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UNITED STATES DEPARTMENT OF LABOR
Frances Perkins, Secretary
CHILDREN’S BUREAU

Katharine F. Lenroot, Chief

The Road to Good Nutrition
By

LYDIA J. ROBERTS
In collaboration with
members of the Children’s Bureau staff

Bureau Publication No. 270

UN ITED STATES
GOVERNM ENT PRINTIN G OFFICE
WASHINGTON : 1942

For sale by the Superintendent of Documents, Washington, D. C.

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Price 15 cents

Much of the material in this bull
etin was based by Dr. Roberts on
her textbook, Nutrition Work With
Children, by permission of the pub
lisher, the University of Chicago
Press.

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Contents
Letter of transmittal____________________________________________________
The healthy, well-nourished child_______________________________________
The malnourished child-----------Specific types of malnutrition-----------------General malnutrition-----------------------Description of a malnourished child____________________________
Degrees of malnutrition________________________________________
Extent of malnutrition_________________________________________
Good nutrition throughout the child’s life----------------------------------------------Needs that continue throughout the child’s life--------------------------------Food----------------------------------------------------------------------------------—
What the day’s food should provide and why______________
Some common foods and their most important contributions
to body’s needs_________________________________________
A daily food plan for children past infancy_________________
Eating habits-----------Sleep and rest_________________________________________________
Sunshine, outdoor play, and exercise____________________________
Daily programs________________________________________________
Supervision by doctor and dentist______________________________
Some continuing hazards to good nutrition__________________________
Neglected teeth___________________________________
Enlarged or diseased tonsils and adenoids______________________
Colds and other communicable diseases__________— ____________
Needs at various periods of the child’s life__________________________
Before birth_____________________________________
Infancy_______________________________________________________
Food and eating habits__ - -----------------------Sleep and rest_____________________________________________
Sunshine________________________________
Exercise______________
Daily programs__________________
Some hazards to nutrition in infancy_____________ ________
Early childhood__________________ ;____________________________
Food and eating habits__________________________________
Sleep and rest________________________________
Sunshine, outdoor play, and exercise. ______________________
Daily programs___________________________________________
Some hazards to nutrition in early childhood________ ______
The school age___________________ . . . ____ _____________________
Food and eating habits________________
Daily programs___________________________________________
Some hazards to nutrition that exist throughout the school
age______________________________________________ W---------Special hazards to nutrition in the teen ages_______________
Readjustments in school life that may be needed__________
Salvaging the child who has had a bad nutritional start. __ ___________
Good nutrition a continuous process____________________________________
Signposts on the road to good nutrition— a check list____________________
Selected publications of the Federal Government with regard to nutrition
in children____________________________________ _______________________

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Letter o f Transm ittal
U nited States D epartment of L abor,
C hildren’ s B ureau ,

Washington, March 23, 1942.
M adam : Herewith is transmitted a bulletin, The Road to Good

Nutrition, written by Lydia J. Roberts in collaboration with members
of the Children’s Bureau staff.
The present war emergency makes it necessary that persons respon
sible for the health of children at various stages of life be better
acquainted with their nutritional needs and with methods of dealing
with such needs. It is hoped that this bulletin will help parents,
teachers, and others in the important task of keeping children on the
road to good nutrition.
Respectfully submitted.
K atharine F. L enroot, Chiej.
H on. F rances P erkins,

Secretary of Labor.
v

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The Road to Good Nutrition
All parents want their children to be well nourished. If this de
sire is to be realized, the parents should have in mind a picture of
what a well-nourished child is like and what their own child, with
his particular heredity, is capable of attaining. If they will learn to
recognize the characteristics of a well-nourished child, as a farmer or
a housewife recognizes the characteristics of an excellent ear of corn
or loaf of bread, they will be better able to direct their children along
the road to good nutrition. If they have no standard by which to
judge the child’s nutrition they may think that it is good when in
reality it is poor.
A description of the well-nourished child is given in this bulletin,
with a general outline of the care that should bring about this desirable
condition. Some of the signs that indicate nutritional failure in a
child are described, and the chief hazards to nutrition at various
periods of a child’s life are pointed out, so that parents, with the
advice of their physician, may recognize and deal with these hazards.
An effort has been made to give a general view of the problem of
nutritional guidance throughout the period of growth, with special at
tention to the continuity of the child’s life. Throughout the bulletin
emphasis has been put on the positive side of good nutrition and the
methods of attaining it.
1

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The H ealthy, W ell-N ou rished Child
When a child is well nourished every part of his body is receiving
all the food materials that it needs in order to grow and function as
it should. Each part of such a child’s body, such as the bones, the
teeth, and the blood, is constantly supplied with all that it needs of
each of the dietary essentials. These essentials include, in addition
to water: (1) Protein for the building and repair of all body tissues;
(2) fat and carbohydrate to furnish fuel for bodily activities and to
supply some surplus to store as body fat; (3) all the minerals and
vitamins that are essential to life, growth, and well-being.
Though all parts of the body need some of each of these dietary
essentials, certain parts need especially large amounts of them.
For example, the bones and teeth need relatively large amounts of
calcium, phosphorus, and vitamin D ; the blood, of iron; the thyroid
gland, of iodine.
If the child is to be well nourished, it is necessary that the food
that he eats every day, year in and year out, shall contain all the
essential food factors in abundance and also that this food shall be
well digested and absorbed and shall be carried to the tissues in all
parts of the body.
One cannot look into a child’s body and examine the individual
cells and organs to see whether they are receiving everything they
need. By examining the child, however, one can judge to some
extent whether his nutrition is adequate. When a physician exam
ines a child and says that he is well nourished, he means that in his
judgment the needs of the child’s tissues are being met.
What are the “ outward and visible signs” of good nutrition? Be
fore these are named it should be stated that even healthy, wellnourished children differ in many respects, according to age, sex, and
the race and family from which they come. They vary in body
shape and size, even at the same age; some will be tall and slender,
others short and stocky. They differ also in color of hair, eyes, and
skin and in other characteristics. But with all these differences
children who are well nourished have certain characteristics in com
mon, as follows:
G eneral characteristics.—The healthy, well-nourished child has a
general appearance of well-being and fullness of life that is character
istic of all healthy young animals.

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Photograph by National Youth A dm inistration Federal Security Agency.

An alert, happy expression is one of the signs of good nutrition.

When lunch is served at school, the children’s selection of foods
should be supervised.

—

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Photograph by Extension Service , United States Department o f Agriculture.

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In the infant this is manifested by an air of contentment and
peace with the world. He sleeps long and soundly. When awake
he lies cooing, gurgling, waving his arms, and kicking happily, or he
plays contentedly. If his general care and training have been good
he cries seldom, and then usually because he is hungry, wet, or other
wise uncomfortable.
The older child who is healthy and well nourished likewise has an
air of contentment, vigor, and interest in life. His body is upstand
ing; his eyes are clear and bright; his facial expression is alert and
happy. His general appearance is one of physical fitness, ability
to do, and enjoyment of life.
In the healthy, well-nourished child of any age appetite and diges
tion are good, elimination is regular, and sleep is sound, wholesome,
and refreshing.
Bones.—The bony framework of the well-nourished child is strong
and well-built. His head and chest are well shaped, and his arms
and legs are straight.
Teeth.—The teeth of the well-nourished child— “ baby teeth” as
well as permanent ones— are likely to be well formed and sound.
The gums are firm and light pink and hug the teeth closely; there is
no tendency to bleeding.
Muscles.—If the child is well nourished and has had plenty of the
right kind of exercise, his muscles are well developed and strong.
This is shown by their size and firmness and symmetry and by the
child’s, ability to use them in activities appropriate to his age.
Posture.—The posture of the well-nourished child tends to be erect,
showing adequate development and proper balance of the various
muscles. The head is erect and well balanced. The chest is sym
metrical, and the shoulder blades are flat. In early childhood the
abdomen is usually somewhat prominent, but after the age of 3 or
4 years it should not extend beyond the chest; after this age the chest
leads.
Fat padding.—In a well-nourished child the bones and muscles
of the arms, legs, and entire body are covered with a moderate pad
ding of fat. This gives the body a well-rounded appearance, with
curves rather than sharp angles. The tissues beneath the skin are
firm. A physician would say that there is good “ tissue turgor.”
Blood and skin.—The body of the well-nourished child has a good
supply of red blood, containing the normal amount of hemoglobin
and the normal number of red blood cells, as determined by a doctor's
tests. One outward sign of a good blood supply is the pinkish color
of the mucous membranes inside the mouth and eyelids, the ears as
seen against light, and the fingernails. The natural skin pigment
varies in persons of different races and in blonds and brunets and is
4 0 6 4 6 7 °— 42------- 2

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affected by tanning. Whatever the color, however, if the child is
well nourished his skin will have a healthy appearance that comes
from a good blood supply. The cheeks may or may not be red, for
red cheeks are a family characteristic, but the skin will have a ruddy
tinge after exercise or play outdoors.
Such in the main are the characteristics of the healthy well-nourished
child. The picture facing page 47, shows such a child at three ages.
It will be seen that the child’s body proportions changed as he grew
older. The short legs and chubby body that he had as a little child
changed into the relatively longer legs and slender body characteristic
of older children. Well-nourished children of the same age also vary
in body build; some are slender and some are stocky.

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The M alnourished C hild
Malnutrition is faulty or poor nutrition. It means that some or all
the parts of the body are not getting all they need of the necessary
food materials. This may be either because the food the child eats
does not supply these materials in sufficient amounts or because the
body is unable to digest and absorb them. In either case the needed
materials are not supplied to the cells, and they become malnourished.
No one description will fit every malnourished child. There are
many kinds and degrees of malnutrition, depending upon which of the
dietary essentials are lacking and the degree of shortage of each; and
the signs of malnutrition vary with the kind and degree of the defi
ciency. With every such deficiency, however, there is failure to
measure up in some respect to the standards of good nutrition.

SPECIFIC TYPES OF MALNUTRITION
If there is a lack of any one of the dietary essentials the organs or
tissues needing the largest amounts of that material will suffer most,
and if there is a great lack of any one of the dietary essentials a specific
deficiency disease will result. (These deficiency diseases are some
times considered specific types of malnutrition, as distinguished from
general malnutrition.)
For example, if too little of the iron or copper or other materials
needed for building enough normal red blood cells is supplied in the
diet, the blood becomes pale, and the child is said to be anemic (or to
have nutritional anemia).
If calcium and phosphorus and vitamin D are not supplied in suffi
cient amounts the bones become malnourished. If this happens to
babies or young children, the bones tend to become soft and bend
easily, the disease called rickets may occur, and lasting deformities
may result. Rickets does not occur in older children, but a deficiency
in calcium, phosphorus, and vitamin D prevents these children’s
bones from growing as they should and from being firm and strong.
A shortage of iodine in the diet causes an enlargement of the thyroid
gland, and the resulting condition is known as goiter.
Long-continued shortage of vitamin A results in night blindness,
or inability to see in a dim light. An extreme lack of vitamin A may
eventually cause a serious eye disease called xerophthalmia.
5

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Inadequacy in the supply of thiamine (vitamin B x), is shown by
lack of appetite, by impaired functioning of the digestive and nervous
systems, and eventually by all the symptoms of a disease of the nervous
system called beriberi.
Deficiency in ascorbic acid (vitamin C) causes a disease known as
scurvy. This disease is manifested chiefly by tenderness and easy
bleeding of the gums; loosening of the tissues around the teeth; and
pain or soreness in the muscles or joints— a condition that may be
mistaken for rheumatism.
Deficiency in nicotinic acid is responsible for the most character
istic symptoms of the disease called pellagra. This disease is marked
by digestive and nervous symptoms and also by a skin condition in
which dark patches appear on the face, the hands, the arms, or other
exposed parts. These patches usually appear as matched spots, as on
both hands, both feet, or both cheeks.
A lack of riboflavin (vitamin G) results in a condition known as
cheilosis, or “ poor man’s mouth.” This is characterized by inflamma
tion and scaling at the corners of the mouth. It may also cause lesions
around the nose and eye and functional disturbances in the eye.
These conditions are commonly found associated with pellagra.
Other vitamins are known to be essential in nutrition— pyridoxin
(B6), choline, and pantothenic acid, but no specific disease in man has
yet been shown to result from deficiencies in them.
The deficiency diseases in this country are much less common in
severe form than they once were. But in mild form they are not
infrequent, and some severe cases still occur. Pellagra is still found
to a considerable extent, especially in the South. Severe rickets,
once very prevalent among infants, is fast decreasing as babies are
given vitamin-D preparations and sun baths, but it is still found,
especially in the poorer sections of large Northern cities. Advanced
cases of scurvy in babies are no longer common, now that orange juice
and tomato juice are fed to babies in the earliest months of life.
Nevertheless, scurvy in a mild form still occurs extensively in all
economic groups.

GENERAL MALNUTRITION
The specific deficiency diseases that have been described appear in
clear-cut form only when the food factor concerned is completely
lacking over a short period of time or is supplied inadequately for a
long time.
A more usual type of malnutrition, which is not so commonly
recognized as such, is general malnutrition resulting from a diet low
in a number of the dietary essentials. Iron, calcium, and other
minerals may all be insufficient in amount. One or more of the

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vitamins may be supplied too meagerly. The protein may be inade
quate in quality or quantity, or both, for the best growth of muscles
and other tissues. The total quantity of food eaten by the child may
not be great enough to supply energy for his bodily activities. In
this case his own body fat, and in time even his muscle tissue, will
be used up to furnish the necessary energy, and his body will become
thin and undernourished. The result of these inadequacies is a com
bination of mild symptoms of the various diseases mentioned in the
preceding section and a general lack of well-being. A child who has
a chronic disease or a physical defect that interferes with nutrition is
likely to suffer from general malnutrition, even if his diet and habits
are good, for the food that such a child eats may not be properly
utilized by his body.

DESCRIPTION OF A MALNOURISHED CHILD
Even a casual look at a child who is very much malnourished tells
an experienced observer that something is wrong. He lacks, first of
all, the vigor and poise of a well-nourished child; his face has a strained,
worried, “ down and out” look; his general attitude is one of drooping
fatigue. He may appear fairly normal at play, or in animated con
versation, but when he is in repose an attitude of fatigue and ill-being
appears. A malnourished child as a rule is thin, his muscles are small
and flabby, his head sags forward, his abdomen protrudes, his chest is
flat, and his shoulder blades extend like wings. His teeth are likely
to be decayed, and even though cavities are filled the teeth soon decay
again. The gums may be tender and may bleed easily. The mucous
membranes inside the mouth and eyelids are pale.
In such a child the animal spirits natural to all healthy young are
likely to be lacking. He may be listless and inactive, and may there
fore be considered lazy, or he may be of the overactive, high-strung
type, constantly on the go. Such a child usually tires easily, lacks
endurance, and is irritable and difficult to manage.
The care of a malnourished child should be under the constant
direction of a physician, who, after investigating the causes of the
child’s malnutrition, will advise the parents about treatment and will
help them to work out the needed changes in his habits of living.

DEGREES OF M ALNUTRITION
Children cannot be separated definitely into two groups, the wellnourished and the malnourished, for there are many degrees between
these two extremes. It is customary, therefore, for physicians to rate
the nutritional condition of children in five classes, “ excellent,”
“ good,” “ fair,” “ poor,” and “ very poor” (or in some similar classes).
Physicians may vary somewhat in rating a child, but in any case

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children in the lowest groups (“ poor” and “ very poor” ) should be
considered as definitely undernourished.
It is a mistake for parents to be content if their child’s rating is only
“ fair,” for in most cases he could be brought up to a higher rating by
proper care. Moreover, every child who is not in the “ excellent”
group should be regarded as in some degree malnourished, and efforts
should be made to bring him into the ranks of the well-nourished.
Four definitely malnourished children are shown in the picture
facing page 46. The page following this picture shows four views of
a somewhat malnourished child. When this child is fully dressed
he might seem to be well nourished, but when wearing only running
pants he shows signs of malnutrition. These pictures indicate the
necessity for examining a child without clothes before judging his
nutritional condition.

EXTENT OF M ALNUTRITION
How do the children throughout the United States measure up to
these standards of good nutrition? This question cannot be answered
with any exactness, for no Nation-wide examination of children has
ever been made. In the few studies in which the number of wellnourished children has been reported, the proportion of such children
is found to be disappointingly small. The large majority of the
children examined are considered “ fair,” and many are definitely
“ poor.”
It must not be assumed that all children in families of low economic
status are malnourished or that all children of well-to-do families are
well nourished. It is true that children may be undernourished
because their parents do not have enough money to enable them to
have the proper foods and the other essentials for good nutrition.
Many families in modest circumstances, however, are able to keep
their children in good nutritional condition by making the best use of
the resources they have. In general, nutrition is better in children in
well-to-do families. These children are larger than children of the
same age and race in poor families, and their teeth are freer from decay.
Nevertheless, because of some children’s pampered appetites, their
overindulgence in sweets and other refined foods, and failure by their
parents to see that they follow an adequate diet and in other respects
live wholesomely, malnutrition is too commonly found among well-todo families. At all levels of income, then, parents need to know how
to safeguard their children’s nutrition through suitable foods and good
health habits.

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G ood N utrition Throughout the C hild9s L ife
With an ideal in mind of what constitutes a well-nourished child,
the question is, What can parents do to insure good nutrition in their
children at all ages?
The program of care should begin in the prenatal period. It should
aim to provide all the essentials of good nutrition continuously
throughout the growth period. This means that it is the parents’
duty, for a period of 18 to 20 years— a total of more than 6,000 days—
to provide their child with everything necessary to keep every cell in
his body well supplied with everything that it needs.
Prospective parents may well look upon the project as a journey
the child is to take from prenatal life to maturity. The parents’
effort should be to keep the child constantly on the road to good
nutrition and good health and to prevent him from wandering off into
dangerous byways. This may seem an almost impossible task, but
fortunately it is not so difficult as it appears. The journey is taken
only one step at a time; the road is easy and well charted; and the
danger spots have been well marked.
The task of keeping the child well nourished at every period of
childhood requires: (1) That the child should eat, digest, and absorb
the essential foods in the amount and form suited to his needs; (2)
that he should get sufficient outdoor play and exercise, with plenty of
direct sunlight; (3) that he should get enough rest and refreshing
sleep; (4) that his general health habits should be good; (5) that he
should be free from chronic infection or physical defect that would
interfere with nutrition; (6) that he should be protected against com
municable disease.
The general aspects of these requirements that continue throughout
the growing period will first be considered. Then the special require
ments as well as the special hazards for each age period will be
described.

NEEDS THAT CONTINUE THROUGHOUT THE
CHILD’S LIFE
FOOD
In order that a child may be healthy, well-nourished, and vigorous,
he must eat the foods that meet his needs. The food requirements of a
child are greater in proportion to his age than those of an adult. An
9

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adult’s food must supply him with energy (incidentally with heat),
maintain his body processes, and repair his worn-out tissues. A
child’s food must do all these things and must also build new tissues
constantly, as he grows taller and gains weight month by month. If
a child’s diet does not supply all these needs, he will suffer from mal
nutrition.
A mother who plans the day’s meals for her children should know
which foods fulfill the children’s needs with regard to the dietary
essentials, so that, whether she has a wide or a restricted choice, she
can select with good judgment from whatever foods are available and
get the best value for her food money. If she is to prepare the foods in
such a way that the children will get the greatest possible benefit,
she should know also how various cooking processes affect the nutri
tive value and digestibility of foods. The following section lists the
dietary essentials and describes what they do for the b od y; tells which
common foods are important sources of these essentials; and makes
some suggestions with regard to the preparation of various types of
food.
W H A T T H E D A Y ’S FO O D SH O U LD P R O V ID E A N D W H Y

Dietary essentials

What the dietary essentials do for the body

Calcium and phosphorus______
phosphorus
gq

H
I Iron
j

Iodine

►
3
<
«
»

Build and maintain teeth and bones.
Constitute part of muscle and nerve tissue
and of body fluids.
Constitutes part of red blood cells which
carry oxygen to all parts of body.
Constitutes part of thyroid gland, which
regulates rate at which energy is used by
body.
(Copper, magnesium, manganese, potassium, sodium
and other mineral elements are also essential; they
are probably present in adequate amounts in diets
that supply plenty of calcium, phosphorus, iron, and
iodine.)

Vitamin A
§
§S
<
<
ö

Thiamine (vitamin
Riboflavin (vitamin
Nicotinic acid_____
Ascorbic acid
C))------:id (vitamin C
Vitamin D

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Is essential to tissues that cover and line
body and help it to resist infection.
Takes part in adaptation of eye to dim light.

Is essential to health of teeth, bones, blood
vessels, and other tissues.
Helps body to use calcium and phosphorus
in food.

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W H A T T H E D A Y ’ S FO O D SH O U LD P R O V ID E A N D W H Y — C on tin u a d

Dietary essentials

)

•Furnish energy for work.

Furnish energy for work.
Give staying power to meals.
Provide fatty acids essential to health.

FATS

Starch
Sugar.

What the dietary essentials do for the body

OME COMM ON FOODS AND THEIR MOST IMPORTANT CONTRIBUTIONS TO BODY'S NEEDS

Most important contributions to body’s needs

Fresh whole milk (or its equiv
alent in unsweetened evapo
rated or dried whole milk).
Fresh skim milk and butter
milk (or equivalent in dried
skim milk or dried butter
milk).
Cream_______________________

Is main source of calcium and vitamin G.
Supplies also protein, phosphorus, vitamin
A, and vitamin Bi.
Makes same contributions as whole milk,
except vitamin A.

Fruits in general

All fruits help in meeting the body’s needs
for iron, vitamin B1( and vitamin G.
Some fruits make special contributions,
as is shown below.
These fruits are the best source of vitamin C.
One average serving will supply a day’s
need for vitamin C.
These fruits, eaten raw in generous quanti
ties, provide significant amounts of vitamin
C, although much less of it than the fruits
listed above.
Yellow-fleshed fruits supply important
amounts of vitamin A.

Contributes more vitamin A than whole
milk does and less of the other vitamins
and minerals.
Cheese made from whole m ilk. _ A generous serving supplies equivalent of 1
cup whole milk in protein, calcium, phos
phorus, and vitamin A.
Is good source of protein and phosphorus; is
Cottage cheese.
low in the other minerals and in vitamins.

M IL K

AND

C H E E S E ___________ |

Food

F R U IT S

Oranges, grapefruit, strawber
ries, cantaloupe.
Apples,
bananas,
peaches,
pears, and most of the com
mon fresh fruits, raw.
Peaches, apricots, and prunes,
and other yellow-fleshed
fruits.
Dried apricots, dates, figs,
prunes, and raisins.
4 0 6 4 6 7 °— 42

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These dried fruits are better than average
sources of iron.

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SOME COMM ON FOODS AND THEIR MOST IMPORTANT CONTRIBUTIONS TO BODY'S NEEDS—
Continued

Food
Vegetables in general
Chard, kale, spinach, turnip
greens, watercress, and other
thin, dark-green leaves.

Broccoli, peas, string beans,
sweetpotatoes, carrots, and
m other green or yellow vege<
E
h ’ tables.
W Cabbage_____________________
as
►4

O
«
> Tomatoes— raw,

cooked, or
commercially canned.
Potatoes, white (Irish)_______

Mature beans, peas, and other
legumes, such as peanuts and
lentils.

Most important contributions to body’ s needs
Are important sources of various minerals
and vitamins, some more than others, as
is shown below.
Thin, dark-green leaves, eaten raw or prop
erly cooked, are an important source of
iron, vitamin A, vitamin Bi, and vitamin
G. Generous servings of such greens,
raw, supply liberal amounts of vitamin C.
Many of these greens help to fulfill the
body’s needs for calcium.
Other green vegetables and yellow ones are
valuable chiefly for vitamin A. Sweetpotatoes are economical energy foods.
Is a good source of vitamin C when eaten
raw.
Are an excellent source of vitamin C and a
good source of vitamin A.
Baked or boiled in skins, potatoes, especially
new potatoes, are a good source of vitamin
C, and provide appreciable amounts of
iron and vitamin Bj. They are also
economical energy foods.
Are good sources of protein, iron, vitamin Bi,
and vitamin G. Help to meet the body’s
needs for calcium and phosphorus. Are
economical energy foods.

)E ggs----------------------------------- '

<<s Lean muscle meat, including

poultry.
»Liver, kidneys, and other
*2“ organs.
sa »S Fish________________________
) Shellfish, such as oysters____,

H fu

00^Grain products in general

E3
g Dark or whole-grain or en£ > riched bread, flour, and
z
breakfast cereals.
§ Macaroni, grits, white rice____
p

o3l Nuts in generai1

i l _____________
1 Refined sugar
® Corn sirup___
« g VHoney_______
o g I Molasses_____
g ) Sorghum sirup

Are most important for protein, iron, vitamin
Bi, vitamin G, and nicotinic acid. These
foods supply phosphorus also. Eggs and
liver supply vitamin A. Salt-water fish
and shellfish supply iodine.
Are economical energy foods that furnish
significant amounts of protein.
Are important sources of iron, vitamin Bi,
and vitamin G.
Are refined grain products; they cannot take
the place of potatoes or other vegetables.
Are concentrated sources of energy and pro
tein and fairly good sources of phosphorus
and vitamin Bj.

Are concentrated energy foods. Dark mo
lasses and sorghum sirup contribute also
calcium and iron.

Butter________________________*
Margarine. _____________ _____ Are concentrated energy foods. Butter, codLard and hardened vegetable
liver oil, and margarine to which vitamin
fats.
( A has been added are important sources
Olive oil and cottonseed oils__
of vitamin A. Cod-liver oil is also very
Bacon________________________
rich in vitamin D.
Salt pork___________________ _
Cod-liver oil_________ ________ ,
i This does not include the peanut, which is a legume, and is therefore listed with the vegetables.

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A daily food plan for children past infancy.
It is not necessary for the parents to count up daily the amount a
child gets of each of the food essentials named in the preceding sections.
Nutritionists have worked out daily food plans that show the quanti
ties of various types of food that will provide enough of each essential.
Following is one such plan, which may be used in selecting foods for
children of all ages after infancy.
M ilk.— One and one-half pints to one quart.
Fruit.— Two or more servings. One should be citrus fruit or
tomatoes or other good source of vitamin C.
Vegetables.— Potatoes and at least one or two other vegetables
(green or yellow vegetables often).
Eggs.— One egg.
Lean meat, fish, or meat substitute.— One or two servings.
Bread and butter.— At two or three meals (dark or enriched
bread often).
Cereal.— At one or two meals (dark or enriched cereals often).
Cod-liver oil.—About two teaspoonfuls a day during the child’s
second year. After that ask the doctor.
Additional foods, as needed, to satisfy the child’s appetite and to
provide energy. The amounts will vary with the age and size
of the child. These additional foods should not take the place
of the foods already listed in the plan.
If a child gets these foods every day in the amounts specified, the
parents can be reasonably sure that his needs are being met.

The amount of milk specified in the plan fulfills the child’s need for
calcium and also supplies protein, phosphorus, and vitamins A, B 1,
and G in generous amounts. The eggs supplement the milk for
protein, phosphorus, iron, and vitamins A, B x, and G. The fruits and
vegetables all provide some iron and some vitamins; the raw fruit and
vegetables fulfill the child’s need for vitamin C (most cooked fruits
and vegetables are not a dependable source of vitamin C, although
when properly cooked they retain part of the vitamin C that they
contained when raw). The meat supplies additional protein, vita
mins Bi and G, and iron. The dark or whole-grain or enriched cereal
and bread contribute some vitamin Bx and iron. The cod-liver oil is
given to provide vitamin D — daily all the year around to children less
than 2 years old, and to older children during cold or cloudy seasons
(cod-liver oil also supplies liberal amounts of vitamin A).
The basic foods listed in the preceding paragraph meet the child’s
need for protein and for most of the minerals and vitamins. They

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fall far short, however, of meeting his need for energy food; at least
half of this need is met by the additional foods that the child eats to
satisfy his appetite— cereals and bread, butter and other fats, and
sweets.
The chart on pages 18-19, entitled, “ How an adolescent boy’s daily
food needs are met,” illustrates how a sample day’s food meets a
child’s daily need for the dietary essentials. The chart has been
planned for an adolescent boy because his needs exemplify strikingly
the needs of children for food that provides both for their activity and
their growth.
Milk.—Whole milk is best for children, especially for young children,
but as page 11 shows, skim milk, although not so rich as whole rnilk in
some important respects, is equally rich in protein, calcium, phos
phorus, and vitamin G. When the water that was removed in the
manufacturing process has been restored, unsweetened evaporated
milk and dried milk have essentially the same nutritive value as the
fresh milk from which they were made. Evaporated and dried milk
are almost sure to be free from disease germs when they are purchased;
fresh whole milk can likewise be free from germs if it comes from a safe
supply. Proper pasteurization of milk or boiling of milk will make it
safe. This applies to milk from the family cow as well as to milk that
is bought. It is advisable to boil any milk that is given to children
under 2 (except evaporated milk, which has been heated and sterilized),
because it is so important to be sure that the milk they drink is safe.
Besides, boiled milk' is easier for many young children to digest. No
raw milk should be given to children.
Cheese can take the place of some milk in the day’s food for children
over 2. Cottage cheese, cream cheese, and mild American cheese
combined with other foods are suitable foods for children. Cheese
should be made from milk that is safe for drinking.
Vegetables andfruits.—Vegetables and fruits are valuable chiefly for
their minerals and vitamins (see pp. 11-12, for the mineral and vitamin
values of different types of fruits and vegetables). Raw fruits or
vegetables should be included in every child’s diet. Orange juice and
mashed ripe bananas are given even to babies. After infancy children
can eat an ever increasing variety of tender raw vegetables and ripe
fruits. Among those that can be given early are cabbage, carrots,
lettuce, tomatoes, and turnips or rutabagas, apples, apricots, and
peaches. These raw foods must, of course, be thoroughly washed.
Vegetables and fruits should be prepared so as to retain as much as
possible of their minerals and vitamins. Some of these minerals and
vitamins are dissolved in the cooking water and are lost if the water is
thrown away. There is also some destruction of vitamins when foods

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are heated, and the longer they are cooked the greater is the loss. The
best method of conserving these food values is steaming or baking or
cooking for a very short tune in a small amount of water. When
possible, the cooking water from vegetables should be used in making
soups and gravies. Baking soda should never be added to the cooking
water because it increases the destruction of some vitamins, especially
vitamin Bi and vitamin C. In cooking vegetables for young children
it is undesirable to use fat, either for frying or as fat meat boiled with
the vegetable.
Vegetables for children should be seasoned lightly with salt, and,
except for babies, may be served with a little butter, cream, or milk.
Fruit needs to be only lightly sweetened in cooking.
The texture of fruits and vegetables as served affects children’s
enjoyment of these foods. Babies become accustomed to the flavor of
fruits and vegetables through tasting the juices; before the end of the
first year they are given the pulp. During their second year children
can eat mashed or finely chopped fruits and vegetables. For a few
more years the pieces should be of a size that the child can handle
easily with a spoon, and the food should be free from coarse woody
fiber, such as the strings of the outer stalks of celery. In general,
children prefer vegetables that are crisp if they are also tender.
Eggs.—Eggs, especially the yolk, are rich in many dietary essentials
(see p. 12). Yolk of egg is given very early in infancy because it con
tains the iron that the baby needs especially at that time. As eggs
do not agree with all children, only a small amount should be offered
until the mother is sure that her baby does not react unfavorably.
After a child is a year old he can, as a rule, take a whole egg a day,
either served as a main dish or combined with milk in a simple dessert.
Eggs for children are best poached, or cooked in their shells; for young
children especially they should not be cooked in fat.
Lean meat andfish.—Tender lean meat, fish, or poultry is needed in
the diet, and small servings are usually given to children early in the
second year. At first the meat should be scraped free from fiber;
later it needs merely to be chopped or cut fine. As is shown on page
12, liver is a particularly valuable form of meat. Salt-water fish and
shellfish are rich in iodine. Meat and fish for children should be
cooked so as to be tender and moist, by broiling, roasting, or stewing
at a moderate temperature; for young children they should not be
fried. Highly seasoned meats, such as sausage, and smoked or pickled
fipb are unsuitable foods for young children.
Among the foods that may serve as substitutes for meat are eggs,
cheese, peanut butter, and dried beans. The suitability of these foods
varies with the age of the child. For example, dried beans, if given

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to children under 6, should be soaked, boiled, and mashed through a
strainer and served with milk.
Cereals and bread.—Starting with cereals that have been strained
to remove the fiber, babies gradually learn to eat cereals that are
thoroughly cooked but not strained. As soon as a baby has teeth he
should be given a crust of dry bread to bite.
Dark or whole-grain cereals and bread contain all the minerals and
vitamins in the grain; and they, as well as enriched cereals and breads,
should be emphasized in the diet of children (see p. 12). The term,
“ enriched, ” when applied to flour, cereal, or bread means that the
product contains more vitamins and minerals than ordinary white
flour, or refined cereal, or bread made from ordinary white flour.
Enriched flour may be made in one of two ways: (1) By a special
milling process that removes the coarser bran from the whole grain
but retains nearly all the vitamins and minerals or (2) by adding to
white flour certain minerals and vitamins that are present in whole
wheat flour. Enriched bread also may be made in one of two ways:
(1) From either type of enriched flour or (2) from white flour by the
use of yeasts high in vitamins and minerals.
In general, bread that is dry enough to require chewing before it is
swallowed is best for children.
Sweets.—Sugar should be used sparingly in food for children because
it takes away the appetite for more important foods. If children will
eat their cereal without sugar they should be encouraged to do so.
Fruits, beverages, and desserts for children should be only lightly
sweetened so that the true flavor of the food is still evident. Molasses,
sorghum sirup, and dried fruits are the most desirable sweets for
children because they contain a good deal of iron. Molasses and other
sirups can be used in making cookies, sometimes in combination with
oatmeal or whole wheat.
Fats.—Some fats supply energy only. The fats that contain vitamin
A are the best for growing children. Butter and cream are naturally
rich sources of vitamin A ; some vegetable margarines have had vita
min A added in the course of manufacture. Cod-liver oil supplies not
only fat, but also vitamins A and D.
Fats for children should be used to spread on bread or to flavor
potatoes or vegetables.
Foods cooked in fat, or fat meats cooked at high temperatures, are
not suitable foods for young children.

EATING HABITS
Eating habits have much to do with health. The child should learn
early in life to eat at stated intervals and not to eat between meals.
At some periods in life, such as infancy, very early childhood, and

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possibly adolescence, more meals are needed, on account of the es
pecially rapid growth that takes place at these times. It should be
realized, however, that eating additional regular meals is quite a differ
ent thing from nibbling between meals.
A child should learn to eat as a matter of course what is set before
him and to like the simple, wholesome foods that are in his diet.
Coaxing and urging will not teach a child to eat, but most children with
healthy appetites are ready to eat almost anything that is offered
them. A child should have nothing to eat between meals that will
keep bim from being really hungry for his next meal.
Some children have better appetites than others, and a child may
have a better appetite at one time than at another. If a child shows
signs of good health and gains weight steadily and if he is eating the
foods in a well-planned diet, his parents should not worry if he does
not seem to want so much food as some other children. He may not
need so much.
Strong likes and dislikes for certain foods are often formed so early
in life that many people believe that they are inherited. Such atti
tudes are not inherited. As a rule they are built up through imitation
of older children and grown-ups. The child who as a baby has been
fed at regular intervals and who has received a variety of vegetables,
fruit, and cereals during the latter part of his first year usually presents
no feeding problems unless he comes in contact with people whose
fussiness about food he learns to imitate.
If a child hears adults or older children talk about disliking a food,
he also may learn to dislike it. A child’s dislike for a single food may
often be traced to the mother’s dislike for it. If his parents expect
him to enjoy food he usually does.
Meals should be well cooked and attractively served, for both adults
and children, but it is not wise to discuss food before children, whether
to praise it or to complain of it. At mealtimes when children are
present older members of the family should act as if they liked every
thing served and as if they took it for granted that all the children
liked it too.
Infancy and early childhood are critical periods in the formation of
good eating habits. The keynote of success in introducing new foods
into a child’s diet during these years is the word “ gradual.” This
applies not only to the addition of new types of food but to the changes
in form in which the new foods are offered. The new foods are intro
duced, not all at once, but one by one, as the child becomes accustomed
to each in turn.
The essence of habit formation can be summed up in the phrase,
“ repetition associated with satisfaction.” A young child learns to like
a new food by repeated tastes, by getting used to it. If his first taste

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A D O L E S C E N T B O Y ’S

F O O D S E A T E N ON A S A M P L E D A Y
■

B A S I C F O O D S TO
I IN S U R E PROTEINS,
V IT A M IN S , AND M INER A LS

I quart

A D D I T I O N A L FOODS
TO M E E T E N E R G Y
N E E D S AND S A T I S F Y A P P E T I T E

whole m ilk.
0

C E R E A L S , FLOUR, B RE AD
I ^ c u p s bo i l e d r i c e .
7 slices w h i t e bread,

2 medium appl es (in sauce).

■^cup f l o u r ( in f o o d s ) .

3 medi um pot at oes.
I c up g r e e n b e a n s .
I c up r a w c a b b a g e .

B U T T E R A N D OT HE R F A T S
5 t a b l e s p o o n f u l s but ter.
4 tablespoonfuls

EGGS

fat

(in fo ods).

• egg.
' Ô ’ S U G A R , M O L A S S E S , J AM
£ ^ > L E A N M E A T , F I S H , FOWL,
_____
OR M E A T S U B S T I T U T E
I l a r g e s e r v i n g r ou nd
steak.
I

cup b a k e d b e a n s .

O 'W H O L E -G R A IN CEREAL
OR B R E A D
l^c up s c o o k e d oatmeal.

I teaspoonful cod-liver
o i l , in w i n t e r .

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6 ta blespoonfuls gran
ulated

s u g a r (in

f o o d s or a d d e d a t
table).

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GOOD N U T R I T I O N

NEEDSAREM ET

How t h e sample d a y ’s f o o d m e e t s the
da il y need f o r e a c h d i e t a r y e s s e n t i a l
Percent
l

---------- 1--------- r

IOO

PROTEIN

CALCIUM

PHOS
PHORUS

IRON

V IT A M IN
A
V IT A M IN

Bi
V IT A M IN
C
V IT A M IN

D
V IT A M IN

(RIBOFLAVIN)

C ALORI ES
/ U N I T S 0F\
V ENERGY /

Suggested a l l o w an c e f o r 1 5 - y e a r - o l d boy of average size
and a c t i v i t y .
4 0 6 4 6 7 °— 42-

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is attended by satisfaction— or at least by the absence of dissatis
faction— he will be more ready to try the food again another time and
will eventually come to like it. If, for example, he is given a large
amount of a new and strongly flavored food such as cabbage, he may
build up a violent dislike for it and firmly refuse ever to taste it again.
If, on the other hand, he is given a small amount, mixed perhaps with
potato or other bland food, and allowed to eat as little or as much as
he wants, he will willingly taste it when it is offered again and he will
probably come to like it. In offering a new food the parent should be
casual and unconcerned.
Establishing good food habits early gives the child a good start in
life and protects him to some extent against unfavorable influences
that he may encounter when he eats at school, at camp, or at other
places away from home.

SLEEP AND REST
The best single test of the wholesomeness of the child’s living is
his sleep. If he goes to bed at night tired, but not excessively so,
sleeps soundly throughout the night, and wakes in the morning
refreshed and happy and alert to begin the new day’s round of activi
ties, the parents can be reasonably assured that the child’s program of
living is a wholesome one.
It is impossible to state exactly the amount of sleep required by
children, or what the bedtime should be, for the need for sleep seems
to vary with the individual. The safest rule is to set a bedtime that
allows the child enoughsleep, so that he wakens naturally in themorning.
For a school child this natural wakening time should be early enough to
permit him to eat an unhurried breakfast, go to the toilet, and arrive
at school in good season.
In some parts of the country the change to daylight-saving time
for the summer months may postpone the child’s bedtime for an
hour, with the result that he sleeps late the next morning, hurries
through breakfast in order to get out to play or to be in time for
school, and starts the day badly.
Nothing will put a child’s nutrition on the down grade more surely
than will lack of sleep. His disposition becomes irritable, he is tired
or restless most of the time, his appetite is fickle, his food intake inade
quate, and his body undernourished. Parents must remember that
the child needs plenty of sleep, whether or not he wants to go to bed,
and they should see that he gets it. The best preparation for a good
night’s rest is a well-spent day; and as has been said previously, the
best barometer of the wholesomeness of the child’s day is his sleep at
night.

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SUNSHINE, OUTDOOR PLAY, AND EXERCISE
Children should spend as much time as possible out of doors in the
fresh air and sunshine. On rainy days a porch may be used for active
play. On bright sunny days in winter, even when the temperature
is low, children will enjoy active play. On cold, damp, blustery days,
some children enjoy being out, but others do not and are better off in a
warm, well-ventilated house. In the hottest weather children should
stay in the shade or indoors during the middle part of the day.
Growing children benefit by sunlight all the year round. Sunlight
enables the child’s body to grow properly by helping it to make the
best use of the bone-building minerals in his food.
How much exercise a child should have depends on his individual
needs. The thin, nervous child usually needs to be given play
materials that will keep him quiet part of the time. The heavy,
inactive child often needs an incentive to do more. The little child
in a large family often overdoes greatly trying to keep up with the
older children and should be given a chance to play less strenuously
with companions of his own age. The irritable child who is spending
much time indoors may be improved by getting more outdoor life.

DAILY PROGRAMS
The foundation of good health habits should be laid early in life
and then should be strengthened throughout the years of growth.
The health habits have to do with the fundamental daily activities of
the child— eating, sleeping, playing, eliminating body wastes, and
keeping the body clean and suitably clothed.
Most adults learn from experience that they are healthier, happier,
and less easily tired if their lives are regular. Need for sleep and
for food recur at regular intervals, and also need for elimination of
wastes. Irregularity makes for discomfort and a sense of ill health.
What is true of adults is even more true of children.
A daily program is a convenience for a family. It should be a
guide, not a hard and fast schedule. Programs for children of
various ages can be planned to fit the family program. (Sample
programs are given on pp. 29, 33, and 38.)

SUPERVISION BY DOCTOR AND DENTIST
Every child should have the advantage of supervision by a doctor.
The baby and the young child need complete health examinations by a
doctor more frequently than dees the older child, but such examinations

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should be given to children of all ages at regular intervals. The
parents cannot recognize many of the early signs of trouble because
they are not trained to do this and because they see the child too often
to realize that any change is taking place. The doctor looks at the
child with a trained eye, and seeing him at regular intervals, can judge
whether his color is as good as usual, whether he is gaining satisfac
torily in weight and height, and whether he shows any early signs
that are the forerunners of trouble.
As part of the doctor’s regular health examination the child will
be weighed and measured. The doctor will use all the information
that he gets from examining the child before he decides whether
his growth and development and his present nutritional condition are
satisfactory. Steady increase in weight over a period of time is one
sign of good nutrition. There is an advantage in having the same
doctor see the child at the successive health examinations so that he
can observe the child’s progress.
At every age from 2 years on, the child’s teeth should be seen every
6 months by a dentist, for examination, cleaning, and any other atten
tion that the dentist finds necessary.

SOME CONTINUING HAZARDS
TO GOOD NUTRITION
There are many hazards to good nutrition which the parent must
recognize and guard against. Some of these exist at all periods of
life from childhood through adolescence; others are most evident at
certain ages. The continuing ones will be pointed out here; the ones
peculiar to the different age groups will be considered later.

NEGLECTED TEETH
Neglected teeth are likely to result in malnutrition. If a small
cavity is not filled, the tooth will decay still more, and the results
of this neglect are familiar to all— ugly, broken teeth, toothaches, and
gumboils. The child with a sore tooth tries not to bite on it and is
likely to avoid wholesome foods that need to be chewed, or else to
chew on one side of his mouth. A child who has poor, decayed, or
abscessed teeth is likely to have a poor appetite and digestion.

ENLARGED OR DISEASED TONSILS AND ADENOIDS
If the tonsils and adenoids become diseased, the child may become
listless and under par, his appetite finicky, and his body under
nourished.
Diseased adenoids may enlarge and may prevent the child from
breathing freely through his nose. If a child habitually breathes

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through, his mouth, especially while asleep, the parents should tell the
doctor.
It is the belief of some physicians that good nutrition and the
prevention of infections may be in some measure a safeguard against
abnormalities of tonsils and adenoids, although even well-nourished,
well-cared-for children may have such abnormalities.

COLDS AND OTHER COMMUNICABLE DISEASES
Among the most serious hazards to successful nutrition and physical
well-being are the communicable diseases that are commonly con
tracted in childhood. When a child is coming down with a cold or
some other infection, he loses his appetite and becomes finicky about
his food. His parents are tempted to pamper him and to give up
temporarily his normal program. Frequent upsetting of the daily
routine because of illness is, alone, sufficient to make a child under
nourished. Communicable diseases may in addition leave the child
with some physical defect that will interfere with good nutrition for
years to come.
Parents should, of course, do their utmost to prevent the child
from having any one of these diseases. Every day, month, and year
that the child remains free from illness, even a cold or a slight indis
position, can be chalked up to the parents’ credit as another important
goal safely reached. Fortunately, a program of good, wholesome
l i v i n g will go a long way toward helping to keep the child well.
Other measures for preventing communicable diseases are also
essential. First of all, little children should be kept out of crowds,
and all children should be kept away from persons with colds or other
illness and those whose state of health is not known. The food and
water supply should be safeguarded. Raw milk should not be given
to children. Flies, mosquitoes, and vermin should be kept away from
the child and his food.
Special measures also must be taken to protect the child against
certain communicable diseases. For example, vaccination against
smallpox and diphtheria should be done before the end of the first
year. In all cases the physician should decide when these inocula
tions shall be done, and he may also suggest ways to help to prevent
other illnesses, such as whooping cough.
To a considerable extent, then, the dangers that threaten the child
from these serious foes to nutrition and health can be avoided entirely
or their harmful effects modified. Regular supervision of the child
by the doctor and the dentist should help to ward off these hazards
or protect the child from their ill effects.

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NEEDS AT VARIOUS PERIODS OF THE CHILD S LIFE
BEFORE BIRTH
During the prenatal period the baby receives his food materials
directly from the mother’s blood. Everything needed for building
his body must come from the food the mother eats or from her own
body. The mother’s diet, therefore, should contain everything that
both she and the baby need. It should have enough calcium and
phosphorus to meet the mother’s needs and to build the bones and
teeth of the baby. It should have enough iron for the mother and
in addition enough to build the baby’s blood and to store a reserve
supply in his liver for the first few months after birth. It must like
wise have enough of every one of the vitamins and other essentials
to protect the mother’s health and to provide for the increasing needs
of the baby.
If the mother’s diet does not contain enough of these dietary essen
tials for both herself and child, she will be the first to suffer, for
nature protects the baby for a while even at the expense of the mother.
If the deficiency in her diet is great, the baby also will suffer.
For example, if the mother’s diet does not contain the needed
amounts of calcium and other bone-building materials, they will be
taken from her own bones, and perhaps from her teeth, to supply
the needs of the child. If the dietary deficiency in calcium and
phosphorus is very great or long-continued, especially if the supply
of vitamin D also is inadequate, the baby’s bones cannot grow nor
mally and he may even develop rickets before birth. Because a large
part of the calcium and phosphorus that the unborn baby receives
from the mother enters his body in the months just before birth and
because of his rapid growth after birth a premature baby is especially
likely to develop rickets.
If there is not enough iron in the mother’s diet for the needs of
both mother and child, the mother’s supply will be used for the child
and the mother will become anemic. If the amount of iron is very
inadequate, the amount stored in the baby’s liver, intended to last
him through the first few months of life, will be smaller than it should
be, and he will become anemic at an early age. As with calcium and
phosphorus, a large part of the iron that the unborn baby receives
from the mother enters his body in the months just before birth, and
therefore a baby born prematurely is especially likely to develop
anemia.
If the iodine supply in the mother’s diet is low, the mother’s thyroid
gland may enlarge and she may develop other symptoms of goiter.
If the iodine supply is extremely low the baby may also be affected.

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If any of the vitamins are lacking in the mother’s diet or are present
in too small amounts the mother will show signs of the deficiency,
and the baby may fail to grow and thrive. He may even develop
symptoms of one of the deficiency diseases mentioned on pages 5-6.
The diet of the expectant mother should be adequate in all respects
both for the protection of the mother herself and of her baby. An
other consideration is that a wholly adequate diet during pregnancy
increases the mother’s chances of being able to nutse her baby, and
breast feeding is the most important factor in good nutrition during
the first year.
How can a mother be sure that she is getting all she needs and
enough for the baby too? She can do it by making every effort to
eat the foods that supply the dietary essentials. This does not mean
that she should eat a large amount of food, but that she should eat
the right kind. The needs of both mother and child should be sup
plied if the mother includes the following foods in her diet every day
in the amounts stated:
A quart of milk. This may be used in cooking foods as well
as for drinking. Fresh milk should be pasteurized or boiled.
Evaporated or dried milk may be used.
An egg.
A serving of meat or fish.
A raw vegetable, or a vegetable or fruit salad.
A cooked vegetable, one or more servings. This should frequently
be a green leafy vegetable or a yellow one.
An orange, half a grapefruit, two or more tomatoes, or some
other fruit or vegetable rich in vitamin C. (Two or more servings
of these are better.)
Two or more servings of whole-grain or enriched bread or cereal.
Other foods, such as potatoes, bread and butter, and dried
or fresh fruits, to complete her meals.
In addition to these specific foods the expectant mother needs a
good source of vitamin D. This maybe cod-liver oil or other sources,
as directed by the doctor. Iodine may also be needed; it should be
taken only under the direction of a physician.
The doctor will tell the mother how much of these foods she should
eat daily. Overeating is undesirable.
The diet of the mother is the factor in prenatal life most directly
related to the nutrition of the child, but all other factors also should
be safeguarded. The expectant mother therefore should be under
the care of a doctor and should carry out faithfully all his suggestions
not only with regard to diet, but with regard to exercise, sleep, rest,
and other matters of hygiene.

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INFANCY
If a child has had the right start in prenatal life he should be born
well nourished. The job ahead is to keep him so.
Food and eating habits.
Since the health and development of the child are closely related
to the way he is fed during his first year, a doctor should supervise
his feeding.
Breastfeeding.—The best way of making sure that a baby is well
nourished is through breast feeding. It is well known that cow’s
milk is best for the young calf, goat’s milk for the young kid, and
human milk for the newborn infant. It is the right of every baby,
therefore, to be fed for the first few months on his own mother’s
milk, if this is at all possible. No baby should be fully weaned
before the end of the first 6 months of life unless there is a very good
reason, as it is during this period of rapid growth that digestive dis
turbances are most serious. Most doctors believe, indeed, that no
method of artificial feeding is quite so good as breast feeding. Expe
rience has shown that breast feeding gives a baby a better chance
for life and for steady and normal growth. More mothers could
nurse their babies if they realized its importance and would do the
things that help to make breast feeding possible. These things are
as follows:
Before the birth of the baby the mother should—*
1. Make up her mind that the baby is to be breast-fed.
2. Select a doctor who believes in breast feeding and who will
help her to prepare for it.
3. Eat the type of diet outlined on page 25 as approved by her
doctor.
After the birth of the baby the mother should—
1. Continue her determination that the baby is to be breast-fed.
2. Continue following her doctor’s directions.
3. Eat— in somewhat larger quantities— the same good foods
that were in her diet before the baby was born, and drink
plenty of fluids.
4. Put the baby to the breast at regular intervals. The best
stimulus to milk secretion is regularity and completeness in
emptying the breasts.
5. Keep on trying to nurse the baby, even if the milk does not
come at once, giving him meanwhile other milk feeding,
as ordered by the doctor. The milk may come in sufficient
quantities after the mother is up and about the house.
6. Have plenty of sleep and rest, and so far as possible keep calm
and unworried.

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When a baby is breast-fed, be is still dependent upon his mother’s
food. If she is to produce milk enough for the baby without deplet
ing her own body stores, she must eat the proper foods. It is fortu
nate that the same diet that she needed in pregnancy is still what
she needs in the period of lactation. She will probably need larger
quantities of some foods, as it requires considerable amounts of all
food materials to enable the mother to supply the amount of milk—
a pint to a quart a day— that she will produce as the child grows
older and needs it. Fortunately the appetite of the nursing mother
is usually good, and if she will satisfy it with wholesome, simply
prepared foods, she will probably have enough of the food essentials
to protect her own body and to supply milk for the baby.
Artificialfeeding.—When weaning time comes, at 7 or 8 months,
or sooner if breast feeding is absolutely out of the question, the baby
must be artificially fed, and at this time a doctor’s supervision is
especially needed. The most important problems in connection with
artificial feeding are: (1) The choice of a good milk supply; (2) the
planning of the milk mixture so that it may be adequate in quantity
and quality; (3) the preparation of the milk mixture so that it may be
safe and digestible.
Clean fresh milk that has been pasteurized, evaporated milk, and
dried milk are all satisfactory types of milk for babies. Cow’s milk
is most commonly used, but in some families goat’s milk is used. The
doctor should decide upon the ingredients of the feeding and upon the
amounts to be given to the baby. It is the consensus of opinion among
child specialists today that any milk or milk mixture fed to a baby
should be boiled to render it absolutely safe and at the same time more
digestible. If evaporated milk is used, however, it ne$d not be boiled
in the home, as such milk has been made safe and digestible by the
process of manufacture.
Additionalfoods besides
Whether the baby is breast-fed or
artificially-fed, other foods besides milk are added to the diet during
the first year to provide the food essentials that milk— even breast
milk— does not supply in adequate amounts. These foods should be
added gradually. Orange juice (or other good source of vitamin C)
and cod-liver oil (or other good source of vitamin D ) should be begun
at the end of the second week of life. Then, one by one, at different
times during the year, cereals, egg yolk, green and yellow vegetables,
fruits, potatoes, and dried bread should be added to the diet.
Although the doctor will give special instructions as to when and
how additional foods should be introduced, it is helpful for the mother
to know the 1-year goal in respect to foods and the general plan
for reaching it. For example, at the beginning of the year the child
is fed on breast milk or a cow’s-milk mixture; toward the end of the

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year his food list will include cow’s milk, egg yolk or even whole egg,
cereals of several kinds, vegetables and fruits, and potatoes and bread.
He starts out on five or six feedings a day, or occasionally seven; by the
end of the year he will be having three meals a day, or possibly four.
These changes should all be made gradually. New foods should be
introduced one after the other as the child becomes used to each in
turn. Fruits and vegetables should be given first as juices, then as
purees, and later merely mashed. New foods should be given at first
in small amounts so that the child may become used to the new flavors
and textures. In similar manner, the number of feedings is gradually
decreased, and the baby learns to drink from a cup instead of a bottle.
When this program is properly carried out, the baby “ grows up”
naturally and arrives easily at the goal set for the year-old child.
Good eating habits should be established from the start. As a
beginning in learning to eat regular meals the baby learns early in
life to expect his food at regular times. If the mother gives him his
food at the times decided on, the average baby will learn very early
in life to wake regularly for food and to sleep most of the time between
feedings.
Sleep and rest.
Life during the first year should be serene and restful. Many a
baby has been started on the road to malnutrition by the fatigue that
comes from lack of sleep or from overstimulation. Babies differ in
the amount of sleep they need, but every baby should have plenty of
refreshing sleep at regular hours. A very young baby sleeps most of
the time. His hours of sleep gradually decrease, but at the end of the
first year he still needs about 12 hours’ sleep at night, besides daytime
naps.
A baby should not be taken out at night nor wakened from sleep
to be shown to visitors. The parents should talk to him every day
and play with him, but the play should not be exciting. Especially in
the late afternoon play should be quiet and gentle; otherwise the baby
will be overexcited and his night rest may be disturbed.
Sunshine.
Sunshine helps the baby to grow normally.
permits, sun baths may be taken out of doors.

When the weather

Exercise.
The baby should have plenty of opportunity for exercising his
growing muscles. The normal baby exercises constantly when awake,
crying, kicking, tossing his arms about, stretching, and, later, learning
to creep. These movements should not be restricted by tight clothing
or bedclothing.

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Daily programs.
Good nutrition in a baby depends largely on his health habits;
these are founded on regularity in eating, sleeping, and elimination.
A daily program should be planned in harmony with the family
arrangements. Whatever plan is chosen should be followed with
reasonable closeness as a guide, but not as a rigid rule. A sample
daily program for a very young baby is as follows:
A SAMPLE PROGRAM FOR A BABY LESS TH AN 4 MONTHS OF AGE
a. m _____ ___________ Feeding. Breast or bottle feeding.
Sleep or play, alone in crib.
9:30 a. m______________Cod-liver oil, or other source of vitamin D, and orange
juice.
Bath. Undress the baby in time to allow for exercise
and play before bath.
10 a. m _______________ Feeding. Breast or bottle feeding.
Nap, out of doors if weather permits.
Drink of water after nap. Put baby where he can play
safely.
Sun bath if weather permits. (In very hot weather
give sun bath before morning bath or after afternoon
nap.)
2 p, m _______________ Feeding.
Breast or bottle feeding.
Nap, out of doors if weather permits.
Cod-liver oil or other source of vitamin D, and orange
juice, when baby wakens from nap. Put baby where
he can play safely. Offer water at some time during
afternoon.
5:45 p. m_____________ Prepare for night. Allow time for exercise and play.
6 p. m _______________ Feeding.
Breast or bottle feeding.
Bed, with windows and lights adjusted for night.
10 p. m _______________ Feeding. Breast or bottle feeding. (If baby does not
waken this feeding may be omitted.)
2 a. m_________________Feeding. Before the end of the second month most
babies give up this feeding. Some give it up soon
after birth.

Some hazards to nutrition in infancy.
Because a child grows more rapidly during the first year of his life
than at any other period, he shows any lack of adequate food much
more readily than an older child. Moreover, food that is wholly
adequate in nutritive value may be a carrier of disease germs. Diar
rhea and other infections of the digestive tract in babies have been
reduced through the action of communities that safeguard the milk
and water supplied to the household, but the mother must continue
to see that all food is free from disease germs when it is fed to the baby.
In the first 7 or 8 months of life, the chances that the infant will acquire
a communicable disease from his food are reduced by breast feeding,
and, after weaning, by boiling his milk.

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Special measures also are needed to prevent diseases in a baby.
The mother should—
1. Take the baby regularly to the doctor.
2. Have him immunized against diphtheria and vaccinated against
smallpox, and, if the doctor advises it, have him vaccinated
against whooping cough.
3. Keep him away from anyone who is ill. A person who has
“ only a cold” or “ just a cough” may infect a baby and make
him seriously ill. A baby should never be taken into
crowded places, such as stores or theaters.
4. Keep flies and other insects away from him and from his food.
5. Boil his milk and drinking water and, unless the doctor orders
otherwise, cook all his other food except fruit juices and
cod-liver oil.
6. Wash the hands before feeding the baby.

EARLY CHILDHOOD
To have brought a child to his first birthday in a state of good
nutrition, with good health habits, is a real achievement. The
parents’ task is now to keep him on the road to good nutrition in the
important period between babyhood and school life.
Between the first and sixth birthdays the child develops rapidly and
forms many lifetime habits. At these ages he needs as much thought
on the part of the parents as he did when he was a baby, perhaps even
more.
Food and eating habits.
The gradual extension of the diet begun in infancy is continued
during the second year. Cereals, vegetables, and fruits are given in
greater variety; meat and fish are begun during the second year; a
whole egg a day is now included; and some of the milk, cereals, and
egg may be used in simple desserts, slightly sweetened. Throughout
the second year all milk should be boiled for safety. After the child
has teeth, vegetables and fruits need no longer be strained or mashed.
Cod-liver oil should be continued.
These same foods are continued throughout the preschool period,
indeed throughout life. The increased energy needs of the child as
he grows older are provided for by larger amounts of cereals, bread,
butter, potatoes, and other foods which his appetite demands. His
added need for proteins, minerals, and vitamins is met by more and
larger servings of fruit, vegetables, eggs, meat, and fish.
A sample day’s meals including these foods is as follows (there are
of course many other combinations of food that will carry out the food
plan equally well):

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SAMPLE MEALS FOR A CHILD ABO U T 4 YEARS OF AGE
B

reakfast

Orange.
Oatmeal (% cup) with top milk
cup).
Whole-wheat toast (2 thin slices) with butter (2 teaspoonfuls).
Bacon (1 slice).
Milk (J4 pint).
D

in n e r

Beef ball (1 small).
Baked potato (1 small) with butter (1 teaspoonful).
Green beans (% cup) with butter (}i teaspoonful).
Custard (% cup).
Milk (% pint).
Supper

Poached egg.
Carrots (tf cup) with butter (H teaspoonful).
Whole-wheat bread (1 slice) with butter (1 teaspoonful).
Apple sauce (y2 cup) with top milk (2 tablespoonfuls).
Milk 0-2 pint).

A child who has been fed at regular intervals during babyhood
expects meals at regular intervals. He should have three meals a day
at regular hours. If he seems to need extra food it should be given as
a regular meal, as a mid-morning or mid-afternoon lunch, but there
should be no nibbling or “ piecing” between meals. He needs to have
plenty of water to drink; if water is available his own thirst will
indicate how much he needs.
During early childhood foods should be prepared in simple ways.
Potatoes may be boiled, mashed, baked, or creamed, or made into a
potato-milk soup. Vegetables may be buttered or creamed; fruits
and desserts should be only mildly sweetened; and elaborate, rich
dishes should be avoided. The diet can, however, have sufficient
variety, even with these simple methods of preparation, to make the
meals interesting and palatable. Young children, moreover, do not
need so much change as many mothers believe; they will eat the same
foods happily day after day if adults do not suggest the need for
variety.
Sleep and rest.
The young child’s bedtime should be regular and early—not later
than 7 o ’clock and he should “ sleep the clock round,” as from
6 p. m. to 6 a. m., or from 7 p. m. to 7 a. m. In addition he should
have a regular daytime rest and relaxation in a quiet room, even
though he may not always fall asleep when he lies down.
Children seldom say that they are tired. They show fatigue by
becoming cross or restless oftener than by wanting to sit or to lie down.
The child under 3 years who is very active in his play is often better
off if he spends at least part of his outdoor time quietly.

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Sunshine, outdoor play, and exercise.
Every young child should spend as much time as possible out of
d oors— 3 to 4 hours in winter and 5 to 6 hours in summer, except on
very windy, dry days when much dust is flying, or on very cold and
overcast or stormy days.
.. _
The child who is not yet 2 years old needs plenty of direct sunlight
even more than other children of preschool age, for the child under 2
is at an age when he may still have rickets. In spring, summer, and
fall the child who plays outdoors every sunny day, wearing a sun
suit part of the time, will get plenty of sunshine. In winter, when
more of the body must be covered and the sun is less strong, he should
play in the sun whenever the weather permits.
The child’s day should be busy and interesting but not overstimu
lating. He should have plenty of opportunities for quiet play and for
free, active play suited to his age. A sandbox may keep a child playing
happily in the sunshine if he has such simple things as spoons, pails,
cans, and small wagons. A play pen large enough to allow the child
considerable freedom of movement will keep him safe while playing
with such toys as blocks. Of course, a child needs to walk and to
run, to climb, to swing, to pull, to push, to dig, and to throw. To do
all these things he needs a yard to play in, and if possible he should
have some simple, home-made play apparatus, such as a seesaw, climb
ing bars, and a slide.
A little child should learn to enjoy playing alone, but he also needs
to play part of the time with children of his own age, as well as to
have companionship with adults. Building a house with blocks, swing
ing on horizontal bars, a game of tag, a romp with the dog, and a walk
with father around the block or a trip with mother to the neighborhood
park— all these may well be part of a child’s busy, well-ordered day.
Daily programs.
.
.
A program of living suitable for a child can be put mto effect only
if he builds up a series of desirable habits and attitudes. Even when a
good beginning has been made during babyhood much remains to be
done in the years from 1 to 6 . The parents should continue to teach
the child to form good health habits; that is, to teach him to do habit
ually and without conscious effort the things that make for good
health habits. The habits that have to do with the fundamental daily
activities of the child— eating, sleeping, playing, and eliminating—
should be learned in the first 3 or 4 years of life. Once learned they
may last a lifetime.
Regularity is a great help in habit building, but at this age, as m
infancy, regularity should not mean rigidity. In planning a routine
for the young child the family life should be considered, for it is not
desirable to upset the plans of the family more than is necessary for the

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health of the children. Regularity in certain things, however, is of
great benefit, such as the daytime nap, outdoor play, meals, bedtime,
and visits to the toilet. A regular schedule will benefit the family in
the end.
Different plans suit the needs of different families. Whatever plan
is made should be followed with reasonable closeness as a guide but
not as a rigid rule. A sample schedule is as follows:
A SAMPLE PROGRAM FOR A CHILD ABOUT 4 YEARS OLD
7:30 a. m ______________Rise. Toilet. Bath. Brush teeth. Dress.
8 a. m_________________ Breakfast. Toilet for bowel movement.
Wash hands.
Out of doors as soon after breakfast as weather permits.
Play in sun when possible.
11:45 a. m ____________ Toilet.
Wash hands and face.
12 noon. ______________ Dinner.
12:30 p. m __ __________Undress for nap. Toilet. Washhands. Nap.
2:30 p. m_____________ Toilet.
Wash hands. Dress. Milkor fruit
if needed.
Out of doors as long as weather permits. Play in sun
when possible.
4:45 p. m____ _________ Toilet.
Wash hands.
5 p. m ________________ Supper. Undress. Toilet. Wash. Brush teeth.
Lights out, windows open, door shut.
6 p. m ______________ Bed.

Some hazards to nutrition in early childhood.
The road to good nutrition for the years from 1 to 6 is one that
should be possible to follow without much difficulty. There are,
however, a number of byways leading away from the main road, and
the parents should be aware of them in advance and strive to avoid
them.
Refusing milk or other necessary food.—Even though a child has good
food habits up to the age of 1 or 2 years, he may at this time or soon
after suddenly seem to take a dislike to milk or some other needed
food. If this situation is more than temporary its cause should be
sought. It may be that the child has been given highly flavored food,
such as sweets, meats, and rich dishes, so that his taste is blunted for
bland foods. If this is the case a return to an extremely simple, bland,
but well-rounded diet will often effect a prompt cure. If he has been
eating sweets or highly flavored foods these should be given up. No
point should be made of the change. It should just happen naturally
that bland foods are the only ones available. It is surprising how
good just plain bread and butter and milk will taste when the child is
hungry and his taste undulled by high flavor.
The nibbling or “piecing” habit—A young child easily falls into the
habit of “ piecing” or nibbling. He is about the house where food is
available, and it is easy to give him a slice of bread, a cookie, or a
cracker, at any time he asks for it, or to allow him free access to a box
of crackers or a cookie jar. It is not uncommon to see children who

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keep up this constant “ piecing” all day long. The effect usually is
that it takes the edge off the appetite, so that the child is not hungry
for his regular meals. The food he eats between meals is seldom what
he needs most, and it does not make up for the essential foods he
should normally eat at mealtime.
The surest way to avoid “ piecing” is to hold to the rule that the
child eats only when seated at the table for a regular meal. If he
seems to need four or even five meals instead of three, he may have
them, but he should sit at the table to eat them, and the foods eaten
at this extra meal should be suitable to his age.
Candy, ice cream, sweets, soft drinks, and other extra foods are
often responsible for upsetting the child’s nutrition at the preschool
age. These foods are not essential, for they provide nothing that
cannot be better supplied by the simple foods that have been listed
previously as needed in the young child s diet. Moreover, when
eaten between meals, they usually spoil the appetite for the foods that
he does need. No objection can be raised to a child’s eating a small
piece of candy occasionally at the end of a meal, nor to a plain ice
cream as dessert. But the child who is constantly nibbling at sweets,
who must have some candy or ice cream every time he goes with his
mother to the grocery store, is likely to be thin and poorly nourished,
and to have decayed teeth and other marks of malnutrition. Candy
should be eaten only occasionally, and should not take the place of the
essential foods.
Interruption o f good sleeping habits.—When the child is about 3 or 4
years old, difficulty may arise in getting him to take his daytime nap;
he may be unwilling to go to bed at night, and he may lie awake
after he does go. When this happens, the parents should look for the
cause of the trouble. Have they been lax in getting him to bed at the
proper hour? Has his play before bedtime been too stimulating? Is
the child aware that pleasant things happen in the household while
he is asleep, so that he does not wish to go to bed lest he miss some
thing? Are the parents expecting him to sleep too long? Or have
they acted as though the child’s daytime rest period were no longer
necessary and an early bedtime unimportant? If these questions are
honestly answered, the remedy for the situation is usually apparent.
Whatever is found to be the cause should be corrected, for lack of
sleep is one of the most common causes of poor nutrition.

THE SCHOOL AGE
If a child reaches school age in a well-nourished condition his parents
can congratulate themselves on having given him the right start on
the road to good nutrition. Their vigilance must not be relaxed,
however, for school life brings about special needs and hazards.

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Food and eating habits.
The child of early school age.—The same foods that were eaten in
early childhood should continue to be the basis of the diet during the
school age. The quantities, however, should be increased to take care
of the child’s greater needs as he grows older, and some of the foods
that are unsuitable for young children may be added to the diet of
older children.
Most school children are able to digest almost any food that is in
the family diet. The school child may be given not only a greater
variety of foods, but also foods prepared in different ways. It should
be emphasized, however, that except for an increase in quantity,
changes in the diet are not essential merely because the child grows
older. Excellent nutrition can be maintained throughout the growing
period upon the same foods that are recommended for the young
child. Moreover, if a school child shows a tendency to lose his appe
tite for any of the essential foods, a temporary return to the simple,
bland diet of early childhood may be needed.
The principal change in meals that takes place when a child,goes
to school is caused by the fact that many children eat the noon meal
away from home. Whether the noon meal is eaten at home or away
from home it should be fitted into the food plan for the day.
The following sample day’s food plan provides for lunch whether
served at home, bought and served at school, or brought from home:
A SAMPLE D A Y ’S MEALS FOR A CHILD ABOUT 10 YEARS OLD
B

reakfast

Tomato juice (% cup).
Hot whole-wheat cereal (% cup) with top milk (}$ cup).
Toast (2 slices) with butter (2 teaspoonfuls).
Milk (Hpint).
L

unch

(If served at school or at home)
Creamed eggs (% cup).
Green beans (H cup) with butter (1 teaspoonful).
Oatmeal muffins (2) with butter (2 teaspoonfuls).
Milk (}4 cup).
(If brought from home)
Sandwich— peanut butter and raw carrot on buttered dark or
enriched bread.
Sandwich— chopped dried apricots on buttered dark or enriched
bread.
Supplemented by—
Orange.
Milk soup (1 cup) or cocoa (1 cup), served at school.

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D

GOOD N U T R I T I O N

in n e b

Meat loaf (1 serving).
Scalloped potatoes (% cup).
Cole slaw with red and green peppers (% cup).
Whole-wheat bread or enriched bread (2 slices) with butter (2
teaspoonfuls).
Apple sauce (H cup).
Molasses cookies— 2 thin.
Milk (J4 pint).

The adolescent.—At adolescence the boy and girl begin to gain in
height and weight very rapidly and they are likely to be extremely
active. They may continue to eat the same types of food eaten by
younger children, but they should eat considerably larger quantities.
Boys of this age are “ always hungry,” and if plenty of food is avail
able they are likely to eat all they need. Girls, however, sometimes
have finicky appetites and may fail to get enough of the proper kinds
of food.
The chief dietary problem for parents of adolescents is to see that
enough food is eaten to meet the greatly increased energy needs. An
adolescent boy may be growing so fast that he needs actually more
than his father; a girl, more than her mother.
Although the adolescent’s need for food is great, a boy or girl of
this age may not be able to eat enough food to fulfill the energy needs
unless foods that are concentrated sources of energy are eaten in
liberal amounts, such as butter, cheese, cream, bacon, cookies, pea
nut butter, jelly and jam, baked beans, macaroni and cheese, ice
cream, and rice pudding. Such foods may, in fact, be allowed almost
without restriction, provided, of course, that they are eaten in addi
tion to— not in place of— the essential foods— milk, eggs, vegetables,
fruit, potatoes, meat, and whole-grain or enriched bread or cereals,
which are needed to supply minerals, proteins, and vitamins, in ade
quate amounts.
Besides the three regular meals a day, additional food, such as
an after-school lunch, is likely to be needed in the adolescent period.
If the after-school lunch is followed by outdoor activity, and if the
appetite for the evening meal is not diminished, parents may be sure
that the additional food is beneficial. If the full amounts given
on page 37 are eaten in three meals, no additional meal will ordinarily
be needed.

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The day’s meals for a very active boy 15 or 16 years of age may be
as follows:
A SAMPLE D A Y ’S MEALS FOR AN ADOLESCENT BO Y
B

reakfast

Orange.
Shredded wheat with top milk (% cup).
Muffins (3) with butter (2 tablespoonfuls) and marmalade (2 table
spoonfuls).
Eggs (2 ).
Bacon (3 slices).
Cocoa (2 cups).
L

unch

Macaroni and cheese (2 large servings).
Sliced tomatoes (2 )with mayonnaise (1 tablespoonful).
Whole-wheat bread (2 medium slices) with butter (1 tablespoonful).
Baked apple (1 large) with sugar (1 tablespoonful) and cream
()i cup).
Cookies (2 large).
Milk (y2 pint).
D

in n e r

Pot roast of beef (large serving).
Mashed potatoes (\y2 cups) with gravy (% cup).
Cabbage (1 cup) with butter (2 teaspoonfuls).
Bread (2 medium slices) with butter (1 tablespoonful).
Milk (Y pint).
Rice-milk pudding (2 servings).

For girls or for younger boys the amounts of the different foods
should be smaller.
Daily programs.
A wholesome, well-balanced program of school work, sleep and
rest, play, and other activities should be established. There can,
of course, be no one daily program that will fulfill the needs of every
school child. The program given here merely suggests approximate
hours for the various activities of the day, as follows:
1 If lunch is carried to school b y a b oy of this age it m ay consist of the same kind of foods suggested for
the 10-year-old child (p. 35), but in larger quantities.

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A SUGGESTED D A Y ’S PROGRAM FOR A CHILD ABOUT 10 YEARS OF AGE
a m _______________ _ Rise. Toilet. Bath. Brush teeth. Dress.
7:30 a. m______________Breakfast. Toilet for bowel movement. Wash hands.
Brush teeth. A few chores.
8:15 a. m______________ Go to school. Arrive in plenty of time to greet friends,
help with school chores, and so forth.
8:45 a. m_______________ School.
10 a. m.________________ Recess out of doors.
10:15 a. m______________ School.
12 noon_______________ Lunch time. In lunchroom about 20 minutes. Rest of
time, about 50-55 minutes, out of doors.
1:15 p. m_______________ School.
2:30 p. m______________ Recess out of doors.
2:45 p. m_______________ School.
3:30 p. m_____________ Play or other wholesome activity, largely out of doors.
5:30 p. m_____________ Wash hands and face. Help set table, and so forth.
6 p. m _______________ Dinner; leisurely meal with family.
6:45 p. m_____________ Help with dinner dishes. Rest of time free for reading,
conversation, handicraft, music practice, and so forth.
8 p. m.________________Toilet.
Wash. Brush teeth. Bed.
(Saturday and Sunday programs can allow more time for playing outdoors, help
ing parents, going on tramps to the woods, collecting or other hobbies, and
so forth.)

Some hazards to nutrition that exist throughout the school age.
Most of the hazards to nutrition that exist in early childhood con
tinue in the school age, and others arise when the child enters school.
Inadequate breakfasts.—One of the most serious hazards of the school
age is the tendency to cut down on breakfast. This is often due to
the feeling of hurry and anxiety that possesses most children in the
morning. This feeling may be attributed to late rising, failure of the
mother to have breakfast ready in time, and the fear of tardiness.
The child goes to bed late, arises late, and must hurry to get to school
on time. He has barely time to snatch a hasty bite before he dashes
off— perhaps to catch a school bus traveling on a fixed schedule.
Even when there really is time to eat, the fear of being late may take
away his appetite. The effect in either case is to reduce the amount
of food that the child eats at breakfast. This usually reduces also
the total amount of food for the day, for children rarely eat enough
at the other two meals to make up the deficit. The child’s body may
thus have to go without an appreciable amount of the energy food
that he needs. If he forms the habit of hurrying through breakfast
he may become thin and undernourished.
Prevention of this situation should be a joint problem of parents
and school. The parents should see to it that the child’s bedtime is
regular and early enough to permit him to have sufficient sleep by
the normal rising time in the morning. The rising time should be
early enough to allow ample time before breakfast for washing, dress-

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ing, and going to the toilet. The breakfast time should be regular^
and the meal should be ready early enough to allow the child time to
eat without hurrying, to brush the teeth and have a bowel movement
after breakfast, and to get to school well before school opens.
Young children have little realization of the time required to do
the various things that are necessary, and so they may feel anxiety
even without cause. The parents, through maintaining the wellorganized morning routine described in the preceding paragraph,
should develop in the child a feeling of assurance that there is plenty
of time for all the necessary things. They should then keep faith
with the child by seeing to it that he always gets to school in plenty
of time.
The teachers should cooperate with the parents in their efforts to
have the child eat a good breakfast. All talk about tardiness is out
of place in the lowest grades. The responsibility for getting the
young child to school in time should be borne by the parents, and the
matter should be worked out by parents and teachers in conference.
As the child grows older he should, of course, take more and more
responsibility for punctuality, but older children also need calm
parental supervision in the morning before school. An adolescent,
especially, needs help from his parents in planning this time suc
cessfully. His need for plenty of food makes it especially important
that he get a good breakfast. Unless his bedtime the night before
was early enough to permit him to get enough sleep he is likely to be
difficult to rouse in the morning and to be sleepy, irritable, and slow
in getting ready for school. If such a child is to get an adequate
breakfast, it is obviously the parents’ duty to see that he gets to bed
early.
When the bedtime and the morning routine have been well estab
lished, there should be no real difficulty about breakfast. If there is,
then the rule that the child must sit at the table a certain time may
need to be enforced.
Inadequate lunches.— The noon lunch of the school child is also
likely to be inadequate. If children go home for lunch the feeling of
hurry and anxiety may be largely responsible for this inadequacy.
The lunch period is usually short, and the fear of being late affects the
child’s appetite, as does also the desire to get back to the school yard
to play. He rushes in, eats enough food to dull his most urgent hunger
pangs, and dashes off.
The problem of an adequate lunch is again a joint problem of parents
and school authorities. If children go home for lunch enough time
should be granted by the school to allow ample time for eating. The
sense of hurry and anxiety should be avoided by some such means as
was suggested with regard to breakfast.

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As a rule children who live far from school either carry their lunches
to school or buy them at the school cafeteria or elsewhere. Children
who bring lunch, as well as those who buy it at school, should be
supervised by the school authorities at lunch tune.
If the child carries his lunch to school, the mother, of course,
should plan the meal as carefully as she plans his breakfast and
dinner, and when possible the child’s lunch should be supplemented
by one warm dish at school.
Lunches bought at school can be both adequate and satisfying if
the school lunchroom is under proper supervision. Without proper
supervision the lunches are likely to be unbalanced, and the essential
foods are likely to be left uneaten in favor of cakes and other sweets.
Although good lunches are usually available in school cafeterias, the
child left to his own devices may avoid the familiar foods he eats at
home and choose those he regards as luxuries, especially sweets. He
may save some of his lunch money to buy other things that he wants.
The result is that his lunches are too small in amount and are lacking
in the essential foods. When such lunches are combined with inade
quate breakfasts, as they often are, malnutrition is the inevitable
result.
The lunch eaten at school should be in charge of a person who is
trained in child feeding and child psychology as well as in lunchroom
management and who is truly interested in the welfare of the children.
The food served should be palatable, attractive, and suited to the
children’s needs. A “ plate lunch” should be served, especially to
young children, with occasional choice allowed between foods of equal
food value. If cafeteria service is provided, the number of foods offered
should be small and the foods arranged on the counter in such order
as to favor good selection.
Educational supervision should be maintained, and no child should
be allowed past the checker’s desk with a lunch that does not meet the
minimum essentials of adequacy. When the child eats a lunch served
at school, it is the school’s responsibility to see that the meal selected
is fully adequate. Parents and school authorities should confer
regarding the type of lunch that the children need and the price that
can be afforded.
The candy habit—a special hazard jo r children of early school age.—
Even though the parents have succeeded in keeping the child free
from the candy habit in the preschool period, they face the problem
anew when he enters school. Temptation meets him on every hand.
Other children have money for candy, and it may be sold in the school
lunchroom or in the school corridors as a money-raising device, at
nearby stores, or by street vendors at the schoolyard gate. The child
would scarcely be human who did not succumb. Even if 5 or 6 years

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of not eating much concentrated sweet food have kept him from ac
quiring the candy habit, he soon develops this habit because of his
natural desire to be like the other children. The result may be that
he ceases to enjoy the bland foods in his normal diet, he eats less of
these foods, and if the candy habit continues he may become under
nourished.
The best slogan for the prevention of the candy habit is, “ Out of
sight, out of mind.,, Parents and teachers should unite to keep
temptation out of the children’s way— to banish candy from the school
lunchroom, to prohibit the sale of candy on the school premises, to
keep vendors away from the school gate, and if possible to regulate the
sale of candy to children at local stores. This should be done quietly,
without stressing the idea that something is being denied the children.
When these steps are being taken special attention should be given to
providing suitable substitutes. In the lunchroom some new and
especially attractive desserts should make their appearance. Fruits
such as apples, oranges, pears, bananas, figs, and dates should be sold
at low prices.
Children should be taught the proper place of sweets in the diet.
The facts to be taught about candy may be summed up [as follows:
Candy is not essential in the child’s diet. It furnishes energy to the
body but little else. It is primarily a flavor food and may be used
in moderation for this purpose, provided it does not in any way reduce
the consumption of the basic foods— milk, green and yellow vege
tables, fruit, eggs, meat, potatoes, whole-grain cereals and bread—
which are essential for good nutrition. The best rule for both parents
and teachers to keep in mind is that the less candy the child eats, the
better he is likely to be physically, especially in respect to his teeth.
Too little sleep: Overfatigue.—The need for sleep decreases as the
small child grows older, but there is danger of a too rapid let-down
when he reaches school age. The nap is given up as the child grows
older; and the home work required by most schools, the child’s desire
to stay up to play or to listen to the radio, and the parents’^growing
laxness in respect to his daily program are all factors that tend to keep
him up beyond his normal bedtime. His sleep may be cut short
nightly by 1 to 2 hours or more, and he may become chronically
fatigued and irritable. This should not be allowed to happen. After
the child enters school a regular early bedtime, determined largely
by the opening hour of school in the morning, should be strictly
enforced. This bedtime should be early enough to allow the child to
get a full night’s sleep, with ample time for breakfast and the morning
routine.
On account of the rapidity of -their growth at the teen ages, the
older boy and girl may need even more sleep than the younger school

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child, and if they do not get it many boys and girls may be sleepy and
tired much of the time and unable to concentrate on their lessons.
Parents should try to see that these older boys and girls get sleep
enough for their needs.
Inadequate outdoor play and exercise.—The long hours of play out of
doors that were possible for the preschool child are of necessity reduced
when the child goes to school. Five or six of the best hours for outdoor
play are now spent in the schoolroom, and these are so spread over
the day that the only time for an extended period out of doors is after
school closes in the afternoon. If the short time allowed for recesses
and the time spent walking to and from school mornings and at noon
are added to this there may be a total of not more than 3 to 4 hours
of outdoor exercise.
Unless parents and teachers are on guard and work together to
keep even this small amount of time from being reduced, the child’s
comparatively short outdoor time may be cut down. After-school
time out of doors also may be shortened by such indoor activities as
home study and music lessons. Study of the daily schedules of many
children has shown that on school days the outdoor playtime of large
numbers of children is almost totally eliminated in these various ways.
Few children can stand this abnormal program without showing the
results in some form of physical impairment.
The necessity for plenty of time for outdoor play for school children
should be recognized by parents and school authorities, and vigorous
efforts should be made to prevent curtailment of this time. If school
children are to get sufficient outdoor exercise and play, most of the
time after school should be spent out of doors, as well as most of
Saturday and Sunday. Time spent on such activities as music
lessons should be limited, so that the child will not lose too much of
his outdoor time. The child himself should be influenced to play out
of doors rather than indoors at such odd bits of time as recess and
the time before and after lunch.
At the high-school age the time spent by the boy or girl outdoors
tends to be reduced by many indoor activities, such as increased home
study and the many indoor recreational activities that are incidental
to high-school life. It will be advantageous to the health of these
young people if the parents and the school authorities encourage the
boys and girls to spend most of their recreation time out of doors.
Special hazards to nutrition in the teen ages.
Lack of provision for the adolescent's special nutritional needs.—
When the child enters the adolescent stage his growth speeds up and
he needs much more food and sleep than he did before he reached this
stage. Many parents do not realize this, and as a result teen-age
boys and girls are likely to be both hungry and tired much of the time.

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This is especially true of boys. Parents may think that the older
child is getting enough sleep because he sleeps as many hours as the
younger children; or that the older child, especially the boy, is getting
enough food because he eats large quantities. As has been pointed
out, the rapidly increasing weight and height of adolescent children,
as well as the vigorous exercise that many of them take, make it the
duty of parents to see that these boys and girls get plenty of sleep and
to make sure that their diet includes sufficient fat and other concen
trated foods to provide for their rapid growth and their great
activity.
The onset of menstruation at puberty influences the nutritional
needs of adolescent girls. Girls at this age should have liberal amounts
of foods rich in iron and in the other dietary essentials involved in the
formation and regeneration of red blood cells.
Many boys and girls leave school to go to work while they are still
in their teens. Some of them live away from their parents’ home, and
their parents can no longer supervise their diet and habits. Even
though such boys and girls have to take the responsibility for their
own health it is a great mistake for them to consider themselves as
adults merely because they have become wage earners. With regard
to physical development they are still adolescents, and they have the
same special needs as the boys and girls of the teen ages who remain
in school. Many young people do not realize this and therefore fail
to get the food, sleep, and outdoor exercise that they need at this age.
Their employers may show some concern for their physical well-being
by offering the opportunity to get palatable and nutritious meals at
low cost. Young people’s organizations may do the same and may
also offer the opportunity to get wholesome rest and recreation.
Unless, however, young people realize that they have special needs
other than those of adults, they may fail to take advantage of such
opportunities and almost invariably will fail to provide for their needs
out of their small earnings. Community agencies, such as 4-H Clubs,
the National Youth Administration, Young Mien’s and Young Women’s
Christian Associations, and church clubs, can do much good by taking
over the health-education work that is done for most school-age
young people by the school and the home.
The “ keep-slender” fad.— In an effort to keep slender an adolescent
girl may restrict her diet, and she may not only eat too little, but she
may fail to eat some of the essential foods. She is likely to omit from
the diet potatoes and milk, with the idea that they are fattening.
She may even make a practice of omitting breakfast.
In order to keep girls from injuring their health through such efforts
to keep slim, parents and school authorities should try to keep before
these girls a sane standard of beauty and to convince them that a well-

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rounded body is beautiful and that an angular, skinny body is not.
The attention of adolescent girls may be directed to the fact that
certain admired young women, although they are slender, show the
signs of good nutrition, such as good muscles, sound, well-formed
teeth, clear skin, glossy hair, and an air of vitality.
If a girl or boy is thought to be really overweight or to be gaining
weight too rapidly, a doctor’s advice is needed. After a thorough
examination the doctor will decide whether or not reduction in weight
is advisable; if he finds that it is, he may direct that the amount of
energy foods in the diet, such as sweets and fats, be decreased, but
that plenty of the basic foods— milk, vegetables, eggs, meat, fruit, and
dark or whole-grain cereals and bread— must be eaten, so as to protect
the body from malnutrition. Indeed, the amounts of the essential
foods in the diet, especially fruit and vegetables, may need to be
increased as an extra safeguard when less of the energy foods is eaten.
The physician undoubtedly will direct that weight should not be
reduced other than gradually.
The problem of overweight is rare in the adolescent years. The
more usual need at this age, as was pointed out previously, is for
enough food to keep up with the body’s demands brought about by
rapid growth and increased activity.
Hazards inherent in high-school lije.—Attendance at high school, es
pecially a large high school, brings about some health hazards that
affect nutrition. For many children the change from a small ele
mentary school to a large high school brings about not only increased
nervous and mental stimulation but also increased danger of getting
infections such as colds and tuberculosis. The strain of hurrying to
and from classes— sometimes of climbing stairs— the greater freedom
in selection of lunches in the cafeteria and the resulting unsuitability
of the lunches chosen, the late lunch hour brought about by the “ onesession” school day, the overstrain due to competitive athletics, the
stimulation caused by extracurricular activities such as clubs and
parties, the home-lesson assignments, the pressure due to collegeentrance examinations— all these are a part of high-school life. The
combined effect of a number of these too often results in chronic
fatigue and consequent malnutrition.
Many of these hazards to nutrition can be dealt with only by school
authorities, but the parents can help their children by seeing to it that
so far as possible conditions at home are conducive to health and that
the right attitudes are developed. They can also seek cooperation
from school authorities in bringing about changes in the high-school
program that will benefit the pupils’ health.

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Readjustments in school life that may be needed.
When parents and school authorities cooperate in analyzing the
problem of children’s nutrition many readjustments in the school as
well as the home may be found necessary. The lunch period may need
to be put at a different hour and lengthened in order to allow for an
unhurried lunch and for some outdoor recreation. Home-study
assignments may need to be restricted or even abolished, to allow for
a long period of outdoor recreation after school, some time for asso
ciation with the family group after the evening meal, and a suitable
bedtime. Extracurricular activities also may need some regulation.
The athletic program in many schools is in need of reform. Many
educators and health authorities believe that competition between
high schools should be entirely eliminated and that all forms of
athletic competition should be greatly reduced.
The parents’ part in bringing about changes in the child’s diet and
habits may be made easier if a nutrition program is being carried on
in the school. If the child is learning in school about the foods he
should eat and the health habits he should form, and if he is given an
opportunity at school to put this knowledge into practice, he is likely
to be willing to do so if only to gain the approval of his teacher. If
his schoolmates also are in favor of the new program, the greatest
obstacle to its success— the child’s resistance to it— will be largely
removed. When this occurs, a child who has in the past refused to
drink milk, to eat vegetables, or to go to bed at a reasonable time, is
likely to change his attitude. The parents’ part then is to support the
school program and to help to carry it out.

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Salvaging the C hild W ho H as H a d a B a d
N u trition a l Start
The program which has been outlined has shown how to keep the
child on the road to good nutrition throughout life. The question now
is, What can be done for the child who has not had the right start?
What can be accomplished by parents who, when their child is 3, 8, 10,
or older, awaken to the realization that he is malnourished? To what
extent can they enable such a child to measure up to the standards for
well-nourished children?
In general, a child who has been malnourished in the past can
eventually measure up to many of these standards if he is given the
benefit of a doctor’s care, if his diet and health habits are sufficiently
improved, and if the good diet and good health habits continue for a
considerable period of time. Early defects caused by malnutrition,
with the exception of certain types of defects in the bones and teeth,
are, as a rule, not permanent but can be remedied to a great extent by
improvement in the child’s nutrition.
Of course, the earlier such improvements are begun, the better will
be the result. For example, the bony defects caused by rickets may
be almost, if not entirely, corrected if treatment is begun early enough.
If the child with rickets remains untreated too long, however, the
bony deformities that have already developed will remain throughout
fife.
Cavities in the teeth should be filled by a dentist. The process of
decay may be arrested thereby, and after that the child’s teeth may be
kept in good condition by means of continued care by a dentist, care
at home, and improved nutrition.
When parents realize that their child is malnourished, the thing
to do, obviously, is to begin at once to get him on the road to good
nutrition; then efforts must be made to keep him there.
First of all, the child should be given an examination by a physician,
who will find out whether any chronic disease or any physical defect is
interfering with the child’s nutrition. Then, with the help of the
parents, he will make a careful study of the child’s diet, his sleep, and
his entire way of living.
As part of the physician’s efforts to put the child on the road to
good nutrition he will advise the parents with regard to corrections in
the child’s diet and habits. Making such corrections is not an easy
task, for poor habits of eating, sleeping, and so forth, are not easily
changed. A badly selected diet in the past may have brought about
food prejudices in the child that will change only with time and through
tactful management on the part of the parents.
46

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The care of a malnourished child, such as those shown here, should
be under the direction of a doctor.

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Photographs by Extension Service, United States Department o f Agriculture .

The difference between this boy’s appearance with and without clothes
indicates the necessity for examining children without clothes before
judging their nutrition.

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Photograph by Bureau o f Home Economics , United States Department o f Agriculture

The differences in body build shown by these girls are not related to
age nor to nutrition. All three girls are 8 years old, and all are
well nourished.

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H h |1

T V ®

l i l “I |||llii|l|i

In his second year.
In his sixth year

l» S f

mmm

In his fourth year

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G ood N utrition a Continuous Process
The process of good nutrition, as seen from the description in the
preceding pages, is a continuous one; the nutrition of a child at any
period of life is dependent on that of all preceding ones.
This means that the nutrition of a person reaching maturity is
affected not only by conditions at that time, but also by what occurred
in the school-age period, in early childhood, in infancy, and in prenatal
life, as well as being affected by his heredity.
The child’s progress toward good nutrition at maturity may be
represented as a road. To follow this road successfully requires that
enough of the essential foods be in the diet throughout the growing
period and that the dangers that may affect nutrition be warded off.
The diet “ pattern” is the same at all ages; it includes, at every period
from prenatal life on, milk, vegetables, fruits, eggs, meat, whole-grain
cereals and bread, and sources of vitamin D and of iodine. Sleep
and rest, as well as play and exercise outdoors in the sunshine, also
are essential at every period of the child’s life.
The chief problem is how to avoid the many dangerous byways that
lead away from the road to good nutrition, for if the byways are
followed too far, they lead to nutritional disaster. If a child, at any
age, chances to get on one of the dangerous byways, he must be
brought back promptly and set again on the right road.
Keeping a child continuously on the right road through all these
periods is a real achievement, and it should result in a well-grown,
physically fit adult.
47

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Signposts on the R oad to G ood N utrition— A
Check h ist
In the foregoing sections the characteristics of a healthy, wellnourished child have been described, and an outline given for a pro
gram of care at every period of the child’s life. The essentials of these
are summarized in the following questions, which may be used as a
check list:
A.

Does He Have General Signs of Good Nutrition and Good Health?
1. Is his general appearance one of vitality and well-being?
2. Is his posture erect? ........... With head up? ______
Chest leading (if he is more than 3 or 4 years o ld )? ______
Shoulders flat? ___.......
3. Is his facial expression in repose calm, interested, and
h a p p y?______ Is it free from strain and w orry?______
4. Is his body well padded with sufficient muscle and fat to
give it a well-rounded contour? ...........
5. Does his skin have a healthy g lo w ?______ Are his finger
nails pinkish?.......... . Are the mucous membranes inside
his mouth and eyelids reddish? __ ___ Are his ears
pinkish when seen against light? ___.......
6. Are his teeth well formed? ............ Regular?______ With
no overlapping or crowding? ........... Do they appear to
be sound? ........... If there has been decay, have the
cavities been filled?______ Is he free from toothache?___
7. Does he breathe easily with his mouth closed? ___....... With
either nostril closed with the finger? ........... Is he free
from snoring?______
8. Does the doctor say that the child’s tonsils are normal? _____
9. Does the doctor say that there is no sign of enlarged thyroid,
or goiter?...........

B. Is His General Behavior That of a Healthy Child?
1. Is he normally active and full of life? ______ Is he free
from nervousness?........... Is he free from restlessness?.__
2. Does he come to his meals hungry enough to eat all that
he needs?______
3. Does he go to bed wholesomely tired, but not excessively
s o ? .......... . Does he go to sleep almost at on ce?______
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4. Does he wake up refreshed and in good spirits in the morn
ing, eager to begin the day’s activities? ...........
5. Do his bowels move regularly without the use of laxatives?
6. Can he play as hard as other children of his age without
becoming unduly tired?
7. Does he recover from fatigue easily and fully after a few
hours’ rest?... ........
C. Is He Growing Normally?
1. Is he weighed at regular intervals? 1______
2. Is bis weight curve 2 generally upward? _.._N
3. Does the doctor consider the child’s gain in weight satis
factory for one of his race, family, sex, and age?_____
(When the doctor says that a child’s gain in weight is
satisfactory, he does not mean that it is satisfactory in
comparison with an average, but for that individual
child.)
D. Is He Getting the Foods He Needs for Good Nutrition?
1. If he is less than 1 year of age, is his feeding under a doctor’s
supervision?______ If he is less than 7 months of age,
is he at least partly breast-fed? ______ If he is artifi
cially-fed, is his milk mixture recommended by the
d o c t o r ? ______ If evaporated milk is not used, is the
milk boiled? _____ _ Does he receive additional foods
besides milk, according to the doctor’s recommenda
tions? ______ Is he “ growing up” with regard to eating
h abits?______
2. If he is more than 1 year old does he get the foods be needs
every day, as follows:
Milk.—Does he get at least
pints daily (a quart is
best)?______
1 During the first year of life a child should be weighed every 2 weeks; from the first birthday to the sixth,
once a month; from the sixth birthday to the sixteenth, at least twice a year—at the beginning and the end
of the school year. (If a midyear weighing can be done also, valuable information will be obtained with
regard to the child’s nutrition.)
A balance scale rather than a spring scale should be used. Each weighing should be done at about the
same time o f day, preferably before a meal. The child m ay be weighed either with or without clothing. If
clothing is worn, it should be approximately the same at all weighings; outdoor clothing should not be worn
when the child is being weighed.
A record should be kept of each weighing, and the record should be taken to the doctor when a health
examination is to be made. Such a record will be a help to the doctor in judging the child’s health and
nutrition.
* The weight record of the older well-nourished child, who is weighed only once or twice a year, should show
a gain at every weighing; the record o f the younger well-nourished child (under 6 years), however, who is
weighed frequently, may occasionally show a failure to gain, or even a slight loss. As a general rule, however,
the record of a well-nourished child should show gain in weight.

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Citrus fruit or tomatoes.—Does he get at least one gen
erous serving daily of orange, grapefruit, or raw or
canned tomatoes (or a larger amount of some other
fruit or vegetable, raw)?______
Other fruit.—Does he get one or more servings daily of
other fruit, raw or cooked (besides citrus fruit or
tomatoes)?______
Potatoes.—Does he get one or more potatoes daily (one
daily for younger children)?______
Other vegetables.—Does he get two or more servings of
other vegetables daily, in addition to potatoes
(one serving for younger children)?_______ Does he
get a green or yellow vegetable at least several times
a week?______
Eggs.—Does he get an egg daily______or at least four
or five a week?______
Lean meat or fish.—Does he get one or more servings
of meat or fish daily?______
Dark or whole-grain cereals and bread.—Does he get two
or more servings daily of dark or whole-grain or en
riched cereal or bread?______
Butter, or margarine with added vitamin A.—Does he get
at least three servings of butter daily, or margarine
with added vitamin A (total amount, 1 ounce or 2
tablespoonfuls) ?______
A source of vitamin D.—Does he get some good source
of vitamin D daily, such as sunshine, or cod-liver oil,
or other source recommended by the doctor?______
Other foods.—Does he get enough bread, butter or other
fats, potatoes, desserts, and other foods to satisfy
his appetite and to provide energy?______
E. Does He Have Good Habits of Eating?
1. Does he have at least three full meals daily?______
2. Are the meals well spaced, with enough time between them
to permit hunger to develop?______
3. Is between-meal eating, if any, restricted to the eating of
simple, easily digested foods, such as fruit, milk, bread?
4. Are sweets eaten only with a meal, as dessert?______ Is
candy eaten infrequently, or not at all?______ If candy
is eaten, is the amount small?______

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5. Is breakfast eaten regularly?______ Is it unhurried?______
Is it generous in amount?______ Does it carry its fair
share of the essential foods: M ilk?______ Fruit?______
Eggs?______Energy food such as bread and butter, cereal,
potatoes?______
»
6. Is lunch eaten regularly?______ Is it generous in amount?
______ Does it carry its fair share of: Milk?____
Fruit and vegetables?______ Meat, fish, or eggs?______
Dark or whole-grain or enriched cereals and bread?______
Additional energy food such as bread and butter, cereal,
potatoes?______
7. Has he learned to like— or to eat without question—most
of the foods that have come into his dietary?______
Checking the foods on the following list will give a good
idea of his “ food vocabulary” : 3
Milk and cheese.
Whole milk (as a drink or in cooked fo o d s )______
Skim milk or buttermilk (as a drink or in cooked
fo o d s )______
Cheese made of whole milk ...____
Cottage cheese...........
Fruit.
A pples...... .....
Bananas...........
Grapefruit or oranges______
Peaches or apricots...........
Prunes ...____
Other fruits..........
Vegetables.
T om atoes______
Cabbage ...........
Green leaves (turnip tops ______spinach ............ ...
beet greens —_____k a le .............lettu ce................
other greens.......... )
Green peas ...... ........string beans________ _ fresh
lima beans ...........
Mature beans and peas (dried lima beans.... ...... .
navy beans........... pinto beans............ black-eyed
p ea s........... others.......... __)
Turnips or rutabagas...........
P otatoes...........
* T he foods that the child m ay be expected to like depends on his age, on the foods available in the locality
where he lives, and on family customs.

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Sweetpotatoes...........
Other yellow vegetables (carrots --------- pumpkin
______ yellow squash.............)
Other vegetables ...........
Eggs, meat, fish.
E g g s --------Lean m ea t....... —
L iv e r______
Fish (salt-water fish ........... fresh-water fish.............)
Shellfish.......
Grain products.
Dark or whole-grain or enriched cereals and bread
(rolled o a t s ______ cracked w h ea t---------- flaked
wheat ........ - whole-wheat bread ----- —- rye
bread ______ brown r i c e -----------oth ers-----------)
F. Does He Have a Wholesome Program of Sleep, Exercise, and Rest?
1. If under 1 year of age, is he in bed by 6 p. m.?__:---------Are his naps taken out of doors whenever the weather
permits?______
Does he have plenty of opportunity for exercise, unre
stricted by tight clothing or bedclothing? - ------2. If he is an older child does he have long hours of active play
or other wholesome occupation out of doors every day in
all but the most unpleasant weather?--------- If he is less
than 6 years old does he have not less than 5 hours?._-----If he is of school age, not less than 3?----3. Does he go to bed at a regular hour?--------- Has he the
habit of going to bed at the appointed time?--------4. Does he go without being reminded?.------- If he does not
go without being reminded does he then go readilv?--------5. Does he sleep till he wakes spontaneously and shows signs
that he has had enough sleep?--------6. If he is less than 6 years old does he have a regular daytime
rest of an hour or more, whether or not he sleeps?--------G. Are Precautions Taken Against Disease?
1. Is he under the supervision of a doctor? --------- Does the
doctor give him a thorough examination at least once a
year?__ ___
2. Has he been immunized against: Smallpox?--------- Diph
theria?______ Whooping cough?— . . . Has he had
any other immunizations advised by the doctor?-----

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3. Is the water supply for drinking known to be safe?______
If not, is it boiled before drinking?______
4. Has all the fresh milk that is purchased been pasteurized?
--------- If the child is less than 2 years old, is his milk
boiled?._____
5. Are raw fruits and vegetables peeled or thoroughly washed?
6. Are flies and other vermin kept away from him?______
and from his fo o d ? ._____
7. Are mosquitoes kept away from him?______
8. Is he kept away from sick people?._____ If he is under
school age is he kept out of crowds?______
H. Are His School Conditions Favorable to Good Nutrition?
1. Is the time when school begins in the morning suited to his
health needs?______
2. Is the time spent in school and at other indoor activities short
enough to permit plenty of outdoor play and exercise?
3. Is a recess of 10 to 15 minutes given both in the morning
and in the afternoon, at least for children in the lower
grades?______ Is this recess spent out of doors when the
weather is suitable?__ „ _ _ When recess is spent indoors
is it spent in a room or shelter allowing fresh air and
relaxation?__ ___
4. Is lunch time long enough for an unhurried meal?______
If lunch is eaten in the school lunchroom, is the food
palatable?______ Is it well planned, as suggested in
question E ?______ Is a “ plate lunch” served at the
school?______ If choice among foods is allowed, is it
restricted so as to insure that the child gets an adequate
lunch?______
5. Is the sale of candy on the school premises prohibited
entirely?______ If not, is candy sold only in the lunch
room?______ Is it sold to a child only in small amounts
and after he has eaten a good lunch?______
6. Are clubs, parties, and other extracurricular activities
regulated so as not to restrict the child's time out of
doors?__ . . . Are they regulated so as not to cause
overstimulation and fatigue?______
7. Is the physical-education program so regulated as to be
conducive to good nutrition and h e a lth ?______
8. Is assignment of home study prohibited in the lower
grades?______and prohibited or reduced to a minimum
in the upper elementary grades?______

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Selected Publications o f the Federal G overnm ent
W ith R egard to N u trition in Children
Children’s Bureau, United States Department o f Labor
Prenatal Care. Pub. 4.
Infant Care. Pub. 8 .
Baby’s Daily Time Cards (seven cards giving daily routine and training for
babies from birth to 2 years of age).
The Child From One to Six; his care and training. Pub. 30.
Child Management. Pub. 143.
Are You Training Your Child To Be Happy? Pub. 202.
Good Posture in the Little Child. Pub. 219.
Guiding the Adolescent. Pub. 225.
Children Bear the Promise of a Better World— Have They the Protection of
Proper Food? Defense of Children Series No. 4 .
Folders:
The Expectant Mother. Folder 1 .
Breast Feeding. Folder 8 .
Keeping the Well Baby Well. Folder 9.
Out of Babyhood Into Childhood. Folder 10.
Your Child’ s Sleep. Folder 11 .
Well-Nourished Children. Folder 14. (Prepared in cooperation with the
Bureau of Home Economics, United States Department of Agriculture.)
The Healthy, Well-Nourished Baby, Birth to 1 Year. Folder 16.
The Healthy, Well-Nourished Child, 1 to 6 Years. Folder 17.
The Healthy, Well-Nourished Child, 6 to 16 Years. Folder 18.
Mother! Nurse Your Baby! Folder 19.
Feeding Your Baby. Folder 20.
Your Young Child’s Health. Folder 2 1 .
Your School Child’s Health. Folder 2 2 .
The Noon Meal at School. Folder 23.
Your Children’s Food and the Family Pocketbook. Folder 24.
Substitutes for the Sun. Folder 25.

United States Department o f Agriculture
Eat the Right Food To Help Keep You Fit. Issued by the Bureau of Home
Economics with the cooperation of the Children’ s Bureau and other Govern
ment agencies.
Food for Children. Farmers’ Bulletin 1674.
Good Food Habits for Children. Leaflet 42.
Human Nutrition. In Food and Life; Yearbook of Agriculture, 1939, pp. 97—379
(also published separately).
Menus and Recipes for Lunches at School. Miscellaneous Publication 246.
54

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Full text of The Road to Good Nutrition, Bureau Publication No. 270

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