INFANCY

• Infancy


  Birth to 1 year old
• Growth


  • Increase in size due to increase in the number of cells
• Development


  • Increase in functional ability
• Weight doubles by 6 months
• Weight triples by 12 months
• Length increased 10 inches (25cms) from birth to 1 yr
• Basal Metabolic Rate is high
• Calorie Needs


  100-120kcal/kg/day
• Carbohydrates


  Provides 60% of energy intake (60-95 g/day)
• Fats


  Provides most of the energy (30-31 g/day)
• Protein


  1.5g/kg/day
• Vitamins


  More than double the needs of adult in proportion to weight (esp. vitamin A, C, D, and Iodine)
• Water


  1. 8 oz/day 0.5-1 cup/day
• Infants' fluid needs


  • 1.5 milliliters/ kilocalorie consumed compared to 1.0 ml per kcal consumed for adults
  • Larger body surface area per unit of body weight
  • Reduced capacity for respiration
  • Greater risk for dehydration
• Breastmilk or milk formula

  Can meet an infant's fluid needs
• As solid foods are introduced, mothers must make sure that infants continue to drink fluids throughout the day
• Exclusive breastfeeding


  For 6 months
• Breastfeeding


  10-15 minutes for each breast
• Breastmilk


  Protein: 6% (less than compared to cow's milk)<|>CHO: 39% (disaccharide lactose, easily digested, enhances calcium absorption)<|>Fats: 55% (linoleic and linolenic acids, DHA-docosahexaenoic acid)
• Bottle feeding (infant formula)


  Recommended only when breastfeeding is contraindicated<|>Costly<|>Less protective antibodies<|>Common source of infection<|>May contain lead-contaminated water during preparation (lead poisoning)<|>May result to infantile obesity
• Mixed feeding


  Combination of breastfeeding and bottle-feeding<|>Complemented - when bottle feeding is given to complete a single breastfeeding because of insufficiency of mother's milk<|>Supplemental - bottle feeding is used to replace one or more breast feeding when mother is away from home for periods longer than feeding intervals
• Feeding time


  1. Newborns usually feed every 3-4 hours

  2. At 2 months, the baby sleeps through the night after 10pm feeding

  3. Between 2-3 months, the baby is on a 4-5 feeding schedule
• Introducing solid foods


  1. Infants should be breastfed exclusively for the first six months of life according to the WHO

  2. Solid food may begin 6 months to provide nutrients no longer supplied adequately by breastmilk

  3. Extrusion reflex - infants' tongue will push the food out; if food is introduced to infant who is too young or is not ready

  4. Introduce single-ingredient foods one at a time

  5. Give small portions only

  6. Wait 4-5 days before introducing a new food
• Foods to Omit


  • Concentrated sweets and dessert
  • Raw carrots
  • Cherries
  • Hotdog slices
  • Marshmallows
  • Nuts
  • Peanut butter
  • Popcorn
  • Whole beans
  • Grapes
• 6 months


  1. Milk is still continued, Iron fortified cereals

  2. Mashed fruits and vegetables (carrots, squash, sayote) and mix with other foods, pureed vegetables and fruits
• 8 months


  1. Textured vegetables and fruits

  2. Unsweetened diluted fruit juice
• 1. 10 months


  1. Bread, cereals, yogurt, pieces of soft, cooked vegetables and fruits from table

  2. Finely cut meat, fish, cheese

  3. Can give the whole egg
• Common food allergens


  Peanut butter, egg whites, wheat, cow's milk, and nuts
• For infants, even a small amount of dangerous food if taken can be life-threatening
• Foods to delay if there is a family history of food allergies

  • Dairy products
  • Eggs
  • Shellfish, fish, other seafoods
  • Nuts
• Gastroesophageal Reflux Disease (GERD)


  A digestive disorder that occurs when acidic stomach juices, or food and fluids back up from the stomach into the esophagus
• Symptoms of GERD


  • Severe spitting up, projectile vomiting, arching of the back as though in pain, refusal to eat or pulling away from the breast during feedings, gagging, or problems with swallowing and slow weight gain
• Management of GERD


  1. Feed in an upright position, wait at least an hour after eating for play time

  2. Give a child smaller, more frequent feedings

  3. Burp more often
• Diarrhea


  Caused by a GI infection and can dehydrate an infant
• Breastfed infants are less likely to contract gastrointestinal viral illness and experience diarrhea
• Infant constipation


  Passage of hard, dry bowel movements, but not necessarily the absence of daily bowel movements
• Management of infant constipation

  1. Pediatricians can provide the best guidance for handling the problem

  2. Applying a small amount of water-based lubricant to an infant's anus to ease the passage of hard stools

  3. Feeding on solid foods pureed pears or prunes or providing barley cereal in place of rice cereal
• Colic


  Defined as crying that lasts longer than 3 hours per day for at least 3 days per week and for at least 3 weeks (which is commonly known as the "Rules of 3s") and is not caused by a medical problem
• About one-fifth of all infants develop colic, usually between the second and third weeks
• Crying spells can occur around the clock, but often worsen in the early evening