1. NUTRITIONAL REQUIREMENT IN CHILDRENS

2. INTRODUCTION:-
Good nutrition is essential for maintaining life.The objective of good nutrition for children are to promote optimal growth and development,to prevent nutritional deficiency states,to help prevent acute and chronic illnesses,and to provide reserves for stress.Nutritional needs can be met in human being through nutrients provide by way of the gastrointestinal tract or through parenteral feeding.

3. NUTRRITIONAL REQUIREMENTS:-
The food and nutrition board, National academy of science-National Research Council,has published the recommended daily dietary allowance(revised 1980)for healthy people of various age in the united states.Human mik provides all the nutritional substance infants need over a period of time,but no other single food meets all the essential requirements of human beings.A varied diet must be eaten,and it must include water,Calories, Protiens, Carbohydrates, Fat,Vitamins, Minerals.

4. BREASTFEEDING:-  
Breastfeeding is the best natural feeding and breastmilk is best milk. The basic food of infant is mother’s milk.Breastfeeding is the most effective way to provide a baby with a caring environment and complete food. It meets the nutritional as well as emotional and psychological needs of the infant.But recently there is tendency to replace the natural means of infant feeding and introduction of breast milk substitutes.
It contains many valuable ingredients, such as antibodies, living immune cells and enzymes.

6. COMPOSITION OF BREAST MILK:-
The composition of breast milk varies at different stages in the postnatal period to fulfil the needs of baby.
Colostrum
Transitional Milk
Mature Milk
Preterm Milk
Fore Milk
Hind Milk

7. 1) Colostrum
During the first two or three days after delivery thick and yellowish fluid is secreted from the mammary gland.
This differs from the regular milk and is called colostrum.
It is secreted in small quantity of about ml.
it is rich in protein.
The total fat content of colostrum is less than mature milk.
Concentration of arachiodonic acid and docosa hexaenoic acid (DHA) as percent of total fatty acids is higher in colostrum than mature milk.
It contains more antibodies and cells with higher amount of proteins and fat soluble vitamin(A,D,E,K).It is sufficient and protective for the baby and should not be discarded.

8. 2) Transitional Milk
During the next two weeks, the milk increases in quantity and changes in appearance and composition is called transition milk.
The immunoglobin and protein content decreases while the fat and sugar content increases.
Exclusive breast feeding of colostrum and transition milk minimizes infection related to neonatal death.
The composition of milk changes even during the length of a single feed to exactly suit the need of a particular baby.

9. 3) Mature Milk 4) Preterm Milk
It is secreted usually from days after delivery.It is watery but contains all nutrient for optimal growth of the baby.
4) Preterm Milk
The breastmilk secreted by a mother who has delivered a preterm baby is different from milk of a mother who has delivered a full term baby.This milk contains more protiens, sodium, iron, immunoglobulins and calories appropriate for the requirements of the preterm neonates.

10. 5) FOREMILK
The milk that comes at the start of a feed is called foremilk. Foremilk which is watery has a low level of fat and is high in lactose sugar, protein, vitamins, minerals and water. It satisfies the baby thirst.
6) HIND MILK
Hind milk which comes later in a feed is richer in fat, it satisfies the baby’s hunger and supplies more energy than foremilk. Babies who are fed fore and hind milk sleep well and grow healthy.

11. WEANING:-  
Weaning is defined as the process of progressive transfer of the baby from breastmilk to the usual family and adult diet.The weaning period in an infants life is, therefore that period when the diet changes from complete breastfeeding(upto 4-6months)to when the child is able to eat normal family food(around one to one and half year).

12. Main categories of indian foods which can be used for weaning:-
High in energy
Easy to digest
Semi-solid in consistency
Low in bulk and viscosity(not to thick)
Fresh and clean
Inexpensive and easy to prepare

13. Foods used for weaning diet:-
Cereals
Oil seeds and Nuts
Vegetables
Fruits
Milk and milk products

14. Improving nutritive value of weaning foods-
Care during preparation
Sprouting
Malting

15. Age related broad guidelines-
From 4-6 months-
Frequent breastfeeding should continue but at the same time start with additional semi-solid foods in the form of mashed fruit like banana, or cereal like suji.
The number of feeds should be gradually increased over 3-4 weeks, so that by that time the baby is taking 50-60g of porridge or 1 whole banana per day.
The semi-solids should be preferabley given after breastfeeding so that there is minimal interfearence with the sukling and breastmilk production.
However some babies do not accept semi-solids once their hunger is partly satisfied by breastmilk. For them semi-solids can be offer prior to breastfeeding.

16. From 6-9 months-
The aim is to get the baby used to feeding from the family pot. Mased rice with dal or khichadi, mased vegetable, little chapatti softened in dal or milk can be given from the food normally cooked at home. Add little oil.
Babies of this age should be feed 4 or 6 times a day as they have small stomachs and can eat only a little at a time.
From 9-12 months-
Near about 9 months,babies have a few teeth, and can start eating larger pieces of food by chewing.
The food at this time does not required mashed but, if require can be chopped and pounded.
A variety of household foods can be given five or six times a day, such as rice, dal ,roti or khichadi and quality can be gradually increased.Besides a variety of vegetables and fruits also can be included. Egg can be given in either boiled or scrambled form.
The infant should now be eating almost everything that is cooked in the house.

17. From 1-1.5years-
The child should now be eating all the food prepared for the family,although it still may have to be softened and given without spice.
By this age there is only ml of breastmilk intake and the bulk of energy(1000calories) has to be supplied by solids.
The mistake that most mothers make is that they give a variety of foods,but in very small quantities which does not contribute much to nutrition.
Both anemia and vitamin A deficiency are common among yong children and every effort must be made to give the child some green leafy vegetables;about 50g per day will satisfy the daily requirement.

18. NUTRITIONAL REQUIREMENT ACCORDING TO AGE GROUP

19. Water: What does it do and how much is enough?
Water cools the body, lubricates the joints, and helps muscles to work. Infants are comprised of about 75% water while adults are about 90% water.
Infants: Up to 16 months, breast milk or formula is enough daily intake of liquid. The infant can get water intoxication if he/she drinks several bottles of water a day or drinks formula that has been diluted with too much water. Formula should be 2/3 milk and 1/3 water. Signs of water intoxication include pale urine; sleeping more than usual; difficult to awaken; and wetting more than 8 diapers a day.

20. Young Child: Needs 1. 5 oz. of water per pound of body weight a day
Young Child: Needs 1.5 oz. of water per pound of body weight a day. The child is more likely to drink cool water. Juice from a squeezed lemon or lime can also be added for taste. Avoid cold water because it can slow the digestive process causing constipation. Other sources of water are fruits and vegetables. Pre-teen, Teen, and Adult: Needs eight 8 oz. glasses a day. Cool water with squeezed lemon or lime juice is usually preferred. Avoid cold water because it can slow the digestive process causing constipation. Fruits and vegetables can be sources of water. This is another reason for pre-teens and teens to regularly include fruits and vegetables in their meal planning. If the pre-teen and/or teen becomes dehydrated, he/she is at higher risk for getting constipated and/or developing kidney stones.

21. What foods encourage regular bowel movements?
Fiber is necessary in the diet to promote regular bowel movements. Food sources include fresh/raw fruits and vegetables, legumes, whole grains. It is also important to drink the daily requirement of water and eat unsaturated fats that include omega 3 such as tuna fish.
What foods should be avoided?
Limit the amount of cheese, fried foods, sweets, carbonated drinks, white flour and all junk food. Avoid ice cold drinks because they will slow the digestive process.

22. Feeding an infant (birth to 12 months)
Feed infant 2-3oz. more than age in months. A 3 month old would therefore be fed 5-6 oz. per day.
Introduce 100% juice, not juice drinks, at 6 months of age.
Limit juice, when introduced, to 4oz. per day. More than this will cause diarrhea and possibly cause the growing baby to become overweight.
Baby food should be soft/mushy so it can be gummed. At 9 months, the baby can eat coarser, chunkier textures of food. This food should be cut in tiny chunks.
Introduce a single food at a time. When the baby has adopted the new food, a previously adopted food can be eaten with the newly adopted food. If feeding baby only a portion of food from a baby jar, place that portion in a bowl and feed with a spoon from the bowl. Do not use the jar as a bowl if feeding a portion of the jar’s contents. The spoon, contaminated with germs from the baby’s mouth, will grow in the jar when it is recapped.

23. Feeding a toddler (ages 1-3)
Needs calories per day. Another way to determine is to calculate 40 calories per inch of height per day.
Nutrient needs include 16 grams of protein; 44 grams of fat; and 210grams of carbohydrate.
The toddler also needs 10 milligrams of iron a day. Good sources of iron include potatoes, spinach, split peas, and strawberries. Milk should not exceed 24oz. per day to prevent reduced iron absorption.
Feed a toddler who eats too much by using a small plate; cut food in small pieces to allow hand eating; serve low calorie foods; be sure he/she is eating fiber foods and exercising (both will reduce appetite) 

24. Nutrition for school age children and teens
Involve school age children in helping to plan, shop for, and cook meals.
Remember, it takes 11 tries for a child to accept a new food. Don’t give up. Serve new food in small amount. Make the food presentation colorful and appealing.
School age children and teens require calories a day depending on age and activity level.
School children require 800 milligrams of calcium and 10 milligrams of iron while teens require milligrams of calcium and mg.of iron a day. Junk food can cause iron deficiency. An iron supplement can significantly improve learning, memory, and cognitive test performance.

25. Teen nutrition deficiency and consequences:-
Most eating habits are already established by the late teen years.
Teens are growing rapidly during adolescence. Twenty percent of adult height and 50% of adult weight is gained during adolescence.
Because 45% of adult bone mass is added during adolescence, the daily requirement of calcium increases to milligrams. A significant number of teens are deficient in calcium and other nutrients due to junk food..
Calcium aids in movement of nerve impulses; muscle contraction and relaxation; blood pressure; and the immune system. Caffeine ingestion has been noted to lower bone mineralization and thus increase fracture risk.
Typical caffeine food sources ingested by teens include chocolate, coffee, soft drinks, and tea. The effect of caffeine is enhanced in the absence of a diet inclusive of required amounts of milk.
Symptoms of calcium deficiency include insomnia, tooth decay, depression, headache, and inability to relax.