Growth and Nutrition in Early Childhood

Growth in early childhood

Children between the ages of 2 and 6 years tend to grow about 3 inches in height each year and gain about 4 to 5 pounds each year. The average 6-year-old weighs about 46 pounds and is about 46 inches in height. The 3-year-old is very similar to a toddler with a large head, large stomach, short arms, and short legs. During early childhood, children start to lose some of their baby fat, making them less like a baby, and more like a child as they progress through this stage. By the time the child reaches age 6, their torso has lengthened and body proportions have become more like those of adults. Their head no longer looks like “an orange on a toothpick” (Schlamme, 1993).

It should be noted that these growth patterns are seen where children receive adequate nutrition. Studies from many countries support the assertion that children tend to grow more slowly in low SES areas or those experiencing famine, and thus they are smaller.

By around age 3, children will have all 20 of their primary teeth, and by around age 4, may have 20/20 vision. Many children take a daytime nap until around age 4 or 5, then sleep between 11 and 13 hours at night.

This growth rate in early childhood is not as fast as in infancy, and we see a reduced appetite between the ages of 2 and 6. This change can sometimes be surprising to parents and lead to the development of poor eating habits.

Nutritional concerns

According to the Centers for Disease Control and Prevention, 13% of children between 2 and 5 were obese, and obesity increased with age in middle childhood and adolescence (Stierman et al., 2021). The American Academy of Pediatrics (AAP) recommends a number of steps to take to help reduce the chances of obesity in young children. Removing high-calorie low-nutrition foods from the diet, offering whole fruits and vegetables instead of just juices, and getting kids active are just some of the recommendations that they make. Muckelbauer and colleagues (2009) found that increasing water consumption in school-aged children by just 220ml (just under 8 oz) per day decreased the risk of obesity by 31%. Finally, the AAP suggests that parents can begin offering milk with a lower fat percentage (2%, 1%, or skim milk) to 2-year-olds. The switch to lower fat milk may help avoid some of the obesity issues discussed above. Parents should avoid giving the child too much milk as calcium interferes with the absorption of iron in the diet as well.

Caregivers (whether parents or non-parents) need to keep in mind that they are setting up taste preferences at this age. Young children who grow accustomed to high-fat, very sweet, and salty flavors may have trouble eating foods that have more subtle flavors such as fruits and vegetables. Lack of a healthy diet may lead to obesity during this and future stages. Offering a diet of diverse food options, limiting foods with high calories but low nutritional value, and limiting high-calorie drink options can all contribute greatly to a child’s health during this stage of life.

Caregivers who have established a feeding routine with their child can find the normal reduction in appetite a bit frustrating and become concerned that the child is going to starve. However, by providing adequate, sound nutrition, and limiting sugary snacks and drinks, the caregiver can be assured that 1) the child will not starve, and 2) the child will receive adequate nutrition. Preschoolers can experience iron deficiencies if not given well-balanced nutrition.

Physical Development in Early Childhood

Brain Maturation

If you recall, the brain is about 75 percent of its adult weight by two years of age. By age 6, it is at 95 percent of its adult weight. The development of myelin (myelination) and new synapses continues to occur in the cortex. The development of new synapses levels off in childhood and we see elimination of unused synapses, called synaptic pruning (Webb et al., 2001). As used connections become more efficient, we see a corresponding change in what the child is capable of doing. A lot of this brain efficiency is due to myelin; remember that myelin is the coating around the axon that facilitates neural transmission. As myelination and pruning increase during this stage of development, neural processes become quicker and more complex.

Greater development in the prefrontal cortex, the area of the brain behind the forehead that helps us to think, strategize, and control emotions, makes it increasingly possible to control emotional outbursts and to understand how to play games. Consider 4- or 5-year-old children and how they might approach a game of soccer. Chances are every move would be a response to the commands of a coach standing nearby calling out, “Run this way! Now, stop. Look at the ball. Kick the ball!” And when the child is not being told what to do, he or she is likely to be looking at the clover on the ground or a dog on the other side of the fence! Understanding the game, thinking ahead, and coordinating movement improves with practice and myelination. Demonstrating resilience and recovering from a loss, hopefully, does as well.

Growth in the hemispheres and corpus callosum

Between ages 3 and 6, the left hemisphere of the brain, which tends to lag behind in terms of activity during the first 3 years of life, increases in activity, which correlates with the burst in language skills during this time period. Activity in the right hemisphere grows steadily throughout early childhood and is especially involved in tasks that require spatial skills such as recognizing shapes and patterns. Both sides of the brain work together, however, and there is no such thing as a person being either left-brained or right-brained. The corpus callosum, which connects the two hemispheres of the brain, undergoes a growth spurt of myelination between ages 3 and 6 as well resulting in improved coordination between right and left hemisphere tasks.

I once saw a 5-year-old hopping on one foot, rubbing his stomach, and patting his head all at the same time. I asked him what he was doing and he replied, “My teacher said this would help my corpus callosum!” Apparently, his kindergarten teacher had explained the process!

Visual Pathways

Have you ever examined the drawings of young children? If you look closely, you can almost see the development of visual pathways reflected in the way these images change as pathways become more mature. Early scribbles and dots illustrate the use of simple motor skills. No real connection is made between an image being visualized and what is created on paper.

At age 3, the child begins to draw wispy creatures with heads and not much other detail. Gradually pictures begin to have more detail and incorporate more parts of the body. Arm buds become arms and faces take on noses, lips, and eventually eyelashes. Look for drawings that you or your child has created to see this fascinating trend. Here are some examples of pictures drawn by girls from ages 2 to 7 years.

Motor Skill Development

Remember that gross motor skills are voluntary movements involving the use of large muscle groups while fine motor skills are more exact movements of the hands and fingers and include the ability to reach and grasp an object. Early childhood is a time of development of both gross and fine motor skills, although fine motor skills take longer to develop.

Early childhood is a time when children are especially attracted to motion and song. Days are filled with moving, jumping, running, swinging, and clapping, and every place becomes a playground. Even the booth at a restaurant affords the opportunity to slide around in the seat or disappear underneath and imagine being a sea creature in a cave! Of course, this can be frustrating to a caregiver, but it’s the business of early childhood. Children may frequently ask their caregivers to “look at me” while they hop or roll down a hill. Children’s songs are often accompanied by arm and leg movements or cues to turn around or move from left to right. Running, jumping, dancing movements, etc. all afford children the ability to improve their gross motor skills.

As their body proportions change, young kids’ center of gravity shifts from their upper chest to the center of their body. As a result, kids can do cartwheels and other gymnastic maneuvers: evidence of growth motor skill improvement. Young children who engage in more physical activity show better gross motor skills (Dapp et al., 2021), and improved motor competence is associated with better cognitive and academic skills, like executive functioning (Willoughby et al., 2021).

Fine motor skills are also being refined in activities such as pouring water into a container, drawing, coloring, and using scissors. Some children’s songs promote fine motor skills as well. (Have you ever heard of the song “itsy, bitsy, spider”?) Mastering the fine art of cutting one’s own fingernails or tying their shoes will take a lot of practice and maturation. Fine motor skills continue to develop in middle childhood, but for preschoolers, the type of play that deliberately involves these skills is emphasized.

Sexual Development in Early Childhood

Historically, children have been thought of as innocent or incapable of sexual arousal (Aries, 1962). A more modern approach to sexuality suggests that the physical dimension of sexual arousal is present from birth. That said, it seems to be the case that the elements of seduction, power, love, or lust that are part of the adult meanings of sexuality are not present in sexual arousal at this stage. In contrast, sexuality begins in childhood as a response to physical states and sensations and cannot be interpreted as similar to that of adults in any way (Carroll, 2007).

Infancy

Boys and girls are capable of erections and vaginal lubrication even before birth (Martinson, 1981). Arousal can signal overall physical contentment and stimulation that accompanies feeding or warmth. Infants begin to explore their bodies and touch their genitals as soon as they have sufficient motor skills. This stimulation is for comfort or to relieve tension rather than to reach orgasm (Carroll, 2007).

Early Childhood

Self-stimulation is common in early childhood for both boys and girls. Curiosity about the body and about others’ bodies is a natural part of early childhood as well. Consider this example. A mother is asked by her young daughter: “So it’s okay to see a boy’s privates as long as it’s the boy’s mother or a doctor?” The mother hesitates a bit and then responds, “Yes. I think that’s alright.” “Hmmm,” the girl begins, “When I grow up, I want to be a doctor!” Hopefully, this subject is approached in a way that teaches children to be safe and know what is appropriate without frightening them or causing shame.

As children grow, they are more likely to show their genitals to siblings or peers, and to take off their clothes and touch each other (Okami et al., 1997). Masturbation is common for both boys and girls. Boys are often shown by other boys how to masturbate, but girls tend to find out accidentally. Boys masturbate more often and touch themselves more openly than do girls (Schwartz, 1999).

Hopefully, parents respond to this without an undue alarm and without making the children feel guilty about their bodies. Instead, messages about what is going on and the appropriate time and place for such activities help the child learn what is appropriate.

Parents should take the time to speak with their children about when it is appropriate for other people to see or touch them. Many experts suggest that this should occur as early as age 3, and of course the discussion should be appropriate for the child’s age.  One way to help a young child understand inappropriate touching is to discuss “bathing suit areas.” Kids First, Inc. suggests discussing the following: “No one should touch you anywhere your bathing suit covers. No one should ask you to touch them somewhere that their bathing suit covers. No one should show you a part of their or someone else’s bodies that their bathing suit covers.” Further, instead of talking about good or bad touching, talk about safe and unsafe touching. This way children will not feel guilty later on when that sort of touching is appropriate in a relationship.

Levels of Prevention

Between two to six-years-old, children are at increased risk for injuries and accidents. Unintentional injuries, like drowning, is the leading cause of death at this age (West et al., 2021). This is a fitting example of interacting domains: young kids are learning to master gross and fine motor skills, their corpus callosum is being myelinated aiding in coordination, their preoperational thinking drives them to actively explore their surroundings but they don’t think logically yet, and they’re learning about the consequences of their actions by what they do and through their friends and families.

The levels of prevention is a helpful public health framework to mitigate harm (Walker & Shinn, 2002). Primary prevention is designed to keep problems from happening for everyone at the population level . It can be thought of at the macrosystem system; laws, regulations, national public safety announcements that increase safety for everyone. For example, poisoning used to be more common in early childhood, but primary prevention laws around child safety caps have decreased child poisoning.

Secondary prevention targets a smaller group who at the most risk of injury. For example, parental monitoring of their young children and placing medicines in a higher, locked cabinet are both secondary prevention strategies. They recognize that young kids in a family are at increased risk of poising and take specific actions to reduce those risks. Lastly, tertiary prevention reduces harm after the fact. For example, calling poison control after a child ingested poison to reduce any further harm is an example of tertiary prevention.Think About It.