Chapter 11 Diet during Infancy yyjdtd Second semester 14 -15 Bader A. EL Safadi BSN , MSc Science of Nutrition Diet during Infancy hjvjbkvv

Nutritional Requirements of the Infant yyjdtd Nutritional Requirements of the Infant Birth weight doubles by 6 months and triples within first year During the first year approximately 98 to 108 calories per kilogram of body weight each day Nutritional needs depend on child’s growth rate The basis of the infant’s diet is breast milk or formula. Essential vitamins and minerals can be supplied in breast milk, formula. Vitamin D supplement given in breastfed infants not exposed to sunlight When reaching 6 months of age, the infant given iron-fortified cereal . Second semester 14 -15 Bader A. EL Safadi BSN , MSc Science of Nutrition Diet during Infancy hjvjbkvv

Benefits for the Infant yyjdtd Breastfeeding Benefits for the Infant Has perfect composition for baby’s needs Breast milk provides antibodies Lower incidence of ear infections, diarrhea, allergies. Promotion of good jaw development Decreased risk of obesity later in life Facilitation of bonding between mother and child Helps lose weight gained during pregnancy Stimulates uterus to contract back to original size Is economical Provides opportunity for resting Is always right temperature and readily available Second semester 14-15 Bader A. EL Safadi BSN , MSc Science of Nutrition Diet during Infancy hjvjbkvv

Breastfeeding (cont'd) yyjdtd Breastfeeding (cont'd) Also beneficial to mothers Less risk of breast cancer and osteoporosis Indications of adequate nutrition of the infant include: Infant has six or more wet diapers per day Infant has normal growth Infant has one to two bowel movements per day Breast becomes less full during nursing Second semester 14 -15 Bader A. EL Safadi BSN , MSc Science of Nutrition Diet during Infancy hjvjbkvv

yyjdtd Bottle Feeding Infant should be cuddled and held in semi-upright position During and after the feeding, the infant should be burped to release gas in the stomach and prevent regurgitation (vomiting). Formulas made from modified cow’s milk to resemble breast milk in nutritional value Formulas has more protein and mineral salts and less lactose than human milk Synthetic formula may be used for infants who are sensitive or allergic Second semester 14 -15 Bader A. EL Safadi BSN , MSc Science of Nutrition Diet during Infancy hjvjbkvv

Bottle Feeding (cont'd) yyjdtd Bottle Feeding (cont'd) Formula must be prepared with correct amount of water to prevent health complications Too little water will create too heavy a protein and mineral load for the infant’s kidneys. Too much water will dilute the nutrient and calorie value so that the infant will not thrive, Infants under the age of 1 year should not be given regular cow’s milk , it can cause gastrointestinal blood loss in infants Infants should not be put to bed with a bottle , The milk then bathes the upper front teeth, causing tooth decay. Second semester 14 -15 Bader A. EL Safadi BSN , MSc Science of Nutrition Diet during Infancy hjvjbkvv

yyjdtd Supplementary Foods The introduction of solid foods before the age of 4 to 6 months is not recommended. Solid foods must be introduced gradually and individually Solids should be started with iron-fortified rice cereal then other infant's cereals Followed with cooked vegetables, then cooked fruits, egg yolk, and finely meats Honey should never be given to an infant because it could be contaminated with Clostridium botulinum bacteria. When the infant learns to drink from a cup, juice can be introduced from a cup better than a bottle Second semester 14 -15 Bader A. EL Safadi BSN , MSc Science of Nutrition Diet during Infancy hjvjbkvv

Supplementary Foods (cont'd) yyjdtd Supplementary Foods (cont'd) Never be given from a bottle because babies will fill up on it and not get enough calories from other sources. Use only 100 percent juice products because they are nutrient-dense. Solid foods are introduced at 4 to 6 months. Breast milk or formula continues to be the main source of calories at this age. Second semester 14 -15 Bader A. EL Safadi BSN , MSc Science of Nutrition Diet during Infancy hjvjbkvv

Special Nutritional Needs yyjdtd Special Nutritional Needs Premature infants Cystic fibrosis Galactosemia Phenylketonuria (PKU) Second semester 14 -15 Bader A. EL Safadi BSN , MSc Science of Nutrition Diet during Infancy hjvjbkvv

Premature Infants An infant born before 37 weeks of gestation yyjdtd Premature Infants An infant born before 37 weeks of gestation Sucking reflex not developed until 34 weeks of gestation Infants born earlier require total parenteral nutrition, tube feedings, or bolus feedings Other concerns: Low birth weight, underdeveloped lungs, immature gastrointestinal tract, inadequate bone mineralization, and lack of fat reserves Many special formulas available, but breast milk best Composition perfect even for premature infants Second semester 14 -15 Bader A. EL Safadi BSN , MSc Science of Nutrition Diet during Infancy hjvjbkvv

Cystic Fibrosis 35 to 40 percent of diet should be from fat yyjdtd Cystic Fibrosis Inherited disease in which body secretes abnormally thick mucus within cells lining organs such as the lungs and pancreas. Decreased production of digestive enzymes and malabsorption of fat Recommendation: 35 to 40 percent of diet should be from fat Digestive enzymes and fat-soluble vitamin supplementation at meal times Nighttime tube feedings may be indicated Second semester 14 -15 Bader A. EL Safadi BSN , MSc Science of Nutrition Diet during Infancy hjvjbkvv

yyjdtd Galactosemia Galactosemia is a condition, in which there is a lack of the liver enzyme transferase which converts galactose to glucose Excessive amount of galactose in blood becomes toxic Signs and symptoms diarrhea, vomiting, edema, and abnormal liver function Cataracts may develop Galactosuria and mental retardation occur Diet therapy: Exclusion of anything containing milk from any mammal Nutritional supplements of calcium, vitamin D, and riboflavin Second semester 14 -15 Bader A. EL Safadi BSN , MSc Science of Nutrition Diet during Infancy hjvjbkvv

Phenylketonuria (PKU) yyjdtd Phenylketonuria (PKU) Infants lack liver enzyme phenylalanine hydroxylase which is necessary for metabolism of amino acid phenylalanine Infants normal at birth, but if untreated, become hyperactive, suffer seizures, and become mentally retarded between 6 and 18 months Lifelong diet therapy: Commercial formula Lofenalac Regular blood tests Synthetic milk for older children Avoidance of phenylalanine Second semester 14 -15 Bader A. EL Safadi BSN , MSc Science of Nutrition Diet during Infancy hjvjbkvv

yyjdtd Conclusion Infants must have adequate diets to avoid impairment of physical and mental development Breastfeeding Nature’s way of feeding infant Formula feeding also acceptable Some infants have special nutritional needs Second semester 14 -15 Bader A. EL Safadi BSN , MSc Science of Nutrition Diet during Infancy hjvjbkvv