Feeding Patterns (2)
Download as PPT, PDF2 likes3,683 views
The document provides guidelines on infant feeding and nutrition. It recommends exclusive breastfeeding for the first 6 months as breast milk provides optimal nutrition for infants. From 6-24 months, the guidelines recommend continued breastfeeding along with introducing complementary foods. The document discusses the benefits of breastfeeding for both mother and infant. It also provides information on infant formula types and guidelines for complementary feeding introduction and dietary supplements.
Feeding Patterns (2)
- 1. Introduction BY : Dr . Baha D Moohy Alosy//DCH ,FICMSP12/10/2008 1.The Newborn Service at National Women’s Health promotes breast milk and breastfeeding as the optimum nutrition for infants as it provides many benefits. Benefits apply to both the mother and the infant and include nutritional, immunological, psycho- social and financial components. 2.The cultural, personal and/or physical factors affecting infant feeding are to be respected and staff are to support and assist women in their choice of infant feeding.
- 2. Nutritional Needs During Pregnancy Nearly all nutrients are recommended in increased amounts during pregnancy and lactation Only small increase in metabolic demands of pregnancy and fetal development 2nd trimester - add 350 calories per day 3rd trimester - add 450 calories per day Nutrients deserving special attention during pregnancy: Protein Folate Iron Zinc Calcium
- 3. (© 2002 Wadsworth Group) Critical Periods of Development
- 4. Feeding disorders can be categorized into three areas Slow to establish feeds Disorganized feeding Dysfunctional feeding. Contributing factors to disorganized/dysfunctional feeding patterns and feeding resistance: Delayed introduction of oral feeds. Prematurity. Birth Asphyxia. Neurological problems. Prolonged respiratory distress. Cardiac anomalies. Averse oral stimulation. Multiple caregivers.
- 5. Feeding pattern Exclusive breastfeeding rate (< 6 mos. & < 4 mos.( Timely complementary feeding rate (6-9 mos.( Continued breastfeeding rate (12-15 & 20-23 mos.( Timely initiation of breastfeeding (within 1 hour of birth( Frequency of complementary feeding (6-11 mos.( Exclusive Breastfeeding (< 6 months( Percentage of infants exclusively breastfed for the first six (or four) months of life Adequately fed infants (0-11 mos.(
- 6. WHO/UNICEF Feeding Recommendations Exclusive breastfeeding for first six months Continued breastfeeding for two years or more Safe, appropriate and adequate complementary foods beginning at 6 months Frequency of complementary feeding: 2 times per day for 6-8 month olds; 3 times per day for 9-11month olds
- 7. Background Exclusive breastfeeding refers to infants who receive only breast milk, or breast milk and vitamins, mineral supplements or medicine Complementary feeding refers to children who receive breast milk and solid or semi-solid food
- 8. Exclusive BF (MENA( 29 12 12 12 12 13 16 27 27 29 30 31 31 34 34 44 47 81 0 20 40 60 80 100 Middle East/North Africa Iraq Kuwait Qatar Yemen Algeria Sudan Jordan Lebanon OPT Egypt Morocco Saudi Arabia Bahrain UAE Iran Tunisia Syria %infants exclusively breastfed for the first 6 months of life
- 9. Recommended Breastfeeding Patterns 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 Exclusive breastfeeding (0-5 months( Complementary feeding (6-9 months( Continued breastfeeding (12-15 months( Continued breastfeeding (20-23 months(
- 10. The WHO recommends human milk as the exclusive nutrient source for feeding full-term infants during the first 6 months after birth Regardless of when complementary foods are introduced, breastfeeding should be continued through the first 12months Recommendations for Infants
- 11. Breast Milk Content Human milk contains protective antibodies against enteric infections Caloric density is the same in breast milk and regular infant formulas(20kcal/oz( Fat absorption is more efficient in breastfed infants when compare to infant formulas
- 12. Breast Milk/Formula Content Human milk has higher concentration of essential fatty acid Formula has higher protein concentration )1.5g/dl in formula vs.0.9g/dl in breast milk( whey/casein in human milk- 80:20 whey/casein in formula-18:82 Whey protein promotes gastric emptying Whey protein have more lactoferrin and secretory immunoglobulin A
- 13. Breast Milk/Formula Content Breast Milk/Formula Content Lactose content is equal in breast milk and infant formula Calcium/Phosphorus ratio in human milk is higher compared to formula )2:1vs. 1.5:1( Human milk has lower iron concentration but iron from human milk is more bio-available
- 14. Infection and Breast Milk Human milk may be a source of CMV Human milk is protective against enter pathogenic E.coli and other GI pathogens. This protection is greatest during the infant’s first 3 months of life and declines with increasing age Human milk is not protective against HSV Breastfeeding is contraindicated in HIV infection, except in underdeveloped countries Human milk does not protect against M.tuberculosis
- 15. Infant Benefits of Breastfeeding Protein in breast milk is more easily digested that protein in infant’s formula Human milk protein promotes more rapid gastric emptying Fat absorption from human milk is more efficient when compared to formula Many factors in human milk may stimulate gastrointestinal growth and motility as well as enhance the maturity of the gastrointestinal track Human milk contains specific protein involved in host defense
- 16. Infants who are breastfed for at least 13 weeks had significantly less gastrointestinal and respiratory illnesses Breast milk appears to be protective against some food allergies during infancy and early childhood Maternal-infant bonding is enhanced during breastfeeding Improved long-term cognitive and motor abilities in full term infants have been directly correlated with duration of breastfeeding
- 17. Benefits of Breast Feeding for Mother Economical and convenient Helps return uterus to normal size faster Helps return to prepregnancy weight faster Delays onset of menstruation (not birth control( Improves bone remineralization Reduces risk for ovarian and premenopausal breast cancer
- 18. Infant Formulas Cow milk-based Soy-based Protein hydrolysate Elemental
- 19. Characteristics of Cow Milk-Based Formulas Caloric density: 20cal/oz Protein: casein/whey (80/20( Carbohydrate: lactose Fat: palm oil, coconut oil, soy-oil, safflower oil Examples: Similac Enfamil Lactofree Neocare Carnation Follow- up
- 20. Characteristics of Soy-Based Formulas Caloric density: 20cal/oz Protein: soy protein with added methionine Carbohydrate: sucrose, corn syrup solids, glucose polymers Fat: as in cow milk-based formula
- 21. Indications for Soy Protein-Based Formulas Healthy term infants as the alternative to cow milk-based formula Galactosemia Lactose intolerance IgE-mediated allergy to cow milk Parents seeking a vegetarian-based diet for a term infant
- 22. Contraindication for Soy Protein- Based Formulas & Hydrolysate Formulas Preterm infants with birth weight <1800g Prevention of colic or allergy Cow milk protein induced enterocolitis or enteropathy Caloric density: 20cal/oz Protein: Casein or whey hydrolysate Carbohydrate: Sucrose, corn syrup solids, cornstarch, tapioca starch Fat: Medium chain triglycerides and vegetable oil *
- 23. Indications for Protein Hydrolysate Formulas Intolerance to cow milk and soy protein formula Fat Malabsorption Short gut syndrome Severe chronic diarrhea Liver disorders (cholestasis, biliary Artesia, cystic fibrosis( Disadvantages of Hydrolysate Formulas Poor taste (presence of sulfated amino acids( Greater cost High osmolarity Protein Hydrolysate Formulas Examples: Alimentum Nutramigen Progestamil
- 24. Characteristics of Elemental Formulas Caloric density: 20cal/oz Protein: free amino acids Carbohydrate: Glucose polymers, sucrose, modified starch Fat: vegetable oil, medium chain triglycerides
- 25. Indication for Elemental Formula Severe food allergy Malabsorption Transition from Total Parenteral Nutrition Elemental Formulas Examples: Neocate (Infants formula( Elecare (Pediatric formula( Vivonex (Pediatric formula(
- 26. Whole Cow Milk Human milk or formula until 1 year of age Cow milk has Less iron, linoleic acid, vitamin E Excessive sodium, potassium, protein Increased incidence of GI blood loss Low iron content and iron bioavailability Low-fat and non-fat milks are inappropriate in the first two years of life
- 27. Complementary Feeding Can be introduced between ages 4 and 6 months Introduce one new food at the time. At least 1 week interval between new foods introduction No evidence to support introducing food in a particular order Fruit juice should not be introduced to infants younger than 6 months of age Intake should be limited to 6-8oz/day Intake of more than 250cc of juice per day can lead to diarrhea (high fructose and sorbitol content of fruit juice(
- 28. Complementary Feeding No need for complementary foods for the first 6 months of life in infants fed iron fortified formula Iron-fortified formula and complementary food in the first year of life will prevent deficiencies of iron, zinc and vitamin D Breastfed and formula-fed infants should have hemoglobin tested at 9 to 12 months of age Breast-fed infants need iron supplement starting at 4 to 6 months of life
- 29. Complementary Feeding Iron-fortified infants cereal and meats are good source of iron If iron intake not sufficient , elemental iron should be started at 1mg/kg/d An average of 2 servings (. oz or 15g of dry cereal per serving) meet the daily iron requirements Infants who are exclusively breastfed beyond 6 months of life should be supplemented with 200 U of vitamin D daily
- 30. Complementary Feeding, cont. Neither breastfed or formula-fed infants require extra water Whole milk should be avoided in the first year of life. Complementary foods should not be prepared with added salt or sugar Hot dogs, nuts, grapes, raisins, raw carrots, popcorn and rounded candies should be avoided in children under age of 4 years to prevent the risk of aspiration
- 31. Dietary Supplements Not recommended for healthy children Supplements needed: Anorexia, inadequate appetite Chronic disease Neglected or abuse children Vegetarian diet without adequate dairy product Failure to thrive Children and adolescent without regular sun exposure, ingestion of less than 500ml/d of vitamin D
- 32. Food Pyramid for Children
- 33. Dietary Guidelines in Childhood Structured 3 meals and 2 snacks Adults should decide when food is offered Eating should occur in a designated area with the developmentally appropriate chair No grazing between meals For preschoolers offer 1 tablespoon of each food for every year of age Snacks should be considered mini-meals