Nutrition and Digestion in Infants
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Questions and Answers

Why are glucose polymers digested and absorbed better than lactose in premature infants?

  • Because glucoamylase is more abundant in the intestine (correct)
  • Because glucose polymers are more abundant in breast milk
  • Because lactose is more difficult to digest
  • Because lactase is more abundant in the intestine

    • Why is unfortified goat milk not recommended for infants?

  • It is high in iron and vitamin D
  • It is too high in protein for infant nutrition
  • It contains too much lactose for infants to digest
  • It is deficient in folate and low in iron and vitamin D (correct)

    • What is a characteristic of fat absorption in newborns?

  • Efficient fat absorption from birth
  • Low pancreatic lipase concentrations (correct)
  • High pancreatic lipase concentrations
  • Fast rates of bile acid synthesis

    • What is the primary reason for adding vegetable oils to milk-based infant formulas?

    <p>To enhance fat absorption</p> Signup and view all the answers

    What is steatorrhea due to in premature infants?

    <p>Reduced absorption of fat by the intestine</p> Signup and view all the answers

    What determines the ability of the kidney to excrete a solute load in infants?

    <p>Maturation of the kidney</p> Signup and view all the answers

    What type of formulas are designed for infants with gastroesophageal reflux?

    <p>Pre-thickened milk-based formulas</p> Signup and view all the answers

    Why is powdered goat milk recommended only for children over 1 year old?

    <p>It is not a complete formula</p> Signup and view all the answers

    What is the average birth weight of a term infant?

    <p>3500 grams</p> Signup and view all the answers

    How many nutrients does the FDA specify minimum amounts for in infant nutrition?

    <p>29</p> Signup and view all the answers

    What is the purpose of adding lactose to milk-based infant formulas?

    <p>To increase the carbohydrate content</p> Signup and view all the answers

    What type of formulas are designed for premature infants?

    <p>Therapeutic formulas</p> Signup and view all the answers

    What proportion of total calories can an infant efficiently use from a carbohydrate source?

    <p>40%-50%</p> Signup and view all the answers

    What is an important part of an infant's diet, given that it makes up a larger proportion of the infant's body weight?

    <p>Water</p> Signup and view all the answers

    What is the primary advantage of using vegetable oils in milk-based infant formulas?

    <p>Better fat absorption</p> Signup and view all the answers

    Why are therapeutic formulas used for infants with specific dietary needs?

    <p>To meet unique nutritional requirements</p> Signup and view all the answers

    What is the recommended age for using human milk as the sole source of nutrition for infants?

    <p>6 months</p> Signup and view all the answers

    What is the primary function of colonic salvage in lactose digestion?

    <p>Production of short-chain fatty acids</p> Signup and view all the answers

    What is a characteristic of premature infants born before 32 weeks gestation?

    <p>Reduced GI tract function</p> Signup and view all the answers

    Why is human milk considered the optimal milk source for infants?

    <p>It is easily digestible and has a low risk of allergy</p> Signup and view all the answers

    What is the primary role of a healthcare provider in infant nutrition?

    <p>To provide information to parents on successful breastfeeding</p> Signup and view all the answers

    What is a result of the acidity created by colonic salvage?

    <p>Promotion of water absorption and prevention of osmotic diarrhea</p> Signup and view all the answers

    What is the period of maximal GI tract growth and differentiation?

    <p>Third trimester of pregnancy</p> Signup and view all the answers

    Why are infant formulas considered an appropriate alternative to human milk?

    <p>They have a high nutritional quality, safety, and convenience</p> Signup and view all the answers

    What margin of physiologic safety is provided by human milk and supplemented in infant formulas during manufacturing?

    <p>The same margin of physiologic safety</p> Signup and view all the answers

    What is the role of taurine in infant nutrition, and what are the consequences of its deficiency?

    <p>Taurine acts as a cell membrane protector and osmoregulator. Deficiency results in retinal dysfunction, slow development of auditory brain stem evoked response, and poor fat absorption.</p> Signup and view all the answers

    What percentage of nonprotein energy in human milk and infant formula is accounted for by fat?

    <p>Approximately 50%</p> Signup and view all the answers

    What is the recommended percentage of total calories from fat for children between 2 and 5 years of age?

    <p>20%-30%</p> Signup and view all the answers

    What is the importance of fat in the diet of children younger than 2 years?

    <p>High energy intakes are required for rapid growth and development.</p> Signup and view all the answers

    What is the maximum percentage of calories from saturated fats recommended for children between 2 and 5 years of age?

    <p>Less than 10%</p> Signup and view all the answers

    What is the maximum percentage of calories from trans fatty acids recommended for children between 2 and 5 years of age?

    <p>Less than 1%</p> Signup and view all the answers

    Who may be candidates for reduced fat milk products, and what is the reason?

    <p>Children between 12 months and 2 years with a family history of obesity, dyslipidemia, or CVD.</p> Signup and view all the answers

    What is the primary difference in the whey:casein ratio between mature human milk and whole cow milk?

    <p>Mature human milk has a whey:casein ratio of 72:28, while whole cow milk has a ratio of 18:82.</p> Signup and view all the answers

    What is the approximate percentage of water in both mature human milk and whole cow milk?

    <p>87.1% in mature human milk and 87.2% in whole cow milk.</p> Signup and view all the answers

    What is the primary micronutrient difference between mature human milk and whole cow milk in terms of calcium content?

    <p>Mature human milk has a calcium content of 200-280 mg/L, while whole cow milk has a content of 1200 mg/L.</p> Signup and view all the answers

    What is the primary advantage of using human milk as the sole source of nutrition for infants?

    <p>Human milk is considered the optimal milk source for infants due to its unique composition and benefits for infant health and development.</p> Signup and view all the answers

    What is the primary reason why whole cow milk is not suitable for providing nutrition to infants younger than 1 year?

    <p>Whole cow milk has a different composition than human milk, making it unsuitable for infant nutrition and growth.</p> Signup and view all the answers

    What is the primary difference in the fatty acid composition between mature human milk and whole cow milk?

    <p>Mature human milk has a fatty acid composition of 3.9 g/100 mL, while whole cow milk has a composition of 3.4-3.8 g/100 mL.</p> Signup and view all the answers

    What is the primary role of micronutrient supplementation in infant nutrition?

    <p>Micronutrient supplementation is essential for filling nutritional gaps in infant formulas and ensuring optimal infant growth and development.</p> Signup and view all the answers

    What is the primary advantage of using infant formulas as an alternative to whole cow milk?

    <p>Infant formulas are designed to mimic the composition of human milk, making them a better alternative to whole cow milk for infant nutrition and growth.</p> Signup and view all the answers

    What is the primary difference in the vitamin composition between mature human milk and whole cow milk?

    <p>Mature human milk has a higher composition of vitamin A and vitamin C, while whole cow milk has a higher composition of vitamin B12 and vitamin E.</p> Signup and view all the answers

    What is the primary benefit of breastfeeding for infants in terms of immune system development?

    <p>Breastfeeding provides infants with essential antibodies and immune factors, which help to develop their immune system and protect against infections.</p> Signup and view all the answers

    What is the primary advantage of glucose polymers over lactose in the premature infant's intestine?

    <p>Glucose polymers are digested and absorbed better than lactose due to the relative abundance of glucoamylase compared to lactase.</p> Signup and view all the answers

    What is the limiting factor in fat absorption in newborns?

    <p>Low pancreatic lipase concentrations and slow rates of bile acid synthesis.</p> Signup and view all the answers

    What is the significance of the kidney's maturation in infant nutrition?

    <p>It determines the ability of the kidney to excrete a solute load.</p> Signup and view all the answers

    What is the primary determinant of birth weight?

    <p>Maternal prepregnancy weight and pregnancy weight changes.</p> Signup and view all the answers

    What proportion of total calories can an infant efficiently use from a carbohydrate source?

    <p>40%-50%.</p> Signup and view all the answers

    Why is water an important part of an infant's diet?

    <p>It makes up a larger proportion of the infant's body weight than in older children or adults.</p> Signup and view all the answers

    What is the role of the FDA in infant nutrition?

    <p>It sets specifications for minimum amounts of 29 nutrients and maximum amounts of 9 of those nutrients.</p> Signup and view all the answers

    What is the significance of fluid in an infant's diet?

    <p>It is an essential component, making up a larger proportion of the infant's body weight than in older children or adults.</p> Signup and view all the answers

    Le proportion de aqua in sia mature lac human e lac de tote vacca es ____________.

    <p>circa 87</p> Signup and view all the answers

    Le ratio de whey:casein in mature lac human es ____________.

    <p>72:28</p> Signup and view all the answers

    Le composition de acidos grasse in mature lac human es differente de lac de tote vacca in que illo contine ____________.

    <p>minus saturate</p> Signup and view all the answers

    Le supplementation de micronutrientes es importante in nutrition infantil porque illo provide ____________.

    <p>nutrientes essential</p> Signup and view all the answers

    Le formularios infantil es un alternative a lac de tote vacca parce que illo es ____________.

    <p>melior adaptate</p> Signup and view all the answers

    Le allaitement es beneficose pro le sistem de immunitate de infantes parce que illo provide ____________.

    <p>antocorpos</p> Signup and view all the answers

    Le lac de tote vacca es non apte pro infantes plus juvene que 1 anno porque illo contine ____________.

    <p>trop de calcium</p> Signup and view all the answers

    Le advantage de allaitement es que illo provide ____________.

    <p>nutrition optimal</p> Signup and view all the answers

    Le formularios infantil es disegnate como un alternative a lac de tote vacca parce que illo es ____________.

    <p>plus adapte</p> Signup and view all the answers

    Le lac human es ric in ____________ que es importante pro le crescentia de infantes.

    <p>vitaminas</p> Signup and view all the answers

    Le composition de acidos gras esseva differente inter le lacte matur de human e le lacte integral de vacca.

    <p>fatty</p> Signup and view all the answers

    Le supplementation de ______es es importante in le nutrition del infant.

    <p>micronutrient</p> Signup and view all the answers

    Le formulas de ______ia es considerate como un alternative appropriate a le lacte de human.

    <p>infant</p> Signup and view all the answers

    Le allementation al seno es beneficiale pro le disveloppamento del systema immunitari del infant.

    <p>breastfeeding</p> Signup and view all the answers

    Le lacte de ______ es considerate como le fonte de lacte optimal pro le infant.

    <p>human</p> Signup and view all the answers

    Le ______ es un protector de membrana cellular e un regulador de osmotismo.

    <p>taurina</p> Signup and view all the answers

    Le fat es le component del dieta plus dense in calories, proporcionante __ kcal/g.

    <p>9</p> Signup and view all the answers

    Le infantia debe obtener %-% de su calories total desde le fat.

    <p>20-30</p> Signup and view all the answers

    Le ______ concentration e pauco bioavailability de ferro in le lacte de vacca habe essite associate con anemia per deficiente de ferro.

    <p>basse</p> Signup and view all the answers

    Le ______ de proteina in le lacte de vacca es plus facilemente digerite que le proteina in le lacte de vacca.

    <p>caprina</p> Signup and view all the answers

    Le lacte de vacca ______ in grasso es advocate per prevenir obesitate e atherosclerosis como parte de un dieta san.

    <p>reducite</p> Signup and view all the answers

    Le ______ del lacte de vacca es plus facilemente digerite que le grasso in le lacte de vacca.

    <p>acidos</p> Signup and view all the answers

    Le lacte de vacca es non recommendate durante episodios de diarrheea a causa del possibilitate de dehydratation hypertonica.

    <p>reducite</p> Signup and view all the answers

    Le ______ del lacte de vacca es sterilitate, convenient, e standardisate in concentrationes de proteina, grasso, e carbohydrato.

    <p>evaporate</p> Signup and view all the answers

    Le ______ benefitio del allactamento es que illo furni un avantaggio importante in le disveloppamento del sistema immunitari.

    <p>principal</p> Signup and view all the answers

    Le ______ composition de acidos grasse in le lacte de vacca es differente del composition de acidos grasse in le lacte human.

    <p>fatty</p> Signup and view all the answers

    Match the following characteristics with the type of milk:

    <p>Higher whey:casein ratio = Human milk Lower whey:casein ratio = Whole cow milk Higher water content = Both human milk and whole cow milk Higher calcium content = Whole cow milk</p> Signup and view all the answers

    Match the following benefits with the type of nutrition:

    <p>Optimal milk source for infants until 12 months = Human milk Appropriate alternative to human milk = Infant formula Supports immune system development = Breastfeeding Provides essential fatty acids = Infant formula</p> Signup and view all the answers

    Match the following fatty acid characteristics with the type of milk:

    <p>Higher proportion of unsaturated fatty acids = Human milk Higher proportion of saturated fatty acids = Whole cow milk Unique fatty acid composition = Human milk Similar fatty acid composition to human milk = Infant formula</p> Signup and view all the answers

    Match the following micronutrient supplementation benefits with the type of nutrition:

    <p>Essential for bone growth and development = Calcium supplementation Important for immune system development = Vitamin supplementation Supports brain and eye development = Taurine supplementation Enhances fatty acid absorption = Vitamin supplementation</p> Signup and view all the answers

    Match the following characteristics with the type of infant:

    <p>Reduced GI tract function = Premature infant Mature GI tract function = Term infant Lower birth weight = Premature infant Higher risk of osmotic diarrhea = Premature infant</p> Signup and view all the answers

    Match the following benefits with the type of nutrition:

    <p>Supports GI tract growth and differentiation = Human milk Provides essential nutrients for growth and development = Infant formula Enhances water absorption = Colonic salvage Supports kidney function = Human milk</p> Signup and view all the answers

    Match the following formulas with their primary usage:

    <p>MCT Formulas = Infants with pancreatic insufficiency, bile acid deficiency, and intestinal resection PRSL Formulas = Infants with renal insufficiency Casein Hydrolysate Formulas = Infants with cow milk protein allergy Standard Infant Formulas = Healthy full-term infants</p> Signup and view all the answers

    Match the following characteristics with the type of formula:

    <p>Designed for infants with specific dietary needs = Therapeutic formula Designed for premature infants = Preterm formula Used as an alternative to human milk = Infant formula Enhances fat absorption = Formula with vegetable oils</p> Signup and view all the answers

    Match the following characteristics with their corresponding formula types:

    <p>Higher MCT content = MCT Formulas Lower mineral and protein content = PRSL Formulas Higher concentrations of lipid and water soluble vitamins = MCT Formulas Standard protein and mineral content = Standard Infant Formulas</p> Signup and view all the answers

    Match the following benefits with the type of nutrition:

    <p>Provides essential fatty acids = Human milk Supports immune system development = Breastfeeding Enhances GI tract function = Colonic salvage Supports kidney function = Infant formula</p> Signup and view all the answers

    Match the following complications with their corresponding formula types:

    <p>Essential fatty acid deficiency = MCT Formulas Diarrhea and dehydration = Concentrated Infant Formula Lymphatic anomalies = MCT Formulas Renal insufficiency = PRSL Formulas</p> Signup and view all the answers

    Match the following nutrients with their supplementation in infant formulas:

    <p>Calcium = PRSL Formulas Iron = PRSL Formulas Linoleic acid = MCT Formulas Vitamins = MCT Formulas</p> Signup and view all the answers

    Match the following conditions with their corresponding formula usage:

    <p>Cystic fibrosis = MCT Formulas Biliary atresia = MCT Formulas Chylous ascites = MCT Formulas Renal insufficiency = PRSL Formulas</p> Signup and view all the answers

    Match the following characteristics with their corresponding formula types:

    <p>Lower PRSL than standard infant formulas = PRSL Formulas Higher concentrations of lipid and water soluble vitamins = MCT Formulas Unique formula due to high MCT content = MCT Formulas Standard protein and mineral content = Standard Infant Formulas</p> Signup and view all the answers

    Match the following formulas with their preparation considerations:

    <p>Concentrated Infant Formula = Proper dilution to avoid hypertonic solution MCT Formulas = Adding linoleic acid to prevent essential fatty acid deficiency PRSL Formulas = Supplementation of calcium and iron Standard Infant Formulas = No special considerations</p> Signup and view all the answers

    Match the following conditions with their corresponding formula benefits:

    <p>Fat malabsorption = MCT Formulas help compensate for impaired digestion and absorption Renal insufficiency = PRSL Formulas help reduce solute load Lymphatic anomalies = MCT Formulas help decrease lymphatic flow Pancreatic insufficiency = MCT Formulas help compensate for impaired digestion and absorption</p> Signup and view all the answers

    Match the following benefits of breastfeeding with their descriptions:

    <p>Exclusive breastfeeding for 6 months = Reinforcement of breastfeeding and human milk as the reference normative standards for infant feeding and nutrition Breastfeeding for 1 year or longer = Mutually desired by mother and infant Primary advantage of breastfeeding = Optimal milk source for infants Immune system development = Primary benefit for infants</p> Signup and view all the answers

    Match the following characteristics of cow milk and human milk with their descriptions:

    <p>Whey:casein ratio = Primary difference between mature human milk and whole cow milk Fatty acid composition = Primary difference between mature human milk and whole cow milk Calcium content = Primary micronutrient difference between mature human milk and whole cow milk Water content = Approximately the same percentage in both mature human milk and whole cow milk</p> Signup and view all the answers

    Match the following fatty acid types with their descriptions:

    <p>Linoleic acid = Omega 6 (n6) fatty acid Linolenic acid = Omega 3 (n3) fatty acid DHA = n3 long chain PUFA ARA = n6 long chain PUFA</p> Signup and view all the answers

    Match the following infant formula alternatives with their descriptions:

    <p>Soy protein-based formulas = Alternatives to human milk and cow milk-based formulas Goat milk = Alternative to cow milk-based formulas Human milk = Reference normative standards for infant feeding and nutrition Cow milk = Primary nutrient source for commercially prepared milk-based infant formulas</p> Signup and view all the answers

    Match the following micronutrients with their roles in infant nutrition:

    <p>Vitamins = Supplemented in infant formulas to meet the needs of most term and premature infants Minerals = Supplemented in infant formulas to meet the needs of most term and premature infants Lactose = Not added to milk-based infant formulas Taurine = Important for infant nutrition, and its deficiency has consequences</p> Signup and view all the answers

    Match the following infant formula characteristics with their descriptions:

    <p>Powdered goat milk = Recommended only for children over 1 year old Soy protein-based formulas = Alternatives to human milk and cow milk-based formulas Cow milk-based formulas = Primary nutrient source for commercially prepared milk-based infant formulas Therapeutic formulas = Designed for infants with specific dietary needs</p> Signup and view all the answers

    Study Notes

    Infant Nutrition and Digestion

    • Glucose polymers are better digested and absorbed than lactose in premature infants due to the relative abundance of glucoamylase in their intestines.
    • Newborns have low pancreatic lipase concentrations and slow bile acid synthesis, which affects fat absorption.
    • Infants born before 34 weeks gestation may exhibit steatorrhea due to reduced fat absorption.

    Kidney Maturation and Nutrition

    • The kidney's ability to excrete a solute load is important for nutrition and determines its maturation.
    • The rate of glomerular filtration increases after birth and reaches a maximum at the end of the second decade of life.

    Infant Growth and Development

    • Birth weight is determined by maternal prepregnancy weight and pregnancy weight changes.
    • Average birth weight of a term infant is approximately 3500 grams.
    • Premature infants are categorized based on birth weight: low (<2500g), very low (<1500g), extremely low (<1000g), and micropreemies (<750g).

    Infant Nutritional Standards

    • FDA sets specifications for minimum and maximum amounts of 29 nutrients in infant nutrition.
    • Infants require the same dietary components as adults, but with different proportions.

    Carbohydrates in Infant Nutrition

    • Infants can efficiently use a diet with 40%-50% of total calories from a carbohydrate source.

    Human Milk and Infant Nutrition

    • Human milk is the optimal milk source for infants until 12 months of age.
    • It is recommended as the sole source of nutrition for the first 6 months of life.

    Gastrointestinal Maturation

    • The GI tract is formed and displays physiologic function by the end of the second trimester of pregnancy.
    • The third trimester is the period of maximal GI tract growth and differentiation.
    • Premature infants may have reduced GI tract function.

    Unabsorbed Lactose and Colonic Salvage

    • Unabsorbed lactose is fermented by bacteria in the colon to short-chain fatty acids, creating an acidic environment.
    • This process favors growth of acidophilic bacterial flora and suppresses growth of more pathogenic organisms.

    Goat Milk and Infant Nutrition

    • Unfortified goat milk is not recommended for infants due to its deficiency in folate and low levels of iron and vitamin D.
    • Evaporated goat milk is supplemented with vitamin D and folic acid, while powdered goat milk is supplemented with only folic acid.

    Commercial Infant Formulas

    • Milk-based formulas are prepared from nonfat cow milk, vegetable oils, and added carbohydrate (lactose).
    • Therapeutic formulas include soy protein-based, casein-based, and whey hydrolysate-based formulas.
    • Pre-thickened milk-based formulas are designed for infants with gastroesophageal reflux.

    Taurine in Infant Formula

    • Taurine is a cell membrane protector that attenuates toxic substances, such as oxidants, secondary bile acids, and excess retinoids.
    • It also acts as an osmo regulator and is not an energy source or used for protein synthesis.
    • Taurine deficiency can result in retinal dysfunction, slow development of auditory brain stem evoked response in preterm infants, and poor fat absorption in preterm infants and children with cystic fibrosis.

    Fat and Essential Fatty Acids

    • Fat is the most calorically dense component in the diet, providing 9 kcal/g.
    • Fat accounts for approximately 50% of the nonprotein energy in both human milk and infant formula.
    • Children younger than 2 years should not receive a fat or cholesterol restricted diet unless medically prescribed.
    • Children between 12 months and 2 years who are at increased risk for cardiovascular disease (CVD) may be candidates for reduced fat milk products.
    • Children between 2 and 5 years of age should adopt a diet that contains 20%-30% of total calories from fat, with less than 10% of calories from saturated fats and less than 1% from trans fatty acids.

    Composition of Human Milk and Cow Milk

    • Water content: 87.1% in human milk, 87.2% in cow milk.
    • Protein content: 0.9-1.3 g/100 mL in human milk, 3.3-3.4 g/100 mL in cow milk.
    • Whey:casein ratio: 72:28 in human milk, 18:82 in cow milk.
    • Fat content: 3.9 g/100 mL in human milk, 3.4-3.8 g/100 mL in cow milk.
    • Carbohydrate content: 6.77 g/100 mL in human milk, 4.7-4.8 g/100 mL in cow milk.
    • Mineral content: human milk has higher levels of calcium, phosphorus, and potassium, but lower levels of sodium, chloride, and magnesium compared to cow milk.
    • Vitamin content: human milk has higher levels of vitamins A, C, and E, but lower levels of vitamins B12 and D compared to cow milk.

    Whole Cow Milk

    • Whole cow milk is not suitable for providing nutrition to infants younger than 1 year.
    • Premature infants may exhibit steatorrhea due to reduced absorption of fat by the intestine.
    • Maturation of the kidney is important in nutrition, as it determines the ability to excrete a solute load.

    Growth

    • Birth weight is determined primarily by maternal prepregnancy weight and pregnancy weight changes.
    • Average birth weight of a term infant is approximately 3500 grams.
    • Premature infants are categorized based on birth weight: low birth weight (<2500 grams), very low birth weight (<1500 grams), extremely low birth weight (<1000 grams), and micropreemies (<750 grams).

    Infant Nutritional Standards

    • FDA sets specifications for minimum amounts of 29 nutrients and maximum amounts of 9 of those nutrients.
    • Infants require the same dietary components as adults, but with differing proportions.
    • Fluid is an important part of an infant's diet, making up a larger proportion of the infant's body weight than in older children or adults.

    Composition of Mature Human Milk and Whole Cow Milk

    • Mature human milk contains 87.1% water, 0.9-1.3g protein, and 3.9g fat per 100mL.
    • Whole cow milk contains 87.2% water, 3.3-3.4g protein, and 3.4-3.8g fat per 100mL.
    • Whey:casein ratio in mature human milk is 72:28, whereas in whole cow milk it is 18:82.
    • Mature human milk contains higher levels of alphalactalbumin, lactoferrin, and secretory IgA compared to whole cow milk.
    • Whole cow milk contains higher levels of calcium, phosphorus, sodium, and chloride compared to mature human milk.

    Vitamins and Minerals in Mature Human Milk and Whole Cow Milk

    • Mature human milk contains 2000 international units of vitamin A per liter, while whole cow milk contains 1000 international units per liter.
    • Mature human milk contains higher levels of thiamin, riboflavin, and vitamin C compared to whole cow milk.
    • Whole cow milk contains higher levels of vitamin B12, pantothenate, and biotin compared to mature human milk.
    • Mature human milk contains higher levels of chromium, manganese, and selenium compared to whole cow milk.

    Whole Cow Milk and Infant Nutrition

    • Whole cow milk is not suitable for infants younger than 1 year due to low iron concentration and poor bioavailability.
    • Whole cow milk has been associated with iron deficiency anemia and milk protein intolerance/allergy.
    • Whole cow milk can lead to unnecessarily high intakes of protein and electrolytes, resulting in a high renal solute load.

    Reduced Fat Cow Milk and Infant Nutrition

    • Reduced fat cow milk has been advocated for preventing obesity and atherosclerosis.
    • However, it is not recommended for children younger than 2 years, as it can lead to failure to thrive and impaired neurologic development.
    • Reduced fat milk is not recommended during episodes of diarrhea due to the risk of hypertonic dehydration.

    Evaporated Milk and Infant Nutrition

    • Evaporated milk is a sterile, convenient source of cow milk with standardized concentrations of protein, fat, and carbohydrate.
    • However, it is not recommended for infant feeding.

    Goat Milk and Infant Nutrition

    • Goat milk contains primarily medium and short chain fatty acids, making it more readily digested than cow milk.
    • Goat milk is commercially available in powdered and evaporated forms.

    Fat and Essential Fatty Acids in Infant Nutrition

    • Fat provides 9 kcal/g, compared to 4 kcal/g for protein and carbohydrates.
    • Fat accounts for approximately 50% of the nonprotein energy in both human milk and infant formula.
    • Children younger than 2 years should not receive a fat- or cholesterol-restricted diet unless medically prescribed.
    • Children between 2 and 5 years of age should adopt a diet that contains 20%-30% of total calories from fat, with less than 10% of calories from saturated fats and less than 1% from trans fatty acids.

    High Medium Chain Triglycerides (MCT) Formulas

    • Used for infants with cow milk protein allergy, multiple food protein allergies, or intolerance to casein hydrolysate formulas.
    • Contain higher concentrations of lipid and water soluble vitamins compared to casein hydrolysate based formulas.
    • Help compensate for impaired digestion and absorption of long chain fats in patients with pancreatic insufficiency, bile acid deficiency, and intestinal resection.

    Use of MCT Formulas

    • Decrease lymphatic flow in patients with lymphatic anomalies such as chylothorax and chylous ascites.
    • Can lead to essential fatty acid deficiency in children with fat malabsorption, which can be prevented by adding linoleic acid to the diet.

    Low Potential Renal Solute Load (PRSL) Formulas

    • Infant formula with lower mineral (potassium and phosphorus) and protein content.
    • Used for infants with renal insufficiency and may require supplementation of calcium and iron.

    Preparation of Formula

    • Failure to properly dilute a concentrated infant formula can result in a hypertonic solution, leading to diarrhea and dehydration.

    Human Milk

    • Most physiologically suited to infants and optimal milk source for feeding infants until 12 months of age.
    • Recommended as the sole source of nutrition for infants during the first 6 months of life.

    Gastrointestinal Maturation

    • Fetus's GI tract is formed and displays physiologic function by the end of the second trimester of pregnancy.
    • Premature infants (born before 37 weeks gestation) often have reduced GI tract function, especially those born prior to 32 weeks gestation.

    Lactose and Fermentation

    • Unabsorbed lactose in the colon undergoes bacterial fermentation to short chain fatty acids, creating an acidic environment that favors growth of acidophilic bacterial flora.
    • Acidity promotes water absorption and prevents osmotic diarrhea.

    Essential Polyunsaturated Fatty Acids

    • Linoleic acid and linolenic acid are essential polyunsaturated fatty acids required in infant formulas.
    • Precursors for the n3 and n6 long chain PUFAs: docosahexaenoic acid (DHA) and arachidonic acid (ARA), respectively.

    Micronutrients

    • Infant formulas are supplemented with adequate amounts of vitamins and minerals to meet the needs of most term and premature infants.

    Infant Food Sources

    • Human milk and cow milk-based formulas are the primary food sources for most infants.
    • Soy protein-based formulas and goat milk are alternatives.

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