A Guide to Developmental Feeding

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.