Nutrition during Infancy

• Stages of infancy• Physiological changes» Charting growth

• Feeding infants:» Formulas: types, concerns» Feeding schedules

» Introduction of solid food» Division of Feeding

Responsibility» Feeding concerns

• Eating Pattern Messages

Nutrition during Infancy

Glossary

• Lactase = digestive enzyme that breaks lactose into glucose and galactose

• ADH = antidiuretic hormone (vasopressin), produced by pituitary gland

• Renal solute load = amount of nitrogen, sodium, potassium, phosphorus, chloride kidneys must filter

• Bioavailability = amount of a dietary nutrient that is actually digested/absorbed

Stages of Infancy

• Prenatal• Perinatal» Neonatal

• Postneonatal

Prenatal

Perinatal

Neo-natal

BirthConception

one year

Infancy

Physiological Changes during

Infancy

Anthropometrics

• Weight» immediate loss of 6-10% body

weight not uncommon» ______ birth weight by _____» ______ birth weight by _____» gain is rapid but

• Length» increases ____ by ______» can “catch-up” or “lag-down”

• Body __________• Body __________!

• Immature; Stomach is small

»______ capacity

»empties in _____ hours» so

• Nutrient digestion/ absorption

»100% ready for _____

» least ready for ______

»____depends on

GI tract

• unable to

» renal solute load determined by ________

_____________________ concentrations» risk of __________

• by ______: able to regulate ____________ via ADH

• by __________: renal tubules mature

Kidneys: Immature

CDC Growth Charts

• Developed by National Center for Health Statistics, 1977

• Based on _______ data

• Two sets:

CDC Growth Charts: Revised

2000

• based on _______________ infants

• racially and ethnically diverse• new ________ charts (for use

over age 2)• exclude _______ infants and

__________ data for children >6

What does a growth chart chart?

• Infants, birth to 36 months»Weight-for-age» Length-for-age»Weight-for-length» Head circumference-for-age

• Children and adolescents, 2 to 20 years»Weight-for-age» Stature-for-age» BMI-for-age

• Preschoolers, 2 to 5 yearsWeight-for-stature

Assessment standards

• ____________ percentile» stunting» underweight» overweight

• ____________ percentile» risk of overweight (BMI-for-age)

Feeding Infants

• Formulas are quite similar because

• Forms:

• ___ regulates composition

Formulas for Infant Feeding

Formulas for Infant Feeding

• __________-based» skim milk, casein proteins» skim milk, whey proteins

• _____-based

• Casein-________» + corn oil (Nutramigen)» + medium-chain TGs

(Progestimil)

• ___________ (Alimentum)

• Too diluted» _______________» water __________–hyponatremia– irritability–coma, death

• Too concentrated» __________» hypernatremia:

» _________ (cellular)» tetany»metabolic acidosis

Formulas: Concerns

Feeding Schedule

Neonate

2 weeks to 1 month

~ 2 months

~ 6 months

On demand: 8-12 times/day every 2-4 hrs for 20 minutes per feeding

~ 6-8 times/day

~ 5 times/day; can sleep through the night

3 meals + 4 milk feedings

Introduction of Solid Foods

• Nutritional need

• Physiological capability

• Physical ability» loss of ____________» head and neck control» ability to _______

• Not too early / not too late!

• Add foods _____________• Suggested order:

1. __-fortified _______2. strained _________3. strained _________4. ________ foods5. ________ foods6. _____ by cup (don’t displace

milk and other foods)

• Don’t add __________; why bother with _________?

• Purchase or prepare at home

Introduction of Solid Foods

What Not to Feed Infants < 1 Year

Old

• Regular _________ » risk of ______» risk of ____________

due to high renal solute load» risk of ________» low in _________________

• ________________» risk of ________ spores

producing toxin in body

nerve paralysis

• Raw carrots

• ____________ foods

• _____________ foods» small grains, grapes, hot dog

bits, hard candy, nuts, popcorn

» __________

• Foods of low nutrient density

What Not to Feed Infants < 1 Year

Old

Division of Feeding

Responsibility

Infancy• Parent is responsible for:

• Infant is responsible for:

• pick out

• hold infant on lap• keep infant company, but

• wait for infant to• let infant touch and explore

food• feed at infant’s speed• allow __________ when

interested• stop when

Division of Feeding Responsibility—Early

Spoon Feeding

Feeding Concerns

• Colic• Spitting• “Nursing bottle syndrome”

• Allergies

• Infant obesity

• Constipation

Failure-to-thrive

• check• check _________ symptoms:» poor _____» _______ during feeding» reflux» delay of …

• nutrient deficiency?

• deficiency of _____________ with parents?» infants need

“Sudden Infant Death Syndrome”

low maternal agemultiparitymaternal smokingmale infantssoft mattresses loose blanketssleeping on stomach

Guidance for Infants

• Build to a variety of foods• Listen to your baby’s appetite

to avoid over-feeding or under-feeding

• Don’t restrict fat and cholesterol

• Don’t overdo high-fiber foods• Sugar is needed in moderation• Sodium is needed in

moderation• Choose foods containing iron,

zinc, and calcium

• Breastfeed your baby for as long as possible

• If you bottle feed, hold your baby during feeding

• If you bottle feed, use formula until the age of one

• Offer solid foods only after your baby is 4-6 months old

• Introduce foods one at a time

Eating Pattern Messages