Diet - age appropriate
An age-appropriate diet is one that provides adequate nutrition and is appropriate for a child’s state of development.
BIRTH TO 4 MONTHS OF AGE
During the first four to six months of life, infants need only breast milk or formula to meet all their nutritional needs. Breast milk is the recommended feeding method for the first six months of life although a fortified formula can adequately meet an infant’s needs.
If breastfeeding, a newborn may need to nurse eight to 12 times per day (every 2 to 4 hours), or on demand. By four months, the baby is likely to cut back to four to six times per day, however, the quantity of breast milk consumed at each feeding will increase.
Formula-fed babies may need to eat about six to eight times per day, starting with 2-5 ounces of formula per feeding (for a total of 16-35 ounces per day). As with breastfeeding, the number of feedings will decrease as the baby gets older, but the amount of formula will increase to approximately 6-8 ounces per feeding.
Never give honey to an infant, as it may contain the spores that cause botulism. An infant’s immune system is not fully developed to fight off this disease.
Although an infant may sleep through the night, waking to feed may be necessary if the infant is not eating enough during the day or if they are underweight. Routine check-ups with your physician to monitor your child’s growth will ensure they are eating adequately during the day. Your doctor or dietitian will inform you if waking to feed is recommended.
4 TO 6 MONTHS OF AGE
At 4 to 6 months of age an infant should be consuming 28 to 45 ounces of formula, and is often ready to start the transition to solid foods. Starting solids too soon may cause the infant to choke if they are not physically ready.
There are several developmental milestones to indicate an infant is ready to eat solid foods: when birth weight has doubled; the baby has good control of head and neck; can sit up with some support; can show fullness by turning the head away or by not opening the mouth; and the baby begins showing interest in food when others are eating.
Start solid feedings with iron-fortified baby rice cereal mixed with breast milk or formula to a thin consistency. The cereal may be mixed to a thicker consistency as the baby learns to control it in his mouth.
Initially, offer cereal two times per day in servings of 1 or 2 tablespoons (dry amount, before mixing with formula or breast milk). Gradually increase to 3 or 4 tablespoons of cereal. Cereal should not be given in a bottle unless a physician or dietitian specifically recommends it (for example, for reflux).
Once the baby is eating rice cereal routinely, you may introduce other iron-fortified instant cereals. Only introduce one new cereal per week so you can watch for an intolerance.
Never put a child to bed with a bottle as this can cause “bottle mouth,” resulting in Tooth decay. Use plain water if a bottle is necessary. Discuss use of water with your physician. (In some cases, use of excess water can lead to seizures in children.)
6 TO 8 MONTHS
Continue to offer breast milk or formula three to five times per day. The consumption of formula or breast milk will begin to level off as solid foods become a source of nutrition. After a baby has tried a variety of different baby cereals, try fruit juices and strained fruits and vegetables.
For juices, use infant-pack juices or unsweetened vitamin C-rich juices such as apple, grape, orange. Do not give juices in a bottle at bedtime as this may lead to Tooth decay. Delay orange juice until 9 months of age if your family has a history of allergy to orange juice.
For strained fruits and vegetables, introduce one at a time waiting two to three days in between to check for any allergic reaction. Start with plain vegetables such as green peas, potatoes, carrots, sweet potatoes, squash, beans, beets; and plain fruits such as bananas, applesauce, apricots, pears, peaches, and melon.
Some dietitians recommend introduction of a few vegetables before fruits as the fruit’s sweetness may make a less-sweet food such as vegetables less appealing. Give fruits and vegetables in 2-3 tablespoon servings and offer about four servings per day.
Amounts of fruits and vegetables consumed per day will vary between 2 tablespoons and 2 cups depending on the size of your child and how well the child eats fruits and vegetables. The consistency of foods offered may be gradually increased as your child tolerates.
Finger foods may be offered in small amounts, but avoid foods such as apple chunks or slices, grapes, hot dogs, sausages, peanut butter, popcorn, nuts, seeds, round candies, and hard chunks of uncooked vegetables that may cause choking.
Soft cooked vegetables, washed and peeled fruits, graham crackers, melba toast, noodles are good finger foods, but salted and/or sugared foods are not recommended. Teething foods, such as toast strips, unsalted crackers, bagels, and teething biscuits may also be introduced at this time.
8 TO 12 MONTHS OF AGE
Breast milk or formula should be offered three to four times per day at this age. At 8 to 12 months of age, a baby will be ready to try strained or finely chopped meats. For breastfed infants, start meats at 8 months of age (breast milk is not a rich source of iron, but infants have adequate iron stores to last until 8 months of age when iron-rich foods such as meats can be given).
As with other foods, offer only one new meat per week in 3-4 tablespoon servings - use strained and finely ground meats, frankfurters, or meat sticks. Serving sizes for fruits and vegetables increases to 3-4 tablespoons, four times per day. Eggs may be given three to four times per week, but only the yolk until the baby is 1 year old, as some babies are sensitive to egg whites.
By the age of 1, most children are off the bottle. If the child still uses a bottle, it should contain water only.
1 YEAR OF AGE
After a baby is 1-year old, whole milk (“vitamin D” or 4%) may replace breast milk or formula. Children under the age of 2 should not be given low-fat milk (2% or skim) as they need the additional calories from fat to ensure proper growth and development.
Children under the age of 1 should not be given whole milk as it has been shown to cause anemia. Cheese, cottage cheese, and yogurt, however, may be given in small amounts.
While milk is not as nutrient-dense as breast milk or formula, the 1-year old child should be getting much of their nutrition from meats, fruits and vegetables, breads and grains, and the dairy group.
Providing a variety of foods will help to ensure adequate intake of vitamins and minerals. Toddlers do not grow as rapidly as babies do, so their nutritional needs relative to their size decrease during the second year of life (although they continue to gain weight, they no longer “double their weight” as infants do).
Keep in mind, however, that toddlers are becoming more and more active as they learn to crawl and walk. Toddlers and small children will usually eat only small amounts at one time, but will eat frequently (four to six times) throughout the day, so snacking is strongly encouraged.
- Feeding solids too early is not recommended and can result in overfeeding.
- Offer only one new food at a time. Offer the new foods for a few days. Watch for allergic reactions (hives, vomiting, diarrhea).
- Do not feed solids in a bottle.
- If your child dislikes the new food, try giving it again later.
- Feed the baby directly from the jar only if you use the entire jar contents, otherwise use a dish to prevent contamination with food-borne illness.
- Opened containers of baby’s food should be covered and stored in a refrigerator for no longer than two days.
- Use a small spoon to feed the baby.
- A baby put to bed with a bottle (milk, fruit juice, or sweetened beverage) can develop bottle mouth, resulting in Tooth decay. Use plain water if a bottle is necessary.
- Avoid foods that may cause the baby to choke (popcorn, nuts, potato chips, whole kernel corn, berries, grapes, hot dogs, raw vegetables, raisins, dry flake cereals).
- Water can be offered between feedings.
- Feeding sweets or sweetened beverages is not recommended because they will spoil the appetite and contribute to Tooth decay.
- Salt, sugar, and strong spices are not recommended.
- Caffeine products are not recommended (soft drinks, coffee, tea, chocolate).
- A fussy baby may need attention, not always food.
Throughout childhood and adolescence, it is important that the diet include a variety of foods for proper development. The principles of the Food Guide Pyramid apply to a child’s diet as well as an adult’s, although portions and number of servings per day are obviously less for children.
After the age of 2, it is recommended that the diet be moderately low in fat, as diets high in fat may contribute to heart disease, obesity, and other health problems later in life.
In areas where water is not fluoridated, however, fluoride supplementation is recommended (for communities with less than .25 ppm fluoride). A diet that contains a variety of foods from each of the food groups (breads and grains, meats, fruits and vegetables, and dairy) will prevent nutrient deficiencies.
Both the American Medical Association and the American Dietetic Association recommend that healthy children should get all their nutrients from foods rather than vitamin supplements.
The nutrients that are most likely to be deficient in a child’s diet are calcium, iron, vitamin C, vitamin A, folic acid, and vitamin B-6. The American Academy of Pediatrics does not support routine supplementation for normal, healthy children. However, there is no significant risk if a parent wishes to give their child a standard pediatric multi-vitamin.
Children who consume little or no dairy products are at particular risk for calcium deficiency that can interfere with bone growth and development. Foods that are good sources of calcium include low-fat or non-fat milk, yogurt, and cheeses. Other foods such as broccoli, cooked greens, and canned salmon (with bones) will also provide a source of calcium in the diet, however it is often difficult to get children to consume adequate quantities of these foods.
Iron requirements vary by age, rate of growth, iron stores, increasing blood volume, and rate of absorption from food sources. Adolescent girls will have increased iron needs due to menstrual losses. Food sources of iron include meat, fish, poultry, iron-fortified cereals, spinach greens, and dried beans and peas.
by Gevorg A. Poghosian, Ph.D.
All ArmMed Media material is provided for information only and is neither advice nor a substitute for proper medical care. Consult a qualified healthcare professional who understands your particular history for individual concerns.
- chakula cha umri sahihi chakula cha umri sahihi ni moja ambayo hutoa lishe ya kutosha na ni sahihi kwa hali ya maendeleo ya mtoto. Katika miezi minne hadi sita ya kwanza ya maisha, watoto wanahitaji tu maziwa ya mama au formula ili kukidhi mahitaji yao yote ya lishe. Maziwa ya mama ni njia inayopendekezwa ya kulisha kwa miezi sita ya kwanza ya maisha ingawa formula iliyoimarishwa inaweza kukidhi mahitaji ya mtoto kwa kutosha. Ikiwa mtoto amechukuliwa na mama, huenda akahitaji kunyonyeshwa mara nane hadi kumi na mbili kwa siku (kila saa mbili hadi nne) au kwa mahitaji. Katika miezi minne, mtoto anaweza kupunguzwa hadi mara nne hadi sita kwa siku, hata hivyo, kiasi cha maziwa ya mama yanayotumiwa katika kila kulisha itaongezeka. Watoto wanaolishwa kwa formula wanaweza kuhitaji kula mara sita hadi nane kwa siku, kuanzia na 2.5 ounces ya formula kwa kulisha (kwa jumla ya 16-35 ounces kwa siku). Kama ilivyo na kunyonyesha, idadi ya kulisha itapungua wakati mtoto anapokuwa mkubwa, lakini kiasi cha formula kitaongezeka hadi karibu 6-8 ounces kwa kulisha. Kamwe usimpa mtoto mchanga asali, kwa kuwa huenda ikawa na spora zinazosababisha ugonjwa wa botulism. Mfumo wa kinga wa mtoto mchanga haujakua kikamili ili kupambana na ugonjwa huo. Ingawa mtoto mchanga anaweza kulala usiku kucha, kuamka ili kula kunaweza kuwa muhimu ikiwa mtoto huyo hawali vya kutosha wakati wa mchana au ikiwa ana uzito mdogo. Uchunguzi wa kawaida na daktari wako ili kufuatilia ukuaji wa mtoto wako utahakikisha kwamba anakula vya kutosha wakati wa mchana. Daktari wako au mtaalamu wa lishe atakuambia ikiwa kuamka ili kula kunapendekezwa. Katika umri wa miezi 4 hadi 6, mtoto anapaswa kula 28 hadi 45 ounces ya formula, na mara nyingi yuko tayari kuanza mpito wa chakula kigumu. Kuanza kula vyakula vyenye nguvu mapema mno kunaweza kumfanya mtoto achoke ikiwa hana tayari kimwili. Kuna hatua kadhaa za maendeleo ambazo zinaonyesha mtoto yuko tayari kula chakula kigumu: uzito wa kuzaliwa umekuwa mara mbili; mtoto ana udhibiti mzuri wa kichwa na shingo; anaweza kukaa juu na msaada; anaweza kuonyesha ukamilifu kwa kugeuza kichwa mbali au kwa kutofungua kinywa; na mtoto anaanza kuonyesha nia ya kula wakati wengine wanakula. Kuanza kulisha kwa chakula kigumu na nafaka ya mchele ya mtoto iliyoimarishwa kwa chuma iliyochanganywa na maziwa ya mama au formula hadi uthabiti mwembamba. Huenda nafaka hiyo ikachanganywa na kuwa na umbo la nene zaidi kadiri mtoto anavyojifunza kuidhibiti kinywani mwake. Kwanza, tolewa mara mbili kwa siku katika vipande vya kijiko kimoja au viwili (kiasi kavu, kabla ya kuchanganywa na formula au maziwa ya mama). Kwa hivyo, hatua kwa hatua, kuongeza kwa kijiko cha chakula cha mchele hadi 3 au 4 kwa siku. Mchuzi haupaswi kutolewa katika chupa isipokuwa daktari au mtaalamu wa lishe anapendekeza hivyo (kwa mfano, kwa reflux). Mara tu mtoto anapokuwa akila nafaka ya mchele kwa ukawaida, waweza kumpa nafaka nyingine za haraka zenye chuma. Kuingiza nafaka mpya moja tu kwa wiki ili uweze kuangalia kwa intolerance. Kamwe usiweke mtoto kitandani akiwa na chupa kwa sababu hii inaweza kusababisha " mdomo wa chupa, " ikisababisha kuoza kwa meno. Tumia maji ya kawaida ikiwa chupa inahitajika. Zungumza na daktari wako kuhusu matumizi ya maji. (Katika visa fulani, kutumia maji mengi kupita kiasi kwaweza kusababisha mshtuko wa akili kwa watoto.) Kwa miezi 6 hadi 8 endelea kumpa mama maziwa au formula mara tatu hadi tano kwa siku. Matumizi ya formula au maziwa ya mama yataanza kupungua kadiri chakula kigumu kinavyokuwa chanzo cha lishe. Baada ya mtoto kujaribu aina mbalimbali za nafaka za mtoto, jaribu maji ya matunda na matunda na mboga zilizosongwa. Kwa juisi, tumia juisi za kipekee za watoto wachanga au juisi zisizo na sukari zenye vitamini C kama vile apple, zabibu, machungwa. Usipe maji katika chupa kabla ya kulala kwa sababu hii inaweza kusababisha kuoza kwa meno. Usiwe na juisi ya machungwa hadi miezi 9 ikiwa familia yako ina historia ya mzio wa juisi ya machungwa. Kwa matunda na mboga zilizochanganywa, weka moja kwa wakati ukisubiri siku mbili hadi tatu kati ya hizo ili kuangalia ikiwa kuna athari yoyote ya mzio. Anza na mboga za kawaida kama vile maharagwe ya kijani, viazi, karoti, viazi vitamu, squash, maharagwe, beets; na matunda ya kawaida kama vile ndizi, apple sauce, apricots, pears, peaches, na melon. Baadhi ya wataalamu wa lishe wanapendekeza kuanzisha mboga chache kabla ya matunda kama utamu wa matunda unaweza kufanya chakula kidogo tamu kama vile mboga chini ya kuvutia. Tumia matunda na mboga katika vipande vya kijiko 2-3 na kutoa vipande vinne kwa siku. Kiasi cha matunda na mboga zinazotumiwa kwa siku inaweza kutofautiana kati ya 2 tablespoons na 2 makopo kulingana na ukubwa wa mtoto wako na jinsi mtoto anakula matunda na mboga. Kiasi cha chakula kinachopendekezwa chaweza kuongezeka hatua kwa hatua kadiri mtoto wako anavyovumilia. Chakula cha vidole kinaweza kutolewa kwa kiasi kidogo, lakini epuka vyakula kama vile vipande vya apple au vipande vya apple, zabibu, hot dogs, sausages, siagi ya karanga, popcorn, karanga, mbegu, peremende za mviringo, na vipande vikali vya mboga zisizopikwa ambazo zinaweza kusababisha kukosa. Mazao ya mboga, matunda yaliyooshwa na kuondolewa, biskuti za graham, toast ya melba, na tambi ni vyakula vyenye kupendeza, lakini vyakula vyenye chumvi na sukari havipendekezi. Vyakula vinavyotokeza meno, kama vile vipande vya mkate uliokaangwa, biskuti zisizo na chumvi, bagels, na biskuti za kutokeza meno zaweza pia kutolewa wakati huo. Kwa watoto wa umri wa miezi 12 na zaidi, maziwa ya mama au formula inapaswa kutolewa mara tatu hadi nne kwa siku. Katika umri wa miezi 8 hadi 12, mtoto wako atakuwa tayari kula nyama iliyokatwa au iliyokatwa vipande vidogo. Kwa watoto wanaonyonyeshwa, nyama inaweza kuanzishwa katika miezi 8 ya umri (maziwa ya mama si chanzo tajiri cha chuma, lakini watoto wana hifadhi ya chuma ya kutosha hadi miezi 8 ya umri wakati chakula chenye chuma kama vile nyama inaweza kupewa). Kama ilivyo na vyakula vingine, toa nyama moja tu mpya kwa wiki katika vipande vya kijiko cha 3-4 - tumia nyama iliyoshushwa na iliyopondwa vizuri, frankfurter, au vijiti vya nyama. Kwa matunda na mboga, kipimo cha kuwahudumia kinapaswa kuwa cha kijiko cha 3-4 mara nne kwa siku. Maziwa yanaweza kutolewa mara tatu hadi nne kwa wiki, lakini tu yai hadi mtoto awe na umri wa mwaka mmoja, kwani baadhi ya watoto ni nyeti kwa nyeupe za mayai. Kwa miaka miwili, watoto wengi wamekoma kunywa chupa. Ikiwa mtoto bado anatumia chupa, inapaswa kuwa na maji tu. Baada ya mtoto kuwa na umri wa mwaka mmoja, maziwa ya mama au formula yanaweza kubadilishwa na maziwa ya mama au maziwa ya mama. Watoto chini ya umri wa miaka miwili hawapaswi kupewa maziwa yenye mafuta kidogo (2% au skim) kwani wanahitaji kalori za ziada kutoka kwa mafuta ili kuhakikisha ukuaji na maendeleo sahihi. Watoto chini ya umri wa miaka 1 hawapaswi kupewa maziwa kamili kwa sababu imeonyeshwa kusababisha anemia. Hata hivyo, jibini, jibini la cottage, na mboga ya mboga za majani yaweza kutolewa kwa kiasi kidogo. Maziwa hayana virutubisho kama maziwa ya mama au formula, lakini mtoto wa mwaka mmoja anapaswa kupata virutubisho vyao kutoka kwa nyama, matunda na mboga, mikate na nafaka, na kundi la maziwa. Kutoa vyakula mbalimbali kutasaidia kuhakikisha ulaji wa kutosha wa vitamini na madini. Watoto wachanga hukua kwa kasi kama watoto wachanga, kwa hiyo mahitaji yao ya lishe kuhusiana na ukubwa wao hupungua wakati wa mwaka wa pili wa maisha (ingawa wanaendelea kupata uzito, wao tena <unk> mara mbili uzito wao <unk> kama watoto wachanga kufanya). Hata hivyo, kumbuka kwamba watoto wadogo huwa na shughuli nyingi wanapojifunza kutambaa na kutembea. Watoto wadogo na watoto wadogo kwa kawaida hula kiasi kidogo tu kwa wakati mmoja, lakini watakula mara nyingi (mara nne hadi sita) siku nzima, kwa hivyo vitafunio vinahimizwa sana. - Kutoa vyakula vyenye nguvu mapema sana hakupendekezi na kunaweza kusababisha kulisha kupita kiasi. - Toa chakula kimoja tu kipya kwa wakati mmoja. Weka chakula kipya kwa siku chache. Angalia kwa athari za mzio (kibofu, kutapika, kuhara). - Usiwale vyakula vyenye umbo gumu katika chupa. - Ikiwa mtoto wako hapendi chakula kipya, jaribu kumpa tena baadaye. - Kulisha mtoto moja kwa moja kutoka chupa tu kama wewe kutumia maudhui yote ya chupa, vinginevyo kutumia sahani ili kuzuia uchafuzi na ugonjwa wa chakula. - Vyombo vilivyofunguliwa vya chakula cha mtoto vinapaswa kufunikwa na kuhifadhiwa kwenye friji kwa muda usiozidi siku mbili. - Tumia kijiko kidogo kumlisha mtoto. - Mtoto anayelazwa akiwa na chupa (maziwa, maji ya matunda, au vinywaji vyenye sukari) anaweza kupata mdomo wa chupa, na kusababisha kuoza kwa meno. Tumia maji ya kawaida ikiwa chupa inahitajika. - Kuepuka vyakula ambavyo vinaweza kusababisha mtoto kuzimia (popcorn, karanga, chips za viazi, mahindi ya kernel nzima, berries, zabibu, hot dogs, mboga mbichi, zabibu, nafaka kavu). - Maji yanaweza kutolewa kati ya milo. - Kutoa peremende au vinywaji vyenye sukari haipendekezi kwa sababu vinaweza kuharibu hamu ya kula na kuchangia kuoza kwa meno. - Chumvi, sukari, na vikolezo vyenye nguvu havipendekezi. - Bidhaa zenye kafeini hazipendekezi ( vinywaji visivyo na kahawa, chai, chokoleti). - Huenda mtoto mwenye wasiwasi akahitaji uangalifu, si chakula sikuzote. Katika kipindi chote cha utoto na ujana, ni muhimu kwamba chakula kiwe na vyakula mbalimbali ili ukuzi uweze. Kanuni za Piramidi ya Mwongozo wa Chakula zinatumika kwa lishe ya mtoto na vilevile ya mtu mzima, ingawa sehemu na idadi ya vipimo kwa siku ni dhahiri chini kwa watoto. Baada ya miaka miwili, inashauriwa kuwa chakula cha watoto ni wastani chini ya mafuta, kama vyakula vyenye mafuta mengi inaweza kuchangia ugonjwa wa moyo, unene, na matatizo mengine ya afya baadaye katika maisha. Katika maeneo ambayo maji hayana fluoride, hata hivyo, fluoride nyongeza ni ilipendekeza (kwa jamii na chini ya 0.25 ppm fluoride). Chakula chenye vyakula mbalimbali kutoka kila kikundi cha vyakula (mkate na nafaka, nyama, matunda na mboga, na maziwa) kitatetea upungufu wa virutubisho. Chama cha Tiba cha Marekani na Chama cha Tiba cha Marekani vinapendekeza kwamba watoto wenye afya wapate virutubisho vyote kutoka kwa chakula badala ya virutubisho vya vitamini. Vyakula vinavyopungukiwa na chakula cha mtoto ni kalsiamu, chuma, vitamini C, vitamini A, asidi foliki, na vitamini B6. Chuo cha Marekani cha Tiba ya Watoto hakipendekezi kutumia dawa za kawaida kwa watoto wenye afya nzuri. Hata hivyo, hakuna hatari kubwa ikiwa mzazi anataka kumpa mtoto wake vitamini nyingi za kawaida za watoto. Watoto ambao hutumia bidhaa za maziwa kidogo au hawana bidhaa hizo wana hatari ya kukosa kalsiamu ambayo inaweza kuingilia ukuaji na maendeleo ya mifupa. Vyakula vyenye kalsiamu nyingi ni maziwa yasiyo na mafuta, yoghurt, na jibini. Vyakula kama broccoli, mboga zilizopikwa, na samaki wa makopo (na mifupa) pia itatoa chanzo cha kalsiamu katika mlo, hata hivyo ni mara nyingi ni vigumu kupata watoto kula kiasi cha kutosha cha vyakula hivi. Mahitaji ya chuma hutofautiana kulingana na umri, kiwango cha ukuaji, maduka ya chuma, kuongezeka kwa kiasi cha damu, na kiwango cha kunyonya kutoka kwa vyanzo vya chakula. Wasichana wachanga watakuwa na mahitaji ya juu ya chuma kwa sababu ya hasara za hedhi. Vyanzo vya chakula vya chuma vinatia ndani nyama, samaki, kuku, nafaka zilizoongezwa chuma, mboga za mchicha, na maharagwe na maharagwe yaliyokaushwa. "Gevorg A. Poghosyan, Ph.D. ""Vitu vyote vya ArmMed Media vinatolewa kwa habari tu na sio ushauri wala mbadala wa huduma sahihi ya matibabu." Mshauri mtaalamu wa huduma za afya ambaye anaelewa historia yako maalum kwa wasiwasi wa mtu binafsi.