14 Providing Good Nutrition
Learning Objectives
By the end of this chapter, you should be able to:
- Describe the changes in nutritional needs as children mature (get older).
- Advocate for the support of breastfeeding mothers.
- Relate bottle-feeding practices.
- Discuss the transition to solid foods and self-feeding.
- Summarize feeding challenges for toddlers.
- Explain effective ways to respond to picky eating.
- Outline the importance of inclusive nutrition policies and practices.
- Identify how to support children with unique nutritional and feeding needs.
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LICENSING REGULATIONS WAC regulations that relate to this chapter include:
110-300-0195 FOOD SERVICE, EQUIPMENT, AND PRACTICES
110-300-0280 BOTTLE PREPARATION
110-300-0281 BREAST MILK
110-300-0285 INFANT AND TODDLER NUTRITION AND FEEDING
110-300-0300 INDIVIDUAL CARE PLAN
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Introduction
To provide all children the appropriate nutrition, it is important to understand how nutritional needs and feeding practices change as children mature. Children with special needs may have different nutritional and feedings needs. Working with families and medical providers, programs can ensure that they meet each and every child’s needs. Early care and education programs can also support and empower families to provide the best nutrition to their children.
Feeding Infants
Requirements for macronutrients and micronutrients on a per-kilogram basis are higher during infancy than at any other stage in the human life cycle. See the average calorie needs for infants in Table 14.1. An infants’ resting metabolic rate is two times that of an adult. These needs are affected by the rapid cell division that occurs during growth, which requires energy and protein, along with the nutrients that are involved in DNA synthesis.[1]
Table 14.1 – Average Calorie Needs for Infants[2]
| Sex/Age | Calories |
| Boys (0-6 months) | 472-645 calories |
| Girls (0-6 months) | 438-593 calories |
| Boys (6-12 months) | 645-844 calories |
| Girls (6-12 months) | 593-768 calories |
| Boys (1-2 years) | 844-1,050 calories |
| Girls (1-2 years) | 768-997 calories |
During this period, children are entirely dependent on their parents and other caregivers to meet these needs. For almost all infants six months or younger, breast milk is technically the best source to fulfill nutritional requirements; however, this may not always be possible. It is important to respect familial decisions on whether a family chooses (or has no other option) to breastfeed or supplement with formula. An infant may require feedings eight to twelve times a day or more in the beginning. After six months, infants can gradually begin to consume solid foods to help meet nutrient needs.
How often an infant wants to eat will also change over time due to growth spurts, which typically occur at about two weeks and six weeks of age, and again at about three months and six months of age.[3]
Breastfeeding
The dietary recommendations for infants are based on the nutritional