Question

Mrs. Nelson is talking with the nurse about the dietary needs of her 22-month-old son. Which of the following responses by the nurse would be appropriate?

A. Your son needs fewer calories in relation to her body weight now than she did as an infant.

B. Your son needs less protein in his diet now because he is not growing as fast.

C. Your son should be drinking at least one quart of milk per day.

D. Use skim milk to cut down on the fat in your son’s diet.

Answer 1

TODDLER IS CHILD BETWEEN 12 to 36 MONTHS OF AGE

It is a period where cognitive, emotional, social development takes place... And hence good nutrition is very much needed .

In the above context where Mrs. Nelson is talking to a nurse about her 22 months baby's nutritional needs,... The nurse advice on making the baby to drink at least one quart of milk per day is a good suggestion... Let us see the nutritional requirements of the baby

Toddlers of 22 months old should have dietary pattern same as adults like 3 meals +2 snacks per day

Before going to that let us recall few measurements which would help in better understanding

1 CUP =8 OUNCES =1/4 QUART=240 ML

1QUART=4 CUPS

1 OUNCE = 28.3 GMS

1OUNCE =30 ML

1 LITRE =33.8 OUNCES

1 TABLE SPOON = 3 TEASPOON (15ML)=1/2 OUNCE

NUTRITIONAL REQUIREMENTS :

• ENERGY --1000 to 1400 k cal
• PROTEIN --55 GM /day
• CARBOHYDRATE --6 PORTIONS OF CARBS
• FATS--3 tspns /day
• Water--1.3 litres /day

ENERGY ---

• meeting energy requirements is very much needed in this age group because children play a lot and they don't know to convey their requirements....
• So providing them with3 meals and 2 snacks a day meets their energy requirements..
• Meeting energy should not be the criteria, providing healthy food along with energy requirements should be the criteria

PROTEINS

• Protein helps in development of body tissues and muscle
• protein sources are meat, fish, chicken, lentils, eggs
• Include at least one of these in each meal

CARBOHYDRATES --

• They provide energy and helps to keep baby active day long and also helps in growth and development
• sources are whole grain,bread,cereals,pasta,rice,wheat etc

FATS:

• they help in brain development ,buildup of cells and in muscle movements
• Sources are meat, egg, cooking oils, ghee, butter, cheese etc

VITAMINS

• Vit B12 and Vit D are very much essential at this stage because they help in DNA synthesis and RBC formation and brain functioning
• It is not available naturally in plants
• Sources are dairy products, fish and supplements from outside and also sunlight

MINERALS

• iron, calcium, phosphorus, sodium, copper, chloride, zinc etc are minerals
• Helps in healthy development
• Sources are dairy products, fruits, vegetables, meat, fish, nuts, dried fruits, green leafy vegetables etc

DIETARY FIBER

• fiber is good for digestion
• Sources are pear, unpeeled apples, yoghurt, banana etc

WATER

• 1.3 ltrs of liquids is needed
• Liquids include all the food taken in liquid form like soups,,juices, water etc
• It helps the baby to stay hydrated and healthy

Milk and iron deficiency are the major issues in toddlers

MILK

• provides calcium and vitamin D for bone strength
• 700 mg of calcium and 600 IU of vitamin D is needed for toddler
• Whole milk should be preferred because it contains dietary fats which help in normal growth and development and also for brain development
• Other sources are calcium fortified juices, cooked beans, dark green vegetables
• 450 to 500 my of milk should be provided to a toddler or at least half of it

If the baby is still breastfeeding and if mother wants to stop it educate her to stop it slowly by reducing one deeper day... If stopped suddenly it would result in plugged ducts and infection

IRON DEFICIENCY IN TODDLERS

• 7 mg of iron is needed
• Cows milk is low in iron content
• Milk reduces absorption of iron
• Milk irritates the intestinal lining and cause small amounts of bleeding and gradual loss of iron in stools
• Hence ask mother not to just rely on milk and not To overfeed the baby with milk
• Suggested amount of 500ml is sufficient for toddlers
• Advice mother to include Vit c in diet because it increases iron absorption
• Sources of iron are meat, poultry, fish, grains, beans etc and sources of Vit c are orange, tomato, lemon etc

​​​​​​​SAMPLE MENU::

This is just a sample out of my experience

Breakfast --

• 1/2 cup of milk and
• 1egg or
• 1/2 cup of cereal or
• 1/4 cup of fruits

Snacks--

• 1/2 cup of fruits

Lunch

• 1/2 whole wheat bread with meat or veggies or cheese or
• 2-3 carrot slices or
• One cup of veggies

Snacks

• 1/2 cup of milk
• Fruits

Dinner

• 1/3 cup of rice or potato or pasta or
• 1/2 cup milk or
• 2ounces of meat

Meal plan for toddlers should be planned according to the children's taste... But variety of foods should be provided ...