Life Cycle: Maternal and Infant Nutrition BIOL 103, Chapter 12-2

Today’s Topics Lactation Resources for Pregnant and Lactating Women and their Children Infancy

Lactation Breastfeeding trends Healthy People 2020 goals To increase the proportion of newborns who are initially breastfed to almost _____% Current stats: 74% of infants breastfed initially 44% of infants still breastfed at 6 months

Physiology of Lactation Changes during adolescence and pregnancy Increased ____________ ___________ of structure  ducts/glands and _________ cells are formed After delivery Milk production and secretion Colostrum:

Physiology of Lactation Hormonal controls stimulated by______ ________________: Prolactin: stimulates milk _____________ Oxytocin: stimulates milk _____________ “Let-down” reflex – release of milk from breast tissue in response to oxytocin.

Summary of Lactation Physiology Infant suckling  pituitary gland release prolactin  milk tissue production Infant suckling  pituitary gland release oxytocin  release milk Thus, giving water or infant formula to the baby reduces the time spent nursing at the breast  ___________________ declines

Nutrition for Breastfeeding Energy and protein _________ needs than during pregnancy Well-nourished pregnant women will ______ weight slowly 1 ¾ lbs/month after ~6 months. Vitamins and minerals Most are ____________ as during pregnancy Iron and folate needs are ___________ Water AI for total water = 3.8 liters/day

Nutrition for Breastfeeding Food choices ___________ Daily Food Plan for Moms ~2,200–2,800 Kcal/day Choose foods high in vitamins and minerals and low in added sugar and solid fats Supplementation is generally not necessary, unless… ________ for vegans ________ for women with irregular sun exposure Practices to avoid during lactation Smoking, Alcohol, Drugs

Benefits of Breastfeeding (PS12, Q3a) Benefits for infants Optimal nutrition Builds stronger __________ system: protects infant from infections and illness including diarrhea, ear infections, pneumonia, and asthma Convenience

Benefits of Breastfeeding (PS12, Q3b) Benefits for mother Enhanced recovery of __________ size Help women return to ____________ weight faster Convenience Contraindications to breastfeeding Infant or maternal ____________________ Damaged breast ducts Drug use

Resources for Pregnant and Lactating Women and their Children Promote health of pregnant and breastfeeding women and their children Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) Service of _________________ Provides food assistance Provides nutrition education Provides referrals

Infancy Infancy: 0 -1 years old _______ is the best marker of nutritional status Evaluated using __________________ Weight gain Double birth weight by _______ months Triple birth weight by _____ months Length gain (not height B/C infants can’t stand) Increase length by 50% by _____ months Head circumference measures _________ growth and development

Energy and Nutrient Needs During Infancy Requirements based on composition of _______________________ Energy and Protein Highest needs of any life stage 2x adult’s needs Carbohydrate and fat Both are ______________ source Carbohydrates as simple sugars Water Supplemental water feeding is ______ necessary for healthy infants who are exclusively breastfed (or receive properly mixed formulas). This is true even in _____________ weather. Once solid foods are introduced, additional water may be required.

Energy and Nutrient Needs During Infancy Key vitamins and minerals Vitamin __: need adequate sunlight exposure Vitamin __: produced by gut bacteria Single dose of vitamin K since gut is sterile at birth Vitamin ___: problem for a strict vegetarian mom Folate metabolism and cell division Iron: if formula fed, need iron-fortified formula Fluoride: at 6 months

Energy and Nutrition needs during Infancy Newborn Breastfeeding Recommended as the ______ method of feeding infants to achieve optimal growth and development. Feedings 2-3 hours for a total of 8-12 feedings/day 10-15 minutes/breast AAP recommends that NO supplements of formula or water be given to breastfed neonates unless medically indicated

Energy and Nutrient Needs during Infancy Alternative feeding: Infant Formula Standard infant formula Cow’s milk base “imperfect copy” of breastmilk Soy-based formula Soy protein base Switched to soy-based if formula-fed infants are having feeding problems (vomiting and diarrhea).

Energy and Nutrient Needs during Infancy Special formula for formula-fed infants who are: ________ to milk/soy ________ babies Have rare defects in metabolic pathway Use medium-chain triglycerides as the fat source

Energy and Nutrient Needs during Infancy How much is enough? Guidelines for feeding infant 6 or more wet diapers per day 3 or more stools per day Regain to birth weight within the first week Best indicators that baby has enough to eat: _____________, ___________ elimination patterns, and satisfied demeanor.

Introduction to Solid Foods Readiness for complimentary foods at ~___ months _______________ to breast milk/infant formula Infants show: Physiological readiness: Digestive ___________________ Ability to maintain __________________ Depletion of iron stores Developmental readiness: Lack of ____________________ – young infant’s response to thrust tongue forward when a spoon is put into the mouth. Head and body control Examples:

The Start Healthy Feeding Guidelines Feeding schedule for the first two years

Feeding Problems during Infancy ______________ Crying and distress, perhaps from abdominal cramping No clear effective treatment Early childhood dental caries Associated with putting baby to bed with a bottle (milk, juice, etc.) Iron-deficiency anemia For ______________ infants who do not eat enough iron-rich foods.

Feeding Problems during Infancy Gastroesophageal reflux - backflow of stomach contents to espophagus ~3% of newborns, usually male Usually disappears within 12–18 months Diarrhea Requires increased _____________ Failure to thrive (FTT) Poor growth in absence of ___________ Can be due to shortage or improper preparation of appropriate foods