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Slower growth
a) Body weight
Most children grow more slowly after the first year. In the first 12 months of life a baby usually triples its birth weight. For example, a baby weighing 3 kg at birth can be expected to weigh about 9 kg at one year of age.

In the next year the child will quadruple its birth weight, i.e. a baby weighing 3 kg at birth, will only be expected to increase her weight to 12 kg at the end of her second year of life. And the average weight of a 3-year-old is only 13 kg, so do not worry if your child does not gain weight rapidly. As long as there is a slow, steady increase in weight, your child is growing normally.

As a rule of thumb, a weight increase of 2 to 3 kg per year from 1 to 9 or 10 years (when the puberty growth spurt occurs) is perfectly normal.

It is essential to understand that this slowing down of growth will affect the child’s appetite and children will eat less if they are not growing actively.

b) Height
After an initial growth spurt, growth slows down – also when it comes to height. During the first year, the baby will have increased its birth length by 50%, but the child will only double its birth length by the age of 4 years. Give the child time to grow and don’t get anxious because the child is not getting taller all the time.

Once again, increases in height of about 6 to 8 cm per year from the age of 2 years, are perfectly normal. Average height statistics indicate that children are about 71 cm tall at 1 year, and about 90 cm by the time they reach 3 years. Keep in mind that these are average figures and that some children will grow taller – especially if there is an inherited tendency to tallness in the family. Some children will remain relatively small until puberty.

Need for nutrients
Toddlers between the ages of 1 and 3 years of age have a much greater need for nutrients than adults. This is because they are growing and developing bones, teeth, muscles, and blood. For this reason, toddlers need more nutritious food than adults, especially as they are not able to eat large portions of food at a sitting.

Energy
The amount of energy toddlers require depends on how fast they are growing and how active they are. Between the ages of 1 and 3 years, children need about 1300 kcal or 5500 kJ a day.

Protein
Most toddlers in the western world do not suffer from protein deficiency. In fact, they may eat more protein than they require. It is suggested that toddlers between the ages of 1 and 3 only require 16 g of protein a day. Malnourished children may have protein and energy deficiencies, which need to be addressed if the child is to grow and develop normally.

Vitamins and minerals
The most common nutrient shortages in the 1-to-3-year-old age group are iron, calcium, zinc, vitamin B6 and vitamin A deficiencies.

Toddlers are particularly prone to iron deficiency anaemia. If your toddler is listless, irritable, tires easily, yawns all the time and is very pale, then it may be a good idea to have her checked for anaemia. Poor eating habits, monotonous diets, overemphasis on foods that have a low iron content, too much liquid in the form of milk and fruit juice, can all contribute to a lack of iron in the diet. Foods that are rich in easily absorbable iron include meat, egg yolk, fish and iron-fortified infant cereals.

Calcium is also often a problem, particularly when toddlers don't drink enough milk. The recommended intake of calcium for this age group is 800 mg a day. Food that provide easily absorbable calcium are milk (2-3 cups a day would supply this amount of calcium), or yoghurt or cheese. If toddlers do not get sufficient calcium they are unable to build strong, healthy bones and teeth.

A toddler with a zinc deficiency may fail to grow, have a poor appetite, and her cuts and scrapes may take longer than normal to heal. The best sources of zinc are meat and fish, especially seafood, which many toddlers may not be inclined to eat. Zinc is, therefore, one nutrient that you may have to supplement.

Vitamin B6 or pyridoxine, is found in meat, fish, potatoes, bananas and legumes (or baked beans for the younger child).

The best sources of vitamin A are dairy products and fatty fish, like snoek. The precursor of vitamin A is called beta-carotene, which is found in the following dark yellow or orange fruits and vegetables: pumpkin, butternut, carrots, yellow sweet potatoes, yellow peaches, apricots, pawpaw, and spanspek.

Food fortification
The South African government has passed legislation which will soon make fortification of staple foods such as bread flour and maize meal compulsory. Vitamins A, B1, B2, niacin, B6, folic acid, iron and zinc will be added to wheat flour and maize meal soon. This fortification programme is specifically developed to address nutrient deficiencies in our country's children. It will be implemented at the beginning of October 2003.

Keep a lookout for products marked with the logo “Fortified for Better Health”. This is indeed a step in the right direction and it should go a long way to ensure that our toddlers and children obtain essential nutrients such as vitamins and minerals to meet their needs. – (Dr I.V. van Heerden, DietDoc)

Any questions? Ask DietDoc

 

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