Infancy Nutrition (Part 2) PDF

Infancy nutrition Part 2  Very Important information immunological Protection of breast milk  Breast milk offers immunological protection. it actively fights disease and protects infants from illnesses.  During the first two or three days after delivery, the breasts produce...

Infancy nutrition Part 2  Very Important information immunological Protection of breast milk  Breast milk offers immunological protection. it actively fights disease and protects infants from illnesses.  During the first two or three days after delivery, the breasts produce colostrum: a pre-milk substance containing mostly serum with antibodies and white blood cells. Colostrum helps protect the newborn from infections against which the mother has developed immunity.  Colostrum and breast milk provide” bifidus factors” , which favor the growth of the “friendly” bacterium Lactobacillus bifidus in the infant’s digestive tract, so that other, harmful bacteria cannot become established.  Breast milk contains a protein called” Lactoferrin.An iron-binding protein in breast milk, , keeps bacteria from getting the iron they need to grow, helps absorb iron into the infant’s bloodstream, and kills some bacteria directly.  Breastmilk contains a protein called “lactadherin” that attacks diarrhea-causing viruses.  Breast milk contains “a growth factor “that is present in stimulates the development and maintenance of the infant’s digestive tract and its protective factors.  Several breast milk enzymes such as “lipase” also help protect the infant against infection.  Infant formula A woman who breastfeeds for a year can wean her infant to cow’s milk, by passing the need for infant formula. However, a woman who decides to feed her infant formula, must select an appropriate infant formula and learn to prepare it.  Wean: to gradually replace breast milk with infant formula or other foods appropriate to an infant’s diet.  Infant formula composition  Formula manufacturers attempt to copy the nutrient composition of breast milk as closely as possible by imitating the composition of breast milk during second month of lactation, when the infant’s growth rate is high to produce standard formula.  The average proportions of energy yielding nutrients in human breast milk and formula differ slightly.  In contrast, cow’s milk provides too much protein( 20 %) and too little carbohydrate( 30%).  Standard cow’s milk-based formulas is usually made from cows' milk that has been treated to make it more suitable for babies. Risks of using formula feeding  Infant formulas contain no protective antibodies for infants.  Formulas may be contaminated (water- handling) leading to diarrhea, dehydration, and malabsorption.  Formula may be unavailable or over diluted in an attempt to save money.  Increasing the risk of nursing bottle tooth decay, if infant put to bed with a bottle of feeding.  The following picture represent a child mouth who was frequently put to bed sucking on a bottle filled with apple juice, so the teeth were bathed in carbohydrate for long periods of time a perfect medium for bacterial growth. The upper teeth show signs of decay. Fig ( 13 ) :Nursing bottle tooth decay  Special milk formulas  Standard cow’s milk-based formulas are inappropriate for some infants.  Special formulas have been designed to meet the dietary needs of infants with specific conditions such as prematurity or inherited diseases.  Infants allergic to milk protein can drink special hypoallergenic formulas or formulas based on soy protein. Soy formulas also use corn starch and sucrose instead of lactose and so are recommended for infants with lactose intolerance as well.  Introducing cow’s milk Whole cow’s milk is not appropriate during the first year because :  In some infants, particularly those younger than six months of age, whole cow’s milk may cause intestinal bleeding, which can lead to iron deficiency. Cow’s milk is also a poor source of iron.  Compared with breast milk or iron-fortified formula, cow’s milk is lower in vitamin C, characteristic that reduce iron absorption.  The higher protein concentration of cow’s milk can stress the infant’s kidneys.  Children one to two years of age should not be given reduced-fat, low-fat, or fat-free milk routinely; they need the fat of whole milk.  Between the ages of two and five years, a gradual transition from whole milk to the lower-fat milks can take place.  Introducing first/ solid foods  Inaddition to breast milk or formula, an infant can accept and begin to eat solid foods between four and six months.  The main purpose of introducing solid foods is to provide needed nutrients that are no longer supplied adequately by breast milk or formula alone.  The foods chosen must be those that the infant is developmentally capable of handling both physically and metabolically. When Babies Should Eat Solid Food 2022  Guidance has gone back and forth over the past few decades regarding when babies should eat solid foods. The American Academy of Pediatrics (AAP) says to wait until about six months if you're exclusively breastfeeding, while the American Academy of Allergy, Asthma, and Immunology (AAAAI) says four to six months is okay. Most pediatricians and pediatric dietitians agree babies should start between four to six months, depending on their readiness. The addition of foods to an infant’s diet should be governed by three considerations: 1. The infant’s nutrient needs, 2. The infant’s physical readiness to handle different forms of foods 3. The need to detect and control allergic reactions.  Food allergies  To prevent allergy and to facilitate its identification experts recommend introducing single-ingredient foods, one at a time, in small portions, and waiting four to five days before introducing the next new food.  For example, rice cereal is usually the first cereal introduced because it is the least allergenic. When it is clear that rice cereal is not causing an allergy, another grain, perhaps barley or oats, is introduced.  Wheat cereal is offered last because it can cause allergy more than other cereals.  If a cereal causes an allergic reaction such as a skin rash, digestive, or respiratory discomfort, it should be discontinued before introducing the next food.  Choice of infant foods  Infantfoods should be selected to provide variety, balance, and moderation.  Homemade or commercial baby foods offer a wide variety of palatable, nutritious foods in a safe and convenient form.  Ingredients for homemade foods should be fresh, whole foods without added salt, sugar, or seasonings.  To guard against foodborne illnesses, hands and equipment must be kept clean.  Foods to provide iron  In addition to breast milk or iron-fortified formula, infants can receive iron from iron-fortified cereals and, once they readily accept solid foods, from meat or meat alternates such as legumes.  Caregivers can enhance iron absorption from iron- fortified cereals by serving vitamin C–rich foods with meals.  Foods to provide vitamin C :  The best sources of vitamin C are fruits and vegetables. It has been suggested that infants who are introduced fruits before vegetables may develop a preference for sweets and find the vegetables less palatable.  Fruit juice is a good source of vitamin C.  Recommendation made to limit juice consumption for infants and young children (one to six years of age) to between 120 and 180 ml per day because : - Drinking too much juice can lead to diarrhea in infants and young children. - Fruit juices contribute excessive kcalories and displace other nutrient-rich foods.  Foods to omit  Concentrated sweets, have no place in an infant’s diet. They convey no nutrients to support growth, and can promote obesity.  Products containing sugar alcohols such as sorbitol should also be limited, as they may cause diarrhea.  Canned vegetables are also inappropriate for infants, as they often contain too much sodium.  Foods with greater choking hazards.  Honey should never be fed to infants less than on year because of the risk of clostridum botulism.  Botulism: an often fatal foodborne illness caused by the ingestion of foods containing a toxin produced by bacteria that grow without oxygen.  Foods at one year  At one year of age, whole cow’s milk can become a primary source of most of the nutrients an infant needs; 2 to 3 cups a day meets those needs sufficiently.  Ingesting more milk than this can displace iron-rich foods, which can lead to milk anemia*. If powdered milk is used, it should contain fat.  * Milk anemia: iron-deficiency anemia that develops when an excessive milk intake displaces iron-rich foods from the diet.  Other foods such as meats, iron-fortified cereals, enriched or whole-grain breads, fruits, and vegetables should be supplied in variety and in amounts sufficient to round out total energy needs.  Ideally, a one-year-old will sit at the table, eat many of the same foods everyone else eats, and drink liquids from a cup, not a bottle.