It is important to differentiate the different stages of growth and development of our children, understanding that each individual has his or her own rhythm.
Growth is an exciting and complex biological phenomenon. It brings together in the same time the increase of body mass and the morphological and psychological maturation until a complete and autonomous functional capacity is progressively acquired.
That is why I like to distinguish several stages, each of them important, unrepeatable and distinct:
- Fetal stage: emphasizes the importance of maternal nutrition during gestation.
- Neonatal stage (1 month): we must not forget the mother’s feeding during breastfeeding.
- Infant-child stage (2 months to 5 years): this is a period in which the speed of growth increases and in which great changes occur in a short time after the child reaches approximately 2 years of age. It is important not to forget the great role of human milk from 0-6 months. Also, the phase of food diversification and complementary feeding begins at 6 months of age.
- Infant stage (2-5 years): a very important stage for the acquisition and consolidation of healthy habits, as well as for the detection of problems derived from bad habits. It is a period that offers important opportunities to establish healthy dietary habits that will persist throughout life.
- Juvenile stage (from 5 years of age to the beginning of adolescence): it is important to emphasize the maintenance of healthy habits, as well as the culture of taking care of oneself and enjoying it. They should be involved in achieving a healthy lifestyle (diet, physical activity and emotional balance).
- Adolescent stage: bad habits and unhealthy fashions must be rectified, insisting that they are the example of the younger ones. At this stage, the second increase in the growth rate of life takes place.
Thus, the child who has begun his extrauterine life as a passive recipient of food ends up taking complete control of his dietary intake, his physical activity and his emotional side.
It is important to assume in a positive and enriching way the changes that have taken place in the various family structures. We are obliged to help them with all their doubts and concerns in order for them to achieve the basis of a life with healthy habits.
Nutritional requirements during the growth stage: What nutrients are necessary for a child to grow and develop well?
Nutrients are the nutritive elements of a food. They are differentiated into essential and energetic.
Essential nutrients need to be taken from the outside or from the environment, since the organism cannot synthesize them; they are about 40-50, including all vitamins and minerals (Mg, Fe), linoleic fatty acid and amino acids.
Children need quality foods, and in adequate amounts, to achieve optimal growth and development. Infants and young children are more vulnerable than adults to poor nutrition for several reasons:
- They have low nutrient stores.
- They require high demands to ensure adequate growth and rapid neural development.
The intake of all foods, prepared in a healthy way and in adequate amounts will allow adequate growth and will imply a long-term investment in health and quality of life (our children will be healthier adults). In this regard, the pediatrician is the ideal professional to promote health by assessing an adequate nutritional status.
Is there any age at which a child cannot decide to follow a restrictive diet (vegetarian, vegan, flexitarian, etc.)?
The vegetarian diet consists of avoiding the consumption of meat and fish. Depending on how strict or less strict it is we can classify it in:
- Ovo-lacto vegetarian diet: includes foods derived from animals such as eggs and dairy products.
- Lacto vegetarian diet: includes vegetable and dairy products.
- Vegan diet: rejects the intake of any product or derivative of animal origin (eggs, dairy, honey).
Pediatricians, endocrinologists and nutritionists recommend a complete, varied and nutrient-balanced diet. Thus, these restrictive diets in several nutrients, followed continuously and without control can generate deficiencies that degenerate into diseases. Nutritional supplements are not recommended for children as long as they can be obtained through a balanced diet.
Compliance with a restrictive diet requires an adequate intake of Omega 3, Iron, Calcium, Vitamin D and Vitamin B12. This last one is only present in animal products. Its deficiency can cause diseases (anemia, neuropathy, atherosclerosis).
The choice of a specific type of diet by parents for their children implies a strict and responsible control by pediatricians, endocrinologists and nutritionists in order to plan and avoid a nutritional deficit.
As pediatricians who take care of the well-being of our infants, children and adolescents, we emphasize above all that the correct development during the growth period is fundamental.
What are the alarms that should make us suspect that a child is not growing well?
Routine monitoring by the pediatrician is essential to detect any anomaly in the growth and development of the child. The meticulous realization of growth curves and growth velocity curves updated for age, sex, ethnicity, modified according to the patient’s maturational state, will allow us to follow up over time, assess the annual growth trend and be in time to refer the child, if necessary, to a pediatric endocrinologist. The specialist will be in charge of making an assessment and requesting complementary explorations to reach a good diagnosis of growth alteration.
What treatments may a child who is not growing well need?
The orientation or treatments that a child who is not growing well may need can range from optimizing his or her nutrition, improving his or her emotional state, detecting a concurrent disease and its treatment, to the need for growth hormone, in the case of a correct diagnosis of a deficiency of this hormone.