Infants and toddlers have distinctive nutritional requirements. An infant’s weight triples by his/her first birthday, but with intestinal absorption commonly inefficient and renal function immature, digestion may be challenged. Breast milk or formula will provide the necessary nourishment during the first 6 months of development. A gradual introduction of solid foods generally occurs around 6 months of age, but every child is different and it is readiness to feed, not the calendar that should determine when a child begins taking solid foods. As a rule, children should be off the bottle or breast by age 1.1 As a toddler begins self-feeding, an erratic appetite and food jags may become more common. Offering healthy snack options and limiting fast foods is important modeling during this impressionable time.7
Orally, primary teeth are beginning to erupt. Parents can prevent early childhood caries by cleaning teeth with a gauze or toothbrush after meals. Having the child sip water instead of juice or milk before nap and bedtime can limit the exposure of fermentable carbohydrates. However, milk or milk substitutes are important sources of the calcium, phosphorus, and vitamin D essential for the calcification of permanent crowns.7
Feeding an infant with cleft lip/palate can be challenging. The main priority is to ensure adequate nutrient intake. The absence of negative pressure needed for sucking can make this taxing for a new mother. Enlarging the hole in the bottle and using special feeding devices will enable the infant to feed more efficiently. Refer patients to the American Cleft Palate Association for more information.1
School-age children need frequent meals to maintain healthy blood glucose levels necessary for optimal academic performance. This is also a time when eating takes on social, psychological, and emotional implications and children develop a lifelong relationship with food. The appetite at this age is usually very good and healthy snacks are an excellent way to incorporate nutrient dense foods into the diet. Involving children in meal preparation and never using food as a reward or a punishment can teach children healthy eating strategies.7
Calcium, phosphorus, and vitamin D requirements increase at this age due to growth spurts in the long bones. Orally, primary teeth are exfoliated and the eruption of permanent teeth begins. Sealant placement on the first permanent molars is standard protocol for caries prevention at this stage of oral development.7
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