Nutrition Is Especially Crucial During

In terms of nutrition, most infants are developmentally ready for an introduction to pureed foods between 4 and 6 months of age to meet the growth and energy needs of the child (Johnson, 2009). It is important NOT to introduce solid foods prior to 4 months for several health reasons:  

In the first weeks of life, immaturity of the kidney excludes large osmolar loads of protein and electrolytes and digestion of some fats, proteins, and carbohydrates is compromised.

At age 3-5 months, infants are able to digest and absorb cereal, but at age 1-2 months carbohydrate and protein digestion and absorption are compromised by cereal ingestion (Shulman, 1995).

In the first months of life poorly developed swallowing skills may lead to aspiration. Increased respiratory illness and persistent cough have been reported in infants given solids early (Forsyth, 1993), and coughing may increase following ingestion of formula thickened with infant cereal (Orenstein, 1992). Early introduction of a variety of solid foods may increase risk of atopic and immunological disease in susceptible children (Herbes, 2004). Semisolid foods progressing to “table foods” in the latter part of the first year provides energy and nutrients as well as support for oral and fine motor development (Johnson, 2009).

Nutrition is important during toddlerhood. Depending on their body weight, small children need more nutrients than adults as their organs and blood starts developing. As the child grows and the activity increases, the nutrient intake needs to be adequate to support this process. Growth spurts alternate with periods of no growth or slowed growth during this period are challenges during this age (Johnson, 2009).

For adequate nutrition requirements during toddlerhood, the Dietary Reference Intakes (DRIs), which include the Recommended Dietary Allowances (RDAs) and Adequate Intakes (AIs), should serve as a guide to prevent deficiencies in this age group. However, most of the levels set for preschoolers and toddlers are based on values established for infants and adults. For parents, a more practical approach to ensuring proper nutrient intake is to use the Food Guide Pyramid for Young Children, devised by the U.S. Department of Agriculture (USDA) (Johnson, 2009). Unfortunately, people most of the time do not follow the specific requirements in these guides.

Potential problems could arise when proper nutrition is NOT met during this period. Although severe nutrient deficiencies are rare in the United States, calcium, iron, zinc, vitamin B6, folic acid, and vitamin A are the nutrients most likely to be low in children as a result of poor dietary habits – needed for growth and building of strong bones and teeth, as well as other physical growth. Ensuring that children eat the recommended number of servings from each of the food groups in the pyramid is the best way to be certain that all nutritional requirements are met. A good rule of thumb for serving sizes is one tablespoon per year of age (Johnson, 2009).

Iron is a vital component of hemoglobin, the carrier of oxygen in the blood. As a young child grows, blood volume increases, and so does the need for iron. Preschoolers and toddlers typically eat less iron-rich foods than they did in infancy. In addition, the iron that children get is usually non-heme iron (from plant sources), which has a lower availability than heme iron (from animal sources). As a result, children up to three years of age are at high risk for iron-deficiency anemia. The RDA for iron for both toddlers and preschoolers is ten milligrams (mg) per day.

Calcium is needed for bone and teeth mineralization and maintenance. The amount of calcium a child needs is determined in part by the consumption of other nutrients, such as protein, phosphorus and vitamin D, as well as the child’s rate of growth. During this period of development, children need two to four times as much calcium per kilogram of body weight as adults do. The AI for toddlers is 500 mg/day, while for preschoolers it is 800 mg/day. Since dairy foods are the primary source of calcium, children who do not consume enough dairy or have an aversion to dairy products may be at risk for calcium deficiency.

The body can produce vitamin D in the skin in response to sun exposure. The amount of vitamin D needed daily thus depends mainly on how much time a child spends outside and on geographical location. The RDA for children living in tropical areas is between zero and 2.5 micrograms (g) per day, depending on the amount of sun exposure. For those living in temperate zones, the RDA increases to 10 mc/day. Vitamin D; fortified milk is the best source.

Zinc is essential for proper development. It is needed for wound healing, proper sense of taste, proper growth, and normal appetite. Preschoolers and toddlers are sometimes at risk for marginal zinc deficiencies because the best sources are meats and seafoods, foods they may not eat regularly. The recommended intake of zinc is 10 mg/day.

Vitamin and mineral supplements are popular with more than 50 percent of parents of preschoolers and toddlers. Most use a multivitamin/mineral supplement with iron. Parents should be aware, however, that such supplements do not necessarily fulfill the needs for marginal or deficient nutrients. For example, although calcium is often a nutrient that is low in children, most multivitamin/mineral supplements do not include it, or include it in very low doses. The American Academy of Pediatrics does not support routine supplementation for normal, healthy kids. Although there is no harm in giving children a standard children’s supplement, mega doses should always be avoided, and caution should be used when supplementing the fat-soluble vitamins (vitamins A, D, E, and K) (excerpted from http://findarticles.com/p/articles/mi_gx5200/is_2004/ai_n19120955).