Pediatric nutrition is something that I am very passionate about. Diet in children might look simple, but establishing healthy eating habits and developing a better gastric environment is surrounded by skepticism.
My experience has not just been with the newborns but also with the new mothers and their immediate families. Toddler tantrums and displeasure in young parents are an everyday affair to me.
There are hundreds of myths and thousands of questions that a new mother wants to know. Young parents who talk to me worry about whether their children receive enough nutrition.
This article will be helpful for all the parents, grandparents, and teachers who are actively working with children for their betterment.
Pediatric Nutrition in Depth
Nutrition starts from the embryo stage, followed by the neonate, the infant stage, the toddler stage, and the adolescent stage. In all these stages, nutrition is vital to the child’s growth and development.
Most of the developmental milestones are achieved very young.
Good nutrition from an early age can compensate for the vitamins and minerals lost gradually from the fetal to the neonatal stage.
This reduces the disease's rate of occurrence as they grow into adults.
Importance of Nutrition from Embryo to Neonates
Nutrition starts in your mother’s womb, and food can strongly influence gene expression.
You heard it right: nutrition starts in the womb, but the nutritional needs amplify as we grow and age. Pediatric nutrition paves a strong foundation for a healthy adulthood.
In my experience, I have learned that it is not about good or bad parenting but about staying aware and working with your kids every day.
This concept might seem complex, but I am here to elaborate and educate you.
As the mother’s nutrition is transferred to her fetus in the womb, it turns to develop the organs and gastric tissues gradually.
Elements like calcium, ferrous, copper, and zinc are found in greater amounts in the fetal stomach than in the neonatal stage.
That is how a fetus stores its energy needs. With growing age, these fetal nutrient stores are lost, correlating with the changes in the elemental character of the nutrient.
As the fetus slowly becomes a neonate, the energy requirements completely depend on the environment and external dietary sources.
Decreased nutrient storage with age also correlates to how babies develop vitamin insufficiency and deficiencies.
Researchers also found that some diseases in adults originate from the fetus. (Hou et al., 2003)
Child Development & Behaviour
I have encountered a couple of cases with children’s eating habits and their psychological development.
Every child behaves differently because of the parental conditioning and their disciplinary actions. Basic nutritional needs remain the same for all children.
However, children do develop deficiencies and lose their immunity owing to their environmental conditions, sanitation, and upbringing. There are three aspects of pediatric nutrition:
- Diet and psychological development: A better quality diet is associated with better mental health and cognition. The role of habitual diet in the development of depressive disorders and symptoms has become a recent research focus over the past decade. A poor quality or malnourished diet can lead to poor motor skills and coordination in younger children. Lack of sufficient nutrition can also lead to ADHD, depressive disorders, and low mood in children, leading to learning disabilities. (O’Neil et al., 2014)
- Dietary, behavioral patterns. Children eat what they like and leave the rest, and they are blissfully ignorant of the nutritional information or the consequences of bad eating habits. Food preferences and consumption patterns developed in early childhood influence their psychology and eating behaviors as they grow up. Children accept certain foods and reject others, shaping their dietary behavioral patterns. ‘Neophobia’ – A tendency to reject and explore new foods is always present in kids. This behavior in kids should be conditioned by nutrition education. Introducing varieties of healthy foods to kids early to improve their eating habits and condition their food preferences is essential. Children are inclined to eat flavour enhancing foods and packaged foods, this inclination leads to addictive eating behaviours negatively influencing their hormonal health. (Birch, 1998)
- Diet and musculoskeletal development: A nutrient-dense diet is crucial for building strong bones and muscles. Musculoskeletal development occurs in the early stages of life; hence, food quality becomes a deciding factor for immunity development and growth hormones. Lack of proper diet in children is the leading cause of adult obesity and diabetic conditions.
Pediatric Nutrition from Newborns to Toddlers
Neonatal health is a very sensitive stage. I have come across many newborn cases with anxious new mothers who are skeptical about their children’s diet and hydration. This has been the most difficult part of counseling and convincing because parents have conflicting thoughts about introducing their babies to new foods.
Breast milk is the preferred diet for the first six months of life. The consequent six months is the most challenging stage for the babies and their mothers. I have always insisted on introducing varieties of finger foods, fruits, vegetables, and whole grains in the second half of their birth period. This helps in food acceptance and reduces neophobia.
The baby develops its gut microbiome and digesting abilities in the second six-month stage. There is rapid growth during infancy till the 12-month mark. Hence, proteins and complex carbohydrates like eggs, yogurt, rice, wheat, idly, dosa, and chicken can be introduced. Healthy fats like ghee and butter are good for DHA and EPA synthesis. Newborns would need 500 – 600 calories daily, slowly increasing to 1000 calories a day up to 12 months. (Patel & Rouster, 2023)
During this stage, the parent must stay alert in identifying their child's food allergies and lactose/gluten intolerances.
This is also a phase where a parent can cultivate healthier food choices and habits.
Kids 12 – 36 months: This is a phase I call the ‘temper tantrums!’ During this age, the child shows interest in engaging themselves in more playful activities and with a decrease in food consumption.
As much as we love kids, we hate it when they throw tantrums. During this age, their cognition works on getting things done in their way. It’s either my way or the highway!
And here comes those hidden parenting tactics during challenging situations with your kids.
This is when parents introduce flavored burst foods only to bribe their kids and silence them for the moment.
Unknowingly, parents are introducing their kids to addictive foods and dopamine-dependent behaviors. A sensitive stage for the child becomes prey to unhealthy eating and junk food.
What is the Solution?
I always insist on parent–child counseling and nutrition education. This intervention can bring in some positive changes through mutual contributions.
The ideal caloric intake would be 1000-1200 calories with moderate carbohydrates, good quality protein, and healthy fats to improve motor skills and brain coordination. Always watch your toddler's skin and breathing responses to foods they are introduced to. Signs of allergies are skin rashes, redness, hives, breathlessness, watery stools, and swelling. (Riley et al., 2018)
4 – 6 years: This stage sees children in a modified version of the ‘How do I throw a fit?’ attitude. Now that they are more evolved, they learn ways to say NO!
This is a phase where interventions can occur to correct their eating behaviors.
During these years of life, there is an increased need for nutrition for both physical and psychological needs to be met. Nutrition becomes an essence of intense learning and rapid growth in their bodies. Nutrition at this stage also supports emotional development. (Colson & Dworkin, 1997)
Their bodies need equal amounts of carbohydrates and protein. Boys and girls have a similar caloric requirement, ranging from 1200 to 1400 calories daily. Maintaining ideal height and weight is important to avoid stunting or wasting and improve brain functions. Avoid providing them with sugary treats and processed/packaged foods.
7 & 8 years: A highly active age group with intensive learning and grasping abilities. By this time, they must establish a healthy and timely eating routine. Avoiding packaged food, confectioneries, and high-fat foods is recommended along with physical activity.
Boys would need 1500-1800 calories, while girls would need 1200-1500 calories daily, focusing on protein intake, fruits, and vegetables.
Being a rapidly developing stage in young school-going children, there are many cases of malnutrition (underweight or overweight) due to deficiencies and lack of nutrition education in families, especially in lower-middle-income countries.
Community nutrition welfare and public health workers have identified the gaps within school-going children. Dietary assessments and anthropometry measurements are useful in school and community settings to educate and intervene with standard guidelines that can better tackle the issue of malnourishment in young and school-going children. (Khan et al., 2022)
Some FAQs
Some questions that I regularly get to hear from parents:
- My child is not interested in eating regular meals; what can I do?
Provide your child with short and frequent meals. Cut short their eating time as active children might not stick to elaborate meals. Force-feeding can demotivate them and can result in more dislike of food.
- Is egg safe for a 6-month-old?
Eggs are a good source of protein and can be introduced from 6 or 7 months of age.
- Does yogurt cause a cold in my baby?
Yogurt does not cause cold. Yogurt should always be fresh, homemade, and at room temperature while you feed the baby. Yogurt is rich in calcium, vitamins, protein, and healthy fats.
Conclusion
Food, sleep, and creative activities are believed to increase neurogenesis (making new neurons) and help improve cognitive functioning apart from physical well-being. Better nutrition at the early stages of life is a perk to your adulthood.
Both the body and the brain depend on nutrition. Good nutrition influences Hormonal, anabolic, and catabolic activities, leading to increased muscle and bone mass, immunity, and strength in young children.
Have any questions for Manisha? Write to her at support@livesthealth.com.
References
Birch, L. L. (1998). Psychological Influences on the Childhood Diet. The Journal of Nutrition, 128(2), 407S-410S. https://doi.org/10.1093/JN/128.2.407S
Colson, E. R., & Dworkin, P. H. (1997). Toddler Development. Pediatrics In Review, 18(8), 255–259. https://doi.org/10.1542/PIR.18-8-255
Hou, S. F., Li, H. R., Wang, L. Z., Li, D. Z., Yang, L. S., & Li, C. Z. (2003). Contents of chemical elements in stomach during prenatal development: different age-dependent dynamical changes and their significance. World Journal of Gastroenterology : WJG, 9(5), 1063. https://doi.org/10.3748/WJG.V9.I5.1063
Khan, D. S. A., Das, J. K., Zareen, S., Lassi, Z. S., Salman, A., Raashid, M., Dero, A. A., Khanzada, A., & Bhutta, Z. A. (2022). Nutritional Status and Dietary Intake of School-Age Children and Early Adolescents: Systematic Review in a Developing Country and Lessons for the Global Perspective. Frontiers in Nutrition, 8, 739447. https://doi.org/10.3389/FNUT.2021.739447/FULL
O’Neil, A., Quirk, S. E., Housden, S., Brennan, S. L., Williams, L. J., Pasco, J. A., Berk, M., & Jacka, F. N. (2014). Relationship Between Diet and Mental Health in Children and Adolescents: A Systematic Review. American Journal of Public Health, 104(10), e31. https://doi.org/10.2105/AJPH.2014.302110
Patel, J. K., & Rouster, A. S. (2023). Infant Nutrition Requirements and Options. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK560758/
Riley, L. K., Rupert, J., & Boucher, O. (2018). Nutrition in Toddlers. American Family Physician, 98(4), 227–233. https://www.aafp.org/pubs/afp/issues/2018/0815/p227.html
