A Guide to Developmental Feeding
Up to now we’ve talked about the physical exam, we’ve talked mostly about physical
aspects and development, hearing, vision etcetera.
One major, major aspect of health care of a child that’s extremely important to both the
parents and the physician and very important even from the infant stage all the way up to
toddler and actually into adulthood is the whole subject of nutrition.
Now, nutrition starts actually with the physical exam. When we are looking in the
physical exam at the hair, the skin, the eyes, the lips, the tongue, the gums, the
subcutaneous tissue, these are all really physical exams for nutrition.
Obviously, decrease subcutaneous tissue fat indicates maybe a marginal nutrition. Nails
size and nail spooning maybe indication of iron deficiency. And also if there’s paleness
to the mucous membrane, she may also have some degree of iron deficiency. So it starts
with the physical exam but it goes further than that. We make sure vitamin supplement is
maintained.
We do counseling or feeding. But feeding counseling has to be counseled on
developmental feeding skills. For instance, up to four months of age, the child just begins
to turn the head toward an object that’s presented to them. Four to six, the reflex of
extruding the tongue is diminished making it better able to swallow and obviously a good
reason why solid foods are started in these four to six month age.
The desire for food becomes fixed. They open their mouth, they learn, they turn towards
food, they can sit erect for feeding by six months. Chewing action even without teeth
begins about this stage. They can also start to grasp objects with the palmer grasp this is
some sort of scraping motion that goes on at this age.
By six to eight months, they’re able to feed themselves. They actually are using finger
foods that’s why the introduction of finger foods at that time. They begin to drink from a
cup and that’s why people are using sippy cups and cups at that time. Eight to ten, they
can actually hold their cup. They sit unsupported, they can reach and grasp for food, all
as a mature in index. And by 12 months of age, they start to master a spoon although they
still have a lot of spilling.
Infant feeding tips we give mothers, there are things we avoid. We avoid honey, corn
syrup because of Botchilism. We often avoid canned vegetables because of very high
sodium content. Sorbatol can cause diarrhea in children so we avoid foods that are made
with sorbatol. Concentrated sweets, baby food desserts, we try to keep to a minimum
because of obese desires, feeding desires, empty calorie desires, this type of thing that
goes on.
We always avoid foods that can choke a baby. This is a major, major message in infant
feeding. And we limit fruit juice to about eight ounces a day.
Meal time with toddlers can be a nightmare. What we do is we tell the parents to
undiscouraged unacceptable behavior. We let the toddler actually explore and enjoy his
food. We choose food and we let them choose food and sometimes how much he will eat.
We do limit sweets or empty calories and we make sure that meal time does not become a
battle ground.
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