111 Questions
What is the age range for toddlers?
1 - 2 years old
Growth velocity increases after infancy until the adolescent growth spurt.
False
At what age can children typically pick up objects while standing without losing balance?
15 months
At age 2, children are able to build a tower of _______ cubes.
6 to 7
Match the following life stages with their age ranges:
Infants = 0 - 1 year old Toddlers = 1 - 2 years old Preschoolers = 3 - 4 years old Primary school children = 6 - 12 years old
What is one of the purposes of growth monitoring?
To assess the adequacy of diet, health care, growth, and development
Growth monitoring is only essential for children below 5 years old.
False
What should a parent do if they have concerns about their child's growth?
Seek medical advice
According to the WHO, which year's chart should be used to monitor the growth of children below 5 years old?
2006
Match the following age groups with the corresponding growth standard or chart:
Below 5 years old = WHO (2006) chart 5 to 19 years old = WHO (2007) reference Above 19 years old = None of the above
What should a parent do to ensure their child's healthy growth?
Measure the child's weight and height regularly
What is the typical weight gain per year for a 3- to 6-year-old?
4-5 pounds
A child typically reaches their full adult height by age 4.
False
What is the typical vision for a 4-year-old?
20/20
By age 3, a child typically has ______ primary teeth.
20
What is the typical sleep pattern for a 4-year-old?
11-13 hours at night, most often without a daytime nap
Sex differences in percent body fat are observed during early childhood.
True
At what age does a child typically reach a nadir (lowest point) in Body Mass Index (BMI)?
5-6
A child's body mass index (BMI) ______ near the end of infancy.
peaks
Why is it important to monitor the growth of children?
To identify any potential health issues early
Match the following physical milestones with the corresponding age:
Has 20/20 vision = Age 4 Has all 20 primary teeth = Age 3 Gains about 1.8 to 2.25 kilograms = Age 3 Reaches about half of final adult height = Age 2
During which stage of childhood does growth velocity slow down?
Toddlerhood
All children develop at the same pace.
False
What is one physical skill that a 2-year-old can do?
Turn a door knob or build a tower of 6 to 7 cubes
By Age 2, children are able to build a tower of _______ cubes.
6 to 7
Match the following life stages with their age ranges:
Infants = 0 – 1 year old Toddlers = 1 – 2 years old Preschoolers = 3 – 4 years old Primary school children = 6 – 12 years old
What happens to growth velocity after infancy?
It slows down until the adolescent growth spurt.
What is one of the main purposes of growth monitoring?
To assess the adequacy of diet, health care, growth, and development
Growth monitoring is only essential for children below 5 years old.
False
What should a parent do if they have concerns about their child's growth?
Seek medical advice
According to the WHO, which year's chart should be used to monitor the growth of children below 5 years old?
2006
Match the following age groups with the corresponding growth standard or chart:
Below 5 years old = WHO (2006) chart 5 to 19 years old = WHO (2007) reference
What is key recommendation 1 for monitoring the growth of children and adolescents?
Monitor the growth of children using specific growth standards or charts
At 24 months, a child will reach about what percentage of their final adult height?
Half
Sex differences in percent body fat are observed during late childhood.
False
What is the typical annual weight gain for a 3- to 6-year-old?
4 to 5 pounds (1.8 to 2.25 kilograms)
A child's body mass index (BMI) ______________ near the end of infancy.
peaks
What is a typical physical milestone for a 3-year-old?
Briefly balancing and hopping on one foot
A child's body mass index (BMI) increases throughout early childhood.
False
Why is it important to monitor the growth of children?
To ensure healthy growth and development
A child typically sleeps ______________ hours at night, often without a daytime nap.
11 to 13
Match the following physical milestones with the corresponding age:
May have daytime control over bowel and bladder functions = 3 Has 20/20 vision = 4 Gains about 1.8 to 2.25 kilograms = 3 Hops on one foot without losing balance = 4
Growth monitoring is only essential for children above 5 years old.
False
What is the recommended way to determine energy requirements for children?
Estimation of resting energy expenditure (REE) and physical activity level (PAL)
The nutrient calcium is essential for growth and development.
True
What is the PAL value for children aged 1-3 years?
1.4
Vitamin D is an essential nutrient for growth and development, and its recommended intake can be found in the ______________ 2017.
RNI Malaysia
Match the following age groups with their corresponding stages of childhood:
Infants = 0-1 year old Toddlers = 1-2 years old Preschoolers = 3-4 years old Primary school children = 6-12 years old Pre-adolescents = 10-13 years old
What is the age range for preschoolers?
3-4 years old
Energy requirements are estimated based on resting energy expenditure (REE) and physical activity level (PAL).
True
What is the PAL value for children aged 1-3 years?
1.4
The recommended daily intake of nutrients for specific age and gender groups can be found in the ______________ 2017.
RNI Malaysia
Match the following stages of childhood with their corresponding age ranges:
Infants = 0-1 year old Toddlers = 1-2 years old Preschoolers = 3-4 years old Primary school children = 6-12 years old
Which of the following nutrients is essential for growth and development?
All of the above
What is a recommended limit for milk consumption per day for children ages 1-5 years to prevent iron deficiency anemia?
24 oz
All children develop at the same pace.
False
What percentage of Asian children are affected by dental caries?
Between 26.5% and 97%
Consuming foods high in vitamin C can ______________ the absorption of non-heme iron.
increase
Match the following oral health issues with their causes:
Baby-bottle tooth decay = Frequent exposure to CHO foods Dental caries = Habitual use of a bottle with milk or fruit juice at bedtime or throughout the day
Vitamin D deficiency is not a concern for children.
False
What is one of the common nutrition problems discussed?
Iron-deficiency anaemia
What is a contributing factor to constipation in children?
Painful experience
Vitamin D deficiency is not a common nutrition problem in children.
False
What is one way to prevent iron-deficiency anaemia in toddlers?
Providing iron-rich foods in their diet
Fluoridated toothpaste can cause fluorosis in children.
True
What is the recommended daily intake of fiber for young children?
19-25 g/day
A diet rich in _______ can help prevent iron-deficiency anaemia in toddlers.
iron
Drinking ______________ water can help prevent dental caries in children.
fluoridated
Match the following physical activities with their intensity level:
Brisk walking = Moderate Jumping rope = Vigorous Swimming = Vigorous
Bone-strengthening activities, such as jumping or running, should be done at least 5 days a week.
False
Match the following with their corresponding role in preventing dental caries:
Sticky candy = Fluoridated toothpaste = Bottle at bedtime =
A diet high in sugar and desserts can help prevent constipation in children.
False
What is one example of a muscle-strengthening activity for school-aged children?
Climbing on playground equipment
How many glasses of water should children between 2 to 6 years old drink every day?
4 to 6 glasses
What is one consequence of anaemia on cognitive development in children?
Impaired cognitive function and decreased academic performance
A diet rich in _______ can help prevent tooth decay in children.
fluoride
What is a consequence of lack of oral hygiene in children?
Dental caries
What is the primary cause of Iron-deficiency anemia in toddlers?
Dietary factor: Deficiency of folate (vit B9)
Iron-deficiency anemia is more common in toddlers above 18 months old.
False
What are the consequences of iron-deficiency anemia on cognitive development?
Long-term delays in cognitive development and behavior disturbances
The protein molecule that carries oxygen in RBCs is ______________.
Hb
Match the following age ranges with their corresponding Hemoglobin concentration (g/dL) and Hematocrit (%) for diagnosing iron-deficiency anemia:
1-2 years = < 11.0 g/dL 2-5 years = < 11.1 g/dL 5-8 years = < 11.5 g/dL 8-12 years = < 11.9 g/dL
What is one way to prevent iron-deficiency anemia in children?
Increase intake of meat, poultry, and fish
Iron-deficiency anemia is a rare condition in toddlers.
False
What is one sign of iron-deficiency anemia in children?
Lethargy
What is a recommended drink to offer children to promote healthy choices?
Plain water
Lead poisoning can affect a child's brain, blood, and kidney development.
True
What is the prevalence of childhood obesity in Malaysia, according to the myBreakfast study in 2015?
2 in 3 of the children who are overweight are boys, and 1 in 3 of the children are low in physical activity
Children who skip breakfast are _______ more likely to be overweight or obese.
1.34 times
Match the following consequences of childhood obesity with their corresponding health problems:
Type 2 Diabetes = PCOS Hypertension = Abnormal lipid profiles Stroke = Knee/hip joint pain
What is a potential consequence of consuming more than 24 oz of milk per day for children ages 1-5 years?
Displacement of high iron foods
What is a possible cause of childhood obesity?
All of the above
True or False: Vitamin C intake can increase the absorption of heme iron.
False
Prevention is the most cost-effective way to address childhood obesity.
True
According to the National Health and Morbidity Survey 2019, what percentage of children aged 5-17 years are overweight and obese?
Almost 30%
What is a common cause of tooth decay in children?
Frequent exposure to CHO foods and poor oral hygiene
Children ages 1-5 years should not drink more than ______ oz of milk per day due to its low iron content.
24
Match the following conditions with their age ranges:
Eastern Asia = 40% to 97% Southern Asia = 38%-73.7% Western Asia = 26.5%-74.7%
True or False: Vitamin D deficiency is not a concern in children.
False
What percentage of Total Energy Expenditure (TEE) is Basal Metabolic Rate (BMR)?
60-75%
Resting Metabolic Rate (RMR) is the same as Basal Metabolic Rate (BMR).
False
What is the difference between Basal Metabolic Rate (BMR) and Resting Metabolic Rate (RMR)?
RMR is BMR plus the thermic effect of food (TEF) and the state of unrelaxed rest.
Basal Metabolic Rate (BMR) is measured under standardized conditions, including a _______________________ environment.
thermoneutral
Match the following terms with their definitions:
BMR = Basal Metabolic Rate, energy required for maintenance RMR = Resting Metabolic Rate, energy expended at rest REE = Resting Energy Expenditure, measurements made in post-absorptive state SMR = Sleeping Metabolic Rate, energy expended during sleep
What is the percentage difference between Basal Metabolic Rate (BMR) and Resting Energy Expenditure (REE)?
10-15%
What is the sum of three components that make up Total Energy Expenditure (TEE)?
Basal metabolic rate (BMR), thermic effect of diet, and energy expended in physical activity
Growth is a significant component of Total Energy Expenditure (TEE) for adults.
False
What is the energy expenditure component that accounts for growth and development in children?
Growth
Total Energy Expenditure (TEE) is the energy expended by an individual within __________ hours.
24
Match the following components of Total Energy Expenditure (TEE) with their descriptions:
Basal metabolic rate (BMR) = Energy expended at rest Thermic effect of diet = Energy expended in digesting food Energy expended in physical activity = Energy expended during physical activity
What is the approximate energy requirement for growth in children?
2 kcal/g of weight gain
Study Notes
Early Childhood Development (0-8 years)
- Infants: 0-1 year old
- Toddlers: 1-2 years old
- Preschoolers: 3-4 years old
Growth Development
- Growth during toddler (1-3 yrs) and preschoolers (3-5 yrs) is slower than in infancy but steady
- Growth velocity slows after infancy until the adolescent growth spurt
- All children develop at a different pace
Physical and Motor Skill Markers
- Age 2:
- Able to turn a door knob
- Look through a book and turn one page at a time
- Build a tower of 6-7 cubes
- Kick a ball without losing balance
- Pick up objects while standing, without losing balance
- Run with better coordination
- May be ready for toilet training
- Typically have 16 teeth
- Age 3:
- Gains about 1.8-2.25 kilograms
- Grows about 2-3 inches (5-7.5 cm)
- May have daytime control over bowel and bladder functions
- Can briefly balance and hop on one foot
- Reaches about half of adult height
- Has improved balance
- Has improved vision (20/30)
- Has all 20 primary teeth
- Needs 11-13 hours of sleep a day
- Age 4:
- Gains weight at the rate of about 6 grams per day
- Weighs 40 pounds (18.14 kilograms) and is 40 inches (101.6 cm) tall
- Has 20/20 vision
- Sleeps 11-13 hours at night, most often without a daytime nap
- Grows to a height that is double the birth length
The Typical 3- to 6-year-old
- Gains about 4-5 pounds (1.8-2.25 kilograms) per year
- Grows about 2-3 inches (5-7.5 centimeters) per year
- Has all 20 primary teeth by age 3
- Has 20/20 vision by age 4
- Sleeps 11-13 hours at night, most often without a daytime nap
Body Composition
- Growth during childhood progresses at a slower pace with less pronounced changes in body composition
- Sex differences in percent body fat observed during infancy continue through this period
- A small increase in the rate of weight-, height-, and body breadth-gain is observed in the mid-childhood growth spurt occurring around ages 6-8
- A rebound in body mass occurs at approximately the same time
Body Mass Index (BMI)
- Peaks near the end of infancy
- Declines in early childhood
- Reaches a nadir (lowest point) around age 5-6
- Increases throughout the remainder of childhood, adolescence, and adulthood
Why Monitor Growth?
- Measure changes of the body size, shape, and composition
- Assess the adequacy of diet, health care, growth, and development
- Evaluate nutritional status and initiate effective action
- Monitor effects of nutritional intervention
- Teach parents how nutrition, physical activity, genetics, and illness can affect growth
Key Recommendations
- Monitor the growth of children and adolescents using appropriate growth standards or charts to ensure healthy growth
- Measure weight and height, calculate BMI, and determine weight status using BMI-for-Age monthly
- Monitor growth of children below 5 years old using WHO (2006) chart and use WHO (2007) reference for children 5-19 years old
Early Childhood Development (0-8 years)
- Infants: 0-1 year old
- Toddlers: 1-2 years old
- Preschoolers: 3-4 years old
Growth Development
- Growth during toddler (1-3 yrs) and preschoolers (3-5 yrs) is slower than in infancy but steady
- Growth velocity slows after infancy until the adolescent growth spurt
- All children develop at a different pace
Physical and Motor Skill Markers
- Age 2:
- Able to turn a door knob
- Look through a book and turn one page at a time
- Build a tower of 6-7 cubes
- Kick a ball without losing balance
- Pick up objects while standing, without losing balance
- Run with better coordination
- May be ready for toilet training
- Typically have 16 teeth
- Age 3:
- Gains about 1.8-2.25 kilograms
- Grows about 2-3 inches (5-7.5 cm)
- May have daytime control over bowel and bladder functions
- Can briefly balance and hop on one foot
- Reaches about half of adult height
- Has improved balance
- Has improved vision (20/30)
- Has all 20 primary teeth
- Needs 11-13 hours of sleep a day
- Age 4:
- Gains weight at the rate of about 6 grams per day
- Weighs 40 pounds (18.14 kilograms) and is 40 inches (101.6 cm) tall
- Has 20/20 vision
- Sleeps 11-13 hours at night, most often without a daytime nap
- Grows to a height that is double the birth length
The Typical 3- to 6-year-old
- Gains about 4-5 pounds (1.8-2.25 kilograms) per year
- Grows about 2-3 inches (5-7.5 centimeters) per year
- Has all 20 primary teeth by age 3
- Has 20/20 vision by age 4
- Sleeps 11-13 hours at night, most often without a daytime nap
Body Composition
- Growth during childhood progresses at a slower pace with less pronounced changes in body composition
- Sex differences in percent body fat observed during infancy continue through this period
- A small increase in the rate of weight-, height-, and body breadth-gain is observed in the mid-childhood growth spurt occurring around ages 6-8
- A rebound in body mass occurs at approximately the same time
Body Mass Index (BMI)
- Peaks near the end of infancy
- Declines in early childhood
- Reaches a nadir (lowest point) around age 5-6
- Increases throughout the remainder of childhood, adolescence, and adulthood
Why Monitor Growth?
- Measure changes of the body size, shape, and composition
- Assess the adequacy of diet, health care, growth, and development
- Evaluate nutritional status and initiate effective action
- Monitor effects of nutritional intervention
- Teach parents how nutrition, physical activity, genetics, and illness can affect growth
Key Recommendations
- Monitor the growth of children and adolescents using appropriate growth standards or charts to ensure healthy growth
- Measure weight and height, calculate BMI, and determine weight status using BMI-for-Age monthly
- Monitor growth of children below 5 years old using WHO (2006) chart and use WHO (2007) reference for children 5-19 years old
Age Groups and Stages
- Infants: 0 – 1 year old
- Toddlers: 1 – 2 years old
- Preschoolers: 3 – 4 years old
- Primary school children: 6 – 12 years old
- Pre-adolescents: 10 – 13 years old
Energy Requirements
- Estimation of energy requirements involves resting energy expenditure (REE) and physical activity level (PAL)
- PAL values:
- 1.4 for 1-3 years age group
- 1.4, 1.6, and 1.8 for >3 years age group
Highlights of Nutrients for Growth
- Energy
- Protein
- Calcium
- Vitamin D
- Iron
- Zinc
Age Groups and Stages
- Infants: 0 – 1 year old
- Toddlers: 1 – 2 years old
- Preschoolers: 3 – 4 years old
- Primary school children: 6 – 12 years old
- Pre-adolescents: 10 – 13 years old
Energy Requirements
- Estimation of energy requirements involves resting energy expenditure (REE) and physical activity level (PAL)
- PAL values:
- 1.4 for 1-3 years age group
- 1.4, 1.6, and 1.8 for >3 years age group
Highlights of Nutrients for Growth
- Energy
- Protein
- Calcium
- Vitamin D
- Iron
- Zinc
Dental Caries
- Streptococcus mutans uses CHO as food and excretes acid, causing tooth decay
- Exposure to strong caries promoters (e.g., sticky candy) contributes to dental caries
- Prevention methods:
- Seek early pediatric dental care
- Begin oral hygiene when teeth appear
- Use fluoridated toothpaste
- Avoid using a bottle (milk or juice) at bedtime
- Avoid snacking on sticky CHO throughout the day
- Drink fluoridated water
- Fluorosis (staining of the teeth) can be caused by:
- Excessive fluoride supplementation
- Consumption of toothpaste with fluoride
- Natural water supply high in fluoride
Constipation
- Passage of hard and dry stools associated with painful bowel movement
- Contributing factors:
- Painful experience
- Lack of privacy or cleanliness (preschool)
- Avoidance of toilet due to involvement in play
- Diet (sugar and desserts prone to constipation)
- Switching milk (breast milk vs. formula)
- Intense changes (illness, bedridden, eating less, dehydration)
Nutrition Recommendations
- Adequate intake of fibre: 19-25 g/day for young children (RNI Malaysian, 2017)
- Fluid intake: 4-6 glasses of water per day for children between 2-6 years (Malaysian Dietary Guidelines)
- Milk intake: not more than 24 oz per day for children aged 1-5 years to prevent low iron content
Prevention of Nutrition-Related Disorders
- Prevention of dental caries
- Prevention of constipation
- Prevention of iron-deficiency anemia
- Prevention of lead poisoning
- Prevention of overweight and obesity
Physical Activity
- Moderate-intensity aerobic activities:
- Brisk walking
- Bicycle riding (on flat surfaces)
- Active recreation (hiking, swimming)
- Playing games that require catching and throwing
- Vigorous-intensity aerobic activities:
- Running
- Bicycle riding (including hills)
- Active games (running and chasing)
- Jumping rope
- Martial arts
- Sports (soccer, basketball, swimming, tennis)
- Vigorous dancing
- Muscle-strengthening activities:
- Games like tug of war
- Resistance exercises using body weight or resistance bands
- Rope or tree climbing
- Climbing on playground equipment
- Children's yoga
- Bone-strengthening activities:
- Hopping, skipping, jumping
- Jumping rope
- Running
- Sports that involve jumping or rapid changes in direction
Iron-Deficiency Anaemia
- Toddlers (esp. 9 – 18 months old) are at highest risk due to rapid growth rate and inadequate iron intake
- Caused by decreased production of RBCs
- Other causes: dietary factor (deficiency of folate) and non-dietary factor (chronic inflammation or recent infection)
Diagnosis of Iron-Deficiency Anaemia
- Based on the 5th percentile of Hb & Ht for age
- Hemoglobin concentration and hematocrit levels vary by age:
- 1–2 years: < 11.0 g/dL and < 32.9 %
- 2–5 years: < 11.1 g/dL and < 33.0 %
- 5–8 years: < 11.5 g/dL and < 34.5 %
- 8 – 12 years: < 11.9 g/dL and < 35.4 %
Signs & Symptoms
- Lethargy, pale skin, unable to pay attention, shortness of breath, palpitations or irritability
- Consequences in young children: long-term delays in cognitive development and behavior disturbances
Identification & Prevention
- Children at risk: those who have a low-iron diet or consume more than 24 oz of milk per day
- Prevention: increase intake of meat, poultry, and fish, and offer children healthier choices
Dental Caries
- Prevalence among Asian children:
- 40% to 97% in Eastern Asia
- 38%-73.7% in Southern Asia
- 26.5%-74.7% in Western Asian countries
- Causes: baby-bottle tooth decay, frequent exposure to CHO foods, and poor dietary choices
- Prevention: good oral hygiene, limiting sugary snacks, and regular dental check-ups
Lead Poisoning
- Consequences:
- High level in the blood: affects brain, blood, and kidney
- Elevated blood levels: decreases growth in children
- Low level exposure: associated with decreases in IQ, behavioral problems, and academic achievement
Childhood Obesity
- Increased prevalence rate, affecting both high and low-income populations
- Prevention is the most cost-effective way
- Possible causes: family history of obesity, environmental and social factors, lifestyle factors, and adiposity rebound
- Consequences: type 2 diabetes, hypertension, stroke, PCOS, and depression/low self-esteem
Total Energy Expenditure (TEE)
- TEE is the energy expended by an individual within 24 hours
- Composed of three components:
- Basal metabolic rate (BMR)
- Thermic effect of diet
- Energy expended in physical activity
Basal Metabolic Rate (BMR)
- Accounts for 60-75% of TEE
- Energy required for maintenance of intracellular environment and crucial mechanical processes (e.g., cardiac function and respiration)
- Measurement of BMR requires standardized conditions:
- Postprandial state (12-14 hours after eating)
- Completely relaxed and still (shortly after waking)
- Thermoneutral environment
- Free from thermic effect of drugs
- 20-30 minutes of stable measurements
Resting Metabolic Rate (RMR) and Resting Energy Expenditure (REE)
- RMR: BMR + thermic effect of food (TEF) + state of unrelaxed rest
- REE: measurements made in post-absorptive state
- Values between BMR and RMR/REE differ by approximately 10-15% (RMR > BMR)
Sleeping Metabolic Rate (SMR)
- Energy expended during sleeping
- Accounts for 1-5% of total energy expenditure
Explore the stages of early childhood development, from infancy to preschool age, and learn about physical and motor skill markers in young children.
Make Your Own Quizzes and Flashcards
Convert your notes into interactive study material.
Get started for free
