Toddler and Preschooler Nutrition

• This study note covers toddler and preschooler nutrition.

Learning Objectives

• Identify the tools used to screen young children for being underweight, overweight, or obese.
• Describe two strategies parents or caretakers can use to encourage toddlers/preschoolers to eat a variety of foods.
• Identify one common nutritional problem in young children, and describe prevention strategies.

Introduction to Toddler and Preschooler Nutrition

• Growth is slower but steady during the toddler and preschool years than infancy.
• Slower growth velocity results in a decreased appetite.
• Young children still need adequate calories and nutrients.
• Eating and health habits established early in life may impact later habits.
• Development of new skills and independence occurs in this stage.
• Learning about new foods, developing feeding skills, and establishing healthy preferences is key.

Definitions of Life-Cycle Stages

• Toddlers are children between 1 and 3 years old.
• This stage includes quick gross and fine motor skill development.
• Toddlers also see increases in independence, exploration, and language skills.
• Preschool-age children are between 3 and 5 years old, not yet in kindergarten.
• This stage involves increasing autonomy and broader social experiences like preschool.
• Language skills increase along with the ability to control behavior.
• Growth velocity is the rate of growth over time.
• Gross motor skills involve large muscle groups, like walking, running, and hopping.
• Fine motor skills involve smaller muscle groups, like stacking objects or scribbling.

Normal Growth and Development

• An infant's birth weight triples in the first 12 months.
• Growth velocity slows until the adolescent growth spurt.
• On average, toddlers gain 8 ounces (0.23 kg) and 0.4 inches (1 cm) of height per month.
• Preschoolers gain an average of 4.4 pounds (2 kg) and 2.75 inches (7 cm) per year.
• Reduced appetite and food intake accompanies the slower growth rate.
• Parents may notice their children have a lower appetite and interest in food compared to when they were infants.
• A decrease in appetite is a normal part of growth for this age group, and parents should be reassured.

Importance of Nutrition

• Adequate energy and nutrients are necessary for optimal growth and development in toddlers and preschoolers.
• Undernutrition during these years can impair cognitive development and exploration abilities.
• Long-term effects of undernutrition like failure to thrive and cognitive impairment can be prevented with adequate support.

Measuring Growth

• Physical growth in children should be monitored considering the following factors:
• Frequency: Weigh and measure toddlers monthly until age 2, then switch to yearly.
• Growth Charts: Plot height and weight on WHO or CDC charts to track progress.
• Consistency: Use the same equipment and methods for each measurement to maintain accuracy.
• Calm Environment: Reduce anxiety for the child to get more accurate measures.
• Professional Guidance: See expert if unsure of the procedure, the measure or the child's measurements.

Measuring Growth in Toddlers Under 2

• When weighing use the following guidelines:
• Remove all clothing/diapers.
• Use a calibrated infant scale.
• Position the child securely and comfortably.
• Record measurements accurately.
• When measuring use the following guidelines:
• Use a recumbent length board with a fixed headboard and movable footboard.
• Recumbent length measures length, and toddlers <24 months, and those between 24 and 36 months who cannot stand unassisted should be measured using the recumbent method
• Two adults are needed: one at the head, one at the feet.
• The adult at the head ensures the crown of the child’s head touches the headboard firmly.
• The adult at the feet gently extends the child’s legs fully, positioning the footboard at the heels.
• Record the length accurately.