NUTR SCI 132 Lecture 34 Outline of Last Lecture I. Breast feedinga. Benefitsb. Recommendationsc. Ratesd. Physiologye. Breastfeedingf. Nutritiong. Breastfeeding supportOutline of Current Lecture Current LectureI. Breastfeeding and Nutritiona. Nutrition for Mom i. General guidelines1. Eats 330 kcal/day more (on normal, balanced diet)a. 170 kcal deficit2. Vegetarian: pay attention to protein, calcium/Iron/zinc3. Drink water every time breast feedii. Who can breastfeed?1. Multiple births2. Preemies3. Vegetarians4. Nutrition not optimal5. Any size breasts, nipples6. Some breast surgeries7. Women who want to exercise or lose weight8. Smokers9. Women who would like an occasional dinkiii. Contraindications (Do not breast feed)1. Maternal HIV (at least in developed countries)2. Active/untreated TB3. Alcohol and drug abuse4. ChemotherapyThese notes represent a detailed interpretation of the professor’s lecture. GradeBuddy is best used as a supplement to your own notes, not as a substitute.5. Radiation therapies6. Infant galactosemia7. Selected medications8. Cystic fibrosis?a. Research underwayII. Breastfeeding supporta. Breastfeeding educationi. WICb. La Leche Leaguec. Lactation consultantsd. Hospital policies and stafe. Doctor, midwife, doulaIII. Feeding Babies 6-12 monthsa. Dietary Guidancei. Nothing official now1. In 2020, guidelines will include dietary guidance for pregnant women and birth-24 months2. Research in progressb. Growth and needsi. Infants grow in spurts, seasonallyii. Weight loss after birth1. 5-7%2. Regained by 2 weeksiii. By 12 months, 2.4-3x birth weight1. 1.5x birth lengthiv. Breastfed vs. formula fed babies grow diferently!v. As babies get older, need less fat and more carbohydratevi. Iron1. Runs out around 0-6 monthsa. Eat Iron in complementary foodsi. Iron-fortified cerealsc. Transition in infant feeding i. Big picture1. Breast milk/formula2. “Baby food” “solids” “weaning” “complementary”3. Family foodsii. Complementary Food1. Developmental readiness for food = 4-6 mothsa. Exclusive breastfeeding for 6 months2. Newer research on allergies:a. “Window” of tolerancei. 4-7 moths?ii. Solids introduced while still breastfeeding3. Need increases in types, texture, mode of feedinga. Food promotes continued development, including mouth and tongue (language)4. Cues of developmental readiness:a. Sitting with supportb. Head and neck controlc. Tongue thrust/gag reflexd. Opening mouth for spoone. Gumming/chewingf. Also-gut maturation5. Foodsa. Meet iron, zinc needsi. Meat, poultry, fishii. Fortified cereals, any grain (with formula, breast milk)iii. Fruit, vegetable, dairyb. Any order, any ratec. Attention to portions!6. Texturesa. Pureed, mashed, lumpy, minced, choppedi. Less than ½ inch piecesb. Foods risky for chokingi. Round and firm foods, large chunks of food, sticky foods, foods hard to chew or gum, nuts, seeds, popcorn, raisins7. Juicea. AAP guidelinesi. “Babies don’t need juice”1. Limited juicea. No benefit vs. whole fruit; less fiver and other nutrients2. Hydrationa. Fluids in breast milk, formula, foodsb. Water after 6 months8. Feeding Implementsa. Bottlesi. For breast milk and formula only1. No cereal!ii. Hold baby1. Don’t prop2. No bottles for sleepingb. Training Cupsi. Age 6 months, up9. Feeding Cuesa. Hungeri. Fussing and then cryingii. Squirming and stretchingb. Satietyi. Stops sucking, lets go of breast or bottle nippleii. Falling asleep!10. Division of responsibilitya. “Parent provides, child decides”i. Transition form “on-demand” (breastfeeding) to schedule (eating with family)11. Feeding environmenta. Earlyi. Seatedii. TV of!iii. Caregiver sits with baby, interactsb. Lateri. Family meals at tableii. Social interactioniii. Utensils, sharing, mannersd. Hot Topicsi. Protein1. Cow’s milk formula feedinga. Protein greater to meet human amino acid requirementsi. Breastfed babies leaner at one year (vs. FF infants)ii. Allergies1. Rethinking of preventiona. Exposure in “window” vs. avoidanceb. See above mention in
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