If solid foods have been gradually introduced before the age of one year feeding children will present fewer problems in subsequent years. Some surveys have shown that even children belonging to high-income groups, especially those in large families are undernourished, mal-nourished or both because of the indifference or ignorance of the parents and sometimes due to the abrupt change to highly spiced foods. Some children, particularly those in small families where there is no competition for food are poor and fuzzy eaters at times. Their food intake could be improved by making the food interesting and attractive. For instance, a child refusing milk will accept it if it is coloured or flavored, or given as a custard.
During pre-school years, from 2 to 6 years, growth proceeds at a slower rate than during the first year. The gain in weight may be only 2.0-2.5 kg in a year during the pre-school period. The pre-school child grows comparatively more in height and gives an appearance of being taller and thinner. Height and weight changes follow a general pattern throughout childhood, but the chronological age at which these changes take place may vary considerably.
Nutritional Requirements of Children 1-6 years
Due to high cellular activity and a proportionately high surface area, the very young child has a high basal metabolic rate. Year by year this rate decreases and then accelerates around adolescence, after which it again declines to the adult level.
The 1-3 year old child needs about 1300 cals daily and the need is 1500 to 1600 cals for the child 3-6 years of age. The best measure of adequacy of energy intake is gain in body weight. Foods high in nutrient content such as milk, fruits, vegetables and cereals (wholegrain or enriched) should be included as supplements in the diet to increase the calories. Concentrated sweets and foods very high in fat should be avoided.
Protein has a very important role in the diet of the pre-school child because there is considerable increase in muscular development during these years. The recommended allowance for protein in early childhood is 17 to 20 gm for the years 1 to 3 and 20 to 22 gm for the years 3 to 6. The allowances for protein provide approximately 10 percent of the calories. Since the requirement for essential amino-acids is comparatively higher for children than for adults, one half to two-thirds of the protein should be selected from complete protein foods.
The recommended calcium allowance is 0.4 to 0.5 gm for children from 1 to 6 years. Adequacy of calcium intake is directly correlated with the intake of milk or milk foods. All non-milk foods rich in calcium can be expected to give only 0.2 gm of calcium in the diet of young children.
The recommended allowance for iron for the pre-school child is 8 mg daily for children 1-3 years of age and 10 mg for 3-6 years of age. To achieve this, one must include iron-rich food such as eggs, meat (particularly liver), green vegetables, enriched and whole-grain bread and enriched cereals and fruits.
Throughout childhood and adolescence 200 I.U.Vitamin D should be provided. The Vitamin A needs are related to body weights. Nearly 250 to 300 mg of Vitamin A in the form of Retinol or 1000 to 1200 mg in the form of carotene is required. The allowances for ascorbic acid range from 30 to 50 mg. As regards thiamine, requirements range from 0.6 to 0.9 mg; riboflavin 0.7 to 1.0 mg; nicotinic acid 8 to 10 mg. When diets are adequate in protein, minerals, ascorbic acid and thiamine the dietary allowances for folic acid, Vitamin B 12 and Vitamin B6 are likely to be met.
Pre-school children prefer mildly flavored foods to those of strong flavor or those which are spicy. Vegetables are usually disliked by this group but it is essential that they are included in the diet in likeable forms. Fruits are generally liked and may be given raw or cooked.
The gastro-intestinal tract of the pre-school child is easily irritated by very sweet or fried foods or excessive amounts of cellulose. It is advisable to exclude them in the diet of 1 to 3 years old and use a minimum for older pre-school children.