Nutrition of children at every age level that all parents need to understand

Every parent certainly wants to provide the best for their children, including in matters of nutrition or child nutrition. To make it clearer, here is complete information you can find out about nutrition for children, from daily needs, food choices, to eating problems that often occur.

The nutritional needs of children according to the nutritional adequacy rate (RDA)

According to the Indonesian Ministry of Health, the nutritional adequacy rate or RDA is adequacy of average daily nutrients which is recommended for a group of people each day. Determination of nutritional value will be adjusted to gender, age group, height, weight, and physical activity.

The nutritional needs of the little one that parents must meet in a day are divided into two groups, namely macro nutrients and micro nutrients. Macro nutrients are all types of nutrients that children need in large quantities, such as energy, protein, fat and carbohydrates. Meanwhile, micronutrients are nutrients that are needed in small amounts, such as vitamins and minerals.

Broadly speaking, the following are children's nutritional needs that should be met according to the 2013 Indonesian AKG from the Indonesian Ministry of Health:

1. Nutrition for children aged 0-1 years

0-6 months of age

Daily macro nutrient needs for children:

• Energy: 550 kCal
• Protein: 12 grams (gr)
• Fat 34 gr
• Carbs 58 g

Children's daily micronutrient needs:

Vitamin

• Vitamin A: 375 micrograms (mcg)
• Vitamin D: 5 mcg
• Vitamin E: 4 milligrams (mg)
• Vitamin K: 5 mcg

Mineral

• Calcium: 200 mg
• Phosphorus: 100 mg
• Magnesium: 30 mg
• Sodium: 120 mg
• Potassium: 500 mg

Age 7-11 months

Daily macro nutrient needs for children:

• Energy: 725 kCal
• Protein: 18 gr
• Fat 36 gr
• Carbohydrates 82 gr
• Fiber: 10 gr
• Water: 800 milliliters (ml)

Children's daily micronutrient needs:

Vitamin

• Vitamin A: 400 micrograms (mcg)
• Vitamin D: 5 mcg
• Vitamin E: 5 milligrams (mg)
• Vitamin K: 10 mcg

Mineral

• Calcium: 250 mg
• Phosphorus: 250 mg
• Magnesium: 55 mg
• Sodium: 200 mg
• Potassium: 700 mg
• Iron: 7 mg

2. Nutrition for children aged 1-3 years

Daily macro nutrient needs for children:

• Energy: 1125 kCal
• Protein: 26 gr
• Fat 44 g
• Carbohydrates 155 g
• Fiber: 16 gr
• Water: 1200 milliliters (ml)

Children's daily micronutrient needs:

Vitamin

• Vitamin A: 400 micrograms (mcg)
• Vitamin D: 15 mcg
• Vitamin E: 6 milligrams (mg)
• Vitamin K: 15 mcg

Mineral

• Calcium: 650 mg
• Phosphorus: 500 mg
• Magnesium: 60 mg
• Sodium: 1000 mg
• Potassium: 3000 mg
• Iron: 8 mg

3. Nutrition for children aged 4-6 years

Daily macro nutrient needs for children:

• Energy: 1600 kCal
• Protein: 35 grams (gr)
• Fat: 62 gr
• Carbs: 220 gr
• Fiber: 22 gr
• Water: 1500 ml

Children's daily micronutrient needs:

Vitamin

• Vitamin A: 375 micrograms (mcg)
• Vitamin D: 15 mcg
• Vitamin E: 7 milligrams (mg)
• Vitamin K: 20 mcg

Mineral

• Calcium: 1000 mg
• Phosphorus: 500 mg
• Magnesium: 95 mg
• Sodium: 1200 mg
• Potassium: 3800 mg
• Iron: 9 mg

4. Nutrition for children aged 7-12 years

7-9 years old

Daily macro nutrient needs for children:

• Energy: 1850 kCal
• Protein: 49 grams (gr)
• Fat: 72 gr
• Carbs: 254 gr
• Fiber: 26 gr
• Water: 1900 ml

Children's daily micronutrient needs:

Vitamin

• Vitamin A: 500 micrograms (mcg)
• Vitamin D: 15 mcg
• Vitamin E: 7 milligrams (mg)
• Vitamin K: 25 mcg

Mineral

• Calcium: 1000 mg
• Phosphorus: 500 mg
• Magnesium: 120 mg
• Sodium: 1200 mg
• Potassium: 4500 mg
• Iron: 10 mg

Age 10-12 years

Daily macro nutrient needs for children:

• Energy: 2100 kcal male and 2000 kcal female
• Protein: men 56 grams and women 60 grams
• Fat: men 70 grams and women 67 grams
• Carbohydrates: 289 grams of men and 275 grams of women
• Fiber: men 30 grams and women 28 grams
• Water: male and female 1800 ml

Children's daily micronutrient needs:

Vitamin

• Vitamin A: men and women 600 mcg
• Vitamin D: men and women 15 mcg
• Vitamin E: men and women 11 mcg
• Vitamin K: men and women 35 mcg

Mineral

• Calcium: men and women 1200 mg
• Phosphorus: men and women 1200 mg
• Magnesium: men 150 mg and women 155 mg
• Sodium: men and women 1500 mg
• Potassium: men and women 4500 mg
• Iron: men 13 mg and women 20 mg

5. Nutrition for children aged 13-18 years

Age 13-15 years

Daily macro nutrient needs for children:

• Energy: male 2475 kcal and female 2125 kcal
• Protein: male 72 g and female 69 g
• Fat: men 83 grams and women 71 grams
• Carbohydrates: 340 grams for men and 292 grams for women
• Fiber: men 35 grams and women 30 grams
• Water: male and female 2000 ml

Children's daily micronutrient needs:

Vitamin

• Vitamin A: men and women 600 mcg
• Vitamin D: men and women 15 mcg
• Vitamin E: men 12 mcg and women 15 mcg
• Vitamin K: men and women 55 mcg

Mineral

• Calcium: men and women 1200 mg
• Phosphorus: men and women 1200 mg
• Magnesium: men and women 200 mg
• Sodium: men and women 1500 mg
• Potassium: 4700 mg men and 4500 mg women
• Iron: men 19 mg and women 26 mg

Age 16-18 years

Daily macro nutrient needs for children:

• Energy: male 2676 kcal and female 2125 kcal
• Protein: men 66 grams and women 59 grams
• Fat: men 89 grams and women 71 grams
• Carbohydrates: 368 grams of men and 292 grams of women
• Fiber: men 37 grams and women 30 grams
• Water: 2200 ml for men and 2100 ml for women

Children's daily micronutrient needs:

Vitamin

• Vitamin A: men and women 600 mcg
• Vitamin D: men and women 15 mcg
• Vitamin E: men and women 15 mcg
• Vitamin K: men and women 55 mcg

Mineral

• Calcium: men and women 1200 mg
• Phosphorus: men and women 1200 mg
• Magnesium: men 250 mg and women 220 mg
• Sodium: men and women 1500 mg
• Potassium: for men and women 4700 mg
• Iron: men 15 mg and women 26 mg

Even so, the nutritional needs of children will certainly vary, depending on their age and condition. The nutritional adequacy figure is only a general guide in fulfilling children's nutritional intake. However, to know exactly how much your little one's nutritional needs are, you should consult a doctor and a nutritionist.

Choice of food sources to fulfill children's nutrition

The older the child gets, the more nutritional adequacy that must be fulfilled every day. So that as a parent, you are required to always provide food sources that can help fulfill children's nutrition or nutrition.

No need to be confused, here are the options you can give your baby:

1. Carbohydrates

Carbohydrates are the staple foods that must be in every little one's diet. Carbohydrates that are eaten will be processed directly into blood sugar, a source of energy for all the organs in your little one's body.

Hence, this food source should not be missed. Various food sources of carbohydrates that you can serve to children, namely white rice, brown rice, pasta, wheat, potatoes, sweet potatoes, corn, and so on.

2. Protein

Protein is one of the most important nutritional needs of children. The reason is, this one nutrient plays a role in building and repairing damaged cells and body tissues, especially during the growing period of children.

In order for the child's protein needs to be fulfilled, there are various food sources that you can provide. Starting from animal protein from animals, to vegetable protein from plants.

Examples of animal protein include eggs, cheese, milk, fish, chicken, beef, shrimp, and so on. While vegetable protein, namely nuts, wheat, lentils, broccoli, oats, and others.

Both types of protein are equally important for your little one, whether it's vegetable and animal. So, make sure that animal and vegetable protein sources are always in every little one's diet.

3. Fat

The calories contained in fat are quite high compared to other nutrients. However, fat is not always bad. Fat is an important source of reserve energy for the body.

In addition, fat also helps the process of absorbing vitamins, building cells and tissues, blood clotting, and supports muscle movement. Various sources of good fats that can be given to children such as avocado, nuts, eggs, tofu, and so on.

4. Vitamins and minerals

If some of the nutrients previously described are classified as macro, vitamins and minerals are included in micronutrients. Even though the name is micro, its daily needs cannot be overlooked and must be fulfilled.

Simply put, you can provide various types of vegetables and fruits every day to help meet the needs of vitamins and minerals. In addition, chicken, beef, seafood, nuts, and mushrooms are equally rich in micronutrients.

The form of children's food must also be considered

Even though they come from the same source, the texture of food for each child's age can be different. Take for example in babies over 6 months, processed food is usually given in the form of fine porridge as a complement to breastfeeding (MPASI). Until 12 months of age, family foods with a softer texture can be introduced.

Meanwhile, when they are over 1 year old, children generally can be given the same food that is eaten by other family members.

How to measure children's nutritional status

In fact, how to measure the nutritional status of children is different from adults. In fact, the measurement is not as easy as calculating the body mass index (BMI) in adults.

Maybe a question arises in your mind, what makes the calculation of the nutritional status of children and adults different? The answer is because children, who are still under the age of 18, will continue to grow and develop.

During this growth period, automatically the weight, height, and size of the child's overall body will continue to change. This will continue until the age of 18, only then does growth gradually stop.

Because it will continue to experience changes, the BMI calculation is not completely accurate if you want to know the nutritional status of children. Body mass index (BMI) to measure the nutritional status of adults can be easily calculated by using the formula for weight in kilograms divided by height in meters squared.

Meanwhile, if you want to know whether your little one has normal nutritional status or not, special calculations are needed. Actually it is still similar to the BMI calculation which includes both weight and height. However, the calculation of the nutritional status of children generally includes age as a comparison. Therefore, indicators to see the nutritional status of children also vary

Various indicators to measure the nutritional status of children

1. Head circumference

Head circumference is an important measurement that helps show the size and growth of a child's brain. That is why, IDAI recommends that this one measurement should not be missed every month until the child is 2 years old.

Health workers such as doctors, midwives, or posyandu officers, will use a measuring tape that is looped around the baby's head. Precisely at the top of the eyebrows, past the top of the ears, until they meet at the back of the head that stands out the most.

After being measured, the results will continue to be recorded so that it can be concluded that they fall into the normal, small (microcephaly), or large (macrocephaly) categories. The size of the head circumference that is too small or large can indicate a disturbance in brain development.

2. Body length

Body length is the measurement usually used for children less than 2 years old. The reason is because in that age range, the child has not been able to stand up perfectly to measure their height.

As a result, the measurement of body length is used as a reference to determine the child's height. You do this by using a tool made of wood, called the length board.

3. Height

After the child is over 2 years of age, the measurement of body length will be replaced by height. Just like adults, measuring the height of children at this age also uses a tool known as a microtoise.

Even though the child's height varies according to their growth, the following is the ideal ideal height according to the Indonesian Ministry of Health:

• 0-6 months: 49,9-67,6 cm
• 7-11 months: 69.2-74.5 cm
• 1-3 years: 75.7-96.1 cm
• 4-6 years: 96.7-112 cm
• 7-12 years: 130-145 cm
• 13-18 years: 158-165 cm

4. Weight loss

Not much different from other indicators, the measurement of body weight should not be ruled out during the growth period. Because at this time, a lot of useful nutrients are needed to support children's growth and development.

But what must be considered, make sure the child's weight is in the normal range. Try not to get too low or too high. The following is the average ideal body weight according to the Indonesian Ministry of Health:

• 0-6 months: 3,3-7,9 kg
• 7-11 months: 8.3-9.4 kg
• 1-3 years: 9.9-14.3 kg
• 4-6 years: 14.5-19 kg
• 7-12 years: 27-36 kg
• 13-18 years: 46-50 cm

Assessment of children's nutritional status

After knowing how much height and weight, to the circumference of the child's head, then these indicators will be used as a benchmark for whether your little one has a good nutritional status or not.

Assessment of nutritional status is carried out by comparing body weight according to height, weight according to children's age, height for age, and body mass index for age. These three categories will determine whether the child is thin, overweight, or even short because they do not have a normal height.

All of these categories will be seen in a special chart from WHO 2006 (cut off z score) for ages less than 5 years and CDC 2000 (percentile measure) for ages above 5 years. The use of WHO 2006 and CDC 2000 charts will be further classified based on male and female sex.

1. Weight based on age (BW / U)

This indicator is used by children aged 0-60 months, with the aim of measuring body weight according to the child's age. The rating categories include:

• Normal weight: ≥-2 SD to 3 SD
• Underweight: <-2 SD to -3 SD
• Extremely underweight: <-3 SD

2. Height based on age (TB / U)

This indicator is used by children aged 0-60 months, with the aim of measuring height according to the child's age. The rating categories include:

• Height above normal:> 2 SD
• Normal height: -2 SD to 2 SD
• Short (stunting): -3 SD to <-2 SD
• Very short (severe stunting): <-3 SD

3. Weight based on height (BW / TB)

This indicator is used by children aged 0-60 months, with the aim of measuring body weight according to the child's height. The rating categories include:

• Very fat:> 3 SD
• Fat:> 2 SD to 3 SD
• Normal: -2 SD to 2 SD
• Thin (wasting): -3 SD to <-2 SD
• Very thin (severe wasting): <-3 SD

4. Body mass index based on height (BMI / U)

This indicator is used by children aged 5-18 years, with the aim of measuring the body mass index (BMI) according to the child's age. The graph used is from the CDC 2000 using percentiles.

The rating categories include:

• Underweight : percentile <5
• Normal: 5th percentile - <85th
• Overweight : 85th percentile - <95th percentile
• Obesity: 95th percentile

Source: Nutritional Status Assessment PPT

Because determining the nutritional status of the baby is quite complicated, you should often take it to the nearest health service so that its growth and development can be monitored.

For toddlers, usually a KIA or KMS (health card) book will be given which shows a chart of your little one's growth and development, so that it will make it easier for you to know whether the nutritional status is normal or not.

Nutritional problems in children

When the baby's nutritional intake is excessive or even deficient, there will be nutritional problems that lurk. The following are various problems of nutritional intake for each child:

1. Marasmus

Marasmus is malnutrition due to insufficient energy and protein intake. Marasmus is included in the malnutrition group, because the supply of nutrients is not fulfilled for a long time.

Apart from chronic hunger, this condition also occurs due to repeated infections so that the child cannot properly digest incoming food.

Characteristics that indicate a child experiencing marasmus are:

• The weight of the child is dropping rapidly
• Wrinkled skin like an old person
• Concave stomach
• Tends to cry

2. Kwashiorkor

Kwashiorkor is a chronic malnutrition due to very low daily protein intake.

Characteristics of children with kwashiorkor are:

• Skin discoloration
• Hair hair like corn
• Swelling (edema) in several parts, such as the legs, hands, and stomach
• Round, puffy face (moon face)
• Decreased muscle mass
• Diarrhea and weakness.

Children who have kwashiorkor are actually thin, but usually don't lose weight like marasmus. This is because the child's body with kwashiorkor is filled with fluid build-up (edema) which makes it look heavy.

3. Marasmik-kwashiorkor

Marasmik-kwashiorkor is a combination of the conditions and symptoms of marasmus and kwashiorkor. This condition is usually caused by a lack of calorie and protein intake.

As much as 60 percent of the body weight of children with marasmic-kwarshiorkor consists of fluid buildup aka edema. Children with this condition indicate that their nutritional status is very poor.

4. Stunting

A child is said to be stunted when his body size is much shorter than his normal size.

According to WHO, stunting is defined if the graph of height for age shows less than -2 SD. Simply put, children who are stunted generally appear shorter than their peers.

Stunting can occur because a child has been undernourished for a long time, which then affects their growth. That is why stunting does not occur suddenly, but is the result of a long-term growth process.

Don't take it lightly, because stunting can carry various health risks in the future. For example in women, stunting has the risk of having children with low birth weight (LBW), malnutrition, and others.

5. Wasting (skinny)

The child's body is considered thin when their weight is very below normal, or if they are already chronic. In other words, the child's weight does not match his height and age.

Sometimes, losing is also known as acute or severe malnutrition. This can happen when the child does not get enough nutritional intake, or has a disease that causes weight loss, such as diarrhea.

The symptom that appears when a child is losing is that the body looks very thin due to low body weight.

6. Failure to thrive (fail to grow)

Failure to thrive is a condition that hinders the development of a child's body, or even stops. This condition is usually caused by insufficient daily nutritional intake for children.

Either because your little one doesn't want to eat, has certain health problems, or the number of calories in the body is not enough to support growth.

7.Underweight (less body weight)

Underweight is almost the same as being thin at first glance. But the difference is, the child is said to be underweight when his weight tends to be below normal when compared to friends his age.

Usually underweight children are known from the nutritional status indicators of body weight based on age (for children 0-5 years) and BMI based on age (6-18 years).

Just like wasting, when the baby's weight is lower than ideal, this indicates that he is experiencing a lack of certain nutritional intake. Infectious diseases experienced by children can also lead to underweight.

8. Lack of vitamins and minerals

Vitamins and minerals are essential nutrients to support the growth of a child's body. If there is a lack of certain nutrients, of course it will result in disruption of the child's body development which makes it unable to develop optimally.

9. Iron deficiency anemia

Iron deficiency anemia occurs when iron stores in the body are depleted, or supplies are running low. This condition is characterized by hemoglobin levels that are below normal limits. Iron deficiency is often experienced by children aged more than 6 months to toddlers.

This happens because after 6 months of age, children's iron needs usually increase along with the higher energy needs. Starting from that age until toddlers or even 6 years of age, children's iron needs will continue to increase.

10.Overweight (overweight)

Overweight or being overweight refers to conditions that make the child's weight above its normal range. Or it could be said that it is not equal to his height, so that it makes the child look very fat.

11. Obesity

When viewed from the category of nutritional status, obesity is a condition of children who are overweight who are not managed properly. You could say obesity is much worse than being overweight.

Obesity is characterized by body weight that has far exceeded its normal category. A very obese child is funny, but the dangers of obesity can have an impact on adulthood. Children are at risk of developing diabetes and cardiovascular disease, such as stroke and heart disease.

What are the problems with eating patterns in children?

The following are the daily diet problems that every child can experience:

1. Food allergies

Food allergy is a condition that occurs when the immune system overreacts due to the presence of certain compounds from food. That is why, children who are allergic to certain types of food will usually experience symptoms after eating these foods.

Symptoms of a food allergy vary, they can be mild, moderate, and even severe. This condition usually makes children unable to eat certain foods, thus losing their source of nutrients from these foods.

2. Food intolerance

Often considered the same as food allergies, even though food intolerance is clearly different. Food intolerance is a condition caused by a child's body not having the ability to digest certain nutrients in food.

In this case, food intolerance does not involve immune system disorders like food allergies. This condition does occur because of a disturbance in the child's body, making it unable to digest food. Take for example such as lactose intolerance.

3. Change in appetite

A child's appetite is one of the factors that affect their daily intake. Appetite is not always in prime condition.

Sometimes, children may experience decreased appetite which makes them reluctant to eat anything. Or even so, his appetite can increase so much that it triggers him to eat anything in large quantities

4. Eating habits

Luckily, your baby has good eating habits. This means that you want to eat anything and are not picky about food. The reason is, not a few children refuse certain types of food, or even tend to be picky and only want to eat certain foods.

This cannot be ignored, because the eating habits instilled from childhood will continue to carry over until the children grow up.

x