Chapter 16: Life Cycle Nutrition: Infancy, Childhood & Adolescence

What is the first year of life a time of

rapid growth and development

What is the primary food for the first year

breast milk or iron-fortified formula

What is gradually introduced at 4-6 months of age

solids

What kind of nutrient needs do preterm infants have

very special

How should mealtimes with toddlers be

pleasant and relaxed environment

how many calories a day should an infant be consuming

- 450kcals/day

- 100 kcal/kg of body weight/day

when does birth weight double in an infant

5 months

when does birth weight triple in an infant

by 1 year old

what is the BMR of an infant in comparison to an adult BMR

BMR is twice that of an adult, based on body weight

what is the protein recommendation for infants

1.5-2.0g/kg body weight

why is protein necessary for infants

needed to support adequate growth

what can excess protein do to infants

stress kidneys and liver

in what proportion are vitamins/minerals needed for infants

needs in proportion to body weight are more than double those of an adult in proportion to body weigh

should babies be given plain water in the first year of life

NO, breast milk or formula provides enough to replace fluid losses

In the US and Canada, what are the two dietary practices that have the most significant effect on an infant's nutrition?

- the milk the infant receives

- the age at which solid foods are introduced

Both the American Academy of Pediatrics and the Canadian Pediatric Society strongly recommend breastfeeding exclusively for how long?

6 months for healthy full-term infants, except where specific contraindications exist

The Academy of Nutrition and Dietetics also advocates breastfeeding for what reasons ?

the nutritional health it confers on the infant as well as for the many other benefits it provides for both infant and mother

Breast milk is _______ easily and ______ digested than formula so breast fed infants usually need to eat ______ frequently than formula fed infants

more, completely, more

how often should you breastfeed per day in the first few weeks

8-12 feedings per day on demand

how often should you breastfeed during a day (hours)

every 2-3 hours

how long should an infant spend on each breast

at least 10-15 minutes or longer

what changes in breastfeeding as the infants get older

stomach capacity enlarges and milk production increases in mother allowing for longer intervals between feedings

what is breast milk considered in terms of energy nutrient

nature's most nearly perfect food

what protein is in breast milk

alpha-lactalbumin

what carbohydrate is found in breast milk

lactose

protein and CHO in breast milk are ____ digested

easily

what is abundant in the CHO componet of breast milk

oligosaccharides

are oligosaccharides abundant in cow's milk and formula

no, only present in trace amounts

what is the function of oligosaccharides in breast milk

they help protect the infant from infection by preventing the binding of pathogens to the infants intestinal cells

____ enhances calcium absorption in breast milk

lactose

_____ provides main source of energy

lipids

what is needed in generous proportions for brain development

essential fatty acids DHA

_____ content adjust during feeding at various times of the day and as infant grows

fat

protein in breast milk is _____ than cows milk which is beneficial

less

why is beneficial that protein in breast milk is less than cows milk

places less stress on the kidneys

vitamins/minerals are ample to support infant growth except which vitamin

vitamin D

which vitamin is low in breast milk and deficiency is most likely in infants who are not exposed to sunlight daily

vitamin D

what does the AAP currently recommend about Vitamin D

a vitamin D supplement for all infants who are breastfed exclusively and for all infants who do not receive at least 1 liter (1000 ml, 1 qt or 32 oz) of vitamin D -fortified formula daily

vitamin and mineral status of breast milk

- calcium content is ideal for infant bone growth and well absorbed

- high bioavailability of iron and zinc (iron and fluoride supplementation needed after 6 mo.

- low in sodium which is beneficial for immature kidneys

what is the immunological protection of breast milk

is sterile and actively fights disease and protects infants from illnesses

breast fed infants have _____ intestinal infections that formula-fed infants

fewer

breastfed infants have a ____ incidence of allergic reactions like asthma, recurrent wheezing, skin rash)

lower

disease protection from breast milk

- offers protection against the development of cardiovascular disease

- breast fed infants have a lower blood pressure as adolescents

- may also help protect against excessive weight gain later on

- also reduces risk of SIDS

what are the immunological protective factors of breast milk

- colostrum

- bifidus factors

- oligosaccharides

- lactoferrin

- lactadherin

- growth factor

- lysozyme

what is colostrum also referred to as

liquid gold

what is colostrum

milk like secretion from the breast

when is colostrum present

during the first 1-3 days after delivery before milk appears

how is colostrum protective for the newborn

- rich in antibodies and white blood cells

- helps protect newborn from infections against which the mother has developed immunity

how do the antibodies from colostrum work

antibodies inactivate disease-causing bacteria within digestive tract before they can start infection

what are bifidus factors

factors in colostrum and breast milk that favor the growth of "friendly" bacterium in infants intestinal tract, so that other, harmful bacteria cannot develop

what are oligasaccharides

- CHO component in breast milk

- prevents pathogens from binding to intestinal cells

what is lactoferrin

a protein in breast milk that binds iron and keeps it form supporting the growth of the infant's intestinal bacteria

what is lactadherin

a protein in breast milk that attacks diarrhea-causing viruses

what is growth factor

stimulates the development and maintenance of the infant's digestive tract

what is lysozyme

- an enzyme that protects the infant against infection

- kills bacteria/assist lactoferrin

what are breast milk banks

donated milk can be provided to those who are unable to provide sufficient milk to their infant

who is not allowed to donate breast milk

cigarette smokers, and those who use illicit drugs, take medications, drink alcoholic beverages (greater than 2 per day), or have communicable diseases

who can go to a breast milk bank

available by perscription

when would a mom go to a breat milk bank

when they have a very-low birthweight infant

Does the FDA recommend purchasing breast milk from online sources

NO

what is the composition of infant formula

- standard formula is cow's milk based

- ample to support infants needs

- attempts to copy the nutrient composition

- iron-fortified formulas recommended by AAP

- special formulas are designed to meet dietary need of infants with specific conditions such as cow's milk allergy

what are the risks of infant formula

- no protective antibodies

- may be prepared with contaminated water (lead)

- over diluted/under dilutes leading to high weight/low weight

- nursing bottle tooth decay due to prolonged contact with milk in a bottle

what is nursing bottle tooth decay

- can be caused by formula, milk, or juice

- prolonged exposure to formula when sleeping

- upper and lower teeth may be affected by decay

what are infant formula standards

- American Academy of Pediatrics guidelines

- FDA mandates safety and nutritional qualities

who are special formulas for

- for premature infants or those with inherited diseases

- hypoallergenic formulas or soy formulas for infants with allergies

- soy formulas for lactose intolerance and vegans

what are inappropriate formulas

- milk beverages (soy milk, rice milk) are nutritionally incomplete and inappropriate

- goat's milk is deficient in folate

when should you begin to introduce solid foods

- between 4-6 months

- AAP supports exclusive breastfeeding for 6 months

- depends on developmental readiness

how should you identify food allergies

introduce single-ingredient foods one at a time, in small portions, and waiting 4-5 days before new food

when can you start giving iron-fortified cereals

4-6 months

when can you start giving whole cow's milk

not before 1 year

how much diluted juice should you give

limit to 8oz/day

should you restrict fat before age 2

no

what foods should omit from an infant's diet

- concentrated sweets

- foods with sugar alcohols (sorbitol)

- canned veggies

- honey

- corn syrup

- popcorn

- whole grapes

- whole beans

- hot dog slices

- hard candies

- nuts

what are common nonfood items that are a choking hazard

- balloons

- coins

- pen tops

- marbles

how should you decide which foods to feed an infant

- should be provided with variety, balance, and moderation

- palatable and nutritious

- no added salt, sugar, or seasonings

- safe and convenient

- fat information is not provided on food labels for children younger than 2 to prevent restricting fat

should cow's milk be given in the first year

NO

what is the issue with the protein in cow's milk

the protein casein is and it may cause intestinal bleeding and anemia in the first year of life

at what age should you be given whole cow's milk and how much

1-2 years and 2-3 cups per day

at what age should you give reduced-fat cow's milk

between 2-5 years of age

tips for mealtimes with toddlers

- discourage standing at table, throwing food

- let toddlers explore and enjoy food (even if ti means with fingers)

- don't force food on children

- provide nutritious foods and let children choose which ones and how much they will eat

- limit sweets

- make mealtimes enjoyable

- teach healthy food choices and eating habits in a pleasant environment

- serve age appropriate portion sizes

energy intake and activity varies in childhood with what

growth and activity

how many calories should a 1 year old consume per day

800

how many calories should a 3 year old consume per day

1,000

how many calories should a 10 year old consume per day

2,000

what percent of energy should fat make up of a 1-3 year old

30-40%

what percent of energy should fat make up of a 4-18 year old

25-35%

how do protein needs change with age

slightly increase

how do vitamin/mineral needs change with age

increases with age

how much iron should children be consuming per day

10 mg/day

how can hunger affect a child's nutritional status and health

affects behavior and academic performance

how can iron deficiency affect a child's nutritional status and health

affects mood, attention span and learning ability

how can lead poisoning affect a child's nutritional status and health

children who are malnourished are vulnerable to lead poisoning; absorb more lead on an empty stomach

what is hyperactivity NOT caused by

sugar

what are allergic reactions caused by

food intolerances and food allergies

what are food intolerances

adverse reactions to food that do not involve the immune system

what are signs of food intolerances

- stomach aches

- headaches

- rapid pulse rate

- nausea

- wheezing

- hives

- bronchial irritation

- coughs

the causes of food intolerances include reactions to....

- chemicals in food

- digestive disease

- enzyme deficiencies

- psychological aversions

what are food allergies

- an adverse reaction to food that involves an immune response

- may be immediate or delayed

can children outgrow their hypersensitivity

yes if offending food is identified and eliminated from the diet for at least a year or two

what is anaphylactic shock

life-threatening food allergy reaction