Child Nutrition Issues, Eating Risks Children

Nutrition Issues

There are a number of nutrition issues that parents may be concerned about. These pages contain information about the following nutrition-related issues:

  • Choking.
  • Gastroenteritis.
  • Food allergy and intolerance.
  • Overweight and obesity.

Choking

Children are first introduced to solid food at around 6 months of age. First foods are usually pureed as children lack teeth to chew food. Gradually solid foods are introduced. They continue to learn how to eat solid food up until 4 years old. Young children do not have molars that can grind and chew solid lumps of food. Up until the age of four, larger pieces of food (and non-food items) can get stuck in a child’s airways resulting in choking. It is important that parents and carers are aware of the risk of choking and take precautionary measures to ensure that it is less likely to occur.

Ways to make eating safe:

  • Make sure children are sitting down while they eat and not moving around.
  • Like many adults, children may find it difficult to eat when they are upset.
  • Avoid foods that break off into large solid pieces or are very hard. e.g. carrot, apple and celery can all be a problem depending on the child’s age.
  • Cut meats into small pieces, particularly tougher meats. Take the skin off frankfurts and sausages for infants.
  • Avoid hard lollies, popcorn, nuts and corn chips for young children. By age four, the majority of children can chew and grind most hard foods. However, if you are unsure about your child’s ability to eat any of these foods, delay until they are five years old.
  • Adapt the types and consistency of harder foods as your child grows and develops. Always watch your child the first time you allow them to eat a hard food that requires a lot of chewing (e.g. carrot sticks).
Choking factsheet : http://www.chw.edu.au/parents/factsheets/safchokj.htm

Constipation

Children may suffer from constipation and experience pain when they have a bowel motion. This may lead to holding on to avoid the pain. Constipation may be caused by the following:

  • Not enough fibre – eating plenty of wholegrain breads and cereals, and fresh fruit and vegetables helps to keep your bowels regular. Children who do not eat enough of these foods may become constipated.
  • Holding onto stools – children may hold on and avoid going to the toilet because they are busy or they do not want to go at preschool or school. The stool builds up in the bowel and can become very hard making it difficult to pass.
  • Illness- If the child is unwell, they may not eat or drink normally. This may lead to constipation.
  • Rarely an underlying medical condition may be responsible for constipation
Tips to prevent constipation:
  • Ensure you give your child plenty of food containing fibre ( fresh fruit, vegetables, wholegrains and nuts where suitable).
  • Encourage your child to drink plenty of water – aim for four to five glasses a day.
  • Do not give your child unprocessed bran as it may interfere with the absorption of nutrients such as iron and zinc.
  • Encourage your child to go to the toilet at least once a day.
  • Avoid the use of laxatives.
If your child is having difficulty passing a stool, please seek medical advice in regards to the correct laxative or stool softener that is suitable for your child’s age and situation.

Examples of high fibre foods:
  • Breakfast cereals such as Wiggles Weetbix™, Shredded Wheat, muesli, porridge, Mini Wheats and Fruity Bix.
  • Wholemeal or wholegrain breads and crackers.
  • Wholemeal flour, which can be used when cooking muffins, biscuits and cakes.
  • Fresh, frozen and canned fruit and vegetables.
  • Dried fruit, in particular prunes (small quantities of diluted prune juice).
  • Legumes and pulses e.g. baked beans, lentil soup, dahl, burritos, lentil burgers, split pea soup, hommus.

Food allergy and food intolerance

Both children and adults can have adverse reactions to certain foods. This reaction can be the result of food allergy or food intolerance.

Food allergy:

Allergies occur when the immune system produces antibodies against a substance in the environment that is otherwise harmless. Food allergy can be a problem for babies, infants and toddlers. Babies are particularly vulnerable to food allergies as their gastrointestinal system is immature. As children mature, they are able to cope with a wider variety and increasing amounts of foods. The most common foods that cause an allergic response are peanut, egg, milk, tree nuts (eg. walnuts, cashews), seafood and sesame. There is usually a family history of an allergic disorder and children may be allergic to two or three different foods at once. However, most children grow out of a food allergy by the age of 5-6 years. Allergies to nuts and seafood are the most likely to persist beyond this age.

Food allergy reactions can range from mild to severe. The majority of food allergies are associated with a chronic rash called atopic eczema. Mild reactions result in hives with severe reactions resulting in an immediate burning sensation, hives and redness around the face. The face and mouth can swell and hives can turn into large rapidly spreading welts. The most severe reaction is anaphylaxis which can lead to breathing difficulties, allergic shock and can be life threatening. This must be treated immediately with ephephrine (adrenaline) by injection. Tiny amounts of the food can trigger a severe reaction in very sensitive children. Many early childhood services do not allow peanut butter to be part of any foods brought to the centre.

Food intolerance:

Food contains naturally occurring chemicals. These add flavour and aroma to food and make it enjoyable to eat. Some babies are born with sensitivity to certain food chemicals and may react when they eat them. There are natural chemicals in many healthy foods and these can create as much of a problem as artificial chemicals added during the manufacturing process. The natural substances that are eaten in greatest quantities and are more likely to cause problems are salicylates, amines and glutamate.

Food intolerance reactions can also result in hives and eczema, with a general feeling of being unwell. Children may become irritable and restless. Breast-fed babies can react to chemicals in their mother’s diet and can become colicky with loose stools, eczema and nappy rashes.

Food allergies and intolerances are rarely serious and can treated by eliminating certain foods from the diet. However, it is very important that children receive all the nutrients they need to grow and develop normally. If you suspect your child has a food allergy, seek the advice of your doctor or dietitian to ensure your child receives all the nutrients they need for good health.

Obesity and overweight

Increasing rates of obesity amongst children is a worldwide issue that can lead to a number of physical, social and emotional health issues. Children who are overweight and obese are at risk of the following:

  • Type 2 diabetes.
  • High blood fats and high blood pressure.
  • Stress on bones and joints.
  • Sleep apnoea.
  • Low self esteem and social stigmatisation.
  • Increased risk of becoming overweight or obese adults.

How do you know if your child is overweight?

Your family doctor, child health care nurse or dietitian can check your child’s growth and tell you if your child is growing normally. Sometimes it is difficult to tell if a child is overweight. If your child is overweight, seek the advice of a health professional as young children should not be placed on restrictive diets.

Nutrition tips to prevent overweight and obesity in children:

  • Breastfeed infants as a first preference when ever possible and introduce solids at around 6 months.
  • Eat a wide variety of foods and do not over-restrict any one food. All foods play a role in a healthy diet.
  • Offer wholemeal breads and cereals and include plenty of fruit and vegetables.
  • Avoid processed snack food (For tips visit Healthy Snacks).
  • Introduce reduced fat dairy products from 2 years of age.
  • Limit sweet drinks, including juice, cordial and soft drinks. Offer water to drink. (link to what to drink page).
  • Limit high fat foods and sweetened foods.
  • Encourage slower eating. Eat as a family and talk during meal times
  • Avoid punishing your child with food or offering it as a reward.
  • Help your child to recognise when they are eating because they are bored, sad and lonely.
  • If your child is preschool or school aged, then let them decide when they have eaten enough. This encourages them to understand hunger and fullness.
  • Set a good example and ensure the whole family eats healthy food. Only buy the food you would like your child to eat.
  • Avoid eating in front of the television and limit viewing time to less than two hours per day.

It is also important to ensure your child is active for around 60 minutes every day. For tips on how to keep your child active, visit the Physical Activity section.

Gastroenteritis

Gastroenteritis is very common in young children and is often caused by viruses in the bowel. It often starts with vomiting and can lead to diarrhoea. Children may also have a fever and a stomach ache. Bacteria may also cause vomiting and diarrhoea in children and this is more commonly due to food poisoning. It may be difficult to tell if it is viral or bacterial, however more extreme stomach aches, higher fevers and blood or mucus in the diarrhoea may indicate a bacterial rather than viral infection. Viral gastroenteritis is highly contagious so keep children at home while they are sick. It commonly lasts about three to four days.

One of the main concerns related to gastroenteritis is the risk of dehydration due to loss of fluid with vomiting and diarrhoea. The younger the child, the greater the risk of dehydration. It is essential that parents consult their doctor if their child:

  • is younger than six months old;
  • keeps vomiting;
  • is not consuming any fluids;
  • is not passing urine;
  • appears drowsy;
  • has fevers;
  • has ongoing pain and blood or mucus in their stools;
  • or doesn’t seem to be getting better.

Replace lost fluid with suitable drinks including oral rehydration fluid (e.g. Gastrolyte or Hydralyte) which help to replace lost fluid rapidly. If your child is breast fed, continue to offer breast milk as well as water and oral rehydration fluid. Other fluids such as juice, cordial or soft drink (including flat lemonade) are not recommended and must be diluted or they will make the diarrhoea worse. Offer your child small amounts of fluid regularly (5ml per kilogram of body weight every hour). Start offering bland, soft food as soon as the vomiting has ceased even if the diarrhoea is still present.

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