Child and Adolescent Subject

1. FACTORS AFFECTING
DEVELOPMENT

2. 1. MATERNAL NUTRITION
 Concerns about nutrition during pregnancy fall into
basic areas, maternal weight gain and nutrient
intake
 Maternal weight gain – during pregnancy results
from variety of factors:
Maternal dietary intake, prepregnancy
weight and height, length of gestation, and
size of fetus.
 Nutrient intake - Need for calories and nutrients
such as protein, iron folate, and other B vitamin is
increased to meet the demands of the fetus as well
as the expansion of maternal tissues that supports
the fetus.

3. WOMEN AT PARTICULAR RISK OF NUTRITIONAL
INADEQUACY DURING PREGNANCY MAY REQUIRE
NUTRITIONAL COUNSELLING.
 Restricting calorie intake or dieting
 Pregnant adolescent women with low income or limited
food budget
 Women with eating patterns or practices that require
balancing food choices
 Strict vegetarian
 Women with emotional illness
 Smokers
 Women with poor knowledge of nutrition due to lack of
education or illiteracy
 Women with special difficulties in food resource
management because of limited physical abilities and
poor cooking or budgeting skills.

4.  Maternal weight gain during pregnancy is highly
correlated with the birth weight of the infant because a
large proportion of the weight gain due to the growth of
the fetus itself.
 Low weight gain may in part be the result of outside
medical advice and personal beliefs.
 While higher maternal weight gain is linked with healthier
fetal weight gains, women and clinicians are concerned
that women may retain weight after delivery and be at
greater risk of obesity.
 Adequate intake of the B vitamin, folic acid, before
conception and in the early weeks of pregnancy has
been shown to decrease the risk of neural tube defects.
 At least 400ug of folic acid daily from fortified foods and
or supplements.

5.  Pregnant women needs to “eat
for two”. A nutrition diet
throughout pregnancy is essential
for both the fetus and the mother.
To meet the increased nutritional
demands of her body, a pregnant
woman shouldn’t just eat more;
she should make sure that her
diet id adequate in all basic
nutritional categories.
 In second and third trimester of
pregnancy, requirements increase
for calories and most nutrients,
including protein, calcium, iron,
magnesium, zinc, and B vitamins
and vitamins A,C,D and E.

6. 2. AVOIDING DRUGS AND OTHER ENVIRONMENTAL
HAZARDS
 Everything the mother ingest may
eventually reach the fetus in some
proportion.
 Some drugs harm the fetus but
not the mother because the fetus
is in the process of developing,
and because the proper dose for
the mother is a massive dose for
the fetus.
 During the first trimester, when
the major body structures are
rapidly forming, the fetus is
extremely vulnerable to
environmental factors such as
viral infections, radiation, drugs,
and other teratogens – any of
which can cause congenital
malfunctions or birth defects.

7.  The most susceptible body parts are those growing
most rapidly at the time of exposure.
 Example: rubella virus (german measle) – can cause
congenital malformation of delicate system such as
eyes or ears, leading to blindness and deafness.
 Tranquilizer, thalidomide – taken early in pregnancy
prevents the formation of arms and legs in fetus, but
taken later when limbs were already formed, it causes
no damage.
 Alcohol – is a potent teratogens. A high level of alcohol
consumptions during pregnancy is associated with
miscarriage, still births and in live babies, fetal alcohol
syndrome (FAS).

8.  Tobacco – pregnant women who smoke
should quit, and non smoking pregnant
women should avoid places where people
smoke. Smoking during pregnancy increases
the rise of miscarriage, low birth weight and
infant death. Infants of women who smoke
during pregnancy have poorer lung function at
birth, and exposure to second hand smoker
after birth increases a baby’s susceptibility to
pneumonia and bronchitis.
 Caffeine – should used conservatively by
pregnant women. It puts both mother and
fetus under stress by raising the level of the
hormone epinephrine. Caffeine also reduces
the blood supply to the uterus.

10. CHILD NUTRITION
 Lactation – the production of milk
begins about 3 days after childbirth.
 Colostrum - contains antibodies and
help protect the newborn from
infectious diseases and also high in
protein.
 Colostrum – yellowish milk a mother
produces during the first few days after
birth which is strong anti viral activity.
 Human milk is perfectly suited to the
baby’s nutritional needs and digestive
capabilities, and it supplies the baby
with antibodies. .

11.  Breastfeeding decreases the
incidence of infant ear
infection, allergies, diarrhea
and bacterial meningitis.
Breastfeeding is also beneficial
to the mother.
1. Stimulates contractions that
help the uterus to return to
normal more rapidly
2. It contributes to post
pregnancy weight loss
3. It may reduce the risk of
ovarian cancer, early breast
cancer and postmenopausal
hip fracture.
4. Nursing also provides sense
of closeness and emotional
well being for mother and
child.

12. Breastfeeding Advantages (by Dr.
Jack Newman)
 Breast-fed infants gain extra
protection from antibodies, other
proteins and immune cells in
human milk. Once ingested, these
molecules and cells help prevent
microorganism from penetrating
the body’s tissue.
 Other molecules lessen the supply
of particular minerals and vitamins
that harmful bacteria need to
survive in the digestive tract.
 Certain immune cells in human
milk are phagocytes that attack
microbes directly.
 Another set of immune cells
produces chemicals that
envigorate the infants’ own
immune system.

13. MICRONUTRIENTS DEFICIENCIES
 Some micronutrients deficiencies that co-exist with
protein and energy deficiency have adverse effects
on metal and motor development of infants and
toddler; and on the cognitive functions of older
children.

14. IRON
 children with iron
deficiency scored lower
on cognitive test and
performed less well on
school test.
 Iron supplementation
led to significantly
improved performance
on measures of overall
intelligence and on test
of specific cognitive
process among iron-deficient
children.

15. IODINE
 Iodine – maternal
iodine deficiency in
early pregnancy and
associated with
thyroxine deficiency
impair the development
of the fetal central
nervous system and
can result in cretinism
in the child.

16. ZINC

17. VITAMIN A
 Vitamin A – this vitamin essential
before protein can be synthesized. It is
required by every cell in the body,
including each cell in the brain
 Essential for the development of
normal bones and of enamel and
dentive of the teeth.
 Vitamin A deficiency can cause the
skull to stay underdeveloped that room
for the brain is limited
 Can result to night blindness,
respiratory infection, diarrhea,
cessation of growth and paralysis
resulting from brain and nerve
damage.

18. VITAMIN B
 Vitamin B – essential part of
enzyme system and to every cell in
the body.
 Help in producing energy; in
utilizing fats, carbohydrates and
proteins and preventing cholesterol
from clogging the baby’s arteries.
 Symptom of vitamin B deficiency is
said to be brain damage
 can also result to beri-beri,
pellagra, and pernicious anemia

19. VITAMIN C
 – it protects child from
anemia, allergies, and
infections. Speeds up
recovery from almost
any type of sickness
VITAMIN D
 protein produced in the
intestine carries calcium
in the blood, thus
allowing the normal
development of the
bones and of well spaced
decay-resistant teeth.

20. VITAMIN E
 Vitamin E – blood analyses show
that all newborn infants are
extremely low in vitamin E.
 The essential fatty acids in the walls
of the red blood cells which are
exposed to larger amounts of
oxygen and cells elsewhere in the
body breakdown to such extent that
is called hemolytic anemia.

21. VITAMIN K
 Vitamin K – deficiency of vitamin K which prevents
blood from clotting and causes hemorrhage are
common in new born infants.
 Causes: cerebral palsy, bleeding of the brain or
spinal cord

22. RESEARCHES RELATED TO CHILD NUTRITION
 Supplementary feeding during pregnancy and the child’s first
months of postnatal life enhanced motor development among
infants ( 8 – 12 months) and toddler (12 – 24 months) and also
mental development among toddlers.
 Supplementary feeding during the first two years of life has
also been found to have long term effects in cognitive
development
 Nutritional supplementation of pregnant and lactating women
anf their offspring for at least two years of postnatal life,
improved the later performance, in adolescence, on test of
reading, vocabulary, arithmetic, and general knowledge.
 Nutrition has a reciprocal relationship between parent and child
– the parent’s caregiving practices influencing infant
development and the infant’s behaviour parents caregiving
practices.

23.  In summary, there is convincing evidence that
general undernutrition and iodine and iron
deficiency can impair behavioural and cognitive
development. Iodine deficiency has its maximal
effect in the utero, while iron deficiency and general
undernutrition is greatest in the early postnatal
period. These effects, however, are no longer
believed to be limited to the phrase of maximal
brain growth or to be mediated exclusively through
neuro-anatomical structural changes.