Healthy Growth Toolkit for Infants and Preschoolers - PowerPoint PPT Presentation

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Healthy Growth Toolkit for Infants and Preschoolers

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Parents want simple and clear messages 'Don't beat around the bush' Statements better received ' ... Baby is feeding 8-12 times in 24 hours. ... – PowerPoint PPT presentation

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Title: Healthy Growth Toolkit for Infants and Preschoolers


1
Healthy 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

2
Toolkit 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

3
Healthy 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

4
Focus 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)

5
Focus 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.

6
Focus 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. . . . .

7
Focus 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

8
Focus 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.

9
Growth 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

10
Growth Assessment Counselling Guide
  • Includes
  • Growth Chart Percentile Criteria
  • Messages to Parent(s)/Caregiver(s)
  • Guiding Points for Discussion
  • Suggested Handouts
  • Suggested Actions and Referrals

11
Teaching 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

12
Growth 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

13
Guiding 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

14
Assessing 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

15
Breastfed 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.

16
Formula 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

17
Infant 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

18
Infant 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

19
Toddler 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)

20
Suggested 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)
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