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Children 0–2 years

Child growth rates vary

Does your child still fit last year’s school uniform?

It is surprising how much growth can occur over school holidays when inactivity, sleeping in late, lack of routine and almost continuous grazing can divert energy away from exercise and into weight gain and growth.

Factors that influence growth rates

Parents often worry about the growth rates of their children. But while growth rates may depend on their child’s protein and energy intake it also varies individually and is dependent on a whole host of factors throughout their life.

Slow foetal growth

Prematurity or congenital abnormality can affect growth rates.

Restrictive eating practices

Such as issues that limit food intake e.g. allergies, weight control during adolescence, vegetarianism, extreme faddiness in childhood can slow growth.

Physical performance

For instance the energy demands of athletic training may compete with the needs for physical growth and mental development.

Hormonal factors

Growth during the first year may simply be a continuation of foetal growth, and relates mainly to nutritional factors; however by the age of one, growth hormone is the controlling
factor aided by sexual hormones when puberty is reached. Adequate sleep in also important for sufficient production of growth hormone.

 Growth spurts

Interestingly children don’t grow at the same rate every day but rather in spurts which are usually associated with increased hunger. Growth is most rapid from birth to three years and again during puberty. This is usually from 10-14 years and 12-16 years for boys. Some children may also experience a mid-growth spurt when they are seven or eight.

Growth trends

Changing views regarding “body shape” greatly impact on growth. A “chubby baby” was once considered a healthy one, but today parents laughingly apologise if their baby is a “little bruiser” and every effort is made to prevent childhood obesity.

To this end, improvements in infant nutrition over the last  20 years which promote breast-feeding and delay the introduction of solid foods have produced children who up to the age of 10 months are shorter, lighter and leaner than before. After 10 months there is a gradual catch-up as solids are introduced.

Environmental factors regarding meal size and patterns later in life are harder to control and probably equally important.

As young men and women approach puberty the pressure’s of peers, fashion and the media can reduce their food intake. this often coincides with a time of critical peak growth which may affect their physical development, sexual maturity, academic and physical performance.

A recent study in New South Wales of 450 teenagers found one-third were preoccupied with dieting and more than a quarter were mostly or always on a diet.

Nutritional factors

As adults adopt low-fat diets as they struggle with expanding waistlines and high cholesterol levels, it is easy to lose sight of the fact that young children have very different nutritional  needs from their parents

  • Protein
    During periods of rapid growth children require protein from foods such as meat, fish, eggs, dairy products and/or legumes. As the body has limited capacity to store or mobilise the protein components (amino acids) necessary to build new tissue, it is important to ensure that protein foods are eaten each day.
  • Energy
    Making new tissue also requires extra energy. Just how much depends on such factors as the child’s age, sex, growth rate and physical activity.
    The Healthy Food Pyramid is a nutritional model which encourages us all to base our diet on complex carbohydrate and dietary fibre-e.g. fruit and vegetables, bread and cereals and to have less protein and fat in the form of meat, eggs and dairy products.
    The Ministry of Health recommends that those over 14 years obtain their energy in the following percentages:

Carbohydrate 45-65%  Protein 15-25%; Fat 20-35%

  • Dietary Fibre
    While these energy goals are appropriate for school-aged children, parents of children, under the age of 5 years or children who are failing to thrive, need to watch the proportion of carbohydrate to protein foods in their diet. This is because children’s stomachs are small and bulky fibre rich foods may reduce their appetite for more protein, energy dense foods required for growth and development of their nervous system.

Tips to maximise growth rates

  • Breast feed if possible during the first year and delay the introduction of solids until 4-5 months
  • Introduce a wide variety of foods over the first  1-3 years.
  • For children under 5 years recognise that they have a greater need for fat and protein to maximise growth and neurological development-than older children however this should come from healthy foods such as meat, fish, eggs and cheese as opposed to fried takeaways, cakes and biscuits.
  • Avoid complacency; it feeding problems and/or food rejection persist seek professional help, especially if growth rate is slow or childhood obesity is a concern.
  • Encourage very active children to consume wholesome snack foods between meals which limit fat, salt and sugar. Low-fat cheese and crackers, fruit, popcorn, sandwiches and milkshakes are filling snacks.
  • Encourage regular meal times, particularly breakfast which contributes more than 25% of their daily nutritional needs.
  • Encourage teenage girls to establish a healthy body image, and good diet with moderate daily exercise.
  • Adequate sleep is important to growth so at an early age try to establish a consistent bedtime and bedtime routine. Allow children to ‘wind down’ before going to bed. Avoid stimulating activities in the lead up to bedtime. Avoid keeping a TV or computer in the bedroom.

If you are concerned about your child’s growth then do contact us for an assessment and practical help.

 

About the author View all

Lea Stening

Lea is one of New Zealand’s leading paediatric dietitians and also specialises in Sports Nutrition. She has specialised in Paediatric Nutrition for 31 years and in 1985 was the first paediatric dietitian to enter private practice in New Zealand. Lea helps families through her private consultations, public lectures, newspaper and magazine articles as well as television and radio interviews. Read more »

View all posts by Lea Stening »

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