Growth and Development PDF

GROWTH AND DEVELOPMENT CASAMINA, Mikyla M. DIMAPILIS, Alixandra LAGUIPO, Rose Ann B. PADUAL, Sheryl V. PANTALEON, Rina Lyn S. PASAG, Christian D. PEPITO, Irish Dianne F. PONCE, Kyla Mae V. PORTON, Bea C. PRADO, Marla Angelica B. SA...

GROWTH AND DEVELOPMENT CASAMINA, Mikyla M. DIMAPILIS, Alixandra LAGUIPO, Rose Ann B. PADUAL, Sheryl V. PANTALEON, Rina Lyn S. PASAG, Christian D. PEPITO, Irish Dianne F. PONCE, Kyla Mae V. PORTON, Bea C. PRADO, Marla Angelica B. SALINAS, Aaliyah Eunice C. TADEO, Jennylyn M. TORZAR, Liezel C, YAMO, Grace Lyn C.  2 NURSING PROCESS OVERVIEW: PROMOTION OF GROWTH AND DEVELOPMENT  NURSING PROCESS OVERVIEW: PROMOTION 3 OF GROWTH AND DEVELOPMENT ASSESSMENT GROWTH - An increase in physical size or a quantitative change in : a) Height - measured in centimeters or inches b) Weight - measured in pounces or kilograms c) Head Circumference - obtained for children ages 2 years and younger. Height, weight, and head circumference are important growth indicators, so they should be measured and plotted on a STANDARD GROWTH CHART.  NURSING PROCESS OVERVIEW: PROMOTION 4 OF GROWTH AND DEVELOPMENT ASSESSMENT DEVELOPMENT - the progression towards maturity in mental, physical, and social markers. Obtain a developmental health history from caregivers and the child including nutritional intake, sleep, elimination, and a description of behaviors that reflect past and current development. Observe specific activities of the child to determine whether developmental milestones are achieved within the age-appropriate time frame.  NURSING PROCESS OVERVIEW: PROMOTION 5 OF GROWTH AND DEVELOPMENT NURSING DIAGNOSIS Examples of nursing diagnoses applicable to growth and development include: Delayed growth and development related to lack of age-appropriate activities Delayed growth and development related to prolonged illness Malnutrition related to parental knowledge deficit regarding a child’s need Knowledge deficiency related to potential long-term effects of obesity in the school- aged child  NURSING PROCESS OVERVIEW: PROMOTION 6 OF GROWTH AND DEVELOPMENT OUTCOME IDENTIFICATION AND PLANNING Provide holistic nursing care, considering the physical, emotional, cultural, cognitive, spiritual, and social aspects of health. Children achieve milestones at a predictable age. Identifying delays encourages prompt evaluation and intervention Parents of a child with a developmental delay may use denial as a protective mechanism. Planning may have to focus on acceptance of a current situation and providing appropriate measures.  NURSING PROCESS OVERVIEW: PROMOTION 7 OF GROWTH AND DEVELOPMENT IMPLEMENTATION Interventions to promote growth and development include: Age-appropriate activities Social Interactions Examples of age-appropriate activities and social interactions Infants (0–12 months) Rolling or crawling games to encourage movement. Singing songs or mimicking cooing sounds. Face-to-face interactions with caregivers to build attachment.  NURSING PROCESS OVERVIEW: PROMOTION OF 8 GROWTH AND DEVELOPMENT Toddlers (1–3 years) Stacking blocks or scribbling with crayons. Encouraging two-word sentences through interactive conversation. Teaching basic social skills like saying “please” and “thank you.” Preschoolers (3–5 years) Counting games or simple board games. Early literacy activities like recognizing letters and writing their name. Role-playing games to explore different social roles and emotions. School-age children (6–12 years) Encouraging participation in clubs or extracurricular activities. Sports like soccer, basketball, or swimming. Encouraging responsibility through chores or pet care.  NURSING PROCESS OVERVIEW: PROMOTION 9 OF GROWTH AND DEVELOPMENT OUTCOME EVALUATION - Evaluation of growth and developmental milestones is monitored throughout childhood. Provide follow-up at subsequent visits if there are any concerns Examples of appropriate visit outcomes may include: Parents/caregivers describe how they have made a safe space in their home for the 9-month-old infant to crawl. express confidence that they will be able to guide the toddler past the stage of the “terrible twos” Parents/caregivers describe how they plan to phase out high-carbohydrate, nonnutritive snacks for preschoolers. List household tasks appropriate for the 6-year-old child.  10 THE ROLE OF THE NURSE IN PROMOTION OF GROWTH AND DEVELOPMENT  HEALTH PROMOTION AND ILLNESS 11 PREVENTION DETERMINING A CHILD’S DEVELOPMENT STAGE IS OFTEN THE PRIMARY FOCUS OF A WELL-CHILD ASSESMENT. CAREGIVER STYLE AND COMPETENCE - influence the overall health of children and should be considered when providing developmental anticipatory guidance. ANTICIPATORY GUIDANCE- should be provided in a timely manner. Recognizing the predictable stages of growth and development, from newborn through late adolescence, enables nurses to provide appropriate anticipatory guidance.  HEALTH RESTORATION AND 12 MAINTENANCE IT IS EQUALLY ESSENTIAL TO CONSIDER THE DEVELOPMENTAL STAGE OF A CHILD WHEN PROVIDING CARE DURING ILLNESS IN PREPARATION FOR PROCEDURES. FOR EXAMPLE, when preparing a 5 year old for surgery, the nurse must understand how to explain medicine, procedures and recovery in a developmentally appropriate way to the child. Growth and development knowledge is utilized to assess whether a child can swallow oral tablets and capsules and accurately rate pain on a standard scale.  HEALTH RESTORATION AND 13 MAINTENANCE DISEASE AFFECTS CHILDREN DIFFERENTLY AT VARIOUS STAGES OF GROWTH AND DEVELOPMENT, MAKING PHYSICAL GROWTH AN IMPORTANT FACTOR A 12 year old child with a fracture long bone has a more serious fracture than an 8 year old who fractures the same bone.  PRINCIPLES OF GROWTH AND 14 DEVELOPMENT GROWTH AND DEVELOPMENT ARE COMPLEX PHENOMENA WITH MANY INTERRELATED FACES. CHILDREN DO NOT MERELY GROW TALLER AND GAIN WEIGHT AS THEY GET OLDER; THE ABILITY TO PERFORM SKILLS, THINK, RELATE TO PEOPLE, AND TRUST OR HAVE CONFIDENCE IN THEMSELEVES ALSO DEVELOPS THE TERM GROWTH AND DEVELOPMENT ARE OFTEN USED INTTERCHANGEABLY BUT THEY ARE VERY DIFFERENT TERMS.  PRINCIPLES OF GROWTH AND 15 DEVELOPMENT GROWTH- increase in physical size ( quantitative change). DEVELOPMENT- an increase in skill or ability to function ( qualitative change) MATURATION- IS A SYNONYM OF DEVELOPMENT PSYCHOSOCIAL DEVELOPMENT REFERS TO ERICKSONS STAGES OF PERSONALITY DEVELOPMENT. KOHLBERGS THEORY OF MORAL DEVELOPMENT REFERS TO THE ABILITY TO KNOW RIGHT FROM WRONG AND TO APPLY IT IN REAL LIFE SITUATIONS  PRINCIPLES OF GROWTH AND 16 DEVELOPMENT COGNITIVE DEVELOPMENT- it may be assessed by intelligence tests and by observing a childs ability to function in different environment. PATTERN- physical growth as well as maturation occurs in a predictable pattern.  BOX 28.2 17 A. General principles of growth and development include: GROWTH AND DEVELOPMENT ARE CONTIONUOUS PROCESS FROM CONCEPTION UNTIL DEATH: A child is growing physically and learning new skills throughout childhood and adolescence GROWTH AND DEVELOPMENT PROCEED IN AN ORDERLY SEQUENCE: growth in height occurs in only one sequence, from smaller to larger. Development proceeds in a predictable order. (SIT-CRAWL-STAND-WALK-RUN)  BOX 28.2 18 A. General principles of growth and development include: CHILDREN PASS THROUGH THE PREDICTABLE STAGES AT DIFFERENT RATES: all stages of development have a range of time rather than a certain point at which they are usually accomplished. NOT ALL BODY SYSTEMS DEVELOP AT THE SAME RATE: certain body tissue mature more rapidly than others do.  BOX 28.2 19 A. General principles of growth and development include: DEVELOPMENT IS CEPHALOCAUDAL: cephalo is a greak word means "head" and caudal means "tails". motor development proceeds from head to tail. DEVELOPMENT PROCEEDS FROM PROXIMAL TO DISTAL BODY PARTS: This principle is closely related to cephalocaudal development. It can best be illustrated by tracing the progress of upper extremity development.  BOX 28.2 20 A. General principles of growth and development include: DEVELOPMENT PROCEEDS FROM GROSS TO REFINED SKILLS: once children are able to control distal body parts like fingers, they are able to perform fine motor skills. THERE IS AN OPTIMUM TIME FOR INITIATION OF EXPERIENCES OR LEARNING: children cannot learn tasks until their nervous system is mature enough to allow that particular learning.  BOX 28.2 21 A. General principles of growth and development include: NEONATAL REFLEXES MUST BE LOST BEFORE DEVELOPMENT CAN PROCEED: An infant cannot grasp an item with skill until the grasp reflex has faded nor can the infant stand steadily until the walking reflex has faded. Neonatal reflexes are replaced by purposeful movements. A GREAT DEAL OF SKILL AND BEHAVIOR IS LEARNED BY PRACTICE: infants repeatedly practice taking their first steps until they can do it confidently. If children fall behind in development due to illness, they can often catch up to their expected developmental level.  22 FACTORS INFLUENCING GROWTH AND DEVELOPMENT  FACTORS INFLUENCING GROWTH AND 23 DEVELOPMENT GENETICS : Refers to the fundamental genetic composition that was present, such as physical characteristics of a person like skin color, possible height, and color of the hair. It may also vary to its genetic abnormality, such as disabilities or diseases that were carried out by genetics by inheriting from its ancestors. SEX DIFFERENCE RELATED TO PHYSICAL GROWTH: The females are weighingless than the males, female are most likely appear smaller or shorter compared to the males from the newborn stage females weighs an ounce or two than males. Females most likely Begin their puberty 6 months to 1 year earlier than the male, and also males during their puberty they may appear taller weigh more compared did the females with the same age.  FACTORS INFLUENCING GROWTH AND 24 DEVELOPMENT TEMPERAMENT : When it comes to temperament it deals with the reaction pattern of an individual on how they characterize there behavior or manner of thinking to a certain scenario. Compared to the other growth development the temperament was not developed stages, it varies on how a person understand certain things, and it is essential understanding that every individuals are different to one another when comes to temperament.  FACTORS INFLUENCING GROWTH AND 25 DEVELOPMENT REACTION PATTERN :The reaction pattern was characterized by Chess and Thomas 1985 they develop denying characteristics to define the child's temperament such as activity level, rhythmicity, approach and withdrawal, adaptability, intensity of reaction, mood quality distractibility attention span and persistence and threshold of response. Those are elements the distinguish a child's individual the environment that may lead to a certain activities they may pursue.  FACTORS INFLUENCING GROWTH AND 26 DEVELOPMENT ACTIVITY LEVEL : It deals with the overall activity of the child, such as excessive energy or quiet. The opposite is whether they are supposed to be quiet or energetic; most likely, children with excessive energy tend to grow outdoors, or most of the time, they like sports because they use extra energy, which they may possess. RHYTHMICITY : Predictable biological functions (sleep, appetite) lead to better routines, stability, and adaptability to different schedules later in life.  FACTORS INFLUENCING GROWTH AND 27 DEVELOPMENT APPROACH :Initial response to new stimuli. Curiosity and enthusiasm lead confidence and outgoingness, while fear and withdrawal might require more support to adjust. ADAPTABILITY : Ease of adjusting to transitions and changes, High adaptability promotes Flexibility and resilience, while slow adaptation might need more time and support.  FACTORS INFLUENCING GROWTH AND 28 DEVELOPMENT INTENSITY OF REACTION : Strength of emotional responses. High- intensity can be expressive and passionate but also prone to outbursts, suggesting potential for creativity and emotional depth. Low intensity might be calm and collected but could be misconstrued and lacking interest or emotion. DISTRACTIBILITY: Ability to shift attention. Distractible children might struggle with focus but are adaptable and open to new experiences. Less distractible children excel in tasks requiring focus and attention to detail.  FACTORS INFLUENCING GROWTH AND 29 DEVELOPMENT ATTENTION SPAN AND PERSISTENCE :Attention span includes the ability to maintain interest in an activity.Persistence is the length of time a child continues an activity despite obstacles, and highly persistent children are more likely to succeed in reaching goals. Children with low persistence may develop strong social skills by realizing others can help. THRESHOLD OF RESPONSE : intensity level of stimulation necessary to evoke a reaction. The child's threshold of reaction tells us how sensitive they are to physical stimuli.  FACTORS INFLUENCING GROWTH AND 30 DEVELOPMENT MOOD QUALITY : Mood describes the tendency to react to the world primarily in a positive or negative way. Serious children tend to be child focus on the analytic and evaluate situations carefully.  ENVIRONMENT 31 It pertains to the emotional, physical, and social surroundings in which a child or individual can flourish and evolve. A nurturing environment is crucial for a child's upbringing, as it fosters healthy development and supports their overall growth and well-being. The following environmental influences are those most likely to affect growth and development.  SOCIAL DETERMINANTS OF HEALTH 32 It is determined in part by access to: Social economic opportunities Quality of schooling Resources and supports available in the homes Cleanliness of food, water, and air Neighborhoods and community The nature of social interactions and relationships Safety of workplaces  The resources available, or lack thereof 33 affect the health of children. Health Equity is when all can obtain the highest level of health. Health disparities are the differences that exist when health is linked with social, economic, and environmental disadvantage.  CARE GIVER CHILD-RELATIONSHIP 34 -Loss of love from a primary care giver, as might occur with the death of a parent, or interruption of parental contact through hospitalization, imprisonment, or divorce, can have such an effect on a child that it interferes with normal growth and development. Providing caregiver support and fostering care-giver child relationship is important. -Adverse childhood experiences (ACE’s) are potentially traumatic events that may occur during childhood that can influence growth and development. (Maltreatment, neglect, and household changes) SIBLING SOCIALIZATION AND RELATIONSHIP 35 -Siblings and their position in the family have a role in the socialization and development of self-esteem in each child. Parents should help siblings develop good relationships with each other, although there will most likely be conflicts. PHYSICAL ACTIVITY AND HEALTH -Beginning in infancy and continuing through puberty, physical activity is crucial for a healthy lifestyle. Lean body mass, muscle strength, and bone health are all enhanced by physical activity. -Engaging in physical activity enhances psychological well-being, learning ability, and a person's sense of self-worth.  NUTRITION 36 - The body depends heavily on nutrition since it keeps the body healthy and fights disease. The body's resistance to infection may be weakened by inadequate diet. Lack of calcium could leave the child prone in shortening of bowing of long bones. Lack of vitamins in body can lead to poor healing and poor bone growth. NUTRITION GUIDELINES FOR A HEALTHY DIET - Since 1980, a new edition of the Dietary Guidelines for Americans has been published every 5 years with the goal of promoting health and preventing disease. Healthy eating habits are established in early childhood and persists throughout a lifetime. Caregivers should model healthy eating patterns for their children. Patterns can be tailored to the individual’s social- cultural and personal preferences.  COMPONENTS OF HEALTHY DIET 37 A balanced diet of proteins, carbohydrates, fats, vitamins, and minerals is important for growth and development (Fig. 28.3). PROTEIN Protein is the major component of bones, skin, hair, and muscle and is responsible for a wide variety of essential functions in the body, including growth. CARBOHYDRATE Carbohydrates are a main energy source for the body, essential to the functioning of body systems. Carbohydrates are important to infants and toddlers because their brain cells are actively growing.  COMPONENTS OF HEALTHY DIET 38 FAT Dietary fat is a second source of energy for the body. It can be an immediate energy source or can be stored if not used, then released when energy is required. Some fat deposits also serve as insulating material for subcutaneous tissues. In infants, fats are necessary to ensure myelination of nerve fibers.  COMPONENTS OF HEALTHY DIET 39 VITAMINS Vitamins are organic compounds essential for specific metabolic actions in cells. For children, fat-soluble vitamins (A,D, K, and E) are mainly supplied by fortified dairy products,cereals, and plant or fish oils. Water-soluble vitamins (B complex and C) do not need far for absorption. They are not stored well in the body, and should be taken daily to maintain effective levels. FOOD GROUP SERVINGS FOR CHILDREN Children 2-6 Old Major nutrients provided by the Group Example of Foods Years of Age Children food group Thiamine, niacin, riboflavin (if Cereals, rice, pasta (best if 6- 11 GRAINS 6 servings enriched), iron, incomplete protein, whole grain and enriched) servings carbohydrates Vitamin A, iron, calcium, 3-5 VEGETABLES Vegetables (yellow and green) 3 servings carbohydrates (include vitamin A servings source at least every other day) 2 -4 Vitamin C (include vitamin C daily), FRUIT Oranges, apples, lemons 2 servings servings carbohydrates Calcium, phosphorus, complete Whole milk and other milk products 2-3 protein, riboflavin, niacin, vitamin D DAIRY such as yogurt and cheese 2 servings servings (if vitamin D fortified milk used), fats Muscle meats (veal, beef, pork) dry 2-3 Complete protein, iron, thiamine, PROTEIN beans, eggs, fish, poultry 2 servings riboflavin, niacin, vitamin b12 fats servings VITAMINS ESSENTIAL FOR HEALTH (FAT SOLUBLE) Vitamin Selected Dietary Sources Function in Body Result of Deficiency Keratinization of the eye Important for night vision and A (retinol) Liver, carrots spinach corneal integrity and growth (xeropthalmia) and blindness Egg yolk, margarine, Regulates absorption of Rickets (bone deformity) D salmon, fortified milk, calcium and phosphorus for bone growth in growing children fortified cereals An antioxidant that protects In immature infants, severe Margarine, corn, oil, E red blood cells from destruction anemia from destruction of peanuts by oxygen red blood cells Cabbage, spinach, Bleeding from lack of K pork, best source: green Aids blood clotting sufficient clotting action leafy vegetables All fat soluble vitamins can be absorbed only in the presence of lipids and can be transported only in the presence of protein. VITAMINS ESSENTIAL FOR HEALTH (WATER - SOLUBLE) Vitamin Selected Dietary Sources Function in Body Result of Deficiency Important for use of glucose in Beriberi, a disease that THIAMINE Wheat germ, yeast, pork cells causes nerve paralysis Red swollen tongue, Beef, chicken, liver, Breaks down fatty acids and RIBOFLAVIN amino acids for energy inflamed eyes, fissures of avocados, milk lips Converts glucose to energy; Pellagra (diarrhea, mental NIACIN Peanuts, rice bran, liver involved in carbohydrate, confusion, dermatitis, death) protein, and fat metabolism VITAMIN B6 Liver, herring, salmon, Metabolizes amino acids and Neuritis, depression, (Pyridoxine) chicken, fish, pork, eggs glucose nausea, vomiting VITAMINS ESSENTIAL FOR HEALTH (WATER - SOLUBLE) Vitamin Selected Dietary Sources Function in Body Result of Deficiency Blood formation; DNA and RNA synthesis; myelin Macrocytic, megaloblastic VITAMIN B12 Lamb, beef kidney, egg formation; carbohydrate, anemia (large, nonfunctioning (Cobalamin) yolk, animal products protein, and fat red blood cells) metabolism FOLIC ACID Red and white blood cell Poor red blood cell Liver, asparagus, bran structure (Folacin) formation C Collagen structure, Scurvy ( weakness, easy (Ascorbic Broccoli, collards, citrus fruit antioxdant bleeding, joint pain) acid)  COMPONENTS OF HEALTHY DIET 44 MINERALS Minerals are necessary for building new cells as well as for the regulation of body processes such as fluid and electrolyte balance, nerve transmission, and muscle contractions. Minerals are classified according to the amounts needed daily: If more than 100 mg is needed daily, a mineral is a macronutrient (a major mineral). If the amount needed is less than 100 mg, it is a minor mineral or micronutrient. Trace minerals refer to those needed in only extremely small amounts.  Promoting adequate nutritional intake 45 in vegetarian diets Families may choose vegetarian diets for ecological, medical, philosophical, spiritual, or economic reasons. While a balanced vegetarian diet can support growth during childhood, careful planning is necessary to ensure adequate nutrition, especially for active children. Five types of Vegetarian Diets 1. Lacto-ovo-vegetarian Diet: Includes dairy, eggs, and plant-based foods. 2. Ovovegetarian Diet: Includes eggs but excludes dairy. 3. Lacto-vegetarian Diet: Includes dairy but excludes eggs. 4. Vegan Diet: Excludes all animal products, focusing on plants. 5. Macrobiotic Diet: Primarily vegetarian, with occasional inclusion of eggs, fish, or wild game. Families following vegetarian diets must ensure that their children get adequate amounts of key nutrients for healthy growth and development.  46 PROTEIN Lacto-ovo-vegetarian, ovovegetarian, and lacto-vegetarian diets provide all essential amino acids for growth. Vegan diets can also supply these amino acids through combinations of cereals and legumes (e.g., peanut butter and bread, corn and beans). Complementary proteins don't need to be eaten in the same meal, as long as a variety of plant proteins are consumed throughout the day. MINERALS ESSENTIAL FOR HEALTH Mineral Selected Dietary Sources Function in Body Result of Deficiency Improper bone growth and Macronutrients Formation of bone and teeth, maintenance shown by Milk,hard cheese muscle contractility Calcium: diseases such as rickets in children Formation of bone and teeth, Deficiency unlikely as long Phosphorus Milk, Meats used in cell structure, aids use as calcium and protein of glucose needs are met Deficiency rare but excess leads to hypertension in Sodium Table salt Regulates fluid volume and pH genetically determined individuals MINERALS ESSENTIAL FOR HEALTH Mineral Selected Dietary Sources Function in Body Result of Deficiency Formation of hydrochloric Deficiency tare except with Chloride Table salt acid, regulates body fluid with vomiting, which causes loss sodium of hydrochloric acid Deficiency leading to Major cation of cells, essential muscle weakness and for electrical conduction in heart irritability, occurs in Potassium Meats, dried fruits muscle and there fore in heart people taking diuretics be action cause potassium is excreted with urine Esential for protein formation Deficiency rate as long as Sulfur Milks, meats, egg and cell growth protein intake is adequate Cocoa, nuts, green leafy Relaxation of muscles after Deficiency leads to muscle Magnesium vegetables contraction contraction MINERALS ESSENTIAL FOR HEALTH Mineral Selected Dietary Sources Function in Body Result of Deficiency Reduced basal metabolic Micronutrients: Seafood, dairy, iodized Formation of thyroxine and rate, goiter (enlarged Iodine salt regulation of metabolic rate thyroid gland) Deficiency leads to microcytic (small) and Formation of hemoglobin, hypo- chromic (pale) red Meats, fish, dried fruits, Iron transport of oxygen to body blood cells firon deficiency nuts, fortified cereals cells anemia); excess leads to infiltration of tissue (hemosiderosis) Anemia, neutropenia, and Formation of collagen and Copper Nuts, rasin, legumes nerve fibers severe bone demineralizations  Minerals Selected dietary resources Function and body Result of deficiency Reduces dental caries and Fluoride Flouridated water demineralization from bone Dental caries Diabetes-like symptoms Formation of eyes, male because of decreased Zinc Meat, eggs, legumes reproductive organs, insulin production, poor insulin, and taste sensation taste sensation leading to poor unlikely Manganese Nuts, grains, legumes Formation of enzyme Deficiency unknown Deficiency apparently Molybdenum Organ meats, grains Mobilizes iron in body unknown Cobalt Many, sources Formation of red bllod Deficiency rare as long as cells in bone marrow animal food sources are ingested Minerals Selected dietary resources Function and body Result of deficiency Immunoglobulin formation and Selenium Seafood, kidneys, liver prevention of oxidation of cells Deficiency unknown Deficiency seen only Chromiun Meat, cheese, grains Glucose metabolism in severe malnutrition Aids growth of connective Retarded growth and bone Silicon Many sources tissue and bone deformity Nickel Duplication of growth Has not been determined Many sources to be essential for health in human of cells Has not bee determined to be essential for health in the Vanadium Many sources Lipid metabolism human Tin Has not been determine to be Many resources Blood formation essential for health in human CALCIUM 52 Typically obtained from dairy products like milk and cheese, but when not taten, calcium can be obtained from other sources like geen leafy vegetables or calcium-fortified tofu or soy Hour. IRON Iron deficiency anemia can be prevented through a balanced diet, including red meat, whole grains, fortified cereals, dark-green leafy vegetables, and dried fruits. Vitamin C-rich fruits and vegetables, like oranges or broccoli, also aid in iron absorption. VITAMINS 53 Vitamin B12 is found only in animal products, so vegans need supplements or fortified foods. Riboflavin is typically in milk but can be sourced from plant foods like soy milk, grains, and leafy vegetables. Vitamin D, essential for bone health, is usually in fortified milk, and vegans need supplements or sunlight for adequate intake. MINERALS Zinc is found in animal foods and also in plant sources like nuts, yeast, and wheat germ, so vegetarians typically get enough. Iodine, usually from seafood, can be obtained from seaweed or iodized salt in vegan diets. Calcium is available from leafy greens or supplements.  54 TOTAL CALORIES Plant foods have fewer calories than meat, so larger servings of nuts and legumes are recommended to replace meat servings. Serving sizes for other foods follow similar guidelines to those for meat-based diets. THANK YOU GROWTH AND DEVELOPMENT