Title: Healthy Growth Toolkit for Infants and Preschoolers
1Healthy Growth Toolkit for Infants and
Preschoolers
- A Toolkit for Public Health Professionals
- Development of Toolkit
- Focus Group Summaries
- Guiding Points for Discussion with Parents
- Suggested Handouts for Parents
2Toolkit Development Process
- Multi-disciplinary consultative process with an
Advisory Committee including - Alberta wide availability and implementation
- Focus group feedback for messages and resources
- Funding from Alberta Health and Wellness (Nov,
2004 to April, 2005)
- Public Health Nurses
- Maternal Child Specialists
- Eating Disorder Prevention Specialists
- Pediatrician
- Medical Officer of Health
- Public Health Nutritionists
3Healthy Growth Toolkit Contents
- Growth Assessment Counselling Guide
- Discussing Growth and Food Issues with Parents
- Parent and Public Health Nurses Focus Group
Summaries - Sample Letter to Physician
- Examples of Community-based Initiatives to
Promote Healthy Eating, Activity and Body Image
for Toddlers Preschoolers - Parent Fact Sheets
- Key references and Web resources
4Focus Groups
- Parent Focus Groups were held in an urban centre
(Calgary) and rural centre (Olds) - Public Health Nursing Focus Groups were held in
Calgary and Drumheller (with staff from
Drumheller and Hanna)
5Focus Groups - Parent Comments
- Parents want simple and clear messages Dont
beat around the bush - Statements better received
- Growth pattern is changing. This signals us to
take a closer look at childs health. - . . . Puts them at risk for being overweight.
6Focus Groups Parent Comments
- Not understood or alarming
- concern
- individual pattern
- may or may not most likely
- Weight-for-length is on the high side. This may
or may not be a concern. Growth patterns are
influenced by genetics and lifestyle. . . . .
7Focus Groups - Parent Comments
- Weight is sensitive issue. Phrasing and
discussions need to be clear and tactful. - Overall approach reassure parents and encourage
life-long healthy choices
8Focus Groups Public Health Nurses Comments
- Clinic visit integrates assessment with advice
and counselling - Experienced Nurses give messages in natural
conversational language. E.g. - Growth pattern is changing and we need to take a
closer look. - There has been a change in how baby is growing.
9Growth Assessment Counselling Guide Premises
- Addresses appropriate messages, actions and
referrals for Alberta public health professionals
- Based on
- 2000 CDC growth charts
- Use of Growth Charts for Assessing and Monitoring
Growth in Canadian Infants and Children (Public
Policy Statement by Dietitians of Canada,
Canadian Paediatric Society, The College of
Family Physicians of Canada and Community Health
Nurses Association of Canada) - Recommendations from focus groups with Alberta
parents and public health nurses - Best practices
10Growth Assessment Counselling Guide
- Includes
- Growth Chart Percentile Criteria
- Messages to Parent(s)/Caregiver(s)
- Guiding Points for Discussion
- Suggested Handouts
- Suggested Actions and Referrals
11Teaching Parents About Growth Charts
- Health care providers are encouraged to take the
time to teach parents/caregivers - how to interpret the growth chart
- about target growth patterns
12Growth Core Messages SHIFT
- Core messages to discuss with all growth
measurements - Weight and length (or height) measurements are
health screening tools - Growth is one sign of general health
- Growth patterns are assessed for the individual
- Growth reflects family growth patterns
- Growth pattern over time is important than one
single measurement - Acronym SHIFT Screen, Health, Individual,
Family, Time
13Guiding Points for Discussion
- Babys overall health
- Parent/caregiver concerns or questions on growth
- Drinking and eating age appropriate milk,
beverages and foods -amounts types - Meal routine or family meal time
- Feeding relationship
- Tummy time or physical activity
- Amount of TV or screen time
- Food and activities in child care
14Assessing Food Intake
- Quick Criteria are points to help remember
significant food criteria that deserve further
exploration - The Quick Criteria must be used in conjunction
with other health and nutrition assessments.
They do not stand by themselves. - For amounts of food or juices, criteria are
primarily from Alberta Health Wellness
pamphlets
15Breastfed Infants
- During the first weeks, breasts feel full before
feeding and soften after nursing. - After a few weeks, full feeling may not be
noticeable. - Baby is feeding 8-12 times in 24 hours.
- Baby gains 5-7 ounces (140-200 g) per week until
3 months of age. - After 3 to 4 months, breastfed infants tend to
become leaner than formula fed infants. These
differences should be considered when assessing
the growth of exclusively breastfed infants.
16Formula Fed Infant Quick Criteria
- For at-risk underweight infant
- Significant formula intolerance for at-risk for
underweight infant - Poor bottling skills more than 60 minutes for a
3 ounce (90 mL) bottle
17Infant Solids JuiceQuick Criteria
- Introduction of solids before 6 months
- Delayed texture progression
- by 9 months, not eating mashed, minced, grated or
finely chopped foods - by 12 months, not eating diced, cubed, mashed
foods - By 12 months, not eating a variety of foods from
the four food groups - More than 4 ounces (125 mL) fruit juice, fruit
beverages or other sweet drinks
18Infant Physical Activity
- Reinforce and encourage tummy time
- Infant is on the floor reaching for toys, waving
arms and legs, and show age appropriate motor
skills - Time in car seats and bouncy chairs should be
limited
19Toddler Physical Activity
- At least 30 minutes of structured activities
- Parent led games and activities
- 60 minutes to several hours of unstructured
activity - Supervised free time for child to play alone or
with other children - Sedentary activities
- No more than 60 minutes at a time except while
sleeping (NASPE) - Screen time
- Limit TV to one hour or less for preschoolers
(CPS)
20Suggested Handouts for Parents
- Parent Factsheets in Toolkit
- Infants under 1 years
- Playing with Your Baby
- Is My Child Growing Well?
- Toddlers over 1 year
- Toddler and Preschool Fun and Activity
- Healthy Snack Facts for Kids
- Motivating Kids with Compliments and Time
- Body Mass Index and BMI-for-Age
- When Your Child Needs More Calories (as
appropriate) - When Your Childs Weight is Ahead of Height (as
appropriate)
- Alberta Health and Wellness Resources
- Infants under 1 year
- First Food Breastfeeding
- Infant Formula (as appropriate)
- Feeding Baby Solid Foods
- Toddlers over 1 year
- Healthy Eating Active Living for Your 1 to 5
year old - Portion Size Charts (1 to 3 Years Old, 4 to 5
Years Old)