Nutritional and Feeding Considerations for Infants PDF

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Menu | Glossary | References Nutritional and Feeding Considerations for Infants Foundational eLearning Module START COURSE CONFIDENTIAL—EDUCATIONAL AND TRAINING MATERIALS. DO NOT DETAIL OR DISTRIBUTE TO ANY THIRD PARTIES.  Menu | Glossary | References Nutritional and Feeding Considerations for Infants Disclaimer Information shared in ANY eLearning module is for your background knowledge only and is not to be shared, discussed, or referenced with anyone outside of Wyeth Infant Nutrition. Any engagement with contacts must take place in accordance with Wyeth Infant Nutrition policies and guidelines. PREVIOUS 2 CONFIDENTIAL—EDUCATIONAL AND TRAINING MATERIALS. DO NOT DETAIL OR DISTRIBUTE TO ANY THIRD PARTIES. NEXT NEXT  Menu | Glossary | References Nutritional and Feeding Considerations for Infants Important Notice The World Health Organization (WHO*) has recommended that pregnant women and new mothers be informed on the benefits and superiority of breast-feeding – in particular, the fact that it provides the best nutrition and protection from illness for babies. Mothers should be given guidance on the preparation for, and maintenance of, lactation, with special emphasis on the importance of a well-balanced diet both during pregnancy and after delivery. Unnecessary introduction of partial formula-feeding or other foods and drinks should be discouraged since it will have a negative effect on breast-feeding. Similarly, mothers should be warned of the difficulty of reversing a decision not to breast-feed. Before advising a mother to use an infant formula, she should be advised of the social and financial implications of her decision: for example, if a baby is exclusively bottle-fed, more than 400g per week will be needed, so the family circumstances and costs should be kept in mind. Mothers should be reminded that breast-milk is not only the best, but also the most economical food for babies. If a decision to use an infant formula is taken, it is important to give instructions on correct preparation methods, emphasizing that unboiled water, unsterilized bottles, or incorrect dilution can all lead to illness. The World Health Organization recommends exclusive breastfeeding during the first 6 months of life and continued breastfeeding for as long as possible. As babies’ growth and development needs vary, health professionals should advise the mother when her baby should start receiving complementary food. *See: International Code of Marketing of Breast Milk Substitutes, adopted by the World Health Assembly in Resolution WHA 34.22, May 1981. I ACCEPT PREVIOUS 3 CONFIDENTIAL—EDUCATIONAL AND TRAINING MATERIALS. DO NOT DETAIL OR DISTRIBUTE TO ANY THIRD PARTIES. NEXT NEXT  Menu | Glossary | References Nutritional and Feeding Considerations for Infants Welcome to the Nutritional and Feeding Considerations for Infants module. The goal of this module is for learners to understand why “breast is best,” and how breast milk as well as complementary foods that are introduced at the right time meet the nutritional needs of preterm and full-term infants throughout the first year of life. This module is divided into 4 chapters: 1. Breast Milk: The Gold Standard of Infant Nutrition 2. Nutritional Composition of Breast Milk 3. Infant Feeding Considerations 4. Preterm Infant Feeding Several Progress Checks are included throughout the module to ensure key concepts are learned. This module should take you approximately 1 hour 30 minutes to complete. PREVIOUS 4 CONFIDENTIAL—EDUCATIONAL AND TRAINING MATERIALS. DO NOT DETAIL OR DISTRIBUTE TO ANY THIRD PARTIES. NEXT NEXT  Menu | Glossary | References Nutritional and Feeding Considerations for Infants Learning Objectives After completing this module, you will be able to: State the recommendations and considerations for breastfeeding and contraindications or medically indicated reasons for not breastfeeding Describe the composition of breast milk and function of each of its components Discuss the feeding recommendations and considerations for infants from 0–12 months Define preterm birth and explain the nutritional needs as well as feeding practices for preterm infants PREVIOUS 5 CONFIDENTIAL—EDUCATIONAL AND TRAINING MATERIALS. DO NOT DETAIL OR DISTRIBUTE TO ANY THIRD PARTIES. NEXT NEXT  Menu | Glossary | References Nutritional and Feeding Considerations for Infants 1 Breast Milk: The Gold Standard of Infant Nutrition PREVIOUS 6 CONFIDENTIAL—EDUCATIONAL AND TRAINING MATERIALS. DO NOT DETAIL OR DISTRIBUTE TO ANY THIRD PARTIES. NEXT NEXT  Menu | Glossary | References Nutritional and Feeding Considerations for Infants 1 Breast Milk: The Gold Standard of Infant Nutrition 2 Nutritional Milk Composition of Breast 3 Infant Feeding Considerations 4 Preterm Infant Feeding Breast milk is the preferred sole source of nutrition for infants1 Breast milk is specifically designed for the optimal growth of the infant’s brain and body, to provide protection against infection, and to promote development of immunity.2 Expert panels, including the World Health Organization (WHO), United Nations Children’s Fund (UNICEF), the American Academy of Pediatrics (AAP), and the European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) recommend that infants be exclusively breastfed for the first six months of life to achieve optimal growth, development, and health. 1,3,4 Thereafter, children should receive adequate and safe complementary foods while breastfeeding continues up until two years of age or beyond.1,3,4 PREVIOUS 7 CONFIDENTIAL—EDUCATIONAL AND TRAINING MATERIALS. DO NOT DETAIL OR DISTRIBUTE TO ANY THIRD PARTIES. NEXT NEXT  Menu | Glossary | References Nutritional and Feeding Considerations for Infants 1 Breast Milk: The Gold Standard of Infant Nutrition 2 Nutritional Milk Composition of Breast 3 Infant Feeding Considerations 4 Preterm Infant Feeding Benefits of breast milk CLICK EACH CIRCLE TO LEARN ABOUT THE BENEFITS OF BREAST MILK. Enhanced Protection against gastrointestinal chronic diseases function Enhanced Enhanced immunity neurodevelopment PREVIOUS 8 CONFIDENTIAL—EDUCATIONAL AND TRAINING MATERIALS. DO NOT DETAIL OR DISTRIBUTE TO ANY THIRD PARTIES. NEXT NEXT  Menu | Glossary | References Nutritional and Feeding Considerations for Infants 1 Breast Milk: The Gold Standard of Infant Nutrition 2 Nutritional Milk Composition of Breast 3 Infant Feeding Considerations 4 Preterm Infant Feeding Benefits of breast milk CLICK EACH CIRCLE TO LEARN ABOUT THE BENEFITS OF BREAST MILK. Breast milk can help prevent infection in the infant by providing Enhanced × Protection against antibodies and other immunologic factors,2 including lysozyme, gastrointestinal chronic diseases lymphocytes, macrophages, bifidus factor, and lactoferrin.2,5 All of function these factors provide the breastfed infant with passive immunity.6 Research in developed and developing countries provides strong evidence that breastfeeding decreases the incidence and/or severity of certain infections, such as3: Bacterial meningitis Enhanced Enhanced immunity Necrotizing enterocolitis9 Gastrointestinal infections7 neurodevelopment Otitis media4 Respiratory tract infections8 Urinary tract infections PREVIOUS 9 CONFIDENTIAL—EDUCATIONAL AND TRAINING MATERIALS. DO NOT DETAIL OR DISTRIBUTE TO ANY THIRD PARTIES. NEXT NEXT  Menu | Glossary | References Nutritional and Feeding Considerations for Infants 1 Breast Milk: The Gold Standard of Infant Nutrition 2 Nutritional Milk Composition of Breast 3 Infant Feeding Considerations 4 Preterm Infant Feeding Benefits of breast milk CLICK EACH CIRCLE TO LEARN ABOUT THE BENEFITS OF BREAST MILK. Some studies suggest that breastfeeding may reduce × Protection against the incidence ofEnhanced chronic diseases in later childhood and gastrointestinal adulthood, such as3,6: chronic diseases function Insulin-dependent (type 1)10 and non–insulin- dependent (type 2) diabetes mellitus11,12 Lymphoma, leukemia,9 and Hodgkin disease Hypercholesterolemia Obesity11,13 Enhanced Enhanced immunity neurodevelopment Asthma14 PREVIOUS 10 CONFIDENTIAL—EDUCATIONAL AND TRAINING MATERIALS. DO NOT DETAIL OR DISTRIBUTE TO ANY THIRD PARTIES. NEXT NEXT  Menu | Glossary | References Nutritional and Feeding Considerations for Infants 1 Breast Milk: The Gold Standard of Infant Nutrition 2 Nutritional Milk Composition of Breast 3 Infant Feeding Considerations 4 Preterm Infant Feeding Benefits of breast milk CLICK EACH CIRCLE TO LEARN ABOUT THE BENEFITS OF BREAST MILK. Many factors in breast milk may stimulate × Enhanced gastrointestinal growth and motility Protection and enhance against maturity of the gastrointestinal tract. gastrointestinal chronic diseases For instance, lactoferrin may affect intestinal function growth, and epidermal growth factor may provide a surveillance system for the intestinal mucosa to repair any injuries. 6 Enhanced Enhanced immunity neurodevelopment PREVIOUS 11 CONFIDENTIAL—EDUCATIONAL AND TRAINING MATERIALS. DO NOT DETAIL OR DISTRIBUTE TO ANY THIRD PARTIES. NEXT NEXT  Menu | Glossary | References Nutritional and Feeding Considerations for Infants 1 Breast Milk: The Gold Standard of Infant Nutrition 2 Nutritional Milk Composition of Breast 3 Infant Feeding Considerations 4 Preterm Infant Feeding Benefits of breast milk CLICK EACH CIRCLE TO LEARN ABOUT THE BENEFITS OF BREAST MILK. Breastfeeding has been associated with slightly × Enhanced enhanced performance on tests ofagainst Protection cognitive development.3,15 gastrointestinal chronic diseases Improved long-term cognitive and motor abilities function in full-term infants have been directly correlated with duration of breastfeeding.6 Enhanced Enhanced immunity neurodevelopment PREVIOUS 12 CONFIDENTIAL—EDUCATIONAL AND TRAINING MATERIALS. DO NOT DETAIL OR DISTRIBUTE TO ANY THIRD PARTIES. NEXT NEXT  Menu | Glossary | References Nutritional and Feeding Considerations for Infants 1 Breast Milk: The Gold Standard of Infant Nutrition 2 Nutritional Milk Composition of Breast 3 Infant Feeding Considerations 4 Preterm Infant Feeding Contraindications or medically indicated reasons for not breastfeeding Breastfeeding is not advised for6: Infants with galactosemia, a condition in which lactose-containing milk is not tolerated Some infants with other inborn errors of metabolism PREVIOUS 13 CONFIDENTIAL—EDUCATIONAL AND TRAINING MATERIALS. DO NOT DETAIL OR DISTRIBUTE TO ANY THIRD PARTIES. NEXT NEXT  Menu | Glossary | References Nutritional and Feeding Considerations for Infants 1 Breast Milk: The Gold Standard of Infant Nutrition 2 Nutritional Milk Composition of Breast 3 Infant Feeding Considerations 4 Preterm Infant Feeding Contraindications or medically indicated reasons for not breastfeeding Women should not breastfeed when they3,6: Have active untreated tuberculosis disease Are human T-cell lymphotropic virus type I- or II-positive Have herpetic lesions on their breasts Are receiving antimetabolites or chemotherapeutic agents Are receiving diagnostic or therapeutic radioactive isotopes Have had exposure to radioactive materials Are using drugs of abuse In some developed countries, women who are infected with human immunodeficiency virus (HIV) are advised not to breastfeed.3,6 However, in developing countries with populations at risk of other infectious diseases and nutritional deficiencies, the mortality risks associated with bottle feeding may outweigh the possible risks of acquiring HIV infection.3 PREVIOUS 14 CONFIDENTIAL—EDUCATIONAL AND TRAINING MATERIALS. DO NOT DETAIL OR DISTRIBUTE TO ANY THIRD PARTIES. NEXT NEXT  Menu | Glossary | References Nutritional and Feeding Considerations for Infants 1 Breast Milk: The Gold Standard of Infant Nutrition 2 Nutritional Milk Composition of Breast 3 Infant Feeding Considerations 4 Preterm Infant Feeding Progress Check SELECT THE BEST RESPONSE TO THE QUESTION. YOU MUST THEN CLICK "SUBMIT" TO MOVE FORWARD. Breast milk is specifically designed for the optimal growth of the infant’s brain and body, to provide protection against infection, and to promote development of immunity. True or false? o A. True Answer: True o B. False Breast milk is the preferred sole source of nutrition for infants and is specifically designed for the optimal growth of the infant’s brain and body, to provide protection against infection, and to promote development of immunity. SUBMIT PREVIOUS 15 CONFIDENTIAL—EDUCATIONAL AND TRAINING MATERIALS. DO NOT DETAIL OR DISTRIBUTE TO ANY THIRD PARTIES. NEXT NEXT  Menu | Glossary | References Nutritional and Feeding Considerations for Infants 1 Breast Milk: The Gold Standard of Infant Nutrition 2 Nutritional Milk Composition of Breast 3 Infant Feeding Considerations 4 Preterm Infant Feeding Progress Check SELECT THE BEST RESPONSE TO THE QUESTION. YOU MUST THEN CLICK "SUBMIT" TO MOVE FORWARD. Which of the following is a potential benefit of breast milk? o A. Enhanced immunity Answer: D o B. Protection against chronic diseases Studies suggest that breast milk may o C. Enhanced neurodevelopment provide benefit in the following areas: Enhanced immunity o D. All of the above Protection against chronic disease Enhanced gastrointestinal function Enhanced neurodevelopment SUBMIT PREVIOUS 16 CONFIDENTIAL—EDUCATIONAL AND TRAINING MATERIALS. DO NOT DETAIL OR DISTRIBUTE TO ANY THIRD PARTIES. NEXT NEXT  Menu | Glossary | References Nutritional and Feeding Considerations for Infants 1 Breast Milk: The Gold Standard of Infant Nutrition 2 Nutritional Milk Composition of Breast 3 Infant Feeding Considerations 4 Preterm Infant Feeding Progress Check SELECT THE BEST RESPONSE TO THE QUESTION. YOU MUST THEN CLICK "SUBMIT" TO MOVE FORWARD. Which of the following is a potential reason for women not to breastfeed? o A. Have active untreated tuberculosis disease Answer: D o B. Are receiving antimetabolites or chemotherapeutic agents Women should not breastfeed when they: Have active untreated tuberculosis disease o C. Are human T-cell lymphotropic virus type I-positive Are human T-cell lymphotropic virus type I- or II-positive Have herpetic lesions on their breasts Are receiving antimetabolites or chemotherapeutic agents o D. All of the above Are receiving diagnostic or therapeutic radioactive isotopes Have had exposure to radioactive materials o E. A and B only Are using drugs of abuse SUBMIT PREVIOUS 17 CONFIDENTIAL—EDUCATIONAL AND TRAINING MATERIALS. DO NOT DETAIL OR DISTRIBUTE TO ANY THIRD PARTIES. NEXT NEXT  Menu | Glossary | References Nutritional and Feeding Considerations for Infants 2 Nutritional Composition of Breast Milk PREVIOUS 18 CONFIDENTIAL—EDUCATIONAL AND TRAINING MATERIALS. DO NOT DETAIL OR DISTRIBUTE TO ANY THIRD PARTIES. NEXT NEXT  Menu | Glossary | References Nutritional and Feeding Considerations for Infants 1 Breast Milk: The Gold Standard of Infant Nutrition 2 Nutritional Milk Composition of Breast 3 Infant Feeding Considerations 4 Preterm Infant Feeding Composition of breast milk Breast milk always contains protein, fat, carbohydrate, vitamins, minerals, and other nutrients, but the composition of breast milk changes as the infant’s needs change.2 The composition can vary based on the stage of lactation, the time of day, maternal diet, and other factors.2 In fact, breast milk content even varies during the course of a single feeding.16,17 SCROLL THROUGH THE TIMELINE TO LEARN ABOUT THE COMPOSITION OF BREAST MILK AT EACH STAGE OF LACTATION. Colostrum is the milk produced during the first few days after birth.2,17 It is a yellowish, thick fluid that is composed of nutrients present in the mammary glands and ducts at delivery mixed with newly secreted milk.2 Compared to mature breast milk, colostrum contains: More protein, less carbohydrates, and much less fat16-18 A higher percentage of fat-soluble vitamins and minerals17 Increased concentrations of secretory immunoglobulin A (sIgA), oligosaccharides, and lactoferrin, which contribute to its infection protection properties2,18 Days after birth 1 ~7 ~14 PREVIOUS 19 CONFIDENTIAL—EDUCATIONAL AND TRAINING MATERIALS. DO NOT DETAIL OR DISTRIBUTE TO ANY THIRD PARTIES. NEXT NEXT  Menu | Glossary | References Nutritional and Feeding Considerations for Infants 1 Breast Milk: The Gold Standard of Infant Nutrition 2 Nutritional Milk Composition of Breast 3 Infant Feeding Considerations 4 Preterm Infant Feeding Composition of breast milk Breast milk always contains protein, fat, carbohydrate, vitamins, minerals, and other nutrients, but the composition of breast milk changes as the infant’s needs change.2 The composition can vary based on the stage of lactation, the time of day, maternal diet, and other factors.2 In fact, breast milk content even varies during the course of a single feeding.16,17 SCROLL THROUGH THE TIMELINE TO LEARN ABOUT THE COMPOSITION OF BREAST MILK AT EACH STAGE OF LACTATION. The milk produced from about seven to ten days postpartum until about two weeks postpartum is called transitional milk. Gradually, transitional milk evolves to become mature milk.2 During this phase2: Concentration of immunoglobulins Levels of fat-soluble vitamins and total protein are decreasing18 are decreasing Lactose, fat and total caloric Levels of water-soluble vitamins content is increasing are increasing Days after birth 1 ~7 ~14 PREVIOUS 20 CONFIDENTIAL—EDUCATIONAL AND TRAINING MATERIALS. DO NOT DETAIL OR DISTRIBUTE TO ANY THIRD PARTIES. NEXT NEXT  Menu | Glossary | References Nutritional and Feeding Considerations for Infants 1 Breast Milk: The Gold Standard of Infant Nutrition 2 Nutritional Milk Composition of Breast 3 Infant Feeding Considerations 4 Preterm Infant Feeding Composition of breast milk Breast milk always contains protein, fat, carbohydrate, vitamins, minerals, and other nutrients, but the composition of breast milk changes as the infant’s needs change.2 The composition can vary based on the stage of lactation, the time of day, maternal diet, and other factors.2 In fact, breast milk content even varies during the course of a single feeding.16,17 SCROLL THROUGH THE TIMELINE TO LEARN ABOUT THE COMPOSITION OF BREAST MILK AT EACH STAGE OF LACTATION. Breast milk is divided into two types: Foremilk is the first milk obtained at the onset of suckling or expression, and contains less fat than later milk of that feeding16 Hindmilk is the milk obtained later during a feeding, is usually high in fat,16 and may be involved in appetite regulation19 Days after birth 1 ~7 ~14 PREVIOUS 21 CONFIDENTIAL—EDUCATIONAL AND TRAINING MATERIALS. DO NOT DETAIL OR DISTRIBUTE TO ANY THIRD PARTIES. NEXT NEXT  Menu | Glossary | References Nutritional and Feeding Considerations for Infants 1 Breast Milk: The Gold Standard of Infant Nutrition 2 Nutritional Milk Composition of Breast 3 Infant Feeding Considerations 4 Preterm Infant Feeding Key constituents of breast milk The constituents of breast milk include 200 different substances, some with nutritional properties, which can be categorized as follows2,6,19-22: Macronutrients Fats Proteins Carbohydrates Vitamins Nucleotides Micronutrients Other nutrients Minerals Carotenoids PREVIOUS 22 CONFIDENTIAL—EDUCATIONAL AND TRAINING MATERIALS. DO NOT DETAIL OR DISTRIBUTE TO ANY THIRD PARTIES. NEXT NEXT  Menu | Glossary | References Nutritional and Feeding Considerations for Infants 1 Breast Milk: The Gold Standard of Infant Nutrition 2 Nutritional Milk Composition of Breast 3 Infant Feeding Considerations 4 Preterm Infant Feeding Macronutrients provide energy to the rapidly growing infant Infants require significant amounts of energy owing to their considerable growth and development during the first year of life. With the exception of the gestational period, infants exhibit greater growth during this time than at any other stage of life. By 6 months of age, most infants have doubled their birth weight.23 The estimated energy requirement (EER) during infancy is defined as the average dietary energy intake needed to sustain various body functions, enable 472 to 645 kcal deposition of tissues, and support growth at rates consistent with good health. per day for boys The energy requirement for infants in this age group is determined by body weight, which in turn is related to gender (as shown on the right).24 438 to 593 kcal per day for girls PREVIOUS 23 CONFIDENTIAL—EDUCATIONAL AND TRAINING MATERIALS. DO NOT DETAIL OR DISTRIBUTE TO ANY THIRD PARTIES. NEXT NEXT  Menu | Glossary | References Nutritional and Feeding Considerations for Infants 1 Breast Milk: The Gold Standard of Infant Nutrition 2 Nutritional Milk Composition of Breast 3 Infant Feeding Considerations 4 Preterm Infant Feeding Macronutrients in breast milk: protein Protein intake is important for growth, repair, and maintenance of CLICK THE BOXES TO LEARN MORE ABOUT WHEY PROTEIN AND body tissue.6,25-27 Dietary protein also provides amino acids required THE PREDOMINANT WHEY PROTEIN FACTOR IN BREAST MILK. for the synthesis of body proteins.6 Mature breast milk has a low total protein concentration (approximately 10–12 grams per liter).28,29 This is important as high levels of dietary protein and electrolytes can result in Whey protein a high renal solute load, which places stress on the infant’s developing kidneys.30,31 Despite its low concentration, mature breast milk protein is of high nutritional quality and is digested and absorbed more efficiently than cow’s milk proteins.6 A high-quality protein is highly digestible and contains essential amino acids in amounts that closely meet human Alpha-lactalbumin needs.5 Breast milk contains two types of proteins: whey and casein. The whey-to-casein ratio in breast milk is variable and ranges from 90:10 to 50:50 during the normal course of lactation.18,32-34 PREVIOUS 24 CONFIDENTIAL—EDUCATIONAL AND TRAINING MATERIALS. DO NOT DETAIL OR DISTRIBUTE TO ANY THIRD PARTIES. NEXT NEXT  Menu | Glossary | References Nutritional and Feeding Considerations for Infants 1 Breast Milk: The Gold Standard of Infant Nutrition 2 Nutritional Milk Composition of Breast 3 Infant Feeding Considerations 4 Preterm Infant Feeding Macronutrients in breast milk: protein Protein intake is important for growth, repair, and maintenance of CLICK THE BOXES TO LEARN MORE ABOUT WHEY PROTEIN AND body tissue.6,25-27 Dietary protein also provides amino acids required THE PREDOMINANT WHEY PROTEIN FACTOR IN BREAST MILK. for the synthesis of body proteins.6 Mature breast milk has a low total protein concentration (approximately 10–12 grams per liter).28,29 This is important as high levels of dietary protein and electrolytes can result in Whey protein a high renal solute load, which places stress on the infant’s developing kidneys.30,31 Despite its low concentration, mature breast milk protein is of high nutritional quality and is digested and absorbed more efficiently than Whey protein has a high concentration of × cow’s milk proteins.6 A high-quality protein is highly digestible and branched-chain amino acids (BCAAs) that are contains essential amino acids in amounts that closely meet human important for tissue growth and repair.35 Alpha-lactalbumin needs.5 Whey reaches the small intestine faster than casein,35,36 and Breast milk contains two types of proteins: whey and casein. The forms soft flocs, or collections of fine suspended particles, whey-to-casein ratio in breast milk is variable and ranges from 90:10 that are easier to digest than the hard curds formed by to 50:50 during the normal course of lactation.18,32-34 casein.37,38 PREVIOUS 25 CONFIDENTIAL—EDUCATIONAL AND TRAINING MATERIALS. DO NOT DETAIL OR DISTRIBUTE TO ANY THIRD PARTIES. NEXT NEXT  Menu | Glossary | References Nutritional and Feeding Considerations for Infants 1 Breast Milk: The Gold Standard of Infant Nutrition 2 Nutritional Milk Composition of Breast 3 Infant Feeding Considerations 4 Preterm Infant Feeding Macronutrients in breast milk: protein Protein intake is important for growth, repair, and maintenance of CLICK THE BOXES TO LEARN MORE ABOUT WHEY PROTEIN AND body tissue.6,25-27 Dietary protein also provides amino acids required THE PREDOMINANT is Alpha-lactalbumin WHEY the PROTEIN FACTOR predominant IN BREAST MILK. whey × for the synthesis of body proteins.6 protein fraction in breast milk, and a good source Mature breast milk has a low total protein concentration of the essential amino acids that are pivotal in the body’s (approximately 10–12 grams per liter).28,29 This is important as high major organ systems, including the brain levels of dietary protein and electrolytes can result in and nervous system.39-42 Whey Protein a high renal solute load, which places stress on the infant’s developing Alpha-lactalbumin may also help stimulate the growth of kidneys.30,31 beneficial bifidobacteria in the gut.43 Despite its low concentration, mature breast milk protein is of high nutritional quality and is digested and absorbed more efficiently than cow’s milk proteins.6 A high-quality protein is highly digestible and contains essential amino acids in amounts that closely meet human Alpha-lactalbumin needs.5 Breast milk contains two types of proteins: whey and casein. The whey-to-casein ratio in breast milk is variable and ranges from 90:10 to 50:50 during the normal course of lactation.18,32-34 PREVIOUS 26 CONFIDENTIAL—EDUCATIONAL AND TRAINING MATERIALS. DO NOT DETAIL OR DISTRIBUTE TO ANY THIRD PARTIES. NEXT NEXT  Menu | Glossary | References Nutritional and Feeding Considerations for Infants 1 Breast Milk: The Gold Standard of Infant Nutrition 2 Nutritional Milk Composition of Breast 3 Infant Feeding Considerations 4 Preterm Infant Feeding Macronutrients in breast milk: fat Fat provides about half of the calories in breast milk. The fat in breast milk is CLICK THE BOXES TO LEARN ABOUT THE ROLE OF structured to facilitate its digestion and absorption.6 About 90% of breast milk fat is DHA AND AA IN VISUAL AND COGNITIVE digested, partly because of the presence of bile salt-stimulated lipase, a fat- DEVELOPMENT. splitting enzyme.23 Fat is an essential component of the diet because it: Role in visual Serves as a carrier for other nutrients, such as fat-soluble vitamins44 development Produces hormones and contributes to satiety Contributes a concentrated source of energy,44 and provides the body’s most economical means of storing energy45 Promotes growth when optimally absorbed46 Role in cognitive The pattern of fatty acids in breast milk is unique because its development composition includes the long-chain polyunsaturated fatty acids (LCPs) docosahexaenoic acid (DHA) and arachidonic acid (AA).6 Although term infants can synthesize AA and DHA from their respective precursors (linoleic acid and alpha-linolenic acid), research indicates that the infant’s immature systems preferentially make use of preformed LCPs.47-49 PREVIOUS 27 CONFIDENTIAL—EDUCATIONAL AND TRAINING MATERIALS. DO NOT DETAIL OR DISTRIBUTE TO ANY THIRD PARTIES. NEXT NEXT  Menu | Glossary | References Nutritional and Feeding Considerations for Infants 1 Breast Milk: The Gold Standard of Infant Nutrition 2 Nutritional Milk Composition of Breast 3 Infant Feeding Considerations 4 Preterm Infant Feeding Macronutrients in breast milk: fat Fat provides about half of the calories in breast milk. The fat in breast milk is CLICK THE BOXES TO LEARN ABOUT THE ROLE OF structured to facilitate its digestion and absorption.6 About 90% of breast milk fat is DHA AND AA IN VISUAL AND COGNITIVE digested, partly because of the presence of bile salt-stimulated lipase, a fat- DEVELOPMENT. splitting enzyme.23 Fat is an essential component of the diet because it: Role in visual Serves as a carrier for other nutrients, such as fat-soluble vitamins44 development Produces hormones and contributes to satiety Contributes a concentrated source of energy,44 and provides the body’s most economical means of storing energy45 DHA and AA are important components × Promotes growth when optimally absorbed46 of cell membranes and abundant in retinal phospholipids.50,51 Role in cognitive The pattern of fatty acids in breast milk is unique because its development composition includes the long-chain polyunsaturated fatty acids (LCPs) A continuous supply of both LCPs may be docosahexaenoic acid (DHA) and arachidonic acid (AA).6 necessary during the first year of life to optimally support the continued maturation of Although term infants can synthesize AA and DHA from their respective precursors the visual cortex.52 (linoleic acid and alpha-linolenic acid), research indicates that the infant’s immature systems preferentially make use of preformed LCPs.47-49 PREVIOUS 28 CONFIDENTIAL—EDUCATIONAL AND TRAINING MATERIALS. DO NOT DETAIL OR DISTRIBUTE TO ANY THIRD PARTIES. NEXT NEXT  Menu | Glossary | References Nutritional and Feeding Considerations for Infants 1 Breast Milk: The Gold Standard of Infant Nutrition 2 Nutritional Milk Composition of Breast 3 Infant Feeding Considerations 4 Preterm Infant Feeding Macronutrients in breast milk: fat Fat provides about half of the calories in breast milk. The fat in breast milk is CLICK THE BOXES TO LEARN ABOUT THE ROLE OF structured to facilitate its digestion and absorption.6 About 90% of breast milk fat is DHA AND AA IN VISUAL AND COGNITIVE digested, partly because of the presence of bile salt-stimulated lipase, a fat- DEVELOPMENT. splitting enzyme.23 DHA and AA are particularly abundant in brain × Fat is an essential component of the diet because it: phospholipids.53 Evidence indicates that theRole in visual effects of LCPs in Serves as a carrier for other nutrients, such as fat-soluble vitamins44 development breast milk, particularly DHA, may be associated Produces hormones and contributes to satiety with lasting increases in cognitive ability and educational achievement.54 Contributes a concentrated source of energy,44 and provides the body’s most economical means of storing energy45 Promotes growth when optimally absorbed46 Role in cognitive The pattern of fatty acids in breast milk is unique because its development composition includes the long-chain polyunsaturated fatty acids (LCPs) docosahexaenoic acid (DHA) and arachidonic acid (AA).6 Although term infants can synthesize AA and DHA from their respective precursors (linoleic acid and alpha-linolenic acid), research indicates that the infant’s immature systems preferentially make use of preformed LCPs.47-49 PREVIOUS 29 CONFIDENTIAL—EDUCATIONAL AND TRAINING MATERIALS. DO NOT DETAIL OR DISTRIBUTE TO ANY THIRD PARTIES. NEXT NEXT  Menu | Glossary | References Nutritional and Feeding Considerations for Infants 1 Breast Milk: The Gold Standard of Infant Nutrition 2 Nutritional Milk Composition of Breast 3 Infant Feeding Considerations 4 Preterm Infant Feeding Macronutrients in breast milk: carbohydrates Carbohydrates contribute to growth and development during infancy. CLICK THE BOXES TO LEARN MORE ABOUT THE Their primary role is to provide energy to cells throughout the body. CARBOHYDRATES IN BREAST MILK. Although relatively little carbohydrate is needed in the diet, carbohydrates spare protein and fat from being metabolized for calories.6 The main carbohydrates found in breast milk are lactose and human milk Lactose oligosaccharides55: Lactose is the predominant carbohydrate in breast milk.2 Because lactose is found only in milk and not in other animal and plant sources, its high level in breast milk indicates its significance2 Human milk oligosaccharides Human milk oligosaccharides (HMOs) are carbohydrate polymers that enhance the growth of certain bifidobacteria2,56 (HMOs) PREVIOUS 30 CONFIDENTIAL—EDUCATIONAL AND TRAINING MATERIALS. DO NOT DETAIL OR DISTRIBUTE TO ANY THIRD PARTIES. NEXT NEXT  Menu | Glossary | References Nutritional and Feeding Considerations for Infants 1 Breast Milk: The Gold Standard of Infant Nutrition 2 Nutritional Milk Composition of Breast 3 Infant Feeding Considerations 4 Preterm Infant Feeding Macronutrients in breast milk: carbohydrates Carbohydrates contribute to growth and development during infancy. CLICK THE BOXES TO LEARN MORE ABOUT THE Their primary role is to provide energy to cells throughout the body. CARBOHYDRATES IN BREAST MILK. Although relatively little carbohydrate is needed in the diet, carbohydrates spare protein and fat from being metabolized for calories.6 The main carbohydrates found in breast milk are lactose and human milk Lactose oligosaccharides55: Lactose is the predominant carbohydrate in breast milk.2 Because lactose is found only in milk and not in other animal and plant sources, its high level in breast milk Lactose is a readily available source of galactose, a × indicates its significance2 key nutrient required for optimal development of the central nervous system.Human 2 milk oligosaccharides Human milk oligosaccharides (HMOs) are carbohydrate polymers that enhance the growth of certain bifidobacteria2,56 (HMOs) Additionally, lactose provides beneficial effects for gut physiology, including prebiotic effects and softening of stools,57 and aids in the absorption of amino acids, as well as calcium and other minerals.19,37,58 PREVIOUS 31 CONFIDENTIAL—EDUCATIONAL AND TRAINING MATERIALS. DO NOT DETAIL OR DISTRIBUTE TO ANY THIRD PARTIES. NEXT NEXT  Menu | Glossary | References Nutritional and Feeding Considerations for Infants 1 Breast Milk: The Gold Standard of Infant Nutrition 2 Nutritional Milk Composition of Breast 3 Infant Feeding Considerations 4 Preterm Infant Feeding Macronutrients in breast milk: carbohydrates Human milk oligosaccharides (HMOs) have a receptor-like × mechanism that helps prevent pathogens, such as viruses, Carbohydrates contribute to growth and development during infancy. bacteria,CLICK and toxins, THE BOXES TO LEARN MORE ABOUT THE Their primary role is to provide energy to cells throughout the body. from attaching to the epithelial CARBOHYDRATES cells, IN BREAST MILK.and thus help protect Although relatively little carbohydrate is needed in the diet, carbohydrates against gastrointestinal infections.2,6,59 spare protein and fat from being metabolized HMOs also support immunity by59: for calories. 6 Preventing bacterial adhesion in the gut The main carbohydrates found in breast milk are lactose and Lactose human milk oligosaccharides : 55 Assisting gut barrier function Lactose is the predominant carbohydrate in breast milk.2 Possibly directly modulating the immune system Because lactose is found only in milk and not in other animal and plant sources, its high level in breast milk indicates its significance2 Human milk oligosaccharides Human milk oligosaccharides (HMOs) are carbohydrate polymers that enhance the growth of certain bifidobacteria2,56 (HMOs) PREVIOUS 32 CONFIDENTIAL—EDUCATIONAL AND TRAINING MATERIALS. DO NOT DETAIL OR DISTRIBUTE TO ANY THIRD PARTIES. NEXT NEXT  Menu | Glossary | References Nutritional and Feeding Considerations for Infants 1 Breast Milk: The Gold Standard of Infant Nutrition 2 Nutritional Milk Composition of Breast 3 Infant Feeding Considerations 4 Preterm Infant Feeding Micronutrients in breast milk: vitamins and choline Vitamins are essential components of cofactors, small organic or inorganic substances that work with an enzyme to facilitate a chemical reaction, in a wide range of metabolic reactions.6 CLICK THE CIRCLES TO LEARN MORE ABOUT THE VITAMINS AND CHOLINE. Vitamin A Choline Vitamin C Vitamin K Vitamin D Vitamin E PREVIOUS 33 CONFIDENTIAL—EDUCATIONAL AND TRAINING MATERIALS. DO NOT DETAIL OR DISTRIBUTE TO ANY THIRD PARTIES. NEXT NEXT  Menu | Glossary | References Nutritional and Feeding Considerations for Infants 1 Breast Milk: The Gold Standard of Infant Nutrition 2 Nutritional Milk Composition of Breast 3 Infant Feeding Considerations 4 Preterm Infant Feeding Micronutrients in breast milk: vitamins and choline Vitamins are essential components of cofactors, small organic or inorganic substances that work with an enzyme to facilitate a chemical reaction, in a wide range of metabolic reactions.6 Vitamin CLICK THE CIRCLES TO LEARN A is a fat-soluble MORE ABOUT vitamin THE VITAMINS 23,60 that AND CHOLINE. × has many functions, including: Roles in growth,61,62 immune function,60 and maintaining cellular differentiation throughout life61,62 Especially important in maintaining healthy vision23,60 Vitamin A Choline Vitamin C Vitamin K Vitamin D Vitamin E PREVIOUS 34 CONFIDENTIAL—EDUCATIONAL AND TRAINING MATERIALS. DO NOT DETAIL OR DISTRIBUTE TO ANY THIRD PARTIES. NEXT NEXT  Menu | Glossary | References Nutritional and Feeding Considerations for Infants 1 Breast Milk: The Gold Standard of Infant Nutrition 2 Nutritional Milk Composition of Breast 3 Infant Feeding Considerations 4 Preterm Infant Feeding Micronutrients in breast milk: vitamins and choline Vitamins are essential components of cofactors, small organic or inorganic substances that work with an enzyme to facilitate a chemical reaction, in a wide range of metabolic reactions.6 CLICK THE CIRCLES TO LEARN MORE ABOUT THE VITAMINS AND CHOLINE. Vitamin C, a water-soluble vitamin, functions as × a cofactor for enzymes involved in63: Biosynthesis of collagen Fatty acid metabolism Iron absorption, transport, and storage It also functions as a highly effective antioxidant.63 Vitamin A Choline Vitamin C Vitamin K Vitamin D Vitamin E PREVIOUS 35 CONFIDENTIAL—EDUCATIONAL AND TRAINING MATERIALS. DO NOT DETAIL OR DISTRIBUTE TO ANY THIRD PARTIES. NEXT NEXT  Menu | Glossary | References Nutritional and Feeding Considerations for Infants 1 Breast Milk: The Gold Standard of Infant Nutrition 2 Nutritional Milk Composition of Breast 3 Infant Feeding Considerations 4 Preterm Infant Feeding Micronutrients in breast milk: vitamins and choline Vitamins are essential components of cofactors, small organic or inorganic substances that work with an enzyme to facilitate a chemical reaction, in a wide range of metabolic reactions.6 CLICK THE CIRCLES TO LEARN MORE ABOUT THE VITAMINS AND CHOLINE. × Vitamin D is a fat-soluble vitamin64: Plays a special role in bone growth by maintaining blood concentrations of calcium and phosphorus64 Necessary for bone mineralization and growth65,66 Vitamin D deficiency is associated with rickets, which Vitamin still afflicts some children and Acauses growth Choline retardation and skeletal abnormalities.64 Vitamin C Vitamin K Vitamin D Vitamin E PREVIOUS 36 CONFIDENTIAL—EDUCATIONAL AND TRAINING MATERIALS. DO NOT DETAIL OR DISTRIBUTE TO ANY THIRD PARTIES. NEXT NEXT  Menu | Glossary | References Nutritional and Feeding Considerations for Infants 1 Breast Milk: The Gold Standard of Infant Nutrition 2 Nutritional Milk Composition of Breast 3 Infant Feeding Considerations 4 Preterm Infant Feeding Micronutrients in breast milk: vitamins and choline Vitamins are essential components of cofactors, small organic or inorganic substances that work with an enzyme to facilitate a chemical reaction, in a wide range of metabolic reactions.6 CLICK THE CIRCLES TO LEARN MORE ABOUT THE VITAMINS AND CHOLINE. Vitamin E is a fat-soluble vitamin67: × Functions within an “antioxidant network” to help protect cells from adverse effects of Vitamin A Choline free radicals23,64,68 Appears to stabilize the cell membranes in Vitamin C the lenses of the eyes67 Vitamin K Vitamin D Vitamin E PREVIOUS 37 CONFIDENTIAL—EDUCATIONAL AND TRAINING MATERIALS. DO NOT DETAIL OR DISTRIBUTE TO ANY THIRD PARTIES. NEXT NEXT  Menu | Glossary | References Nutritional and Feeding Considerations for Infants 1 Breast Milk: The Gold Standard of Infant Nutrition 2 Nutritional Milk Composition of Breast 3 Infant Feeding Considerations 4 Preterm Infant Feeding Micronutrients in breast milk: vitamins and choline Vitamins are essential components of cofactors, small organic or inorganic substances that work with an enzyme to facilitate a chemical reaction, in a wide range of metabolic reactions.6 CLICK THE CIRCLES TO LEARN MORE ABOUT THE VITAMINS AND CHOLINE. Vitamin K is a fat-soluble vitamin: × Important for biological reactions such as blood coagulation and bone metabolism65 Vitamin A Choline Participates in synthesis of bone proteins62 Vitamin C Vitamin K Vitamin D Vitamin E PREVIOUS 38 CONFIDENTIAL—EDUCATIONAL AND TRAINING MATERIALS. DO NOT DETAIL OR DISTRIBUTE TO ANY THIRD PARTIES. NEXT NEXT  Menu | Glossary | References Nutritional and Feeding Considerations for Infants 1 Breast Milk: The Gold Standard of Infant Nutrition 2 Nutritional Milk Composition of Breast 3 Infant Feeding Considerations 4 Preterm Infant Feeding Micronutrients in breast milk: vitamins and choline Vitamins are essential components of cofactors, small organic or inorganic substances that work with an enzyme to facilitate a chemical reaction, in a wide range of metabolic reactions.6 CLICK THE CIRCLES TO LEARN MORE ABOUT THE VITAMINS AND CHOLINE. Choline is an essential nutrient: × Important for brain development related to memory69 Necessary for synthesis of phosphatidylcholine, an important component of cell membranes23,69,70 Vitamin A Choline Vitamin C Vitamin K Vitamin D Vitamin E PREVIOUS 39 CONFIDENTIAL—EDUCATIONAL AND TRAINING MATERIALS. DO NOT DETAIL OR DISTRIBUTE TO ANY THIRD PARTIES. NEXT NEXT  Menu | Glossary | References Nutritional and Feeding Considerations for Infants 1 Breast Milk: The Gold Standard of Infant Nutrition 2 Nutritional Milk Composition of Breast 3 Infant Feeding Considerations 4 Preterm Infant Feeding Micronutrients in breast milk: minerals Minerals participate in many of the body’s most important functions,6 and those needed in small amounts are called trace elements.71 These include zinc, iodine, and selenium, which are essential to metabolic processes because they are components of many enzyme systems.6 CLICK THE CIRCLES TO LEARN MORE ABOUT THE MINERALS. Calcium Phosphorus Iron Zinc Iodine Selenium PREVIOUS 40 CONFIDENTIAL—EDUCATIONAL AND TRAINING MATERIALS. DO NOT DETAIL OR DISTRIBUTE TO ANY THIRD PARTIES. NEXT NEXT  Menu | Glossary | References Nutritional and Feeding Considerations for Infants 1 Breast Milk: The Gold Standard of Infant Nutrition 2 Nutritional Milk Composition of Breast 3 Infant Feeding Considerations 4 Preterm Infant Feeding Micronutrients in breast milk: minerals Minerals participate in many of the body’s most important functions,6 and those needed in small amounts are called trace elements.71 These include zinc, iodine, and selenium, which are essential to metabolic processes because they are components of many enzyme systems.6 CLICK THE CIRCLES TO LEARN MORE ABOUT THE MINERALS. Calcium Phosphorus Calcium is the most common mineral in the human body.19 It is a major structural element in Iron bones and teeth, where about 99% of the calcium in the body is found.19,65 Adequate calcium intake is required for the attainment and maintenance of optimal bone density.72 Zinc Calcium also plays a key role in muscle contraction and blood clotting.73 Iodine Selenium PREVIOUS 41 CONFIDENTIAL—EDUCATIONAL AND TRAINING MATERIALS. DO NOT DETAIL OR DISTRIBUTE TO ANY THIRD PARTIES. NEXT NEXT  Menu | Glossary | References Nutritional and Feeding Considerations for Infants 1 Breast Milk: The Gold Standard of Infant Nutrition 2 Nutritional Milk Composition of Breast 3 Infant Feeding Considerations 4 Preterm Infant Feeding Micronutrients in breast milk: minerals Minerals participate in many of the body’s most important functions,6 and those needed in small amounts are called trace elements.71 These include zinc, iodine, and selenium, which are essential to metabolic processes because they are components of many enzyme systems.6 CLICK THE CIRCLES TO LEARN MORE ABOUT THE MINERALS. Calcium Phosphorus Phosphorus is a major component of bones and teeth.65 Approximately 85% of total body Iron phosphorus is found in bone.65 However, a low intestinal phosphorus concentration is an essential condition for generating Zinc an acidic pH of the feces, which inhibits the growth of potentially pathogenic organisms.74 Iodine Selenium PREVIOUS 42 CONFIDENTIAL—EDUCATIONAL AND TRAINING MATERIALS. DO NOT DETAIL OR DISTRIBUTE TO ANY THIRD PARTIES. NEXT NEXT  Menu | Glossary | References Nutritional and Feeding Considerations for Infants 1 Breast Milk: The Gold Standard of Infant Nutrition 2 Nutritional Milk Composition of Breast 3 Infant Feeding Considerations 4 Preterm Infant Feeding Micronutrients in breast milk: minerals Minerals participate in many of the body’s most important functions,6 and those needed in small amounts are called trace elements.71 These include zinc, iodine, and selenium, which are essential to metabolic processes because they are components of many enzyme systems.6 CLICK THE CIRCLES TO LEARN MORE ABOUT THE MINERALS. Calcium Iron is an integral part of many proteins and enzymes that maintain good health. There are two categories of iron-containing compounds in the body: Phosphorus Those associated with iron storage and transport Iron Those known to serve a metabolic or enzymatic function Iron is a critical component of hemoglobin, a protein necessary for the transport of oxygen Zinc to tissues throughout the body.19,62 Additionally, iron is important for the development of a healthy central nervous system. 19 The neurotransmitters involved in cognition require iron for proper functioning.19 Iron also Iodine has an essential role in myelin formation and maintenance, which is critical for proper motor function.75 Selenium PREVIOUS 43 CONFIDENTIAL—EDUCATIONAL AND TRAINING MATERIALS. DO NOT DETAIL OR DISTRIBUTE TO ANY THIRD PARTIES. NEXT NEXT  Menu | Glossary | References Nutritional and Feeding Considerations for Infants 1 Breast Milk: The Gold Standard of Infant Nutrition 2 Nutritional Milk Composition of Breast 3 Infant Feeding Considerations 4 Preterm Infant Feeding Micronutrients in breast milk: minerals Minerals participate in many of the body’s most important functions,6 and those needed in small amounts are called trace elements.71 These include zinc, iodine, and selenium, which are essential to metabolic processes because they are components of many enzyme systems.6 CLICK THE CIRCLES TO LEARN MORE ABOUT THE MINERALS. Calcium Iron deficiency anemia is a public health problem in both industrialized and Phosphorus non-industrialized countries. The WHO and FAO have identified iron as a nutrient in which older infants are often at risk for deficiency.76 Iron Potential effects of iron deficiency in infants include: Impaired cognitive and physical development77-79 Zinc Disruption of multiple brain development processes80; an association with delayed auditory and visual system functioning81 Iodine Creation of long-lasting developmental disadvantages in cognitive, motor, and socioemotional functioning75,82 Selenium PREVIOUS 44 CONFIDENTIAL—EDUCATIONAL AND TRAINING MATERIALS. DO NOT DETAIL OR DISTRIBUTE TO ANY THIRD PARTIES. NEXT NEXT  Menu | Glossary | References Nutritional and Feeding Considerations for Infants 1 Breast Milk: The Gold Standard of Infant Nutrition 2 Nutritional Milk Composition of Breast 3 Infant Feeding Considerations 4 Preterm Infant Feeding Micronutrients in breast milk: minerals Minerals participate in many of the body’s most important functions,6 and those needed in small amounts are called trace elements.71 These include zinc, iodine, and selenium, which are essential to metabolic processes because they are components of many enzyme systems.6 CLICK THE CIRCLES TO LEARN MORE ABOUT THE MINERALS. Calcium Zinc is important for maintaining the integrity of the immune system and for supporting the enzymatic activities of numerous metabolic processes.62,76 Growth, reproduction, vision, taste, Phosphorus and appetite, as well as the structure and function of the brain, are all dependent on an adequate supply of zinc.83 Iron Zinc deficiency has consequences for growth and the immune system: Mild cases are characterized by slower-than-normal growth5 Zinc Moderate cases can result in rapid diminishment of immune responses, which may alter host’s defensive capacity and lead to increases in opportunistic infections.84 In Iodine mouse models, as short a period as 30 days of suboptimal zinc intake led to losses of 30–80% in defense capacity84 Selenium PREVIOUS 45 CONFIDENTIAL—EDUCATIONAL AND TRAINING MATERIALS. DO NOT DETAIL OR DISTRIBUTE TO ANY THIRD PARTIES. NEXT NEXT  Menu | Glossary | References Nutritional and Feeding Considerations for Infants 1 Breast Milk: The Gold Standard of Infant Nutrition 2 Nutritional Milk Composition of Breast 3 Infant Feeding Considerations 4 Preterm Infant Feeding Micronutrients in breast milk: minerals Minerals participate in many of the body’s most important functions,6 and those needed in small amounts are called trace elements.71 These include zinc, iodine, and selenium, which are essential to metabolic processes because they are components of many enzyme systems.6 CLICK THE CIRCLES TO LEARN MORE ABOUT THE MINERALS. Calcium Phosphorus Iodine is a primary component of certain thyroid hormones, and is therefore essential for normal thyroid function. Thyroid hormones help to regulate growth and development and modulate the Iron body’s metabolic processes, including protein synthesis and enzymatic activity.65,85 Zinc Additionally, iodine is essential to brain development during the first 2 years of life. 86 It supports brain cell proliferation and regulates overall brain function,76 playing a crucial role in the intellectual development of children.87 Iodine Selenium PREVIOUS 46 CONFIDENTIAL—EDUCATIONAL AND TRAINING MATERIALS. DO NOT DETAIL OR DISTRIBUTE TO ANY THIRD PARTIES.