INFANCY
EFFECTS OF SOUND NUTRITION
1.Promotes normal growth and development.
2. Facilitates academic and physical performance
3.Helps prevent obesity, HD, Cancer and degenerative
disease in adulthood.
NOTE:
A foundation built by years of eating nutritious
foods is best way to prepare children entering the teen years
in the incoming demand of rapid growth.
- Early nutrition affect later development.
- Early feeding sets the stage for eating habits
that will influence nutritional status for a lifetime.
- are found abundant in the developing brain
and retina of the eye.
- will make infant score high in test of mental
development than milk formula- fed infants.
4. CHON - contain largely with ALPHA – LACTALBUMIN
a protein a human infant can easily digest
- contain also LACTOFERRIN
1. An iron gathering compound that helps
absorb iron into the infant's bloodstream
2. it also acts as an antibacterial agent
-helps intestinal bacteria from getting
enough iron not to grow out of control
- works directly to kill some bacteria
B. ) Immunological protection
1. Have unsurpassed protection against infection
it has protective factors that includes :
a. antiviral agents
b. antibacterial agents
c. other infection inhibitors
2.Contains colostrum- 1st two or 3 days of lactation
- a premilk substance containing antibodies and
white blood cells from the mother's blood
- the infant cannot contract a bacterial infection
even if the mother has one.
- contains material immune factors that inactive
harmful bacteria within the digestive tract.
METHODS OF FEEDING INFANTS
1. BREASTFEEDING - immature stomach and
intestine can digest milk sugar but not starch
A. ) Nutrient content of breastmilk
1. ENERGY - has a balance of energy and make
the most nearly perfect food.
2. CHO - it contains lactose , easily digested
and enhance Ca absorption
3. LIPIDS - provide the main source of energy
- contain generous proportion of EFA
1.LINOLEIC ACID OR OMEGA 6
2. LINOLENIC ACID OR OMEGA 3
3. DHA – ARACHIDONIC DERIVATIVES
5. VITAMINS
1. Vitamin D
-concentration in breastmilk is low’ so advised to keep
infants under six months of age out direct sunlight
to prevent rickets during childhood.
Or if infants do not received at least 500ml /day of
vitamin D fortified formula.
2. Vitamin C – abundantly supplied in breastmilk.
6. MINERALS
1.Ca- content of breast milk is ideal for infant's
bone growth and is well absorbed
2.Na- low in Na
3.Fe- although in limited supply but highly absorbable.
4.Zn- is also highly absorbable due to the presence
of a zinc - building protein
3. Breastmilk also contain :
1. BIFIDUS FACTORS
- factors in colostrum that favors the growth of
the friendly BACTERIUM LACTOBACILLUS BIFIDUS
in the infant's int’l tract.
2. LACTADHERIN
- A CHON in breastmilk that attacks diarrhea-
causing viruses
3.SEVERAL ENZYMES AND SEVERAL HORMONES
a. thyroid hormone
b. prostaglandins - a hormone like substance
causing contraction of the muscle of mammarian
tissue –Uterus
 INFANTS who are breastfed are less prone to
develop stomach and intestinal disorders during
the first few months of life and so experience less
vomiting and diarrhea than formula-fed infants.
-It also protects common illnesses of infancy like ;
a. middle ear infection
b. respiratory illness
C. ) Other potential benefits
1. Offer protection againts the development of CVD
2. Have lower blood cholesterol as adults
3. May also have + effect on intelligence later in life
B. ) Infant formula standard
1. Both national and international standards has been
set for the nutrient content of infant formula.
2. All standard formulas are therefore nutritionally
similar.
C. ) Special formula - given to :
1. Premature
2. Allergy - drink special hypoallergenic formulas or
formulas based on soy protein.
3. Lactose Intolerance - used soy formulas that are
lactose- free
lactose free - also useful as an alternative to milk
-based formulas for vegetarian families.
F. ) Nursing Bottle Tooth Decay - will result from :
1. When salivary flow diminishes as the infant
falls asleep
2. Putting an infant to bed with a bottle
3. Putting the child in bed with a bottle as pacifier
3. THE TRANSITION TO MILK FORMULA
A. COW’S BASED MILK FORMULA
Unmodified cow’s milk
1. Whole cow's milk is not appropriate during
the first year.
a. cause intestinal bleeding
2. INFANT FORMULA
- offers an acceptable alternative to breastfeeding
A. )Composition
1. From cow's milk but they do not differ
significantly from human milk in nutrients.
2. Although do not contain protective antibodies
it can still be recommended through ;
a. preventive medical care – vaccination
b. reliable public health measures - clean water
D. ) Risks of formula feeding
1. Overdilution - can cause malnutrition and growth
failure
- may happen if there is an attempt to save money
2. Poor sanitation and preparation with contami-
nated water
- result to infection leading to diarrhea , dehydra-
tion and failure to absorb nutrients
E. ) Iron in Formula
1. low - iron in formula have no role in infant feeding
2. Recommendation is to fortify all milk formula
with iron
3.Proven that iron fortified infant formula decline
iron deficiency.
b. lead to iron deficiency
c. poor source of iron
d. bioavailability of iron from infant cereal and
other foods is reduced when cow’s milk
replaces breastmilk
e. cow's milk is higher in Ca and low in vitamin C
f. higher concentration of cow's milk can stress
the infants kidneys
g. so therefore cow's milk is poor choice during
the 1st year of life
 Modified Cow’s milk
- recommended for infant feeding
- fortified with iron ,linoleic acid ,
vitamin E and taurine
B.SOY BASED MILK FORMULA
1. Recommended for infants that do not
tolerate cow’s milk.
2.Good for vegetarian born child.
3. For children with galactosemia or
primary lactose deficiency
4. For children recovering from lactose
intolerance.
5. Children who are allergy to cow’s milk
6. Has phytoestrogen or isoflavones
3. Supplementary Foods By Age in Months
0-4 Feed breastmilk or infant fomula
4-6 Begin iron- fortified cereal mixed with breast-
milk formula or water.
Begin pureed vegetables and fruits
6-8 Begin mashed vegetables and fruits ,
Begin plain baby food meats ,
Begin plain unsweetened fruit juices from cup.
8-10 Begin breads and cereals from table .
Begin yogurt , Begin pcs of soft , cooked
vegetables and fruit from the table.
Gradually begin finely cut meat , fish casserole ,
cheese , eggs and mashed legumes.
11-12
Add variety . Gradually increase portion size.
6. FEEDING GUIDELINES
1. Feed with love - will grow more in both wt.
and ht. than children fed with same food
in an emotionally negative climate.
2. Discourage unacceptable behavior
( standing on the table or throwing foods )
- you may remove the child from the table
and let him wait to eat
3. Let the child explore and enjoy food
4. Do not force food on children
5. Limit sweet strictly
4. INTRODUCING SOLID FOODS
1. When to introduce solid foods - is between 4
to 6 months
Indications of readiness for solid foods are :
a. the infant can sit with support
b. the infant is six months old
2. 3 things to consider in giving solid foods
a. the infant's nutrient needs
b. the infant's physical readiness to handle
different forms of foods
c. the need to detect and control allergic reaction
4. Give foods that will provide Fe and Vitamin C
1. cereal that are iron fortified
2. meats and nuts alternatives such as legumes
3. fruits and vegetables that rich in vitamin
C - to enhance iron absorption
5. DIETARY GUIDELINES
1.Infants and young children should not eat or
drink unpasteurized milk , milk products ,
or juices raw or undercooked eggs , meat,
shellfish or fish or raw sprout
SPECIAL CONSIDERATIONS FOR INFANTS WITH
ALTERED NUTRITIONAL NEEDS
1.PREMATURE INFANTS
- infants born before 34 weeks of gestation,
the sucking reflex is not developed yet.
- premature infants has low birth weight, under developed
lungs,
immature GI tract, inadequate bone mineralization and
lack of fat reserves.
- must be fed by total Parenteral Nutrition.
- PN can be given through tube feeding or
bolus feeding.
- the best food is breastmilk .
- mothers should be encouraged to pump their milk
until the infant is able to nurse.
2.Infants with Cystic Fibrosis
- is a hereditary disease that causes the body to produce
abnormally thick, sticky secretions of mucus within
cell lining organs such as the lungs and pancreas.
- thick mucus will obstruct the pancreas, preventing
enzymes from reaching the intestine to help
breakdown and digest food.
- 85% of infants with CF have exocrine pancreatic
deficiency (PI) that leads to malnutrition due to
fat malabsorption.
Recommendations:
- 35% to 40% of total calorie intake is fat
- doctors may prescribed supplementation of fat soluble
vitamins at mealtime.
- night time tube feeding can be given to supplement
oral intake if adequate nutrition and weight
cannot be maintained.
2.Phenylketonuria (PKU)
- lack the liver enzyme phenylalanine hydroxylase which
necessary for the metabolism of the amino acids phenylalanine.
- part of newborn screening
Management:
- commercially infant formula is LOFENALAC
which is 95% phenylalanine free; provides just enough
for basic needs but no excess.
- synthetic milk available for older children are Phenyl-free
and PKU-1,2 or 3.
- foods that are rich in phenylalanine should be avoided ;
1. dairy and dairy products
2. poultry, fish, meat
3. soy, nuts and beans
3.Metabolic Disorders
- inborn errors of metabolism caused by mutation in the genes.
1. Galactosemia
- is an excessive amount of galactose in the blood
- caused by the lack of the liver enzyme transferase, that
converts galactose to glucose.
- newborn infants may suffer from diarrhea, vomiting,
edema and abnormal liver functions.
- galactosuria may occur and mental retardation ensues.
Management:
1. Lactose free diet
- breastmilk is the best
- lactose-free milk formulas
- avoid any food containing lactose
- supplementations of Ca, vitamin D and riboflavin.
3.Maple Syrup Urine Disease(MSUD)
-congenital defect resulting in the inability to metabolize three
amino acids:
1. leucine – dairy , soy, beans and legumes
2. isoleucine – meat, fish, poultry, eggs, cheese, nuts, seeds
3. valine – soy, cheese, peanuts, mushroom,whole grains
and vegetables.
- named after the odor of the urine
- intake of these AA will increased blood level of these AA’
causing KETOSIS.
- Hypoglycemia, apathy and convulsions occur very early.
- If not treated promptly the child may die from acidosis.
- In mild forms, if left untreated will cause mental retardation
and bouts of acidosis.