Nutrition And Infant Feeding PDF

NUTRITION AND INFANT FEEDING Dr Said Elsawy Lecturer of Pediatrics  General nutritional requirements during infancy & childhood Food During 1st year During childhood items Water 150 ml / kg/ day 5 % of body weight (1/...

NUTRITION AND INFANT FEEDING Dr Said Elsawy Lecturer of Pediatrics  General nutritional requirements during infancy & childhood Food During 1st year During childhood items Water 150 ml / kg/ day 5 % of body weight (1/6 of body wt.) Calories 110 kcal/kg/day (Age in years X 120) + (150 ml milk/kg/day) 1000 Proteins 2 g/kg/day or 14 g/day 15 - 30 g/ day protein of high biological protein of high value* biological value* Best combination of food should provide : Food Item % of Calories Protein 10 % of calories Carbohydrate 40 % of calories Fat 50 % of calories Breast feeding  Advantages (benefits) of breast feeding For the mother More convenient and economic, available at any time, and needs no preparation. Emotional satisfaction, strong bonding and loving relationship between mother and baby. Oxytocin helps uterine contraction that controls postpartum hemorrhage and helps uterine involution. Birth spacing: exclusive breast-feeding for 1st 6 months by day and night suppresses ovulation in 90% of women thus helping in family planning.  Lactational amenorrhea prevents iron loss. Women regain their normal weight and activities faster. Cancer breast and cancer ovary are less common in women who breast‑feed. Risk of osteomalacia is less.  Advantages (benefits) of breast feeding For the infant Breast milk is the natural food for human infants. Self regulated. Always fresh and free from contaminating bacteria. At proper temperature. Helps perform better on intelligence tests in later childhood. Fewer problems of digestion, colic and constipation, so baby sleeps well.  Emotional security and better infant- maternal bonding Perfectly balanced and nutritionally complete food for babies Anti-infective properties Anti-inflammatory properties Anti-allergic properties Formula feedings (Artificial feeding)  Breastfeeding for all infants is the best, but if it is impossible, a formula, as compositionally close to breast milk as possible is desirable. The aim of formula or "artificial" feeding is to supply, as a substitute to breast milk, a modified animal milk, which as much as possible, promotes health and normal growth of the baby.  Indications of formula feeding Death of the mother Mother unwilling to breast-feed Failure of lactation: no or very little milk Institutes and nurseries Absolute contraindications to breast feeding (e.g. galactosemia and maternal AIDS).  Supplemental feedings (both breast milk and formula) Suitable for employed mothers( as a second option after expressed breast milk), multiple delivery or if the amount of breast milk is inadequate.  Forms of animal milks Liquid milks : These milks, as such, are NOT suitable for feeding young infants (< 1 year) because they still contain microorganisms and still have huge biological differences from human milk.  To be used for infant feeding, they should be modified and sterilized.  Dried Whole Milk This is simply dried cow's milk. After reconstitution it is similar in composition to fresh cow's milk. It cannot be used for feeding of young infants unless modified. Examples: Nido, Celia, Carnation, France Lait, La Friziana, etc...  Adapted Cow's Milk Formulas Adaptation means modification of cow’s milk to adapt it for infant feeding. Examples: Similac, S 26 Gold, Nan 1, Bebelac1, Aptamil 1, etc. Follow-on milk formulas for healthy infants over 6 months contain more protein and iron and less fat than adapted milk formulas. Examples: Promil, Progress, Bebelac 2, Nan 2  Therapeutic Milk Formulas Milk formulas with modifications were done to suit certain metabolic errors or disease states. These formulas may be based on cow's milk, other mammal's milk or on vegetable ingredients. Examples: Lactose free milk (e.g. following acute diarrhea or in PEM cases). Special formulas for low-birth-weight newborns Hypoallergenic milk Contains NO milk protein which is completely replaced by Soya protein. It is indicated in cases with cow’s milk protein allergy. Phenyl‑alanine‑free milk for cases of phenylketonuria. Predigested or hydrolyzed formulas (e.g. Nutramigen, Pregestimil) for severe malnutrition. HOW MUCH TO FEED? (QUANTITY) Daily needs = 150 ml formula for each kg of body weight then the calculated amount is divided by the number of feeds per day (usually 6 feeds).  Weaning and complementary feeding  What is weaning? It is a gradual process starting at the age of six months. By which - Breast fed infants, formula fed infants or Combined breast feeding and formula feeding infants start to be fed with complementary foods. Complementary foods should replace gradually an increasing number of breast or formula feeds.  Principles of Complementary Feeding o Do not start a new food when the baby is sick or not doing well. o Start by replacing one milk feed by any other food. o Sudden weaning may predispose the young infant to a psychological trauma. o Gradually replace milk by food until all milk feeds are replaced at age of 2 years. o The new food is given gradually and in small amounts at first (1-2 spoons). If accepted by the baby, the amounts can be increased. o Consistency: should be semisolid, so do not use mixer or blender because they transform the vegetables and fruits into liquid. Better, use strainer or mash with a fork. o Amounts are determined by baby’s appetite. Many parents tend to overfeed their babies. o Never force the infant to take a new food (forced feeding). o The presentation of food is important; so better use colorful attractive spoons and plates to stimulate baby's interest and appetite and should better eat with family members but has his own plate (responsive or active feeding). o New food items should be introduced one at a time. o Vegetables and non-sweetened foods may be introduced before sweetened foods to reduce the tendency to develop desire for sweets. THANK YOU