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Nutrition during Infancy. 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. Glossary.

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Nutrition during infancy
Nutrition during Infancy

  • 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


Glossary
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


Stages of infancy
Stages of Infancy

  • Prenatal

  • Perinatal

    • Neonatal

  • Postneonatal

one year

Conception

Birth

Infancy

Prenatal

Neo-natal

Perinatal


Physiological changes during infancy
Physiological Changes during Infancy


Anthropometrics
Anthropometrics

  • Weight

    • immediate loss of 6-10% body weight not uncommon

    • ______ birth weight by _____

    • ______ birth weight by _____

    • gain is rapid but

  • Length

    • increases ____ by ______

    • can “catch-up” or “lag-down”

  • Body __________

  • Body __________!


Gi tract
GI tract

  • Immature; Stomach is small

    • ______ capacity

    • empties in _____ hours

    • so

  • Nutrient digestion/ absorption

    • 100% ready for _____

    • least ready for ______

    • ____depends on


Kidneys immature
Kidneys: Immature

  • unable to

    • renal solute load determined by ________

      _____________________ concentrations

    • risk of __________

  • by ______: able to regulate ____________ via ADH

  • by __________:

    renal tubules mature


Cdc growth charts
CDC Growth Charts

  • Developed by National Center for Health Statistics, 1977

  • Based on _______ data

  • Two sets:


Cdc growth charts revised 2000
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


What does a growth chart chart
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


Assessment standards
Assessment standards

  • ____________ percentile

    • stunting

    • underweight

    • overweight

  • ____________ percentile

    • risk of overweight (BMI-for-age)



Formulas for infant feeding
Formulas for Infant Feeding

  • Formulas are quite similar because

  • Forms:

  • ___ regulates composition


Formulas for infant feeding1
Formulas for Infant Feeding

  • __________-based

    • skim milk, casein proteins

    • skim milk, whey proteins

  • _____-based

  • Casein-________

    • + corn oil (Nutramigen)

    • + medium-chain TGs (Progestimil)

  • ___________ (Alimentum)


Formulas concerns
Formulas: Concerns

  • Too diluted

    • _______________

    • water __________

      • hyponatremia

      • irritability

      • coma, death

  • Too concentrated

    • __________

    • hypernatremia:

    • _________ (cellular)

    • tetany

    • metabolic acidosis


Feeding schedule

Neonate

2 weeks to 1 month

~ 2 months

~ 6 months

On demand:

8-12 times/day every 2-4 hrs for 20 minutes per feeding

~ 6-8 times/day

~ 5 times/day; can sleep through the night

3 meals + 4 milk feedings

Feeding Schedule


Introduction of solid foods
Introduction of Solid Foods

  • Nutritional need

  • Physiological capability

  • Physical ability

    • loss of ____________

    • head and neck control

    • ability to _______

  • Not too early / not too late!


Introduction of solid foods1
Introduction of Solid Foods

  • Add foods _____________

  • Suggested order:

    • __-fortified _______

    • strained _________

    • strained _________

    • ________ foods

    • ________ foods

    • _____ by cup (don’t displace milk and other foods)

  • Don’t add __________; why bother with _________?

  • Purchase or prepare at home


What not to feed infants 1 year old
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


What not to feed infants 1 year old1
What Not to Feed Infants < 1 Year Old

  • ____________ foods

  • _____________ foods

    • small grains, grapes, hot dog bits, hard candy, nuts, popcorn

    • __________

  • Foods of low nutrient density


Division of feeding responsibility
Division of Feeding Responsibility

Infancy

  • Parent is responsible for:

  • Infant is responsible for:


Division of feeding responsibility early spoon feeding
Division of Feeding Responsibility—Early Spoon Feeding

  • 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


Feeding concerns
Feeding Concerns

  • Colic

  • Spitting

  • “Nursing bottle syndrome”

  • Allergies

  • Infant obesity

  • Constipation


Failure to thrive
Failure-to-thrive

  • check

  • check _________ symptoms:

    • poor _____

    • _______ during feeding

    • reflux

    • delay of …

  • nutrient deficiency?

  • deficiency of _____________ with parents?

    • infants need


S udden i nfant d eath s yndrome
Sudden Infant Death Syndrome”

  • low maternal age

  • multiparity

  • maternal smoking

  • male infants

  • soft mattresses

  • loose blankets

  • sleeping on stomach


Guidance for infants
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


Eating pattern messages
Eating Pattern Messages

  • 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


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