Transcript Infant Feeding Through Year One

Feeding Infants
Through One Year
Digestion
• One of the many advantages to breastfeeding is the ease and
protection of breast milk on your baby's gastrointestinal
system
– Mouth: some digestion and breakdown of food
– Esophagus: two principal jobs--to push food or fluid from the mouth to
the stomach and to stop backflow, or reflux, of the contents of the
stomach.
– Stomach: This is responsible for storing the swallowed food, combining
and disintegrating the food, and regulating excretion of the stomach
contents
– Small intestine: in charge of digestion and most of the absorption of
nutrients. The digestive enzymes break down proteins into amino acids;
carbohydrates into glucose and other monosaccharides; and fats into
glycerol and fatty acids.
–
Large intestine (colon): This curves upward, across and down to the rectum. It is
mostly in charge of the absorption of water and electrolytes.
Infant Digestion
•
In the infant, the tongue is proportionally larger and they have extra fat
pads on the sides of the tongue that help with sucking.
•
The larynx, or voice box, is situated higher and the epiglottis lies over the
soft palate to supply extra airway protection.
•
A newborn’s esophagus is about 11 centimeters long (vs. 9 1/2 inches long in
•
A newborn’s stomach can only hold about 60 to 90 ml of fluid
•
Small intestines measure 250 to 300 cm in newborns
•
The colon is sterile at birth, but within a few hours E. Coli, Clostridium
and Streptococcus are established--the gathering of bacteria in the GI
tract is essential for digestion and formation of Vitamin K.
•
Finally, the first stools passed are called meconium. Meconium is thick,
sticky and tar-like. It is black or dark green in color and made up of
mucus, vernix, lanugo, hormones and carbohydrates.
adults)
in adults!)
(vs. about 14 c.
(vs 600 to 800 cm in adults)
Infant Digestion
Breast Versus Bottle
• The bowel movements of breastfed versus bottlefed newborns are different from each other,
varying in consistency, color and odor.
• Breatfed Infants will have a yellow-orange very
liquid, possibly seedy texture to their bowel
movements.
• Formula-fed Infants will pass stools that are pale
brown, more solid in texture and that contain a
strong odor.
Digestive Problems & Cause
• Gas- acts like a cork, impeding or halting the flow of gastric
juices and built-up pressure causes painful bloating and
swelling of the abdomen. Baby’s immature digestive system is
unable to cope effectively. When gas pockets form in the
stomach, this can cause the stomach to distend but is also
the main cause of hiccups.
• Reflux- Regurgitation or spittle is very common during the
first few months of life. Some babies spit up a little others
with almost every feeding.
• Other: most commonly other problems include inflammation
of parts of the digestive tract due to numerous reasons.
Oral Structure & Reflexes
Proportional differences exist between the young infant
and the older infant, child, and adult. These include:
– The oral cavity is small in the newborn and is totally filled by
the tongue due to a small and slightly retracted lower jaw.
– The newborn has a set of sucking pads in the cheeks which
provide stability during sucking.
– The soft palate and epiglottis are in contact at rest, providing
an additional valve at the back of the oral cavity.
– The larynx are higher in the neck and closer to the base of
the epiglottis, providing added protection of the airway.
– The infant’s eustachian tube runs horizontally from the
middle ear into the nasopharynx
– The small infant oral cavity creates abundant sensory input to
the tongue, giving information on spatial and movement
relationships within the mouth.
Oral Structure & Reflexes
• Sucking- to rhythmically receive nourishment by
mouth
• Swallowing- extra valve in back helps prevent
choking
• Breathing- babies usually pause from eating to
breathe
– Coordination of sucking, swallowing and breathing
• Tongue Thrust- to prevent choking
0 to 6 months old
• Babies need only breast milk or an iron-fortified
formula for the first 4–6 months of life.
• Breast milk is preferable to formula:
– It has the right proportion and kinds of nutrients for
babies.
– Breast milk is easily and rapidly digested
– have fewer colds and ear infections.
– less likely to be overfed.
– supply of breast milk from a nursing mother is dependent
on the infant’s needs, not on adult guesses.
– As the infant requires more or less milk, the supply
increases or decreases appropriately.
Do not use cow’s milk.
Suggested Ages and Growth Clues for
Adding New Foods
Age
Birth to 4 months
4 to 6 months
6 to 8 months
Growth clues for adding foods
Foods to introduce
Baby can:
• Suck and swallow liquid. or
Breast milk *
• Push tongue out.
Iron-fortified infant formula
Baby can:
Breast milk *
•Hold head steady.
Iron-fortified infant formula
• Sit with support.
Baby cereal: Rice, oatmeal or barley.<<<<<<<<<<<
•Take food off spoon with mouth and
swallow it easily.
Feed cereal from a spoon.
Baby can:
First:
Grab and hold onto things.
Strained, pureed, or mashed cooked vegetables
Sit without support.
Strained or mashed soft fruits.
Begin to chew.
Soft fruits do not have to be cooked.
Later:
Strained meat; cooked, mashed dry beans and finely
chopped, cooked chicken
6 to 12 months old
• Starting solids too early can cause:
– Strain on baby's intestinal tract as it is not as
fully developed during the first few months
– Unintentional overfeeding, (younger babies can
not offer you signals when they are full)
– Potential to cause choking before 4-6 months
because of inability to swallow solids correctly
• Starting solids early will not help your
child to sleep through the night.
6 to 12 months old
• When offering a new type of food, always
feed it for several days in a row before
starting another new food.
– easier to detect food allergies, (diarrhea, vomiting,
coughing, hives or a rash)
• Do not offer mixed ingredient foods until
you are sure that the baby isn't allergic to
any of the individual ingredients.
• Do not add any seasonings to your baby's
foods.
Quick Questions
• What are some noted items about
breastfeeding and infants or reasons
pediatricians recommend exclusive
breastfeeding for infants through 6
months of age.
• When and how should an infant start
solids? Why?
Suggested Ages and Growth Clues for
Adding New Foods
8 to 10 months
Baby can:
• Cooked, mashed egg yolks.
• Take a bite of food.
• Mixed baby cereal may be introduced.
• Pick up small pieces and feed self.
• Cottage cheese and yogurt.
• Use a cup with help.
Finger foods:
• Small pieces of cooked vegetables and
peeled, soft fruits.
• Small pieces of cooked, ground meat,
chicken, or fish with all bones and tough
parts removed
Continue to introduce new fruits and vegetables
to baby, baby will like a variety of foods.
10 to 12 months
Baby can:
• Chew and swallow soft, mashed
foods.
Small pieces of cooked or soft foods the rest of
the family eats:
• Use a cup.
Cereals, bread, and crackers.
• Begin to use a spoon.
Vegetables and fruits.
Cheese, cottage cheese, and yogurt.
Cooked meat, cooked dried beans, peas or
lentils, cooked egg yolks
Foods to Avoid
•
Honey and corn syrup: These
foods may contain bacterial spores
that cause food-borne illnesses,
which are often fatal in infants.
•
Salted and overly sweet foods: A
baby’s immature kidney cannot
handle much salt. Too much sugar
in the diet displaces the calories
and essential nutrients available in
cereals, fruits, meats and
vegetables.
•
Too much formula: Don’t feed 6month-olds more than about 40
ounces of formula. Too much
formula displaces the calories and
other nutrients from solid foods.
•
Too much apple or pear juice: Too
much may cause diarrhea.
•
Foods that cause choking: Hot dogs,
candy, nuts, grapes, coarsely cut
meats, raw carrots, apples and popcorn
are all foods that can get caught in a
baby’s throat.
•
Cow’s milk: Only breast milk or formula
should be fed until after the first
birthday. Cow’s milk has too much
protein and sodium and too little iron
for babies less than one year old.
•
Citrus fruits and strawberries: These
foods may cause an allergic reaction if
fed before one year of age.
Food Allergies
• What Causes Allergies?
Preventing food allergies may be possible
1. Breastfeed and avoid supplementing with infant formula or
offering solids for at least the first six months of your child's
life.
2. If your child is at high risk of having food allergies, you should
also delay offering solids until he is at least six months old (and
continue breastfeeding)
3. Foods to avoid until your infant is at least a year old include
cow's milk, citrus fruits and juices, and wheat and egg whites
until he is two.
4. When you do introduce new foods, do so slowly and only give
one new food every four to five days. This way, if your child
does have a reaction or allergy, then you will know which food
caused it and you will be able to avoid giving it again.
Allergies Cont.
• Studies show that the introduction of solid foods before 4
months of age increases the risk of atopic dermatitis until the
age of 10 years.
• The use of cow’s milk-based formulas in early infancy has been
associated with the development of cow’s milk allergy.
• Introduction of solid foods in infants until after 6 months of
exclusive breast-feeding showed lower risks of atopic
dermatitis and asthma later in childhood.