Infant Nutrition PDF

Life Cycle Nutrition: Infant Nutrition Faculty of Science Department of Biochemistry Nutrient Needs in Early Life Growth rate during the first year is faster...

Life Cycle Nutrition: Infant Nutrition Faculty of Science Department of Biochemistry Nutrient Needs in Early Life Growth rate during the first year is faster than any other stage of life Faculty of Science Department of Biochemistry Nutrient Recommendations Infant vs. 20 yr old Energy: 100 vs. 40 kcal/kg Vit D: 10x as much (per kg) Energy & nutrient dense milk (human or formula) is the basis of the diet from 0 to 12 mo Faculty of Science Department of Biochemistry Infant Feeding in Year 1 of Life At birth – an injection of vitamin K for blood clotting As gut bacteria get established, they produce vit K which is absorbed by the infant Careful consideration of dehydration – infant body is more water than in adults, with large surface area so high water losses Diarrhea or vomiting can rapidly cause dehydration because kidneys are immature and cannot concentrate urine Under normal circumstance, breast milk (or formula) meets all water needs ONLY BREAST MILK OR IRON FORTIFIED FORMULA FOR 0 TO 6 MOS Nothing else is required…..or is recommended Early introduction of solids might increase the risk for allergies – esp gluten/celiac disease Faculty of Science Department of Biochemistry Infant Feeding in Year 1 of Life Infants are not developmentally ready for solid (baby) foods prior to ~ 6 mo (see Table 13‐10) – strong “extrusion” reflex, inadequate head control At 6 mo, liver iron stores are depleting Introduction of iron containing foods, such as infant cereals, meats or meat alt. Next foods should be Fruits & Veg to provide a source of vitamin C But not juice! Never juice from a bottle! Increase texture from pureed to thicker to soft lumps as infant develops, has good head control and is grabbing at food (developmental advantages) Encourage use of open cup and self feeding Breast milk or formula for at least one year – then weaning to whole cow’s milk COMMON MYTH: ‘Stuffing the baby’ to sleep through night—no evidence! Faculty of Science | Department of Biochemistry Faculty of Science Department of Biochemistry Never use honey in infant foods because of risk of botulism! Never feed Read the sweets ingredient list – (including avoid added baby salt and sugar desserts)! Faculty of Science Department of Biochemistry Infant Feeding beyond Year 1 Whole cow milk plus wide variety of foods (careful to avoid ‘milk anemia’) Let them pick from a variety and encourage handling of foods Always introduce many healthy foods, repeatedly— tastes change fast Habits are developed now, so encourage good habits Respect appetite cues—will fluctuate with activity, growth spurts, etc! Avoid sugar/fat/salt foods which can disrupt cues Faculty of Science | Department of Biochemistry Childhood Dental Caries/Nursing Bottle Syndrome Prolonged sucking on a bottle of milk or juice erodes tooth material Putting an infant/toddler to sleep with a bottle causes extended oral bacterial exposure to carbohydrate rich fluids In extremes can alter normal jaw line shape, and teeth alignment Faculty of Science Department of Biochemistry Appearance of Food Allergies in Infants Infants: Introduce new foods one at a time, every few days to watch for allergies May take a few days for a reaction to appear – skin rash, GI symptoms, respiratory symptoms (raspy breathing, wheezing) Common allergens for infants include egg white, soy, milk and citrus fruit If a reaction appears, re‐test the food after a “wash‐ out” period of 1‐2 mo – but caution if family history Most infants out‐grow food allergies in early childhood Faculty of Science | Department of Biochemistry Food Allergies – Children (Chapter 14) True incidence in children is 3 to 5%, and 1% in adults although ~ 7% of children and 7.7% of adults self‐report food allergies Caused by food proteins or protein fragments that get Prevalence in Canada through the epithelial surface of the intestine into the body (%) to trigger an immune response Food Children Adults allergen Adaptive immune system recognizes protein as “foreign”, and produces antibodies to that food protein Peanut 2.4 0.7 Each subsequent exposure results in a greater response Tree nuts 1.6 1.2 “anaphylaxis“ is a very severe response, that includes constriction of Fish 1.0 0.6 the airway and a sudden drop in blood pressure, called “anaphylactic shock” – rare but life threatening, treated with epinephrine Shellfish 1.4 1.9 Peanut, tree nuts, fish/shellfish, egg, milk, soy and wheat are the Egg 1.0 0.5 most likely to cause anaphylaxis. Milk 0.7 0.7 Children. tend to “outgrow” many food allergies by age 10 http://allergen‐nce.ca/wp‐content/uploads/Canadian‐food‐allergy‐prevalence‐Jul‐2017.pdf; Statistics Canada, 2016 Faculty of Science | Department of Biochemistry Why are Food Allergies on the Rise??? “Hygiene theory” Increasing cleanliness of our environment and overuse of antibiotics have led to an exaggerated response by the immune system to harmless foreign proteins People with allergies lack “oral tolerance” of some food proteins Inducing Oral Tolerance Recent clinical trials including children with anaphylactic responses to peanut (and milk) allergies Exposed children to very small amounts of the allergen, with very gradual increases over time Children gained oral tolerance (unknown if it is necessary to continue to consume the allergen to maintain tolerance). Removes the threat for anaphylaxis with accidental exposure Faculty of Science Department of Biochemistry Food Intolerance versus Allergies Food allergy involves the immune system, but intolerance does not ADHD has NOT been linked to food allergies (or sugar) Food dyes may be related to ADHD (which would be an intolerance) Faculty of Science Department of Biochemistry