Lactation and Infant Feeding Nutrient needs during lactation Energy Additional 500 kcal per day From diet and fat stores Consume additional 330 calories rest comes from storage Protein Vitamins A E C most B not folate Minerals zinc selenium magnesium not iron Water 2 quarts per day Other Recommendations for lactation Decrease use or consumption of Cigarettes Marijuana Alcohol Caffeine Get plenty of rest Don t try to lose weight quickly by severely restricting calories Milk production and Let down Stimulates hypothalamus Release of hormones oxytocin and prolactin by pituitary gland Prolactin stimulates milk production Oxytocin causes release of milk from storage Sucking infant Ability to Breastfeed Only 1 in 500 women is unable to breastfeed Poor nutrition in mother will decrease quantity but not quality of breast milk HIV can be passed through breast milk Controversial public health recommendation in undeveloped nations 1 5 million infants die around the world every year because they are not breastfed Certain drugs can pass through breast milk Advantages to Breastfeeding Colostrum Milk produced first few days after milk Thin yellowish High in antibodies Factors to stimulate growth of healthy gut bacteria Mature milk Nutritionally complete for first 4 6 months Easily digested protein called lactalbumin High bioavailability of nutrients Protective against infection Decreased risk of food allergies Emotional bonding Cost and convenience Reduced risk for breast cancer for mother May help with weight loss Disadvantages of breastfeeding Father s bonding Mother s environment impacts breast milk Tobacco caffeine alcohol drugs environmental contaminants foods Not immediately easy lactation consultants Societal barriers Different pattern of weight gain may cause concern breastfed infants gain weight more rapidly in the first 2 3 months from 6 12 months breast fed infants tend to weigh less than formula fed infants Supplements for breastfed infants Vitamin D if little sunlight Fluoride if water not fluoridated Vitamin B12 if mother is complete vegetarian Infant formulas Cow s milk Soy based Protein hydrolysate Other components Iron RDAs for most vitamins minerals DHA and ARA Feeding periods Nursing 0 6 months Breast milk or formula only Immature kidneys and GI tract Suckling reflex Transitional 5 12 months Still taking breast milk formula Begin adding foods beginning with iron fortified cereal Maturing kidneys GI tract Maturing suck swallow reflex Modified adult 1 10 years Feeds self Increasing variety and texture Mature kidneys and GI tract Introducing Solids Nutritional needs Increased calorie needs Iron Developed readiness Mature suck and swallow Holds head up Teeth erupt How to introduce solids Begin with iron fortified cereal usually rice Introduce one new food per week Low salt sugar Give vegetables before fruits No cow s milk eggs or honey in first year Avoid choking foods Division of Responsibility Parent responsible for presenting nutritious and appealing food choices Parent responsible for time of feeding Child responsible for how much he she eats
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