NUTRITION

CHPT 12

Diet During Infancy

How important is food during the 1st year

• Baby needs good healthy food for both physical growth and mental growth

Mealtime

• Is very important time for babies

• Food should not be forced on children rather good role models should be there to help baby grow psychologically

On Demand

• Infants should be fed on demand however, if you stay ahead of the game a bit, baby won’t be starving and become frustrated and not easy to console…mealtime will be better

When to feed baby

• At 2-3 months old, baby should be eating Q 4hr

A Baby’s weight

• The 1st year of life is a period of the most growth

• A baby doubles his birth weight by 6 months old and triples the birth weight by age 1

Water

• Remember that a baby’s body is 75% water…this is more than the adult

• Baby’s however DO NOT NEED plain drinking WATER in their diet while breast feeding or while on formula. Water is already in these nutrients

What does breast milk have in it that’s good for baby?

• Essential vitamins• Minerals• Water• 100 ingredients that aren’t in formula• Vitamin C• Breast milk provides all nutrients an infant needs

for the first 4-6 months of life• Vitamin D can be prescribed as a supplement

Excess in Vitamin A or D

• Parents must be careful as to not overdose their baby on these

• Excess of Vitamin A can damage the liver and cause bone abnormalities

• Excess Vitamin D can damage the cardiovascular system and kidneys

Why Breastfeed?

• Mom’s milk provides temporary immunity to many infectious diseases

• It’s economical• Nutritionally perfect• It’s sterile and easy to digest• Does not cause G.I. Disturbances or allergy• Less protein and minerals are in breast milk, making it

easier for the kidneys to handle• Promotes oral motor development• Decreases the risk of obesity in the baby

• Baby should nurse q 2 hrs, breast milk is so pure, they need the food

• Weeks down the road, baby should nurse at each breast for 10-15 minutes each session

Growth Spurts for baby

• Occur at 10 days, 2 weeks, 6 weeks and 3 months

• Baby needs more nutrients at this time and may wake up more to feed

How can you be sure baby is getting enough fluid/milk in with

each feed?

• There are 6 or more wet diapers /day

• There is normal growth

• There are 1-2 mustard colored BMs/day

• The breast becomes less full during feeding

Feeding on the go

• Mom’s can pre-pump or express their milk and freeze it using it for a later time

• NEVER microwave breast milk, it kills the antibodies to fight infection

Bottle feeding

• Some women are afraid to breastfeed

• Some women have no support for this at home

• Iron fortified formulas are out there to provide nutrients

What’s better, human milk or formula

• Either way of feeding is acceptable however…

• The infant should be given love and attention during the feed

• The infant should be cuddled and held up in a semi-upright position during the feeding

What happens when baby goes to bed with a bottle or lays flat to

drink• Saliva in the mouth diminishes

• Tooth decay of teeth under the gums can occur

• Possibility of aspiration

• Increased chance of ear infections (Otitis Media). Ear canal is more flat

Synthetic milk

• Is given when baby is allergic to everything, esp. milk.

• Predigested proteins are used for infants

• such as Nutramagen or Ailmentum

Formula

• Some are premixed (add no water)

• Some are powder that you add water to it

• The powder type is the least expensive but you MUST add the correct amount of water or…

• Too much water – dilutes formula, doesn’t provide the right amt of nutrients and can cause seizures or brain edema

• Too little water – causes formula to be too concentrated and causes too much protein or minerals for the kidneys to handle

Cow’s milk

• Should not be given to children under 1

• It can cause GI bleed d/t the milk protein being too hard to digest. Children digest this milk protein slower

• Kidneys are challenged by the high protein and mineral content

Cow’s milk

• Dehydration or damage to the central nervous system can result

• The fat in cow’s milk is not absorbed as efficiently as that in human’s milk

How to warm baby’s milk

• Never microwave any type of milk, it kills off the good stuff

• Use a warm glass of water and place the bottle in the water for a few minutes

• Shake the bottle before giving it to baby, test it on your wrist, just like in the old days

Bedtime

• Never put baby to bed with a bottle

• Baby can aspirate (fluid in the lungs = pneumonia), no propping bottles

• Tooth decay forms due to milk on gums

Supplementing foods

• Infants should be on formula or breast milk until 4-6 months old, cereal can start then, usually at 6months is better

• BREAST MILK OR FORMULA SHOULD REMAIN THE MAJOR FOOD SOURCE UNTIL THE CHILD IS 1 YEAR OLD

SOLID FOOD

• Should not be introduced until after 4-6 months

• The kidneys and G.I. Tract are not adequately developed before this time

• When the baby is taking 32 ounces of formula or is feeding 8-10xs in 24hrs, has good neck control, is willing to take food and can sit up, then it’s time for solid food – DONT RUSH IT

What to feed first

• Always start with baby cereal – iron fortified rice, then oat, wheat and mixed cereals

• Vegetables always come next, if you give fruit first, baby won’t like the veggies, he’ll want sweet fruit

6-12 months

• Toast, Zwieback baby cookies, cheerios can be offered in small amounts

• Baby likes to pick up these by himself and feed himself

What not to feed small childrenthese can cause choking (age

1y.o)• Hot dogs

• Nuts

• Whole peas

• Grapes

• Popcorn

• Small candies

• Small pieces of tough meat

Fruit Juices

• Should be given in 4oz increments as to not overfill the child

• Only serve pasteurized juice

• May dilute juice with water

Weaning from bottle

• Usually begins when the infant is first given food from a spoon

• By about 15 months at the latest, should baby be weaned from the bottle

Galactosemia

• There is a lack of the liver enzyme transferase

• Galactose is a simple sugar resulting from the digestion of lactose, the sugar found in milk

• In this illness, when transferase is missing, anything the infant ingests containing galactose becomes toxic d/t no transferase to break it down

• This is a life-long illness/problem

Side Effects of Galactasemia

• Diarrhea

• Vomiting

• Edema

• Liver does not function properly

• Cataracts

• Mental retardation occurs

Adults with Galactasemia

• Can never ingest any lactose

• Baby formula is special added vitamins and supplements are needed

• Calcium, Vit D, riboflavin (water soluble vit of the B complex group)

Phenylketonuria (PKU)

• Infant lacks the necessary liver enzyme that is needed for metabolism of the amino acid phenylalanine hydroxylase

• Not noticed until child is 6-18 months

• Kids become hyperactive, have seizures and become mentally retarded

Testing for PKU

• Is done at birth as a heel stick for blood

Lofenalac

• Specially formulated infant formula that has 95% of the amino acid Phenylalanine removed from its protein source.

• Other liquid beverages can be purchased to use in puddings or baked products that have the phenylalanine removed (lifetime monitoring of foods to avoid this amino acid)

Maple Syrup Urine Disease (MSUD)

• Is a congenital defect resulting in the ability to metabolize 3 amino acids

• It is named for the smell of the urine of infants (like syrup)

• When the infant ingests food protein, there are increased levels of these 3 amino acids causing ketosis

Side effects of Maple Syrup Urine Disease

• Hypoglycemia

• Apathy

• Convulsions

• Death from acidosis

Diet for (MSUD)for life

• Must contain nutrients and sufficient calories

• Extreme restricted amounts of the 3 amino acids

• Low protein foods

Cystic Fibrosis

• Is an inherited disease

• Causes the body to produce abnormally thick secretions or mucus within cells lining the lungs and pancreas. This thick mucus blocks the pancreas preventing the digestive enzymes from getting out into the duodenum

How to care for the C.F. child

• Increase the fat in their diet to 35-40% instead of 30%

• Digestive enzymes in capsules are given during mealtime and supplements of fat-soluble vits are given

• C.F. kids can be malnourished

Failure to thrive (FTT)

• Kid’s ht and wt are plotted on growth charts to determine if there are problems with diet

• Regular Dr. visits help aid in the needs of the child• Support is needed for those parents who do not

take their children in to the Dr. regularily

• All children should be seen at a yearly physical

In review

• It is important that babies have adequate nutrition to aid in growth and development

• Some diseases cause difficulty in nutrition for children

• Frequent Dr. visits, growth records and professional advice will aid the parents in knowledge to be able to effectively care for their child

The End