Lactation and Infant FeedingNutrient needs during lactationEnergyAdditional 500 kcal per dayFrom diet and fat storesConsume additional 330 calories (rest comes from storage)ProteinVitamins: A, E, C most B (not folate)Minerals: zinc, selenium, magnesium (not iron)Water: ~2 quarts per dayOther Recommendations for lactation Decrease use or consumption of:CigarettesMarijuanaAlcoholCaffeineGet plenty of restDon’t try to lose weight quickly by severely restricting caloriesMilk production and Let downStimulates hypothalamusRelease of hormones oxytocin and prolactin by pituitary glandProlactin stimulates milk productionOxytocin causes release of milk from storage Sucking infantAbility to BreastfeedOnly 1 in 500 women is unable to breastfeedPoor nutrition in mother will decrease quantity but not quality of breast milkHIV can be passed through breast milkControversial 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 milkAdvantages to BreastfeedingColostrumMilk produced first few days after milkThin, yellowishHigh in antibodiesFactors to stimulate growth of healthy gut bacteriaMature milkNutritionally complete for first 4-6 monthsEasily digested protein called lactalbuminHigh bioavailability of nutrientsProtective against infectionDecreased risk of food allergiesEmotional bondingCost and convenienceReduced risk for breast cancer for motherMay help with weight lossDisadvantages of breastfeedingFather’s bondingMother’s environment impacts breast milkTobacco, caffeine, alcohol, drugs, environmental contaminants, foodsNot immediately easy (lactation consultants)Societal barriersDifferent 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 infantsVitamin D, if little sunlightFluoride, if water not fluoridatedVitamin B12, if mother is complete vegetarian Infant formulasCow’s milkSoy-basedProtein hydrolysate Other componentsIronRDAs for most vitamins/mineralsDHA and ARAFeeding periodsNursing (0-6 months)Breast milk or formula onlyImmature kidneys and GI tractSuckling reflexTransitional (5-12 months)Still taking breast milk/formulaBegin adding foods, beginning with iron-fortified cerealMaturing kidneys/GI tractMaturing suck/swallow reflexModified adult (1-10 years)Feeds selfIncreasing variety and textureMature kidneys and GI tractIntroducing SolidsNutritional needsIncreased calorie needsIronDeveloped readinessMature suck and swallowHolds head upTeeth eruptHow to introduce solidsBegin with iron fortified cereal (usually rice)Introduce one new food per weekLow salt, sugarGive vegetables before fruitsNo cow’s milk, eggs or honey in first yearAvoid choking foodsDivision of ResponsibilityParent responsible for presenting nutritious and appealing food choicesParent responsible for time of feedingChild responsible for how much he/she
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