FEEDING AND COMMON

NUTRITION PROBLEMS
OF PRESCHOOL
 Topic Outline
Introduction Common Nutrition Problems
Feeding behaviors of Toddler Iron-Deficiency Anemia
Appetite and Food Intake of Toddlers Dental Caries
Feeding behaviors of Preschool Constipation
Appetite and Food Intake of Preschool Overweight and Obesity in
Energy and Nutrient Needs Toddlers and Preschoolers
Growth in toddlers and preschoolers is
slower than in infancy but remains steady.
This slowing of growth velocity is
reflected in a decreased appetite;
however, young children need adequate
calories and nutrients to meet their
nutritional needs.
Life-Cycle Stage
Toddlers
1 to 3 years
rapid increase in gross and fine motor skills
with subsequent increases in independence,
exploration of the environment, and language
skills.

Preschool-age children
3 to 5 years of age
increasing autonomy; experiencing broader
social circumstances, such as attending
preschool or staying with friends and relatives
increasing language skills; and expanding
ability to control behavior.
Feeding Behaviors of Toddlers
Many toddlers demonstrate strong food preferences and
dislikes.

New foods are better accepted if they are served when

the child is hungry and if she sees other members of the
family eating these foods. Eventually, toddlers’ natural
curiosity will get the best of them.

Toddlers are great imitators, which includes imitating the

eating behavior of others.

It is important to offer a variety of foods and textures but

not to force a toddler to eat.
Appetite and Food Intake of Toddlers
Parents need to be reminded that toddlers
naturally have a decreased interest in food
because of slowing growth, and a
corresponding decrease in appetite.

Toddlers need toddler-sized portions.

It is important that toddlers be allowed to

control the amount of food eaten by hunger
rather than by parental pressure to eat more
Development of F eeding Skills in Preschool
Preschool-age child
can use a fork and a spoon and uses a cup well
Cutting and spreading with a knife may need some
refinement
Seated comfortably at the table for all meals and snacks
Eating is not as messy
Spills still do occur,

Foods that cause choking in young children

should be modified to make them safer:

such as cutting grapes in half lengthwise

Cutting hot dogs in quarters lengthwise
Cutting into small bites
Feeding Behaviors of Preschool Age Children
Growth occurs in “spurts” during childhood. Appetite
and food intake increase in advance of a growth spurt,
causing children to add some weight that will be used
for the upcoming spurt in height.

Preschool years is a good time to teach children about

foods, food selection, and preparation by involving
them in simple food-related activities.

Families of preschool-age children need to continue to

be encouraged to eat together.
Appetite and Food Intake of Preschool
Often describe their appetite as “picky.”

One reason a child may want the same foods

all of the time is because familiar foods may
be comforting to them.

They typically do not like strongly flavored

vegetables and other foods, or spicy foods, at
this young age.
Food Preference Development,
Appetite,and Satiety
It is clear that children’s food preferences do determine
what foods they consume. Children naturally prefer sweet
and slightly salty tastes and generally reject sour and bitter
tastes.

Children who are raised in an environment where all

members of the family eat a variety of foods are more likely
to eat a variety of foods.
Energy and Nutrient Needs
Energy Needs - Energy requirements for pre-school
children increase as the child grows older:
1-2 yrs old girl requires 920 kcal/day
1-2 yrs old boy needs 1,000 kcal/day
3 - 5 year old boy requires 1,350 kcal/day
3-5 year old girl needs 1,260 kcal/day.

Protein - All pre-school children should have adequate

intake of protein and they can eat meat, dairy produce,
eggs, chicken and fish to meet their protein needs.

Vitamins and Minerals - Most children from birth to 5

years are meeting the targeted levels of consumption of
most nutrients, except for iron, calcium, and zinc.
Common Nutrition Problems of
Toddlers and Preschoolers
Common Nutrition Problems
Iron-Deficiency Anemia
Iron deficiency anemia is a prevalent nutrition problem
among young children in the Philippines.
Common Nutrition Problems
Iron-Deficiency Anemia
Iron deficiency can be defined as absent bone marrow
stores, an increase in haemoglobin concentration of
<1.0g/dL after treatment with iron, or other abnormal
lab values, such as serum ferritin concentration.

Cut off values for anaemia derived from NHANES III

1-2 years old
Haemoglobin conc - <11.0g/dL
Haematocrit - <32.9%

2-5 years old

Haemoglobin conc - <11.1g/dL
Haematocrit - <33%
 Preventing Iron Deficiency
The Centres for Disease and Control (CDC) recommends that children 1-5
years of age drink no more than 24 ounces of cow’s milk, goat’s milk, or soy
milk each day because of the low iron content of these milks.

Children who are at high risk for iron deficiency, such as low income children
and migrant and recently arrived refugee children, be tested for iron
deficiency between the ages of 9 and 12 months, 6 months later, and then
annually from ages 2-5 years.

The American Academy of Pedriatics recommendations support universal

screening for iron deficiency and iron deficiency anemia at about 12 months
of age.
Nutrition Intervention for Iron-deficiency anemia
Supplementation with iron drops at a dose of 3mg/kg per day
Counseling of parents or caretakers about diets that prevent
iron deficiency
Repetition of screening in 4 weeks

If anemia is responsive to treatment, dietary couseling should be

reinforces, and the iron treatment should be continues for two
months.
Common Nutrition Problems
Dental Caries

A primary cause of dental decay is habitual use of a

bottle or a no-spill training cup with milk or fruit juice
at bedtime or throughout the day. Prolonged
exposure of teeth to these fluids can produce early
childhood caries (ECC) formerly called nursing bottle
caries or baby bottle tooth decay.
Common Nutrition Problems
Dental Caries
Food sources of carbohydrates such as milk and fruit juice
can have direct effects on dental caries development
because Streptococcus mutans, the main type of bacteria
that cause tooth decay use for food. Bacteria present in the
mouth excrete acid that causes the tooth decay.
Common Nutrition Problems
Constipation
Constipation, or hard and dry stools associated with
painful bowel movements, is a common problem of
young children.

Sometimes stool holding develops when the child does

not completely empty the rectum, which can lead to
chronic overdistension so that eventually the child is
retaining a large fecal mass.
Common Nutrition Problems
Food Security
Food security is particularly important for young
children because of their high nutrient needs for
growth and development.

Children who are hungry and have multiple

experiences with food insufficiency are more likely to
exhibit behavioural, emotional, and academic
problems.
Common Nutrition Problems
Food Safety
Young children are especially vulnerable to foodborne
illnesses because they can become ill from smaller
doses of organisms.

Employing proper food storage and preparation

techniques at home, in child care centres, and in retail
food establishments is essential for decreasing the
incidence of foodborne illnesses in young children.
Common Nutrition Problems
Food Safety
Food-safety practice messages from a food safety
education program called FightBAC:

Cleam: Wash hands and surfaces often

Separate: Don’t cross contaminate
Cook: Cook to proper temperature
Chill: Refrigerate promptly

The AAP endorses the consumption of only pasteurized

milk and milk products for pregnant women, infants, and
children.
Prevention of Nytrition Related Disorders

Overweight and Obesity in Toddlers and

Preschoolers in the Philippines
Prevention of Nutrition Related Disorders
Assessment of Overweight and Obesity
Body mass index for-age percentile is recommended as the screening
tool for assessment of pedricatic overweight and obesity.

A BMI-for-age percentile of 85th to 94th percentile is defined as

overweight, and a BMI-for-age >95th percentile is defined as obesity.
BMI normative values are not available for children less than 2 years
of age. For these young children, a weight-for-length >95th
percentile is considered to be overweight.

Other essential components of assessment include

-Evaluation of the child’s medical risk
-Behavior risk assessment
Prevention of Nutrition Related Disorders
Prevention of Overweight and Obesity
All children should be targeted for prevention of overweight
and obesity from birth by instituting lifestyle behaviors that
prevent obesity.

Treatmend of Overweight and Obesity Expert

Committee Recommendations
Maintaining weight while gaining height can be the best
trearment for obese children between the ages of 2 and 5.

If weight loss does occur, it should not exceed 1 pound per

month in children this age whether thay fall into the
overweight or obese category.
Prevention of Nutrition Related Disorders

Nutrition
and
Prevention
of CVD
Prevention of Nutrition Related Disorders

Heart disease is the number one cause of death in the

Philippines today. A leading risk factor for cardiovascular
disease, which includes diseases of the heart and blood
vessels, is elevated levels of LDL cholesterol.

Causes of elevated LDL cholesterol:

Familial hyperlipidaemias
obesity, high bmi
diets high in saturated fat, trans fatty acids, and dietary
cholesterol
high triglyceride levels
fatty streaks (atherosclerosis)
Prevention of Nutrition Related Disorders
American Heart Association’s (AHA) guidelines for the Primary prevention
of atherosclerotic CVD beginning in childhood:
screening during childhood
healthy eating pattern
maintain appropriate body weight, desirable lipid profile, and blood
pressure
avoidance of smoking
physical activity

Acceptable macronutrient distribution ranges for fat

Children 1-3 years old – 30-40%
Children 4-18 years old – 25-35%

Children who are at increased risk of developing premature cardiovascular

disease are restricted to a diet with less than 7 percent toral calories from
saturated fat and a dietary cholesterol to no more than 200mg per day.
Prevention of Nutrition Related Disorders
Dietary Recommendations

Nutritional Guidelines
for Filipinos (NGF)
Prevention of Nutrition Related Disorders
Dietary Recommendations Pinggang Pinoy for Kids
Prevention of Nutrition Related Disorders
Recommendations for Intake of Iron, Fiber, Fat,
and Calcium (based on PDRI 2018)
Iron
Children 1-2 years old (M and F) – 8mg
Children 3-5 years old (M and F) – 9mg

Fiber
Prevention of Nutrition Related Disorders
Recommendations for Intake of Iron, Fiber, Fat,
and Calcium (based on PDRI 2018)
Fat
Children 1-2 years old – 25-35%
Children 3-18 years old – 15-30%

Fat Soluble Vitamins

Vitamin D – 600IU

Calcium
Children 1-2 years old – 500mg
Children 3-5 years old – 550mg
Prevention of Nutrition Related Disorders
Recommended Energy Intakes per day
Prevention of Nutrition Related Disorders
Acceptable Macronutrient Distribution Range
 References
Brown, J. E. (2016). Nutrition through the life cycle (6th ed.). Cengage Learning.

Goyena, E. A. (2018). Nutritional status of Filipino infants and young children 0-23
months. Department of Science and Technology – Food and Nutrition Research Institute.

Mapa, C. D. S. (2023). 2022 Causes of deaths in the philippines (preliminary as of 28

february 2023). Philippine Statistics Authority.

Vargas, M.B. (2018). Nutritional status of Filipino pre-school children (2-5 years old).
Department of Science and Technology – Food and Nutrition Research Institute.
Thank you for listening!