increase in calories - due to the greater energy
needed for basal metabolism, increased activity,
increased growth of muscle and adipose tissue.

Boys have greater energy needs than girls and

that the boys eat more to meet their requirements.

Recommended intake is 1350 kcal (males) and

1260 (females) for 3-5 years old.

REGIDOR, CM // 040216

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 Protein Vitamins and Minerals
Protein allowance of 1.25 to 2.0 Calcium and phosphorus - needed for bone
grams/ kg DBW is recommended mineralization.
to provide for increase in skeletal
As body size increases, the other systems also
and muscle tissue and for
increase (skeletal, cardiovascular, etc), thus the
protection against infection
increased needs for nutrients
(PDRI, 2015).
Tooth formation increases the need for fluorine.
Common sources for children:
milk, meat, eggs, cheese Vitamin C is needed for the formation of collagen

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WHAT IS COLLAGEN?
Fluids
Collagen is a protein that provides structure to
much of your body, including bones, skin, 60% of the child’s body weight is water.
tendons, and ligaments.
A normal healthy child needs a minimum of 4 to 7
glasses or 1000-1500 ml per day.

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 Transitional Foods
• Refers to the transition from an infant diet
to a regular adult diet.
• Formation of good eating habits is critical at
TRANSITIONAL FOODS this stage
• Children react more to color, flavor,
texture, temperature, size of serving,
attitude and atmosphere in which it is
presented.

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 Pre-schoolers’ food
preferences
1.Preference for energy dense foods; rejects sour and
bitter tastes.

2.Mildly flavoured foods rather than strongly flavoured

foods - the digestive tract is less easily irritated by very
rich foods, fried foods, and excessive fiber.

3.Plain foods are preferred over mixed dishes

4.Foods that are softly textured, as determined by

child’s ability to chew.

5.Soft and moist foods (lack supply amount of saliva)

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Meeting the food

Meeting the food allowances
allowances of pre-schoolers
of pre-schoolers
• Make available to the child ample amounts of
• Although the foods the children need are the body-building, energy-giving, and regulatory foods.
same as adults, the portion sizes are not.
• Offer small and frequent servings of nutrient
• Rule-of-thumb to determine age-appropriate dense foods.
serving sizes: 1 tbsp of food per year of age (e.g.,
the serving size for a 3-year-old is 3 tbsp). • Offer nutritious snacks in the morning and
afternoon, making sure they are far from mealtime
• By ages 4 to 6 years, recommended serving sizes
are similar to those for adults. • If there is a tendency to decrease milk intake,
incorporate milk in other dishes.

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 Meeting the food
allowances of pre-schoolers
• Milk is a major source of nutrients (eg. fat) -
“Type a quote here.” children between the ages of 1 and 2 years
have a relatively higher need for fat to support
rapid growth and development (Daniels and
Greer, 2008).
–Johnny Appleseed
• Milk intake should not exceed 2 to 3 cups per
day - may displace the intake of iron-rich foods
from the diet and promote milk anemia.

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Feeding Problems
FEEDING PROBLEMS
1. Food Jags - eating too Food jagging- children on food jags want to eat
little and very limited number the same food over and over again, sometimes
of foods. in large quantities. The jags are usually short
lived and do not present problems unless the
This should not be a
child becomes too “picky” for a long period of
problem if the accepted
foods are nutritious time. In such case, it would help if new kinds of
food are given slowly. As long as what he eats
Jags do not last long so do are the right foods and the right amount.
not make an issue out of it.

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 Feeding Problems
FEEDING PROBLEMS
2. Dawdling - the child plays Dawdling - One who lingers or dillydallies with his
with the food during food during mealtime. Oftentimes, he is only
mealtimes trying to get attention or the serving portion
given him is more than what he wants. To
Reasons: the child is not prevent such problem, try to make his meal an
hungry, too large portions, enjoyable experience.
the child is not feeling well
or needs attention;
asserting independence

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Feeding Problems
FEEDING PROBLEMS
3. Food dislikes; variable appetite; capricious Gagging- A child who gags is one who feels like
behaviour - the child may not like the taste of vomiting especially when fed with coarsely textured
the food; child may want to attract attention. foods. This is due to failure in training him while he
was still an infant to eat chopped foods. To remedy,
• Do not make an issue out of it; maintain a encourage self feeding and let him eat with other
calm and relaxed attitude; avoid being rigid children. It will also help him if he is given attractive
place, spoon, fork and cup which he can manage with
• Combine foods with other well-liked foods his hands.
or prepare that food in other ways.

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 Feeding Problems Feeding Tips
4. Eating too much - may be due to appetite, 1. Offer a variety of nutritious foods
heredity, temperament, mother’s insistence of a
‘clean plate’. Introduce new food with a familiar favorite
May lead to overweight and obesity in the long Make food appetizing, vary shapes, color, and texture
term.
Use different cooking styles
Restrain the child from eating too much rich
foods like cakes, pastries, candies.

Management: small frequent feeding of

nutritious foods; avoid large portion sizes

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Feeding Tips Feeding Tips

2. Give child-sized servings 3. Involve your child
Allow mini-meals Allow your child to explore
foods by touching
Offer foods the child can
easily chew and digest Encourage your child to
participate in planning,
Use child-sized utensils buying, and preparing foods

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 Feeding Tips Feeding Tips
5. Always encourage
4. Provide an enjoyable
atmosphere Never force a child to eat.
Do not use food to reward, punish, bribe, or
Make eating comfortable
convey love
Make eating safe 6. Set a good example
If you want your child to eat a well-balanced
Set the times for eating
diet, you should do the same
Keep mealtime pleasant,
relaxed, and unhurried

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Other Factors Affecting Signs of Good Nutrition in

Food Intake Young Children
1.Peer influence - with growth, a child’s world Alert, vigorous, and happy
expands and social contacts become more Has endurance during activity
important. Sleeps well
Normal height and weight for age
2. Media messages - food is marketed to children
Stands erect; arms, and legs straight
using different techniques such as advertising,
Clear bright eyes; smooth, healthy skin; lustrous hair
in-school marketing, sales promotion, Internet.
Firm and well developed muscles\
3. Illness or disease - children who are ill usually Not irritable and restless; good attention span
have reduced appetite and limited food intake.

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 Why is there a need to Measurements:
assess NS?
Essential component of health care
Helps to confirm a child’s healthy growth and
development
Helps identify early potential nutritional/health
problem
Immunity Cognitive
problem
Stunted growth
Overnutrition
World Health Organization. Training Course on Child Growth Assessment. Geneva,
WHO,2008. A health professional’s guide for using the new WHO growth charts. Paediatr Child Health Vol
15 No 2. 2010 World Health Organization. Training Course on Child Growth Assessment. Geneva, WHO,2008.
A health professional’s guide for using the new WHO growth charts. Paediatr Child Health Vol 15 No 2. 2010

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Measurements: Weight for age:

index used in growth monitoring for assessing
children who may be underweight. Assess weight-
for-age of all children under two years

Height for age

index used for assessing stunting (chronic

malnutrition in children).
Stunting of children in a given population indicates
the fact that the children have suffered from chronic
malnutrition so much so that it has affected their
linear growth
World Health Organization. Training Course on Child Growth Assessment. Geneva, WHO,2008.
A health professional’s guide for using the new WHO growth charts. Paediatr Child Health Vol 15 No 2. 2010 World Health Organization. Training Course on Child Growth Assessment. Geneva, WHO,2008.

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 Weight for height
Signs of Poor Nutrition
Poorly formed teeth Inelastic,
• Index used for assessing wasting (acute
malnutrition) dry, pale skin
Dull, dry conjunctiva, dark circles on lower lid
• Wasting is defined as a low weight for the
height of the child compared to the standard Dull, dry, easily plucked hair, flag sign in severely
child of the same height. Wasted children are underweight child
vulnerable to infection and stand a greater Emaciated (thinness), flabby muscles (lack of
chance of dying.
firmness), tender to the touch Short attention span
Sickly, frequent colds
World Health Organization. Training Course on Child Growth Assessment. Geneva, WHO,2008.

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Signs of Poor Nutrition Common Problems and Disorders

among Young Children
• Poor attention span, diminished interest in
activities, lethargic, apathetic, irritable and cries • Diarrhea - stools contain more water than normal and are not
often well formed
• Easily tires, tendency to fall asleep in school,
• Dysentery - diarrhea where the stools contain blood;
restless and irregular sleeping patterns
may lead to dehydration and undernutrition if
• Underweight or irregular weight gain uncontrolled
Slouching posture with protruding belly

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 HOW TO MAKE A HOMEMADE Common Problems and Disorders
ORESOL among Young Children
Ingredients: Six (6) level teaspoons of Sugar. Half (1/2) level
Management:
teaspoon of Salt. One Litre of clean drinking or boiled water 1. Prevent dehydration
and then cooled - 5 cupfuls (each cup about 200 ml.)
2.Treat dehydration if present

3.Feed the child - progress to soft then regular

foods

4.Use of ORS (oral rehydration solution)

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Common Problems and Disorders

among Young Children
• Constipation - difficulty of emptying the bowel due to
poor muscle contraction in the GI tract and/ or lack of
fluids to facilitate excretion

• Management: High fiber and adequate fluid

intake

• Exercise and physical activity to promote bowel

movement.

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 IMPORTANCE OF FIBER
Common Problems and Disorders
Soluble fiber allows more water to remain in your stool,
making waste softer, larger, and thus, easier to pass through
among Young Children
your intestines. Insoluble fiber adds bulk to your fecal material,
which hastens its passage through your gut and prevents Food allergy - adverse body reaction after intake
that constipated feeling. of certain foods; allergies to eggs, milk, and
seafoods may decrease protein intake.

Lactose intolerance - deficiency in lactase; milk

is substituted with fermented milk, soy, or other
lactose free products.

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TOP 8 FOOD ALLERGENS

Lactose intolerance is when
the body can't easily break
down or digest lactose.
Lactose is a sugar found in
milk and milk products. If your
child is lactose intolerant, he or
she may have unpleasant
symptoms after eating or
drinking milk products. These
symptoms include bloating,
diarrhea, and gas.

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 Common Problems and Disorders Common Problems and Disorders
among Young Children among Young Children
Dental caries - dentin and the enamel is infected by Management:
cariogenic microorganisms
• Mother must develop good oral hygiene in the
• The strength of the teeth is developed
child
during conception, thus the mother should
have an adequate diet • Provide fluoride treatment.
• Factors that influence the development of dental • Minimize simple sugar intake
caries: a.) susceptibility of the tooth, b.)
presence of fermenting CHO, c.) presence of
bacteria causing CHO fermentation

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Common Problems and Disorders PICTURES OF PARASITES

among Young Children
Intestinal parasitism - medical problem
leading to nutrient deficiencies
• Etiology - ingestion of parasites and/or its
egg from infected food, vegetables, or soil
• Most common forms are ascariasis caused
by Ascaris lumbricoides and trichinosis
caused by Trichinella spiral

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 Common Problems and Disorders
among Young Children
Intestinal parasitism
Nutritional effects - ascaris interferes with absorption
of iron, fat (and fat-soluble vitamins), nitrogen, and
ote here.”
“Type a qu

ascorbic acid
Prevention - observe hygienic preparation of foods, –Johnny A ppleseed
personal hygiene
Treatment - anti-helminthic drugs with high energy,
high protein diet, iron and ascorbic acid
supplementation

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BUTO’T BALAT BY KARA DAVID

https://www.youtube.com/watch?v=1yH-4el0X7c • SPECIAL THANKS TO Mr. Kevin E. Carpio,
MSc, RND for the Power Point Presentation

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 References
• Brown, J. (2011). Nutrition Through the Life Cycle.
(2nd ed). California: Wadsworth Cengage Learning.

• Claudio, V., et al. (2004). Basic Nutrition for

Filipinos. (5th ed). Manila: Merriam Webster
Publishing, Inc.

• Orense, C., Barba, C., Tuazon, A. (2009).

Fundamentals in Nutrition in Public Health and
the Life Stages. (2nd ed). Nutritionist Dietitians THANK YOU!
Association of the Philippines Foundation.

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