Infant Nutrition

• • Organs & organ system developed in utero continue to increase in size + complexity during infancy
  • Newborn’s central nervous system = Immature = Less organized
  • Critical period when certain skill must be learned for subsequent learning to occur
• • Birth weight: 2500 – 3800 g
  • Length: 18.5 – 21.5 inches
  • Head circumference: 13.5 inches
• • Average weight loss in the first week: 10% (Premature: 15%)
  • Regain/ surpass birth weight by 10 – 14 days
• • Healthy infant’s birthweight -- 6 months: Double; 1 year: Triple
  • Length -- 1 year: Increase 10 inches
  • Head circumference -- 1 year: Increase 4.7 inches
• Warning signs of growth difficulties

  • Atypical rates of head circumference growth

  • NO increase in length/ weight

  • Continue decline/ rapid increase in weight, length, or head circumference percentile
• Accurate growth measurement

  • Use standardized methods; Use calibrated infant scales

  • Head circumference: Widest part of the head

  • Weigh the infant nude

  • Length: Lying down w/ head and feet at right angle
• Energy Needs

  • Higher per lb of body weight
  • 0 – 6 months: 49 kcal/ lb
  • 6 – 12 months: 45 kcal/ lb
  • 20% for brain
• Protein needs

  • Higher per kg for infant: Essential to growth
  • Too much protein --> Stresses the liver & kidney (Protein metabolism, Nitrogen excretion)
  • 0-6 m: 1.52 g/ kg
  • 7-12 m: 1.2 g/ kg
  • 1-3 yrs: 1.1 g/ kg
• Fat needs

  • Contribute 50% of calories
  • Supply energy to the liver + brain + muscle (including heart)
  • NO restriction of fat & cholesterol
  • Provides essential FA for brain
  • Retina development
  • Concentrated source of energy
• Fat needs

  • 0-6 m: 31 g/ day
  • 7-12 m: 30 g/ day
• Carbohydrate needs

  • Provide energy to ALL cells (esp. brain)
• Vitamin and Mineral needs

  • Needs greater than adults
• Breastmilk = Most nutritionally ‘normal’ food

  • Exclusive breastfeeding for first 6 months; Continue breastfeeding for the next 6
• If NOT breastfeeding --> Infant formula ONLY for the 1st year

  • NO cow’s milk, goat’s milk (Renal failure + Hard to digest + Low iron availability + Linked to iron deficiency anemia)
• • Milk composition is adequate UNTIL 4 – 5 months when iron needs increase
  • Breastmilk: Low in fluoride & vit D

  • Give Fluoridated water & small amount of Sun exposure
• Beverage guideline

  i) 0 – 6 months: Breast milk/ Formula ONLY

  ii) 6 – 12 months: Small amount of water

  iii) 12 – 24 months: Whole milk; Fruit juice/ Fruit; NO sport drinks (Promote dental caries)
• When to feed the baby?

  • Feeding ON DEMAND: allow infant to initiate and guide feeding interaction
  • Respond early & appropriately to infant’s hunger and satiety cues
• Infant Growth Spurts

  • Infant need more milk --> Sudden change in nursing pattern = Approaching a growth spurt/ developmental change --> Prepare for upcoming spurt
  • Spurt: 2 – 3 weeks, 6 weeks, 3 months, 6 months (Usually last a few days)