Fourth Edition
Carol M. Bareuther, RD
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© 2008 Wolf Rinke Associates, Inc. All rights reserved for this self-directed accredited learning program. Reproduction in whole or part without written permission, except for brief excerpts, is prohibited.
Customer Comments
Karen Knechtl: "It was very complete, covered everything you might need. From resources for vegetarian meal planning for children to more technical lab and kcal calculations. What an awesome course!"
Sally Johnson: "Easy to read. Interesting. Well organized."
Stephanie Collins: "Very well organized."
Marilyn Shulman: "Good sound advice, clear and concise information that can be used with public health."
Christine Settino: "Now that I'm the mother of a 10 month old and another on the way, I have a big interest in proper childhood nutrition. This was an excellent program, very easy to read, informative and interesting. I read it from beginning to end in just one day!"
Dawn Kern: "This course was my favorite."
Sunday Long, RD: "The material is written in a simple manner that is easily understood."
Stephanie Jacobson: "Very well written, easy to understand, a fast read."
Bernie Keller: "Easy reference charts that can be used as desktop reference guides."
Annette Witter: "I liked all the organized info in the appendixes. I liked the examples/case studies used to explain formulas and calculations."
Donna Christman: "Well written. A lot of information."
Lee Anna Stock: "This course is very interesting and very specific. The entire content of the book is useful information, especially the appendixes."
Amanda Vdoviak: "The information was well organized and clearly written so I was able to get the facts without a lot of extra un-needed information."
Mary Grieb: "It was very applicable to actual practice not just theory."
Courtney R. Goff: "It was an excellent course! Very well organized. I feel so much more confident on this topic now. I look forward to applying it with my baby girl."
Overview and Introduction
Welcome to Nutrition for Infants and Young Children, a self-directed accredited learning program.
Providing nutritional care for infants and young children presents a unique challenge. These tiny tots need the proper quality and quantity of nutrients to fuel dynamic growth and development processes and build both strong bodies and good eating habits to last a lifetime. At the same time, provision of nutrients is limited by children's developing physiology and physical abilities. Challenges range from assuring that a newborn who can only suck gets an adequate amount of breast milk or formula to formulating a meal plan for an underweight preschooler who is frustrated by his lack of dexterity in handling a spoon. Successfully steering infants and young children through this demanding time brings the unequaled reward of seeing little smiles beam bright from the glow of good nutrition.
This self-directed, accredited learning program will provide you with detailed information that will enable you to care for infants and young children, including:
This learning program is designed to help you earn 12 continuing professional education units (CPEUs). It is a Category 2 Continuing Professional Education (CPE) program approved for 12 Continuing Professional Education Units (CPEUs), meaning that the reader has general knowledge of the literature and professional practice within the area covered. The focus of the program is to enhance knowledge and application.
To get the most out of this program, it is suggested that you follow these four steps:
Step 1: Read the material presented in each of the three chapters.
Step 2: When you come to an example, try working out the answers yourself using
pen and paper.
Step 3: Assess what you have learned by completing the self-assessment instrument
contained at the end of this learning program.
Step 4: Compare your answers with the answer key contained at the end of this
learning program. If you score at least 80 percent correct, you have completed
this program and are ready to transfer your answers to the CONTINUING PROFESSIONAL
EDUCATION REPORTING FORM. If you have less than 80 percent correct, re-read
this learning program until you score at least 80 percent correct.
After you have successfully completed this course, fill out the CPE REPORTING
FORM and
Mail to: Wolf Rinke Associates, Inc.
P.O. BOX 350
Clarksville, MD 21029
or fax to 1-410-531-9282
or submit online at www.easyCPEcredits.com
Once your successfully completed CPE REPORTING FORM has been received, we will send you a certificate of completion and we will report your CPEUs to your association if required.
Happy Learning!
Carol M. Bareuther, RD
Wolf Rinke, PhD, RD, CSP
Goal and Objectives
GOAL
To provide you with practical information that will enable you to deliver appropriate nutritional care to infants and young children.
OBJECTIVES
By studying and applying the concepts presented in this accredited, self-directed learning program, you will be able to:
Table of Contents
CHAPTER I INFANTS--BIRTH TO ONE YEAR 1
GROWTH AND DEVELOPMENT 1
Growth Rate 1
Developmental Milestones 2
Physiological 3
Physical 4
NUTRIENT NEEDS 5
Carbohydrates 5
Fat 6
Protein 7
Calories 9
Vitamins and Minerals 10
Water 12
FULFILLING NUTRIENT NEEDS 14
Breast Milk 15
Nutritional Benefits 15
Protective Benefits 16
Handling Breast Milk 17
Commercial Infant Formulas 19
Cow's Milk-Based 20
Soy-Based 20
Protein Hydrolysates 22
Single Nutrient Supplements 23
Formula Preparation 24
Whole Cow's Milk 25
Introduction of Solids 27
Birth to 4 Months 28
5 to 6 Months 28
7 to 8 Months 29
9 to 12 Months 31
Commercial Versus Homemade Infant Foods 31
NUTRITIONAL ASSESSMENT 32
Anthropometric 32
Biochemical 34
Clinical Assessment 37
Dietary Evaluation 37
CASE STUDY: THE CASE OF THE SHRINKING INFANT 38
CHAPTER II CHILDREN 1 TO 6 YEARS 43
GROWTH AND DEVELOPMENT 43
Growth Rate 43
Developmental Milestones 43
NUTRIENT NEEDS 45
Calories 45
Vitamin A 49
Vitamin C 50
Vitamin B6 50
Iron 51
Calcium 52
Zinc 53
Supplements 54
Fluids 56
FULFILLING NUTRIENT NEEDS 57
Basic Meal Plan 61
Snacks 62
Common Feeding Problems and Solutions 64
Choking 66
Feeding the Hospitalized Child 67
NUTRITION ASSESSMENT 68
Anthropometrics 68
Weight and Stature 69
BMI 69
MAC, TSF, MAMC 71
Biochemical 73
Clinical Assessment 73
Dietary Evaluation 73
CASE STUDY: THE "FOOD IS LOVE" CAPER 74
CHAPTER III SPECIAL NEEDS 79
AIDS 79
ALLERGIES 80
DENTAL HEALTH 84
DEVELOPMENTAL DISABILITIES 87
DIABETES MELLITUS 89
DIARRHEA/CONSTIPATION 93
DIET AND BEHAVIOR 95
ENTERAL/ PARENTERAL NUTRITION SUPPORT 98
Enteral Feedings 99
Parenteral Feedings 100
LACTOSE INTOLERANCE 102
VEGETARIAN DIETS 103
APPENDIXES 107
APPENDIX A:
Girls: Birth to 36 Months Weight-for-Age Percentiles 109
Girls: Birth to 36 Months Length-for-Age Percentiles 110
Girls: Birth to 36 Months Weight-for-Length Percentiles 111
Girls: 2 to 20 Years Weight-for-Age Percentiles 112
Girls: 2 to 20 Years Stature-for-Age Percentiles 13
Girls: 2 to 20 Years Weight-for-Stature Percentiles 114
Boys: Birth to 36 Months Weight-for-Age Percentiles 115
Boys: Birth to 36 Months Length-for-Age Percentiles 116
Boys: Birth to 36 Months Weight-for-Length Percentiles 117
Boys: 2 to 20 Years Weight-for-Age Percentiles 118
Boys: 2 to 20 Years Stature-for-Age Percentiles 119
Boys: 2 to 20 Years Weight-for-Stature Percentiles 120
APPENDIX B: BMI CALCULATION TABLES:
29-37 inches, 18-26 pounds 121
29-43 inches, 26.5-34.5 pounds 122
29-43 inches, 35-43 pounds 123
43.5-48 inches, 35-43 pounds 124
30-44 inches, 43.5-51.5 pounds 125
44.5-52 inches, 43.5-51.5 pounds 126
32.5-46.5 inches, 52-60 pounds 127
47-56 inches, 52-60 pounds 128
APPENDIX C:
Girls: 2 to 20 Years BMI-for-Age Charts 129
Boys: 2 to 20 Years BMI-for-Age Charts 130
APPENDIX D:
Reference Values for Biochemical Indices in Nutritional Assessment 131
APPENDIX E:
Physical Signs and Symptoms of Nutrient Deficiency and Excess 133
APPENDIX F:
Food Diary for Infants (Birth to 1 Year) 135
APPENDIX G:
Selected Recommended Dietary Allowances for Infants and Children (RDA, 1989)
137
APPENDIX H:
Selected Dietary Reference Intakes for Infants and Children (DRI, 2001) 139
APPENDIX I:
Food Diary for Children (1 to 6 Years) 141
APPENDIX J:
Norms for Mid-Arm Circumference (cm) in Children 143
APPENDIX K:
Norms for Tricep Skinfold (mm) Measurements in Children 145
APPENDIX L:
Norms for Mid-Arm Muscle Circumference (cm) in Children 147
REFERENCES 149
FOR YOUR CONTINUED LEARNING 163
RESOURCES 165
LIST OF ABBREVIATIONS 171
GLOSSARY 173
SELF-ASSESSMENT QUESTIONS 175
ANSWER KEY 187
EXPLANATION TO QUESTIONS 189
ABOUT THE AUTHOR 193
ABOUT WOLF RINKE ASSOCIATES, INC. 192