Proper nutrition in childhood can reinforce lifelong eating habits that contribute to children's overall well-being and help them to grow up to their full

potential and a healthy life.

Some parents over-think what to do about their child's eating habits, which give way to practices

like forcing kids to clean their plates.

Some parents don't think about nutrition at all, letting their kids eat a lot of junk food and drink a lot of juice. So, it's important to find a balance.

In addition to contributing to the current childhood obesity epidemic,

children who don't have healthy diets as young children are likely to continue to make unhealthy choices as teens and

adults.

Taking some time to understand the basics of child nutrition can help parents avoid

common mistakes, make healthy choices, learn about new things (eg probiotics) and healthy eating habits.

Complementary feeding

• referred to as the transition from exclusive breastfeeding to family foods

• When breast milk is no longer enough to meet the nutritional needs of the infant, complementary foods should be added to the diet of the child.

• typically covers the period from 6 to 18-24 months of age, and is a very vulnerable period.

• It is the time when malnutrition starts in many infants, contributing significantly to the high prevalence of malnutrition in children under five years of age world-wide.

• WHO estimates that 2 out of 5 children are stunted in low-income countries.

• WHO recommends that infants start receiving complementary foods:

6 months of age in addition to breast milk, initially 2-3 times a day between 6-8 months, increasing to 3-4 times daily between 9-11

months 12-24 months with additional nutritious snacks

offered 1-2 times per day, as desired.

• Timely : meaning that all infants should start receiving foods in addition to breast milk from 6 months onwards.

• Adequate : meaning that the nutritional value of complementary foods should parallel at least that of breast milk.

• prepared and given in a safe manner, meaning that measures are taken to minimize the risk of contamination with pathogens.

• appropriate, meaning that foods are of appropriate texture and given in sufficient quantity.

Weaning• introduce one new food at a time, to

identify any foods that cause allergies .

• Some foods to stay away from include eggs, honey, peanuts (including peanut butter)

Infant and Newborn Nutrition

• For a baby, breast milk is best. It has all the necessary vitamins and minerals. Infant formulas are available for babies whose mothers are not able or decide not to breastfeed.

• Infants usually start eating solid foods at 6 months of age..

Birth to 6 months• Exclusive breastfeeding is recommended for the first months for healthy

term infants

• Encourage parents to feed whenever baby show signs of hunger

• Breastfed infants tend to become leaner than formula fed infants. This should be anticipated on assessing growth to avoid unnecessary supplementation with formula or early introduction of solids

• Fruit juice, water or any beverages should not be given other than breast or formula milk

• To prevent infant botulism, honey should not be given under 1 year

• For the prevention of allergy, the avoidance of solid food for a least 6 months

6-9 months• Continued breastfeeding is recommended

• If infant is not breastfed or is partially breastfed, milk-based iron-fortified infant formulas are the most acceptable alternative.

• Introduce one new food at a time with an interval of 2 - 7 days before introducing another to allow infant to identify the taste for a new food and make it easier to find cause of an allergic reaction

• Start with small serving sizes (1-3 tsp)

• Complementary foods should initially be provided 2 -3 times a day

• Infants will indicate hunger or satiety. Forced feeding promote negative associations with eating

• Gradually offer food with more texture, progressing from purée to mashed and then to soft finger foods of about ¼ inch pieces

• Use a cup regularly with meals by 8 months

• Wait until 1 year to introduce egg white to minimize risk of allergic reactions

9-12 months

• Continued breastfeeding is recommended

• Between 9-11 months, increase the number of times day infants are fed complementary foods to 3-4 times

• Parents/caregivers should encourage self-feeding by offering more textured finger/table foods

• Include baby at the table for family mealtimes

• Fruit juice offers no nutritional benefits over whole fruit

• Excessive fruit juice consumption may be associate diarrhea, flatulence, abdominal distension, tooth decay and poor weight gain

• More willing to accept lumpy textures, especially when self-feeding

• Initial refusal of new flavours and textures is common. It may take up to 10 offerings before infant accepts a new food

Good Nutrition for Children• Nutrition guidelines recommended

for adults are inappropriate for most children under the age of five.

• young children need plenty of calories and nutrients in a small amount of food to ensure they grow properly.

Calorie Intake for Children

Calorie Intake for ChildrenAlthough obesity is a major problem, children and teenagers still need enough calories to grow and develop into healthy adults. This chart gives a rough guideline to the daily calorie needs of boys and girls at different ages. Kids who are really active may need more; those who are inactive may need less.

Salt Intake for Children

Although obesity is a major problem, children and teenagers still need enough calories to

grow and develop into healthy adults.

a rough guideline to the daily calorie needs of boys and girls at different ages.

Kids who are really active may need more; those who are inactive may need less.

FAT

• low-fat diets are recommended for older children and adults, under-fives need diets that contain good amounts of fat.

• should come from foods that contain plenty of other nutrients like meat, oily fish and full-fat milk (semi-skimmed milk is unsuitable for children under the age of two, and skimmed unsuitable for under-fives), rather than from high-fat foods that contain few vitamins and minerals like cakes, biscuits and chocolate.

fibre• Meanwhile, young children shouldn’t eat too many , either, as these may fill them up

so much they can’t eat enough to provide them with adequate calories and nutrients.

• However, as kids approach school age, they should gradually move towards a diet that’s lower in fat and higher in fibre. And by the age of five, their diet should be low in fat, sugar and salt and high in fibre with five fruit and veg a day – just like adults.

• Add more veggies to favourite dishes – for example, add finely sliced mushrooms to Bolognese, finely chopped red pepper to tomato sauces and steamed leeks to mashed potato 

• Serve big portions of veggies they like – sweetcorn, carrots and peas are often popular. 

• Mix together grated carrot and cheese and use to fill sandwiches and jacket potatoes – the colours blend so well they may not notice the carrot.

• Add two portions of fruit – don’t just stick to apples and pears, though. For variety, add grapes, fruit salad, a slice of melon, a small box of raisins or a can of fruit in juice

Vitamin and Mineral Intake

• Choosing foods from each of the four main food groups will help to ensure that kids receive all the vitamins and minerals they need for good nutrition and health.

• poor intakes of vitamins and minerals were combined with too much salt, sugar and saturated fat.

Vitamin and Mineral Intake

• If a child is eating according to the Food Guide, is growing well and is healthy, vitamin/mineral supplements are rarely necessary. The nutrient of greatest concern this period is iron

• If a child has a vitamin deficiency, does not have access to fluoridated water, or has anemia or other illness or disease, vitamin supplements may help improve the condition.

• Vitamins are not replacements for food. By themselves, they have no calories. Vitamins are not substitutes for protein, fats, minerals, carbohydrates or other nutrients. You cannot stop eating, take vitamins and expect to be healthy.

Vitamin and Mineral Intakepediatricians may recommend a daily multivitamin

or mineral supplement for children who:

• aren't eating regular, well-balanced meals made from fresh, whole foods

• finicky eaters who simply aren't eating enough• chronic medical conditions such as asthma or

digestive problems, especially if they're taking medications

• play physically demanding sports• eat a lot of fast foods, convenience foods, and

processed foods• on a vegetarian diet (they may need an iron

supplement), a dairy-free diet (they may need a calcium supplement), or other restricted diet

• drink a lot of carbonated sodas, which can leach vitamins and minerals from their bodies

Top Six Vitamins and Minerals for children

• Vitamin A promotes normal growth and development; tissue and bone repair; and healthy skin, eyes, and immune responses. Good sources include milk, cheese, eggs, and yellow-to-orange vegetables like carrots, yams, and squash.

• Vitamin Bs. The family of B vitamins -- B2, B3, B6, and B12 -- aid metabolism, energy production, and healthy circulatory and nervous systems. Good sources include meat, chicken, fish, nuts, eggs, milk, cheese, beans, and soybeans.

• Vitamin C promotes healthy muscles, connective tissue, and skin. Good sources include citrus fruit, strawberries, kiwi, tomatoes, and green vegetables like broccoli.

• Vitamin D promotes bone and tooth formation and helps the body absorb calcium. Good sources include milk, cheese, and yogurt (especially fortified dairy products), egg yolks, and fish oil.

• Calcium helps build strong bones as a child grows. Good sources include milk, cheese, yogurt, tofu, and calcium-fortified orange juice.

• Iron builds muscle and is essential to healthy red blood cells. Iron deficiency is a risk in adolescence, especially for girls once they begin to menstruate. Good sources include beef and other red meats, turkey, pork, spinach, beans, and prunes.

• Megavitamins -- large doses of vitamins -- aren't a good idea for children. The fat-soluble vitamins (vitamins A, D, E, and K) can be toxic if kids overdose on excessive amounts

Salt Intake• While adults should have no more than 6g of salt a day, children need even less as

they have smaller bodies.

• salt is ‘hidden’ in many ready-made foods, such as bread, baked beans, and even biscuits, it can be easy to have too much.

• So don’t add salt to cooking or meals and check information on labels when you buy processed foods such as crisps, ready meals and sauces – even if they’re aimed at children.

• Opt for those with the least sodium – it’s the sodium in salt that’s linked to health problems like high blood pressure.

• Sausages and cheese are also high in salt so limit these.

• The maximum amounts of salt children should have at different ages:• 1–3 years – 2g a day (0.8g sodium)• 4–6 years – 3g a day (1.2g sodium)• 7–10 years – 5g a day (2g sodium)• 11 years upward – 6g a day (2.5g sodium)

• reducing salt intake by half leads to immediate falls in their blood pressure.

• Immediate benefits of such reductions of blood pressure in the young may quickly become apparent in those suffering with asthma, since high salt intakes have been shown to aggravate symptoms.

• a high salt intake can cause the mineral calcium to be lost from bones, leading to an increased risk of bone thinning, and thus fractures that take longer to heal.

• many teenage girls do not get enough calcium, this could lead to problems from adolescence onwards and may well increase the risk of developing osteoporosis in later life.

Healthy Eating Tips for children

 • Buy lower-fat versions of sausages, burgers and oven chips and grill or oven

bake them rather than frying.

• Alternatively, make homemade burgers and swap chips for homemade potato  

• Add barley, beans or lentils to soups, stews and other meaty dishes – children won’t notice baked beans in a cottage pie or lentils in a stew. 

• Avoid using food as a reward – it simply becomes more desirable. But that’s not all – other foods become less desirable, too. In other words, telling children they can have some sweets if they eat their veggies simply makes the sweets more alluring and the veggies less appealing

• Get children involved at mealtimes – younger children in particular are far more likely to eat something they’ve made themselves so let them help cook healthy meals such as fishcakes, homemade burgers, fruit muffins, wholemeal scones, smoothies and sandwiches. Meanwhile, encourage teenagers to eat with the family. 

• encourage children to eat regularly, especially breakfast – studies show that breakfast eaters tend to be slimmer than people who skip this meal.

• Swap fizzy drinks for water, unsweetened fruit juice, fruit smoothies, cartons of semi-skimmed milk or unsweetened yogurt drinks.

• Don’t make child’s weight and size an ‘issue’. avoid using the ‘diet’ word, don’t weigh regularly and lead by example: eat sensibly and exercise frequently

• Talk about the benefits of eating well and looking after their body. Health is generally not a priority for children so focus on other issues that are important to them.

For example, for teenage girls explain that a healthy diet will give them glowing skin, shiny hair and strong nails, give them more energy to go shopping with their friends and help them concentrate so they’ll perform better in their favourite subjects at school.

For boys, explain that eating well will help to build and tone muscles, give them great skin and help them do well in their favourite sports.

• Take a look at what the whole family are eating – kids rarely have bad eating habits on their own.

• if child is gaining too much weight, it’s unlikely the rest of the family is having a healthy diet. If this is the case, encourage a healthy, balanced diet for everyone :

- Cutting down on sweets, cakes, biscuits and fizzy drink

- Eating fewer fatty foods such as chips, burgers and fried food

- Eating regularly, especially breakfast

- Basing meals on starchy foods and choosing wholegrain varieties, when possible

- Eating more fruit and vegetables

Healthy Snacks for Children and Teenagers

• Fresh fruit – chop it into bite-sized pieces for young children to make it easier to eat or buy packs of ready-prepared fresh fruit slices or chunks 

• Mini boxes of dried fruit such as raisins or small packs of apricots or mixed fruit 

• Small packs of chocolate-covered raisins or nuts (avoid giving nuts to young children because of the risk of choking) 

• Chopped up vegetables such as carrot, celery and pepper sticks and cherry tomatoes with a favourite dip (look for those low in salt and fat if you’re buying ready-made dips) 

• Fresh popcorn made without salt or sugar 

• Wholemeal toast with peanut butter and banana or low-fat soft cheese and tomato 

Healthy Snacks for Children and Teenagers

• Fruit smoothie 

• Unsweetened yogurt drinks or a pot of low-fat fruit yogurt or fromage frais 

• High-fibre cereal with semi-skimmed milk 

• Wholemeal sandwiches filled with lean meat, chicken, tuna in water, cheese or egg and salad. 

• Small packets of unsalted nuts and seeds – try mixing with dried fruit.

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