Chapters 8&9: Infant Nutrition

Why are nutrient requirements (DRI's) for infants expressed as AIs rather than as RDAs?

B/c most research evidence is based on observation data

- can't do that on infants

Infants (0-6 months) require

108 kcal/kg/day on average

Two factors that affect the changing needs of an infants energy requirements are..

Growth rate decreases

Physical activity increases

By 6 months an infants energy needs are

98 kcal/kg/day on average

Rage of 80-120 kcal/kg/ day

Factors affecting infants energy needs

Differences in growth rate

Differences in physical activity

Efficiency of digestion and absorption

Body weight

Temp and climate

Sleep/ wake cycle

Health status

Protein intake for infant (0-6 months)?

1.52 g/kg/day

Protein intake for infant (7-12 months)

1.20 g/kg/day

Dietary fat during infancy (0-6 months)

31 g/day

Dietary fat during infancy (7-12 months)

30 g/day

Major carb source for infants is

lactose

Infants need good source of fluoride for..

teeth formation

American Academy of Pediatrics increased vitamin D recommendations from 200 IU/d

to 400 IU/d

Vitamin D is low in

breast milk

Sodium requirements for infants

0-6 months: 120 mg/day

7-12 months: 370 mg/d

Infants need sodium for..

Fluid and electrolyte balance

Cell growth

Activation of muscles and nerves

Infants need iron for...

growth and cognitive development

- breast milk is a poor source

Infants have iron stores...

which meet the needs of the infant for 4-6 months

Preterm infants (28 to <34 weeks) should receive

1-4 mg/kg/day iron through 12 months of age

Term infants that are exclusively breastfed should receive

1 mg/kg/day iron starting at 4 months of age

Iron for formula fed infants

is not a needed supplements because iron is already in infant formula

Daily formula volumes for infants:

At birth infant needs

16-20 oz/day

Daily formula volumes for infants:

3-4 moths old needs

24-32 oz/day

Order of food infroduction

1. Iron fortified infant cereals

2. Vegetables, then fruits

3. Pureed meats

Foods to avoid

unpasteurized foods and beverages

honey

no cows milk or 100% fruit juice

no sugar sweetened beverages until 5yr old

Texture progression:

4-6 months

pureed soupy foods

no lumps

Texture progression:

6-8 months

foods with lumpy but soft texture

Texture progression:

8-10 months

soft mashed foods

No type of milk should be given to an infant because

Iron deficiency anemia

High renal solute load

Micronutrient concentrations are low

Factors that might affect a baby's comfort level during feeding include..

Reflux

Constipation

Caregiver demeanor

Environment vs Personality

Readiness

When should the transition from breast/bottle to cup feeding begin?

at 6-8 months

When can babies begin to elevate the tongue and control the liquid?

at about 12 months

Issues with using cups as main feeding method too early

Poor fluid intake can lead to constipation

Poor caloric intake can lead to poor growth

Typical amount of fluid from an open cup is

1-2 ounces

Ways to tell if infant is eating/ drinking enough

Overall health

Growth slows (in 2nd month by ~50%)

Concerns of infant eating/ drinking

Drop or gain 2 or more % curves

Infant falls between 5th-25th percentile or gains above 75th-95th