Nutrition in infancy Flashcards
(20 cards)
What is infancy
First year of life and we have rapid time of growth
Infants – Growth Facts
Brain weight:-
Is 25% that of an adult at birth
And 90% at the age of 5 years
75% of brain growth takes place in the first 2 years
In the first 12 months body length doubles
Thus nutritional requirements are very high in this age group
Main Nutritional Requirements
Energy
Infants have a high BMR
During the second half of infancy growth slows but activity increases
High requirements when expressed per kg of body weight
3-4X than an adult
Protein
High requirement per kg of body weight to support growth
Too much can be harmful
Fats
Fat from breast milk provides 50% of energy
Carbohydrates
Main source is lactose
Provides 40% energy
Ensure adequate fluids
150ml/kg
Vulnerable to dehydration
Supplementary drinks not required
What is human milk low in (FIRST VITAMIN)
VITAMIN D
Breast fed infants have a 10% increased risk of becoming deficient
Lactating mothers should supplement with 10 μg/d
Especially an issue if maternal status was low in pregnancy due to:-
Poor diet & did not take a supplement
Lack of exposure to sunlight
Significant problem in some ethnic groups
Babies will be born with low stores
Potential problem:-
Vitamin D required for the absorption of calcium
‘Softening’ of the bones
rickets
Effect in later life?
What else is human milk low in (second one)
VITAMIN K
Routinely administered at birth to prevent haemorrhagic disease
There is a low risk in the first few weeks after birth
In addition:-
Born with a sterile gut
Little body stores
Iron
By 6 months additional iron is needed as body stores become diminished & milk is a poor source
Therefore iron rich foods are significantly important during weaning
Benefits of Breast Feeding
Natural source of nutrients that are readily digested & absorbed
Improved immunity – contains immunological factors
Develops jaw & teeth development
Is free, at the correct temperature & requires no preparation
Bonding
Less chance of overfeeding
Less risk of allergy, respiratory & gastrointestinal problems
Improved cognitive function
Utilizes mums fat stores & aids uterine muscle tone
Reduced risk of breast & ovarian cancer in mum
Obstacles to Breast Feeding
can’t really do it in public/ mums don’t feel comfortable
very difficult
difficult to combine with work and lifestyles
Formula Feeding - what is it based on
Based on modified cows milk
Whey dominant
60% whey 40% casein
Casein dominant – ‘hungrier babies’
20% whey 80% casein
Same energy content as whey dominant
Follow on milks (+ 6 months)
Casein dominant
Contain more protein, iron & vitamin D
Not required unless infant at nutritional risk
Pre –Term Formula Feeding and the problem
Pre-term milk
+ 34 weeks
Prior to 34 wks normal feeding not possible
Problem:-
Growth rapid
Body stores of nutrients are low
Immature physiology
GIT
Kidneys
Suckling ability
Reduced capacity to take in large volumes
But have high nutritional requirements & need to be in a highly available form
Soya Formula
Soya based formulas
Not advised & if used not U6 months
Considered ‘healthier’
As contains glucose link with dental caries
Or used by vegans who choose not to breast feed
Should not routinely be given for cow’s milk allergy
Concern over phytoestrogen content
Affect sexual development & fertility espicially in males
Increases risk of sensization to soya protein
Use for 2 years if not using cows milk
Use only with medical advice
Other Types of Formula
Comfort Milk
Colic & constipation
Pre-digested formulas
Hydrolysed protein or amino acid based
Cow’s milk allergy or digestive & malabsorption problems
Lactose free milk
Anti-reflux formulas
High energy formulas
Medium chain triacylglycerol formulas
Complementary Feeding/Weaning - what is weaning and why do we wean
What is weaning?
‘the process of expanding the diet to include foods & drinks other than breast milk or infant formula’
Why Wean?
Time of rapid growth & development
Need more energy & nutrients than milk can supply
To encourage transition onto family foods
Develop ‘bite & chew’ mechanism
Body stores start to become depleted
Why not wean before 17 weeks?
Neuromuscular co-ordination not developed
Kidneys unable to cope with high solute load
GIT is immature
Unwillingness to accept new tastes, textures & consistencies
Increased risk of allergy, respiratory & digestive disorders
Increased risk of been overweight & obese
what is the process of weaning
Gradual process (6-12 months)
Become less dependent on milk
Transition from pureed & mashed foods to family foods
First foods tend to be bland
Aim to offer a variety
Milk continues to be important
Cows milk should not be given as a drink until over 12 months
By 12 months should be having 3 meals/day plus 2/3 snacks
Foods to Avoid - before 12 months
Before 12 months
Honey
Salt
Unpasteurised soft cheeses
Hot chillies
Foods with added sugar
Foods to be given occasionally:-
Liver – limit to once per week
Oily fish – limit to twice a week
Cows milk
Can be used in cooking post 6 months
Not as a main drink until 12 months
Whole nuts (under 5)
Low fat – high fibre foods
Potential Allergens
Should be avoided prior to six months
Introduce one at a time
These are:-
Foods based on cow’s milk – formula milk, yoghurt, fromage frais, cheese
Foods based on wheat – bread, pasta & some breakfast cereals
Eggs
Shellfish/fish
Nuts
Soya
Sesame seeds & mustard seeds
Celery
Any foods containing sulphites
Baby led weaning - who controls the process?
Infant directs and controls the process
Decides what to eat, how much & how quickly
Suggested that babies who are spoon-fed:-
may eat more than they would choose
delays the development of chewing
that babies fed food they dislike on a spoon may become fussy eaters
allowing independence in eating encourages the development of a range of motor skills.
Healthy Start - what does it do
Pregnant women and families with children under the age of four who are in receipt of benefits
And all pregnant women under 18 years of age regardless of income
Provides vouchers to purchase:-
fruit and vegetables
milk and infant formula milk
Supports breastfeeding
Provides free vitamin supplements
