Week 9 - Infant Feeding

Feeding the InfantEarly nutrition affects later development, and early feedings establish eating habits that influence nutrition throughout life. Nutrient Needs Nutrient Needs Nutrient Needs Nutrient Needs Infants’ rapid development depends on adequate nutrient supplies, including water from breast milk or formula.After six months of age, the energy saved by slower growth is spent on increased activity. Why Is Breast Milk So Good for Babies? Why Is Breast Milk So Good for Babies?The Canadian Paediatric Society, the Dietitians of Canada, and Health Canada recognize exclusive breastfeeding for 6 months, and breastfeeding with complementary foods, especially those with iron, for up to two years and beyond, as an optimal feeding pattern for infants. Breastfeeding is a natural extension of pregnancy – the mother’s body continues to nourish the infant. Breastfeeding TipsBreast milk is more easily and completely digested than infant formula, so breastfed infants usually need to eat more frequently than formula-fed infants do.During the first few weeks, the newborn will need approximately 8 to 12 feedings a day, on demand.As the infant gets older, there are longer intervals between feedings. style.visibilitystyle.visibility Energy Nutrients in Breast Milk Energy Nutrients in Breast MilkFor infants, breast milk is the most nearly perfect food.The carbohydrate in breast milk is lactose.Contains a generous proportion of the essential fatty acids as well as their longer-chain derivatives, arachidonic acid and DHA.The protein is largely alpha-lactalbumin and lactoferrin.style.visibilitystyle.visibilitystyle.visibility Vitamins and Minerals in Breast MilkWith the exception of vitamin D, the vitamin content of the breast milk of a well-nourished mother is ample.The Canadian infant feeding guidelines recommend a 400 IU (10 mcg) vitamin D supplement to all breast-fed infants starting at birth and continuing until the diet includes this amount from other sources, or until the breastfed infant reaches 12 months of age.At six months of age, an exclusively breast-fed baby needs additional iron.If the water supply is low in fluoride, fluoride supplementation is needed after 6 months. Immune Factors in Breast MilkDuring the first two or three days of lactation, the breasts produce colostrum, a premilk substance containing antibodies and white cells from the mother’s blood. Breastfed infants may have: Less allergiesLess CVDLower blood cholesterolLess ear and respiratory infections Other Potential BenefitsMay protect against obesity in childhood and later years.May have a positive effect on later intelligence. Formula FeedingInfant formulas are designed to resemble breast milk and must meet Health Canada’s standards for nutrient composition.Special formulas are available for premature infants, allergic infants, and others.Formulas can be replaced with milk between 9 and 12 months of age. Formula Feeding Formula FeedingThe infant thrives on formula offered with affection Consumer Corner: Formula’s Advertising Advantage Advertisers of infant formulas often strive to create the illusion that formula is identical to human milk.No formula can match the nutrients, agents of immunity, and environmental information conveyed to infants through human milk, but the ads are convincing.Formula-fed infants in developed nations are healthy and grow normally but they miss out on advantages of breast milk. Consumer Corner: Formula’s Advertising Advantage An Infant’s First FoodsWith the approach of an infant’s first birthday comes the possibility of tasting whole, unmodified cow’s milk for the first time. When to Introduce Solid FoodSolid foods may be started gradually beginning at six months of age. Most evidence suggests that introducing solid foods before 2 to 3 months of age or later than 6 months of age has more risks than benefits. When to Introduce Solid Food Foods to Provide Iron and Vitamin CIron ranks highest on the list of nutrients needing attention in infant nutrition.Excessive milk consumption can displace iron-rich foods and lead to iron-deficiency anemia, popularly called milk anemia.To prevent vitamin C deficiency:Many fruit juices (4-6 ounces per day) Foods to Provide Iron and Vitamin CTo prevent iron deficiency:Breast milkIron-fortified formulaIron-fortified cerealsMeat or legumesFoods such as iron-fortified cereals and formulas, mashed legumes, and strained meats provide iron. Physical Readiness for Solid FoodsWhen the baby can sit up, can handle finger foods, and is teething, hard crackers and other finger foods may be introduced under the watchful eye of an adult.Avoid foods that are choke hazards. Food AllergiesTo prevent allergy and to facilitate its prompt identification should it occur, experts recommend introducing single-ingredient foods, one at a time, in small portions, and waiting up to four to five days before introducing the next food. Choice of Infant Foods Commercial baby foods in the U.S. and Canada are safe, and except for mixed dinners with added starch fillers and heavily sweetened desserts, they have high nutrient density. Foods to OmitSweets of any kind (including baby food “desserts”) have no place in a baby’s diet.Honey and corn syrup should never be fed to infants because of the risk of botulism. Foods at One YearChildren love to eat what their families eat Foods at One Year Looking AheadThe first year of life is the time to lay the foundation for future health.From the nutrition standpoint, the problems most common in later years are obesity and dental disease.It is important in the first year to encourage eating habits that will support continued normal weight as the child grows. Looking AheadNursing bottle syndrome in an early stage Looking AheadNursing bottle syndrome--an extreme example. The upper teeth have decayed all the way to the gum line. Food Feature: Mealtimes with Infants Foster a sense of autonomy.Discourage unacceptable behavior.Let the child explore and enjoy food.Don’t force food on children.Limit sweets strictly. Controversy: Childhood Obesity and Early Development of Chronic DiseasesLarge numbers of children and adolescents are being diagnosed with obesity and type 2 diabetes.1 in 10 Canadian children are obese, and an additional 1 in 4 children are overweightChildhood obesity rates are increasing all over the world. Childhood Obesity and Early Chronic DiseasesType 2 diabetes strikes more children today than ever before and is closely associated with obesity. The Challenge of Childhood ObesityPercentage of Young People Who Are Overweight Characteristics of Childhood ObesityWhile no group has fully escaped this trend, obese children:Are often female and of non-European descentHave a family history of type 2 diabetesWere born to mothers who had diabetes while pregnant with themHave metabolic syndromeHave a low family incomeAre sedentaryHave parents who are obese The Influence of GeneticsGenetics appears to play a permissive role – the potential for obesity is inherited but the condition itself will develop only if given a push by environmental factors. Early Childhood Influences on ObesityMuch evidence points to the importance of early childhood as a period of influence on obesity development.Children learn behaviors from their families, and entire families may be:Eating too muchDieting inappropriatelyExercising too littleWatching too much televisionstyle.visibilitystyle.visibilitystyle.visibilitystyle.visibilitystyle.visibility Early Childhood Influences on Obesity Early Childhood Influences on Obesity Early Development of Type 2 Diabetes85% of children with type 2 diabetes are obeseEight to 45% of all children with newly diagnosed diabetes have a form other than type 1 diabetes. Early Development of Heart DiseaseAtherosclerosis, which only becomes apparent as heart disease in adulthood, begins in youth. Children with the highest risk of developing heart disease:Are sedentary and obeseMay have diabetesMay have high blood pressureMay have high blood LDL cholesterolstyle.visibilitystyle.visibilitystyle.visibilitystyle.visibilitystyle.visibility High Blood CholesterolBlood cholesterol in children is a good predictor of their future adult cholesterol and like in adults is related to:High saturated fat intakeOverweightSedentary lifestyleCholesterol testing is not recommended for children and adolescents at moderately high risk for elevated blood cholesterol in Canada because of the harmful psychological effects in the families involved. High Blood PressureHypertension that develops in the first decades of life, especially in overweight children, tends to worsen if untreated. Children with hypertension can lower their blood pressure by:Participating in regular activityLosing weight or maintaining weight as they grow tallerRestricting dietary sodiumDecreasing intake of caffeinated beveragesstyle.visibilitystyle.visibilitystyle.visibilitystyle.visibilitystyle.visibility Preventing Weight Gain in Children: A Family AffairAn initial goal is to slow the obese child’s rate of gain – that is, to hold weight steady while the child grows taller.Treatment of obesity in adults is notoriously unsuccessful, and so preventing childhood obesity is a national priority. Parents Set An Example Diet Moderation, Not DeprivationAll children should eat an appropriate amount and variety of foods, regardless of their body weight. Diet Moderation, Not Deprivation Physical Activity