Diet During Infancy Iron-fortified cereal is usually started at about 6 months.

 Objectives A vitamin K supplement is routinely given shortly after birth.

 State the effect inadequate nutrition has on an infant Infants should not be given an excess of vitamin A or D.
 Identify the ingredients used in infant formulas Why is mother’s milk important?
 Describe when and how foods are introduced into the  Breastfeeding
baby’s diet Provides infant with temporary immunity to many infectious
 Describe inborn errors of metabolism and their dietary diseases.
treatment It is economical, nutritionally adequate, and sterile
Infant = not more than 12 months of age Easily digested
 Energy and Nutrient Needs Breastfed infants grow more rapidly during the first few months
Energy intake and activity of life than formula-fed babies and have fewer infections.
- birthweight doubles by about five months of age (20 to 25  Breastfeeding
lbs) Breast should be offered every 2 hours in the first few weeks.
Protein The infant should nurse 10-15min on each breast.
- All of the body’s cells and most of its fluids Growth spurts occur at about 10 days, 2 weeks, 6 weeks, and
- 0 to 6 months -1.5 to 2.5 gm per kg in the body weight 3 months; infant may nurse more frequently.
from  Breastfeeding
- 6 to 12 months – 1.5 to 2 gm per kg in the body Indications of adequate nutrition include:
weight • The infant has six or more wet diapers per
Fat day.
- Whole cow’s milk contains fatty acids, linoleic and • The infant has normal growth.
arachidonic acids • The infant has one or two mustard-colored
- If restricted, high protein and sugar is required bowel movements per day.
 Calories • The breast becomes soft during nursing.
- High because the larger skin surface leads to large  Bottle Feeding
heat loss. The infant should be cuddled and held in an upright position.
- 350 to 500 cal; in 1 year from 800 to 1200 cal ; 120 He should be burped.
cal per kg. body weight from 2nd to 7th month and 100 Formulas are developed so that they are similar to human milk
cal per kg from 7th to the 12th month. in nutrient and kcal values.
- First yr is 50 cal per lb of expected weight Synthetic milk made from soybeans may be used for sensitive
- 2/3 from milk ; 1/3 added carbohydrates or allergic infants.
 Carbohydrates  Burping a Baby
- 1/10 oz per lb.of body weight = 1 oz per 10 oz of milk  Bottle Feeding
prescribed Sterile water must be used to mix formula.
- later, is given in the form of starch cereal Infants under one year should not be given cow’s milk.
 Vitamins and Minerals Consistent temperature should be used.
Are based on the average amount of nutrients consumed by Infants should not be put to bed with bottle.
thriving infants breastfeed by a well-nourished mothers.  Mixed Feeding
Water - Combination of both
- Most essential nutrients for infants ; the younger the infant - Is not encouraged as it may lead to lactation failure
the greater the percentage of body weight Formula Preparation:
 Nutritional Requirements of the Infant 1. Aseptic Method – the equipment and ingredients are
During the first year, the normal child needs about 100 kcal per sterilized separately either by steam or by boiling water for at
kilogram of body weight each day. least 25 min.
Infants up to 6 months of age should have 2.2 g of protein per - Funnel the sterile formula into sterile bottles, nippled
kg of weight each day; age 6-12 months should have 1.56 g of and then capped.
protein per kg of weight each day. 2. Terminal Method
 Nutritional Requirements of the Infant
- The formulas are poured into clean but unsterilized bottles  Iron-fortified cereal mixed with breast formula and
and are sterilized together water
 Supplementary Foods  Begin pureed vegetables and fruits
Limit diet to breast milk or formula until the age of 4 to 6  6-8 months- able to feed self finger foods; develops
months. pincer grasp; begins to drink from cup
Cow’s milk should be avoided until after one year of age.  8-10 months – begins to hold bottle; reaches for and
Solid foods should not be introduced before 4 to 6 months of grabs food and spoon; begins to drink from cup
age and should be done gradually.  Breads and cereals ; textured vegetables and
 Supplementary Foods fruits;plain, unsweetened fruit juices from cups
The typical order of introduction begins with cereal, usually  Breads and cereals from table;yogurt;pieces of soft ,
iron-fortified rice, then oat, wheat, and mixed cereals. cooked vegetables and fruits;finely cut meats,
Cooked and pureed vegetables follow, then cooked and fish,legumes,cheese,eggs
pureed fruits, egg yolk, and finally, finely ground meats.  10-12 months – begins to master spoon, but still spills
 Supplementary Foods some.
Between 6 and 12 months, toast, zwieback, teething biscuits,  4 servings of breads and cereals ; 2 servings of fruits
custards, puddings, and ice cream can be added. and 3 servings of vegetables; 2 servings of meat, fish,
Honey should never be given to an infant because it could be poultry, eggs or legumes
contaminated with Clostridium botulinum bacteria.  Special Nutritional Needs
 Supplementary Foods Premature infants
When the infant learns to drink from a cup, juice can be Cystic Fibrosis
introduced. Failure to thrive
Juice should never be given from a bottle because babies will Metabolic Disorders
fill up on it and not get enough calories from other sources. • Galactosemia
 Supplementary Foods • Phenylketonuria
Pasteurized apple juice is usually given first. • Maple Syrup Urine Disease
It is recommended that only 4 oz. of 100% juice products be  Premature Infants
given because they are nutrient-dense. An infant born before 37 weeks gestation.
 Indications for Readiness for Solid Foods The sucking reflex is not developed until 34 weeks gestation.
Ability to pull food into the mouth rather than pushing the Infants born earlier will require total parenteral nutrition, tube
tongue and food out of the mouth. feedings, or bolus feedings.
Willingness to participate in the process.  Premature Infants
Ability to sit up without support. Other concerns include: low birth weight, underdeveloped
 Indications for Readiness for Solid Foods lungs, immature GI tracts, inadequate bone mineralization, and
Having head and neck control. lack of fat reserves.
The need for additional nutrients. Many special formulas are available.
Drinking more than 32 ounces of formula or nursing 8 to 10  Cystic Fibrosis
times in 24 hours. An inherited disease
 Infant feeding skills and Recommended foods Decreased production of digestive enzymes
 0-4 month – turns head toward any object that Malabsorption of fat
brushes cheek ; initially swallows using back of Recommendation: 35-40% of diet should be from fat
tongue, gradually begins to swallow front of tongue as  Cystic Fibrosis
well Digestive enzyme is taken in pill form.
 Strong reflex (extrusion) for 2-3 months old There is a water-soluble form of fat-soluble vitamins that can
 Breast milk and infant formula be administered if normal levels cannot be maintained with the
 4-6 months – extrusion reflex diminished and ability to use of fat-soluble vitamins.
swallow liquid foods develops; desire for food; Nighttime tube feedings may be indicated.
indicates satiety or disinterest, sits erect with support;  Failure to Thrive
brings hand to mouth;grasps objects Determined by plotting the height and weight of the infant on
the growth chart.
May be caused by poverty, congenital abnormalities, AIDS, Babies must have adequate diets so that their physical and
lack of bonding, child abuse, or neglect. mental development are not impaired.
The first six months are the most crucial for brain development. Breastfeeding is nature’s way of feeding an infant.
 Galactosemia Formula feeding is also acceptable.
A condition in which there is a lack of the liver enzyme Some infants have special nutritional needs.
transferase.
Transferase normally converts galactose to glucose.
The amount of galactose in the blood becomes toxic.
 Galactosemia
Diarrhea, vomiting, edema, and abnormal liver function
Cataracts may develop, galactosuria occurs, and mental
retardation develops.
Diet therapy: exclusion of anything containing milk from any
mammal; nutritional supplements of calcium, vitamin D, and
riboflavin.
 Phenylketonuria (PKU)
Lack the liver enzyme phenylalanine hydroxylase, which is
necessary for the metabolism of the amino acid phenylalanine.
Infants are normal at birth, but if untreated become
hyperactive, suffer seizures, and become mentally retarded
between 6 to 18 months.
 Phenylketonuria (PKU)
Diet Therapy: commercial formula “Lofenalac”, regular blood
tests, synthetic milk for older children, avoidance of
phenylalanine.
Hospitals routinely screen newborns for PKU.
 Maple Syrup Urine Disease (MSUD)
Congenital defect resulting in the inability to metabolize three
amino acids: leucine, isoleucine, and valine.
Named for the odor of the urine of clients with the condition.
Leucine- is an α-amino acid used in the biosynthesis of
proteins.
Isoleucine - appears to promote glucose consumption and
uptake
Valine - to promote normal growth, repair tissues,
regulate blood sugar, and provide the body with energy.
 Maple Syrup Urine Disease (MSUD)
Hypoglycemia, apathy, and convulsions occur and if not
treated promptly, will result in death.
Diet therapy: extremely restricted amounts of the three amino
acids; a special formula and low protein diet is used; diet
therapy necessary throughout life.
 Women, Infants, and Children (WIC)
A federally funded program that provides monthly food
packages of infant formula or milk, cereal, eggs, cheese,
peanut butter, and juice for a mother who is breastfeeding.
 Common Disorders
 Conclusion