Download Feeding Infants Feeding Infants

NUTRITION FOR INFANTS AND
CHILDREN
Objectives
 To recognize the changing nutritional needs of
developing children through infancy
 To understand that nutritional recommendations for
children vary by age, stage of development,
and gender.
 To recognize that nutritional and dietary behaviors
learned in children can have a significant impact on
nutrition later in life
Why is Nutrition Important?
 Energy of daily living
 Maintenance of all body functions
 Vital to growth and development
 Therapeutic benefits
 Healing
 Prevention
Feeding the Newborn
 What are the options?
 Breast feeding
 Colostrum: Transitions around days 3-5 and
mature by day 10
 The American Academy of Pediatrics
recommends exclusive breast feeding for 6
months.
 Formula feeding
Breast Feeding Questions
 Why should I breast feed my baby?
I thought formula was the identical alternative.
 How often and for how long will my baby nurse?
 How do I know if the baby is getting enough?
 How many months can I breast feed the baby
and when can I add formula?
Breast Feeding
Advantages to Infants
 It's usually more easily digested than formula. So breastfed babies
are often less constipated and gassy.
 It may lower the risk of sudden infant death syndrome in the first
year of your baby's life.
 It may raise your child's intelligence. Studies show breastfed babies
have higher levels of cognitive function.
 Decreased incidence of ear infections, UTI, gastroenteritis,
respiratory illnesses, and bacteremia.
 Convenient and ready to eat.
 Fosters mother-infant bonding.
Breast Feeding
Advantages to Mothers
 May delay return of ovulation.
 Cost effective
 Suppresses post-partum bleeding.
 Reduced risk of breast cancer, diabetes, heart
disease, osteoporosis, and ovarian cancer.
Assessment of
Breast Feeding
 Weight pattern - consistent weight gain.
 Stooling - generally more stools than formula.
 Feed-on-demand ~ every 2-3 hours.
 Duration of feedings - generally 10-20 min/side.
 Primary source of nutrition first 6 months
Storing Breast Milk
Store in hard plastic container with a label stating time
and date.
Store at 40˚ F or below and transport on ice
Do not leave at room temperature and do not reuse
Breast Fed Infants
 My 8 week old breast fed baby has not had a bowel
movement in 6 days. He gets 1 or 2, 4 oz bottles of iron
fortified formula at night as well. He is happy and
active. His appetite is good. He is not vomiting. His
abdomen is soft and nontender. What should I do?
What should I do? - cont.
 Discontinue the iron formula, it may be constipating.
 Give 1 tsp of mineral oil per day until he goes.
 Give a suppository each day until he goes.
 Add cereal to the bottle to help his bowels and to sleep.
 Dilute the formula to give more water.
 Give 1 oz apple juice per day until he goes.
 Do nothing, breast fed infants may not have a bowel movement
for up to 7 days.
Infant Formula
 3 Forms:
 Ready to feed - most expensive, does not require
water.
 Concentrate - requires mixing with water in equal
parts.
 Powder - requires mixing with water.
Composition of Standard
Infant Formula
 Caloric density: standard formulas contain
20 calories/oz (0.67 calories/cc).
 Protein content: ratio of whey to casein variesmost are 60:40 similar to human milk.
 Fat: most provide ~50% of calories from fat from saturated and
polyunsaturated fatty acids.
 Carbohydrate: lactose, beneficial effect on mineral
absorption (Ca, Zn, Mg), and on colonic flora.
 Micronutrients: Higher vitamin and mineral content than
human milk
Special Formulas
 Soy: used for vegetarians, lactase deficiency,
galactosemia.
 Lactose free: cow’s milk-based formula.
 Protein hydrolysate: infants who can not digest or are
allergic to intact protein.
 Free amino acids.
 Pre-term infant: unique for premies, predominant whey
protein, cow’s milk based, higher protein and calcium, 2050% MCT.
 Pre-term follow up
If feeding baby formula or preserved breast milk, some
babies prefer their milk and sometimes even the
nipple warmed. Test the temperature of the milk by
sprinkling a few drops on the back of the hand or the
inside of the wrist. It should be tepid…not hot.
Feed Within 30 Min.
of Preperation
Use caution if using a microwave to heat
the bottle. The milk or formula is heated
unevenly. Shake before feeding.
Warming milk is NOT necessary, but
once baby becomes accustomed to it,
they may refuse cold milk.
Do’s and Don’ts
 Need soft and squeeze easy
 Check condition of nipple, should drip out steadily
 Nipple should be kept full of milk to avoid excessive air
swallowing
 Never prop bottle - choke more often when bottles
are propped. They also fall asleep with milk in their
mouth, promoting gum disease and tooth decay. Milk
runs down the face and into the ears, causing more
ear infections
 Never put baby to bed with bottle- can cause tooth
decay
Proponents of breastfeeding
encourage mothers to feed their
babies “on demand”, with no
schedule established. It provides
baby with comfort as well as
nutrition.
NO COWS MILK UNTIL 1
YEAR OLD
If bottle feeding, whether it is with formula or
expressed breast milk, baby needs
one ounce per hour.
If they drink 4 ounces, therefore, they can usually
wait about 4 hours before they eat again.
4-6 months
Until baby has teeth and is able to chew food well, they should eat only
pureed food. Pediatricians recommend starting with a bland rice cereal,
followed by oatmeal and then barley cereals. Vegetables such as peas and
carrots come next, followed by fruits.
There are some foods that
should be avoided for the entire
first year, as baby has or easily
develops allergies to them:
chocolate, citrus fruits, peanut
butter (it also presents a choking
hazard for children under 3), egg
whites, honey (may contain
botulism food poisoning), wheat
products, cow’s milk
When starting baby on solid foods, introduce only one new food every 3
days. If your baby has an allergy to this food, you will be able to pinpoint
which food is a problem and avoid it. Babies do not need a wide variety
of foods in their diet, and very bland foods are flavor- packed for baby!
Feeding Skills Development
 4-6 mos - experience new tastes.
 Give rice cereal with iron.
 6-7 mos - sits with minimal support.
 Add fruits and vegetables.
 8-9 mos - improved pincer grasp.
 Add protein foods and finger foods.
 10-12 mos - pulls to stand, reaches for food.
 Add soft table food, allow to self-feed.
Feeding Skills Development
 12-18 mos - increased independence.
 Stop bottle, practice eating from a spoon.
 18 mos -2 yrs - growth slows, less interest in eating.
 Encourage self-feeding with utensils.
 2-3 yrs - intake varies, exerts control.