POCKET GUIDE - Bright Futures - American Academy of Pediatrics

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Middle Childhood 38 Bright FUTURES oral health ■ Children begin to lose primary teeth, and permanent teeth begin to erupt. ■ Children may have difficulty chewing certain foods, such as raw vegetables or meat, if they are missing teeth or undergoing orthodontic treatment, and they may require foods that are easier to eat. physical Activity ■ Children’s muscle strength, motor skills, and stamina increase. ■ Children acquire the motor skills required for complex movements, allowing them to engage in a variety of physical activities. ■ Children are motivated to be physically active by having fun, feeling competent, and engaging in a variety of activities. ■ Parents influence a child’s level of physical activity when they participate with their child and show that physical activity is fun. ■ Parents’ encouragement to be physically active significantly increases their child’s activity level. ■ teachers and children’s friends influence a child’s physical activity level. ■ Participating in physical activity programs helps children learn to cooperate with others. Common nuTriTion ConCerns ■ Decrease in consumption of milk and other milk products. ■ increase in consumption of sweetened beverages, especially soft drinks. ■ Limited intake of fruits and vegetables. ■ higher consumption than recommended of foods high in fat, especially saturated and trans fats. ■ rise in overweight and obesity. ■ increase in body image concerns. (see Key indicators of Nutrition risk for Children and Adolescents.) nuTriTion suPerVision A child’s nutrition status should be evaluated during nutrition supervision visits or as part of health supervision visits. health professionals can do the following: ■ Begin nutrition supervision by selectively asking interview questions or by reviewing a questionnaire filled out by parents before the visit. Continue by conducting screening and assessment and providing anticipatory guidance.
■ recognize that interview questions, screening and assessment, and anticipatory guidance will vary from visit to visit and from child to child. ■ see strategies for health Professionals to Promote healthy eating Behaviors. Interview Questions eating Behaviors and Food Choices for the Child ■ Which meals do you usually eat each day? how many snacks? ■ how often does your family eat meals together? ■ Where did you eat yesterday? At school? At home? At a friend’s house? ■ What do you usually eat and drink in the morning? Around noon? in the afternoon? in the evening? Between meals? ■ What snacks do you usually eat? ■ What is your favorite food? ■ Are there any foods you won’t eat? if so, which ones? ■ What do you usually drink with your meals? With snacks? ■ What fruits and vegetables, including juices, did you eat or drink yesterday? for the Parent ■ how often does your family eat meals together? ■ Do you have any concerns about your child’s eating habits or behaviors (getting him to drink enough milk)? ■ Do you think your child eats healthy foods? Why or why not? ■ how often does your child eat breakfast? ■ What does he usually eat for snacks? ■ Where does your child eat snacks? At home? At school? At after-school care? At a friend’s house? ■ What does he usually drink (milk, water, fruit juice, fruit drinks, soft drinks)? Food resources for the Child or Parent ■ Who usually buys the food for your family? Who prepares it? ■ Are there times when there is not enough food to eat or not enough money to buy food? Weight and Body image for the younger Child ■ how do you feel about your weight? 39 Bright FUTURES Middle Childhood
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POCKET GUIDE - Bright Futures - American Academy of Pediatrics

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