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jpg Nutrition ThroughoutNutrition ThroughoutNutrition Throughout The LifespanThe LifespanThe Lifespan NURS 125 11 NURS 125 11 10 10

C:\Users\daisy\Desktop\nutri\images\infant-passport.jpg Nutrition in Infancy Nutrition in Infancy Infant means a person not more than 12 months of age. Developmental period begins at birth and ends at one year. Stage of Trust versus Mistrust and oral gratification.

C:\Users\daisy\Desktop\nutri\images\infant-passport.jpg Nutrition in Infancy Nutrition in Infancy

Characteristics Characteristics Weight= 2.7 to 3.2 kg (6-7 lbs) Length= 48-50 cm (19-20 in) Between 2nd to 3rd days of life, there is weight loss due to loss of fluids.

Blood glucose as source of energy goes down and stored proteins and fats in the tissues are utilized.

C:\Users\daisy\Desktop\nutri\images\infant-passport.jpg Process of digestion, absorption, and metabolism of foods are the same with that of the older child with the following exception: . pancreatic amylase deficient . inadequate fat absorption . stomach acidity is low

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C:\Users\daisy\Desktop\nutri\images\infant-passport.jpg Nutrient Requiremen ts Nutrient Requiremen ts Energy

Milk is the sole source of energy DRI ranges from 570-743 kcal for males and 520-676 for females. Nutrition in Infancy Nutrition in Infancy

C:\Users\daisy\Desktop\nutri\images\infant-passport.jpg The increases for the high energy allowance of infants are: 1) rapid rate of growth; 2) great heat loss due to large body surface area; 3) activity of the infant

Gains in weight, length and weight-for-length for age and plotting these data on the growth charts is an effective method of determining the adequacy of an infant s energy intake. Nutrition in Infancy Nutrition in Infancy

C:\Users\daisy\Desktop\nutri\images\infant-passport.jpg Protein Protein Allowances of 1.5 to 2.5 gm per kg BW from 0-6 months of age, and 1.5 to 2 gm per kg in BW from 6-12 months of age are recommended. Infants require a larger percentage of essential amino acids than adults. Histidine is the essential amino acid for infants but not for adults. Tyrosine, cystine, and taurine are essential for premature infants.

Nutrition in Infancy Nutrition in Infancy

C:\Users\daisy\Desktop\nutri\images\infant-passport.jpg The amount of protein in human milk is adequate for the first six months of life. In the last 6 months, diets should be supplemented with additional sources of high-quality protein such as yogurt, strained meats or cereal mixed with formula or milk. Nutrition in Infancy Nutrition in Infancy

C:\Users\daisy\Desktop\nutri\images\infant-passport.jpg Lipids Lipids The RDA is 30 g. of fats/day which is present in human milk and all infant formulas. Human milk contains large amounts of essential fatty acids and linoleic acids. Nutrition in Infancy Nutrition in Infancy

C:\Users\daisy\Desktop\nutri\images\infant-passport.jpg Carbohydrates Carbohydrates CHO should supply 30-60% of infancy. 37% of energy in human milk energy in infant formulas is RDA is 60-95 g. Infants who cannot tolerate diet. Nutrition in Infancy Nutrition in Infancy the energy during and 40-50% of the derived from lactose. lactose require a special

C:\Users\daisy\Desktop\nutri\images\infant-passport.jpg Water Water The need for water is greater than that of the adult. The recommended water intake is 1.5 ml/kcal/day or 125-135 ml/kg/day. Human milk and formula that is properly prepared supply adequate amounts of water. Nutrition in Infancy Nutrition in Infancy

C:\Users\daisy\Desktop\nutri\images\infant-passport.jpg Boiled milks are inappropriate Additional water is required during hot and humid weathers Nutrition in Infancy Nutrition in Infancy

C:\Users\daisy\Desktop\nutri\images\infant-passport.jpg Vitamins Vitamins Poorly supplied by human milk (1-1.5 mcg), present in infant formulas. Regular exposure to sunlight is needed for 30 minutes per week with the infant wearing only a diaper.

Nutrition in Infancy Nutrition in Infancy

C:\Users\daisy\Desktop\nutri\images\infant-passport.jpg VITAMIN A 200,000 IU within 4 weeks after delivery so the baby may also get the vitamin A coming from the mother(IMCI). Nutrition in Infancy Nutrition in Infancy

C:\Users\daisy\Desktop\nutri\images\infant-passport.jpg Vitamin K Injection with Vitamin K Suggested intake of 5-15 mcg/day can be supplied by mature breast milk after 1 week of life. Nutrition in Infancy Nutrition in Infancy

C:\Users\daisy\Desktop\nutri\images\infant-passport.jpg The thiamine requirement of the infant, based on intake from mother s milk appears to be approximately 0.2 mg/1000 kcal. Based on intake-excretion data obtained at different levels of riboflavin intake, infants require 0.1 mg/kg of maintain tissue saturation. Philippine RNI for 6-11 month old infant is 0.5 mg/day. Nutrition in Infancy Nutrition in Infancy

C:\Users\daisy\Desktop\nutri\images\infant-passport.jpg Human milk contains about 5.0 mg ascorbic acid/100 ml. Pyrioxine is essential in the diet of human infants; the minimum requirement is 60 to 100 mcg/day Plasma vitamin E concentration in the newborn infant is about one-third that of the adult. About 0.7 IU per 100 kcal is advised for the artificially-fed infant. Nutrition in Infancy Nutrition in Infancy

C:\Users\daisy\Desktop\nutri\images\infant-passport.jpg Calcium Calcium RDA for breast fed infants range from 210-270 mg/day. (They retain 2/3 of their calcium intake.) RDI for formula-fed infants range from 400-800 mg/day. (They retain only 2530% of their intake) Nutrition in Infancy Nutrition in Infancy

C:\Users\daisy\Desktop\nutri\images\infant-passport.jpg Iron Term infants who are exclusively breast-fed do not need supplemental iron until they are four-six months of age. (One liter of human milk contains 0.3 to 0.5 mg of iron.)

If solid foods are introduced earlier they should contain an adequate amount of iron.

Nutrition in Infancy Nutrition in Infancy

C:\Users\daisy\Desktop\nutri\images\infant-passport.jpg By four-six months of age, breast-fed infants should receive extra iron in the form of iron-fortified infant cereals and other iron-rich foods. These infants should be offered an iron-fortified infant formula after they have been weaned from breast milk.

Nutrition in Infancy Nutrition in Infancy

C:\Users\daisy\Desktop\nutri\images\infant-passport.jpg Term infants who are not breast-fed should be given an iron-fortified infant formula from birth. (Infant formulas based on cow s milk contain 1.0 to 1.5 mg of iron per liter.) After four to six months of age iron-fortified infant cereals provide a good additional source of iron.

Nutrition in Infancy Nutrition in Infancy

C:\Users\daisy\Desktop\nutri\images\infant-passport.jpg Cow s milk should not be introduced until an adequate amount of solid food containing iron and vitamin C is included in the diet, preferably at 12 months of age. RDA for infants from 6-12 months is 11 mg/day. (or 1 mg/kg/day)

Nutrition in Infancy Nutrition in Infancy

C:\Users\daisy\Desktop\nutri\images\infant-passport.jpg Initial Feeding Patterns Initial Feeding Patterns There are three ways to feed an infant; (1) breastfeeding; (2) bottlefeeding; and (3) mixed feeding Nutrition in Infancy Nutrition in Infancy

C:\Users\daisy\Desktop\nutri\images\infant-passport.jpg Initial Feeding Patterns Initial Feeding Patterns Breast feeding for the first six months is strongly recommended. Nursing is encouraged immediately after birth. Formula fed infants are likely to receive ready-to-feed formula in the hospital. Infants should be held/cuddled during feedings. Feed by demand.

Nutrition in Infancy Nutrition in Infancy

C:\Users\daisy\Desktop\nutri\images\infant-passport.jpg Bottle feeding Bottle or artificial feeding with cow s milk or other proprietary milk preparations is recommended only when breast feeding is contraindicated. Artificial feeding is associated with infantile obesity or protein-calorie malnutrition plus. Artificial feeding is costly Nutrition in Infancy Nutrition in Infancy

C:\Users\daisy\Desktop\nutri\images\infant-passport.jpg Two types of infant milk formulas: 1.whey adapted and 2.casein predominant. Nutrition in Infancy Nutrition in Infancy

C:\Users\daisy\Desktop\nutri\images\infant-passport.jpg Formula Preparation Milk formulas are sterilized in order to reduce curd size and to prevent the growth of harmful bacteria.

Two Methods of Formula Preparation 1.Aseptic Method 2.Terminal Method

Disadvantages: a. All formulas (sterilized) are slowly cooled without shaking and stored immediately in the refrigerator. b. Left-over formulas should not be used again or reheated. Nutrition in Infancy Nutrition in Infancy

C:\Users\daisy\Desktop\nutri\images\infant-passport.jpg Feeding Time The self-demand concept is not feeding the baby whenever he is awake or starts to cry. Rather it is the observance of a regular feeding schedule without being meticulous or rigid about time. A 2.5 to 2.7 kg baby feeds q 3 hours. A 3.6 to 4 kg baby q 4 hours At 2 months old, the baby sleeps through the night after 10 pm feeding Between 2 to 3 months old, the baby is on a 4 to 5 feeding schedule. A baby s hunger is considered the best clock to go by. Nutrition in Infancy Nutrition in Infancy

C:\Users\daisy\Desktop\nutri\images\infant-passport.jpg Mixed Feeding 1.complemental 2.supplemental Note: Mixed feeding is not encouraged as it may lead to lactation failure Nutrition in Infancy Nutrition in Infancy

C:\Users\daisy\Desktop\nutri\images\infant-passport.jpg Addition of Semisolid Foods Addition of Semisolid Foods Semisolid foods may be introduced between 4-6 months of age. Introduce semisolid foods one at a time. Avoid foods with skins, rinds and foods that stick on the roof of the mouth. Weaning from breast/bottle to cup may be started at about 6-9 months of age Nutrition in Infancy Nutrition in Infancy

C:\Users\daisy\Desktop\nutri\images\infant-passport.jpg Problems associated with breastfeeding Nursing bottle mouth / bottle-baby tooth decay To prevent nursing bottle mouth, if you must give your baby a bottle at nap or bed time, fill it with plain water and not milk, formula or juice. Nutrition in Infancy Nutrition in Infancy

C:\Users\daisy\Desktop\nutri\images\infant-passport.jpg Milk anemia when milk is non-iron fortified formula Microwave heating Use of inappropriate liquids Nutrition in Infancy Nutrition in Infancy

C:\Users\daisy\Desktop\nutri\images\infant-passport.jpg Types of Infant Formulas . Commercial Cow s Milk-Based Formula . Soybean-based Formula . Special Formula Nutrition in Infancy Nutrition in Infancy

C:\Users\daisy\Desktop\nutri\images\infant-passport.jpg Additional foods given during the first year 1.iron-fortified baby cereal 2.Pureed meats 3.Juice 4.Foods with more texture & finger foods 5.Allergenic foods Nutrition in Infancy Nutrition in Infancy

C:\Users\daisy\Desktop\nutri\images\infant-passport.jpg Nutritional Problems & Intervention Iron Deficiency Anemia Cause: consume few solid foods rich in iron Management: - iron-fortified cereals - red meats as tolerated (pureed) - iron supplements as prescribed

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C:\Users\daisy\Desktop\nutri\images\infant-passport.jpg Nutritional Problems & Intervention Fluoride & Dental Caries Cause: unavailable fluoridated water Management: - flourinated water and toothpaste

Dental Carries: Cause: Bottle-baby tooth deacay or Nursing-bottle mouth Management: same in breastfeeding Nutrition in Infancy Nutrition in Infancy

C:\Users\daisy\Desktop\nutri\images\infant-passport.jpg Nutritional Problems & Intervention Colic - repeated episodes that don t respond to feeding, holding or diaper change. - infants generally unhappy, fussy & cries a lot

Cause: - swallowing air (bottle-fed babies, nipples too large or too small) - gas-forming foods Nutrition in Infancy Nutrition in Infancy

C:\Users\daisy\Desktop\nutri\images\infant-passport.jpg NOTE: Colic usually resolves by 3 months & is not associated w/ later dysfunction or disease. Colic Management: 1.Change mother s diet. Avoid onions, cow s milk, chocolate, broccoli, cauliflower and brussels sprouts. 2.Change the routine. Try different positions during feeding. Try using warm water, diluting formula, holding, rocking & using pacifier. Nutrition in Infancy Nutrition in Infancy

C:\Users\daisy\Desktop\nutri\images\infant-passport.jpg Nutritional Problems & Intervention Diarrhea (Non-infectious diarrhea) Cause: overfeeding and food intolerance Management: - Electrolyte replacement formulas (Pedialyte) - Continue breastfeeding, formula maybe withheld temporarily. - If symptoms persist consultation is needed! Nutrition in Infancy Nutrition in Infancy

C:\Users\daisy\Desktop\nutri\images\infant-passport.jpg Nutritional Problems & Intervention Constipation - rare in breastfed infants, occasionally a problem for formula-fed. Cause: - Inadequate CHO intake - consumption of overly concentrated formula Management: - Adjust the dilution of the formula -Older infants: add fiber to diet (fresh fruits & vegs) Nutrition in Infancy Nutrition in Infancy

C:\Users\daisy\Desktop\nutri\images\infant-passport.jpg Nutritional Problems & Intervention Food Allergies Cause: common allergy risks include milk, eggs & wheat. Management: - Introduce solid foods slowly to assess intolerance, record initial response and if similar reaction occurs the 2nd time, eliminate the food from the diet! Nutrition in Infancy Nutrition in Infancy

C:\Users\daisy\Desktop\nutri\images\infant-passport.jpg Nutritional Problems & Intervention Failure to Thrive (FTT) - a weight-for-length measurement less than the fifth percentile or weight for age below the 3rd percentile. Causes: Organic metabolic disorders: CHD, HIV infection

Non organic psychosocial: inadequate maternalinfant bonding, poverty, child abuse or neglect. Nutrition in Infancy Nutrition in Infancy

C:\Users\daisy\Desktop\nutri\images\infant-passport.jpg Nutritional Problems & Intervention FTT Management: - Nutrition intervention: promote wt. gain - Therapy to correct developmental delays & any psychosocial problems in home environment.

Inborn Errors of Metabolism (MCN 1) Nutrition in Infancy Nutrition in Infancy

C:\Users\daisy\Desktop\nutri\images\infant-passport.jpg Premature Infant The premature infant has higher basal metabolism than his full term counterpart. requires a large amount of food to supply building materials and energy. his requirements are from 30-50% greater than those of the full term infant. Nutrition in Infancy Nutrition in Infancy

C:\Users\daisy\Desktop\nutri\images\infant-passport.jpg Nursing Considerations for Premature Infants Breast milk - supplemented with such nutrients as calcium, phosphorus, sodium, protein which are necessary to supplement a premature infant s rapid growth

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C:\Users\daisy\Desktop\nutri\images\infant-passport.jpg Nursing Considerations for Premature Infants Other nutritional concerns .Increase caloric & nutrient requirement .Lack of enzymes that enable digestion & absorption .Neuromuscular immaturity .Small gastric capacity .Risk of dehydration due to immature kidney function & proportionally high body-surface area .Risk of hypoglycemia due to immature liver function, hypothermia, or respiratory distress syndrome .Vitamin E deficiency due to inability to digest & absorb fats

Nutrition in Infancy Nutrition in Infancy

C:\Users\daisy\Desktop\nutri\images\infant-passport.jpg Premature Infant

does not receive food for about 24 hours after birth until he establishes his respiration and loses the edema fluid with which he is born food is administered parenterally or through a tube. SFF, amount gradually increasing until food intake reaches 120-140 kcal/kg and 3-4 gm protein/kg body weight. Nutrition in Infancy Nutrition in Infancy

C:\Users\daisy\Desktop\nutri\images\infant-passport.jpg Premature Infant The limited capacity of PM stomach must not be exceeded to avoid vomiting, aspiration of food, or diarrhea. PM tolerates fat very poorly milk formulas must provide fat in the form which is easily absorbed, such as a mixture of medium chain triglycerides, butterfat, and cornoil Nutrition in Infancy Nutrition in Infancy

C:\Users\daisy\Desktop\nutri\images\infant-passport.jpg Premature Infant

PM calls for EAA tyrosine and cystine, in addition to the basic eight and histidine intake of 50 mg ascorbic acid daily protects the PM from the adverse effects of transient tyrosinemia during the first week of life Prophylactic quantities of the vitamins are usually given in double the dosage recommended for the full term infant Nutrition in Infancy Nutrition in Infancy

C:\Users\daisy\Desktop\nutri\images\infant-passport.jpg Premature Infant Calcium and phosphorous are proportionately higher with a ratio near 2.0. Iron supplementation is started by two months of age at 2 mg/kg/day. The ideal milk for PM and LBW infants remain controversial but BM is still the best Nutrition in Infancy Nutrition in Infancy

C:\Users\daisy\Desktop\nutri\images\infant-passport.jpg For premature infants who are breast-fed iron supplement should be started by at least eight weeks of age and continued until the first birthday. Iron-fortified formula for bottle-fed infants and commercial iron drops for breast-fed infants are the recommended source of supplemental iron.

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C:\Users\daisy\Desktop\nutri\images\infant-passport.jpg Nutrition in Infancy Nutrition in Infancy I I WAS BORN TO EAT!