nutrition to the infant

8/11/2019 Nutrition to the Infant

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Outline

Breast milk vs. infant formulaIntroducing solid foodsFeeding infants safelyFruit juice debate

Introducing fluid cow milk


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Periods of Infant Growth

Critical period of brain growth- 1 st 2 yrs.of life (more proteins, EFA) Tooth development- 1-6 yrs

(adequate Ca,P,Vits. A,D,C)

Overlapping phases of infant feeding Nursing phase

Transitional phase Modified adult phase


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Success of infant nutritiondepends on:

Early feeding methods Correct use of nutritional supplements Pattern & timing of introduction of solid

foods Careful monitoring of growth Nutritional status monitoring & disease

condition.


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BreastfeedingBenefits to mother and childExtra food to breastfeeding mothersis a prime concern

How can we help new mothers? encouragement education

Breastfeeding is BEST during the first year of life.
http://www.usda.gov/oc/photo/93c0005.jpg


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Advantages of breastfeedingBreastfeeding offers unique advantages beyond nutrition to the infant.

Breastfeeding (BF) is the gold standard in infantfeeding.Offers many benefits to the infant, includingoptimal nutritionReduces incidence and severity of infectiousgastrointestinal disease, as well as somerespiratory and ear infections.


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Advantages of breastfeeding BF protects against food allergies, and improves mental,

cognitive, and visual development, especially in pre-terminfants.

BF can be continued through most illnesses, procedures,and while on most medications.

The longer the duration of breastfeeding, the more benefitsconferred.

Current guidelines recommend breast feeding for the firstsix months to 1 year of life.


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Human milkGenerally, human milk is the only nutrition an infant needs

until 4 to 6 months.

With the exception of vitamin K, and possibly vitamin D, afull-term infant can generally meet all nutritionalrequirements from human milk, along with the infants own stores.

No additional fluids or foods are needed during the first 4

to 6 months.


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Human milk

Vitamin D content of human milk may be inadequate forsome infants;

Especially if they are dark-skinned or have limitedexposure to sunlight, and may require supplementation.

If the lactating mother is vegan, supplemental VitaminB12 is suggested for the mother.

Any breastfed infant with limited exposure to sunlight may

need vitamin D supplements.


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Influences on milk production

Milk production is based on principles of supplyand demand.

Initially, hormones of pregnancy start the milk

manufacturing process, i.e. it is controlledinternally.

Shortly after birth, it switches so that milkremoval is the controlling factor.


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Milk production, especially early on, is related tofrequency and amount of feeding.

For this reason, infants should be fed on demand.

During growth spurts, infants feed morefrequently which signals the breast to make moremilk.

In addition, regular, frequent feedings can reducecomplications in the mother, such as engorgement.


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At birth, low secretion of digestive enzymes makesdigesting solids foods or cows milk impossible.

Low renal capacity means high protein intake can causerenal overload and induce osmotic diuresis and water loss.

After 4-6 months an infants kidneys will mature enoughto handle the high solute loads caused by solid foods.


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Optimal macronutrient intake

Infant feedings must be lipid and carbohydrate-rich.

Energy for growth and development comes fromcarbohydrate, protein, and fat metabolism:

45-50% as lipids and 40-50% as carbohydrates(mainly lactose in human milk which also

promotes beneficial intestinal flora and calciumand magnesium absorption).


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Glucose metabolism is the primary energy pathway of the

term infant.

Optimal protein intake is relatively low. Intake of 150-200ml of breast milk/kg/d provides adequate protein; 25-40%of human milk protein is secretory IgA and lactoferrin.

Insufficient calories cause protein to be sacrificed forenergy.


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Vitamins and minerals

Vitamins and minerals are important for growth:excess or deficits can be detrimental.

Healthy term infants in developed countries are atlow risk for vitamin and mineral deficiency.

Although important for growth, excesses ordeficits can be detrimental.


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Healthy term infants are born with iron storessufficient for the first 6 months of life, but infants

born to mothers suffering from anemia during pregnancy may have stores for only three months.

Milk of vegan mothers is likely to be deficient inB12 because of low maternal intake.

Infants need limited sun exposure to ensure

adequate levels of vitamin D.


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Assessing nutritional status ofinfants

Low weight, length and head circumference point to nutritionaldeficiencies.

Growth charts track body weight to measure of nutritional status anddetect

protein-energy malnutrition (PEM); length and head circumference arealso good measures.

Infants are categorized as small, appropriate, or large for theirgestational age of Preterm (42 weeks).


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Infants may lose up to 10% of their birthweight in the first few days of life withoutcause for alarm.

Evaluate a weight loss >10% or beyond 10days and not regained by 3 weeks.


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Formula FeedingInfant formula package less food for moms and their familiesMead Johnson formula can size changes one less can per month issued through WIC

Enfamil and Anmum addition of two fatty acids: ARA & DHA mixed study results

higher costs


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Infant formulas are the only acceptable humanmilk substitute for the young infant.

When a mother does not breastfeed, iron-fortifiedinfant formulas are the only acceptable humanmilk substitutes.These resemble human milk in all majorconstituents to promote normal development andgrowth.


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There are several categories of formula,differing in their source of protein,

allergenic potential, or other specialformulation.

Cows milk should never be given to aninfant under 1 year of age.


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Slow infant growthUnderfeeding, malabsorption and genetic disorders slow infant growth.

When infants grow slower than predicted by the appropriate growthcharts, the underlying cause must be sought with great consequence.

Inadequate intake should be considered first, often due to faulty breast-or bottle feeding technique.

Infections and organic illnesses also are common.

Malabsorption and inborn errors of metabolism are much rarer causes.


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Introducing Solid Foods

Supplement - NOT replacement for breast milk or formula.Introduce when developmentally ready

sit up with support, hold head steady,draw in lower lip infants reach age 4 to 6 monthsTiming

risks to early and late introduction order of food groups

Developmental readiness, NOT age,

determines when to introduce solid foods.


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Feeding Baby Safely

Guard against choking hazards hot dogs, soft bread, grapes, hard candiesBeware of these ingredients honey, salt, sugar home cooked beets, carrots, spinach, turnips,

collards

Prevent food borne illnesses no unpasteurized fruit juices

Feeding foods safely is the Number 1 priority.


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Homemade Baby Food

Homemade baby foods are popularFood safety is critical

preparation and storageWhat are the pros and cons offeeding baby homemade baby

foods vs. commercial?


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Comparing Costs

Product4 oz

Homemade Commercial

Sweet potato $0.33 $0.44

Carrot $0.12 $0.44

Sliced peaches $0.34 $0.44

What is the cost of convenience? How much is your time worth?


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Food AllergiesResult in immunologic reactions

Caused by common foods eggs, milk, peanut, soy, wheat, fish, tree nuts, shellfish

Lead to diarrhea, vomiting, wheezing, anaphylactic shock,

abdominal pain, gas, hives, skin rashesCan be avoided (at least in part) slowly introduce new foods delay introduction of common food allergens until at

least 1 year of age, longer depending on allergen


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Fruit JuiceToo much of a good thing? Nutrient density and displacement of nutrients Diarrhea Dental cavities

Know the limits 8 oz diluted 100% fruit juice (4 oz fruit juice

and 4 oz water)


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Feeding Infants Cow Milk

Not recommended during the first year.Fluid cow milk consumption can lead to: GI bleeding

Iron deficiency Displacement of nutrients

Other dairy products at 8 months

Yogurt and cheese


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Conclusion

Breastfeeding is best for infants and should be avidly supported by nutrition educators.Developmental readiness determines whento introduce solid foods.Feeding infants safely should be a top

priority.

12/12/08

nutrition to the infant

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