1. 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

2. 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

3. Stages of Infancy Prenatal Perinatal »Neonatal Postneonatal Prenatal Perinatal Neo-natal Birth Conception one year Infancy

4. Physiological Changes during Infancy

5. Anthropometrics Weight »immediate loss of 6-10% body weight not uncommon »______ birth weight by _____ »gain is rapid but Length »increases ____ by ______ »can “catch-up” or “lag-down” Body __________ Body __________!

6. Immature; Stomach is small »______ capacity »empties in _____ hours »so Nutrient digestion/ absorption »100% ready for _____ »least ready for ______ »____depends on GI tract

7. unable to »renal solute load determined by ________ _____________________ concentrations »risk of __________ by ______: able to regulate ____________ via ADH by __________: renal tubules mature Kidneys: Immature

8. CDC Growth Charts Developed by National Center for Health Statistics, 1977 Based on _______ data Two sets:

9. 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

10. 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 years Weight-for-stature

11. Assessment standards ____________ percentile »stunting »underweight »overweight ____________ percentile »risk of overweight (BMI-for-age)

12. Feeding Infants

13. Formulas are quite similar because Forms: ___ regulates composition Formulas for Infant Feeding

14. __________-based »skim milk, casein proteins »skim milk, whey proteins _____-based Casein-________ »+ corn oil (Nutramigen) »+ medium-chain TGs (Progestimil) ___________ (Alimentum)

15. Too diluted »_______________ »water __________ –hyponatremia –irritability –coma, death Too concentrated »__________ »hypernatremia: »_________ (cellular) »tetany »metabolic acidosis Formulas: Concerns

16. Feeding Schedule l Neonate l 2 weeks to 1 month l ~ 2 months l ~ 6 months l On demand: 8-12 times/day every 2-4 hrs for 20 minutes per feeding l ~ 6-8 times/day l ~ 5 times/day; can sleep through the night l 3 meals + 4 milk feedings

17. Introduction of Solid Foods Nutritional need Physiological capability Physical ability »loss of ____________ »head and neck control »ability to _______ Not too early / not too late!

18. Add foods _____________ Suggested order: 1.__-fortified _______ 2.strained _________ 3.strained _________ 4.________ foods 5.________ foods 6._____ by cup (don’t displace milk and other foods) Don’t add __________; why bother with _________? Purchase or prepare at home Introduction of Solid Foods

19. 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

20. ____________ 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

21. Division of Feeding Responsibility Infancy Parent is responsible for: Infant is responsible for:

22. 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

23. Feeding Concerns Colic Spitting “Nursing bottle syndrome” Allergies Infant obesity Constipation

24. Failure-to-thrive check check _________ symptoms: »poor _____ »_______ during feeding » reflux »delay of … nutrient deficiency? deficiency of _____________ with parents? »infants need

25. “Sudden Infant Death Syndrome”  low maternal age  multiparity  maternal smoking  male infants  soft mattresses  loose blankets  sleeping on stomach

26. 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

27. 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