Infants and Toddlers

Infants and toddlers have distinctive nutritional requirements. An infant’s weight triples by his/her first birthday, but with intestinal absorption commonly inefficient and renal function immature, digestion may be challenged. Breast milk or formula should be feed exclusively for infants 4 to 6 months of age. Research shows infants breastfeed for 6 months or more have a lower incident of tooth decay.¹¹ A gradual introduction, one at a time, of solid foods generally occurs around 6 months of age, about the same time the primary dentition begins to erupt into the oral cavity. Parents should be counseled on cleaning newly erupted teeth with a soft toothbrush or wipes. Self-feeding should be encouraged around age 1 to promote self-sufficiency, motor control, and a more varied diet. Offering healthy snack options and limiting fast foods is important modeling during this impressionable time.

Worldwide, Early Childhood Caries (ECC) is the most chronic infectious disease in childhood. It is defined as the presences of one or more missing, decayed or filled primary tooth within the first 3 years of life.¹⁸ The etiology of ECC is a combination of oral bacteria, consumption of carbohydrate rich beverages and food, and poor oral hygiene. Candida albicans and S. mutans, and the two bacteria together that make for a virulent form of ECC.¹¹ As oral health educators, knowledge of cultural practices, feeding habits and emphasis on patient education are important considerations when communicating with our patients. Recent research concludes there is a lower incidence of ECC with breastfed verses bottle fed children younger than 12 months. The World Health Organization encourages breast-feeding for infants and children up to 2 years of age or beyond in combination with food introduction.³⁰

School-age children need frequent meals to maintain healthy blood glucose levels necessary for optimal academic performance. This is also a time when eating takes on social, psychological, and emotional implications and children develop a lifelong relationship with food. The practice of “mindful eating” as a family, away from the television and electronic devices are good habits to instill at this age. A study by AC Nielsen, Co. found that 66% of American families watch television as they eat dinner.¹¹ While target advertising and a sedentary lifestyle contributes to the incidence of childhood obesity, encouraging healthy eating habits are important considerations during this rapid growth phase. The appetite at this age is usually very good and healthy snacks are an excellent way to incorporate nutrient dense foods into the diet. Involving children in meal preparation and never using food as a reward or a punishment can teach children healthy eating strategies.