Lecture 22 Ch 11 cont.Remember colostrum has antibodies - not found in formula! It also includes the hormones that are related to food intake and helps the baby to know when hungry/full. Breast Milk is Best for an Infant’s Unique Nutritional Needs: Composition changes as infant grows. Colostrum:milk produced just after birth; compared to mature milk it contains more antibodies, protein, minerals, Vit A, and less fat Milk production:  Synthesis of milk components Stimulated by pituitary hormone prolactinLet down:  Release of milk from milk-producing glands and movement through the milk ducts to the nipple Stimulated by pituitary hormone oxytocin Inhibited by nervous tension, fatigue, or embarrassmentBreast Feeding Helps with Pregnancy Recovery and Reduces the Risk of Some Chronic Diseases: Oxytocin causes uterine contractions that help the uterus to return to normal size more quickly. Increases energy expenditure, which may speed return to pre-pregnancy weight. Inhibits ovulation, lengthening the time between pregnancies. Lower risk of developing type 2 diabetes, breast & ovarian cancer. Improves bone density.Breast-Feeding Protects Against Infections. Allergies, and Chronic Diseases and May Enhance Brain Development. Decreases risk and severity of diarrhea, meningitis, respiratory, ear, and urinary tract infections  Lactoferrin (protein in breast milk) binds IRON, making it unavailable to bacteria. Reduces risks of asthma, leukemia, heart diseases, and diabetes. Might help infants with their intellectual development NUTR 202 1nd Edition Development of facial muscles, speech, tooth formation Reduces chance of overfeeding Additional calories needs for mom while breastfeeding from nutrient dense diet (pregnant women less than breastfeeding).  500 EXTRA CALORIES during first 6 mos. of lactation:  170 Calories from fat stores (Potential weight loss of 2 pounds/week)*** Only 320 Calories from food first 6 months During the second 6 months: 400 Calories/day from foodProtein needs: Increased by 25g/day above DRI. Mom needs to consume adequate fluid: additional 1 Liter (therefore 3.7 L). Avoid alcohol and illicit drugs, limit caffeine, and follow FDA’s guidelines on fish consumption. Talk to physician regarding medications because can pass into breast milk.Even expand to 1-2 years breastfeeding.Formula better option when: 1) Some women may not be able to breast-feed. Women infected with HIV/AIDS, human T-cell leukemia or active tuberculosis, receiving chemotherapy and/or radiation, or use illegal drugs should not breast-feed. Infants with galactosemia can’t metabolize lactose, shouldn’t be breast-fed. Women taking prescription medications should check with health-care provider regarding safety.2) Formula can be a healthy alternative to Breast-feeding The best alternative is commercially made formula. Cow’s milk cannot be used (less FAT CONTENT and fat needs to be the main component of baby’s diet).  Too much protein (casein), difficult for infant to digest. Kidneys can’t break down/excrete. Too low in fat, too high in sodium and potassium.  Iron is poorly absorbed Cow’s milk cause intestinal blood loss=anemia. Too big of protein!  Increase risk of developing allergy to cow’s milk.Infant: birth  1 year oldInfants grow at an ACCELERATED RATE. Nutrient needs increased with rapid rate of growth: Birth weight 4-6 mo Birth weight should triple by 12 months. Most infants 50%Growth charts: used to monitor rate of growth. Compare weight, length, or head circumference to the population: Ranking, or percentile, indicates where the infant’s growth falls in relation to population standards. Baby of 8 lbs  16 lbs  24 lbs at end of year. And length increase by 50% and head size enlarged. Infant Growth tracked using growth charts - Slight variations normal - should follow a normal increase in height vs. weight. Failure to Thrive inability to remain on normal growth curve. Causes? Maybe congenital condition, disease, poor diet, neglect, abuse, psychosocial problems.Based on these tables, height, weight, head circumference  determine if baby is healthy or not.Infant specific Nutrient Needs: Calories: 0-6 months= 108 Cals/kg Body Weight Protein: 9.1 g /day first 6 months then 11 g/day NEED Fat, esp. essential fatty acids.  Infants Risk Deficiencies for 3 Micronutrients: Vitamin K injection needed at birth: Due to sterile gut (usually non-essential but GI tract of infant in immature and don’t produce vitamin K therefore inject immediately). Vitamin D drops needed unless on formula that contains this vitamin and consuming > 1L/day Iron stores generally last for 6 months: Iron-enriched foods should be introduced at 4-6 months.Breast milk does not have a lot of iron. The bioavailability is HIGHER in breast milk yet quantity is depleted at 6mo. Why you need to make sure a 6 month baby gets SOLID foods FORTIFIED IN IRON.• Calorie/Energy Recommendations made for three age groups:0-3 months, 4-6 months, 7-12 months• More calories in small stomach  ENERGY-DENSE diet (vs. your nutrient-dense diet)  FREQUENT SMALL ENERGY DENSE MEALS! MORE WATER per kg body ß high urine output, evaporation. (In adult we always want nutrient dense, not energy dense yet for infant that is the most important.US health professionals recommend exclusive breast feeding for 6 months and breast feeding with complementary foods for at least 1 year and as long thereafter as mutually desired. Complementary foods canbe started at 6 months; why decided this? The fat the amt mom built during pregnancy will start to decrease and iron storage will deplete.May eat solid foods once certain milestones are reached: First the infant must be nutritionally ready, e.g., at 6 mos., infant iron stores are depleted Must be physiologically ready: GI tract can’t process solid foods in early infancy; and kidney function not fully developed  Tongue-thrust reflex fades at 4-6 months Swallowing skills matured adequately Voluntary muscle control, e.g., can sit-up with support, head & neck control Ability to turn his/her head to indicate “I’m full”Solid foods should be introduced gradually to make sure the infant isn’t allergic or intolerant One new food per week Rice cereal is a great first food: least allergy-causing (and not sweet)  Other grains, then