Infant Nutrition
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Transcript Infant Nutrition
Infant Feeding 2014
Resident Nutrition Education
Session
2-19-2014
Objectives
Increase
skills at recommending foods and
formulas for infants
Increase skills at recommending
substitutes for possible feeding intolerance
Increase awareness of resources that can
help with infant feeding
Calorie Needs for Infants/Toddlers
Infants
0 to 5 months : 108 kcals/kg / estimate
650/day
• Most formulas 20 kcals/oz.
6 to 12 months:96 kcals/kg/ estimate 850/day
Children
1 to 3:102kcals/kg/estimate 1,300/day
4 to 6: 90 kcals/kg/ estimate 1,800/day
7 to 10: 70 kcals/kg/ estimate 2,000/day
1st month
8
to 12 feedings per day
watch for signs of hunger not the clock
frequent feedings help build mom’s supply
On demand bottle feeding not clock
greater
or equal to 6 wet diapers per day
sign baby is drinking enough
check weight to monitor feeding progress
Weight gain rate
4
to 8 ounces per week for the first 6
months
1 LB every 2 weeks
Monitoring Feeding Progress
Weight
checks main way to assess if
intake is adequate
breastfed babies should be checked several
days after discharge since there is not
another good way to monitor intake
some initial weight loss is normal
>8% of birth weight lost is excessive
should pass their birth weight by 10 to 14
days
Monitoring elimination
Number,
size, color of stooling and voiding
is another way to tell if breastfed infants
are getting adequate calories
colorless, dilute, urine, 6 to 8x per day
urate crystals look like brick dust, may be
present in first few days but abnormal if
detected any other time
4th-5th day, stools-small, yellow curds x 4
Formula feeding
Ready
to feed formulas-no water added
liquid or powered concentrate-mix with
water, standard 1 oz. formula with 1 oz.
water=20 calories per oz.
calorie goal 108 kcals/kg
do not added cereals, solids, honey, corn
syrup
Easy flow nipples increase consumption
allergies
1
to 3% infants have allergy to cow’s milk
protein
10 to 14 days for allergic response to
occur after exposure to allergen
severity of signs vary-emesis, bloody
stools, dermatitis, anaphylactic shock,
Feeding challenge
If
allergies suspected change formula for
2 to 4 weeks
use a hypo-allergenic formula, then switch
to previous formula
monitor reactions
may want to do under your supervision if
reactions were severe
WIC NEEDS MD ORDER/DIAGNOSES
For special formulas
Formula Types
Standard
milk based formula
soy-based non-milk based, lactose free,
lactofree
hypercaloric
Hypoallergenic formulas-Neocate
See
handout for brand names/categories
Nutrition care manual
https://www.nutritioncaremanual.org/formu
lary.cfm
Formula
Types
Formula recipes to adjust calories
Infant Feeding guides
Formula feeding basics
Prepare
only amount of formula baby will
drink at one time
discard any unused formula to avoid
foodborne illness
keep all supplies clean
refrigerate prepared or open formula
check for these steps if GI distress occurs
Formula feeding problems
Colicky
-switch to hypoallergenic formula
for several months
discourage bottle propping
Vitamin/ mineral supplements
Fluoride
supplements at 6 months if local
water supply does not contain fluoride or
bottled water used
if exclusively breast fed, start Vit. D 400 IU
at birth
iron-start iron fortified cereals at 6 month
Breast fed babies supplements
Neonate
has adequate iron stores for first
4 months, bioavailability of iron in
breastmilk high, supplements not usually
given until after 6 months, if even then
Strict
vegetarian moms should take B12
supplements
Feeding schedules
Use
resources to reinforce feeding
schedule
schedules should review amts., types, motor
skills needed, temperatures, preparation, food
safety, and healthy feeding relationship
between infant and caretaker
Never
FORCE feedings, or force baby to
eat all of container
Resources
Feeding
schedules that can be
downloaded from WIC program websites
or infant feeding companies
reviews physical, developmental changes
and foods that would work with different
changes
reviews their foods for each step: 1, 2, 3
Nutrition Care Manual
Focus on Mindful Eating in Infants
Habits start young, avoid being over or
undernourished as infant or adult
Turn off TV
Focus on eating and hunger
Establish meal times and routine
Avoid Multi-tasking and rushing feedings
Put away toys
Make eye contact with infant
0 to 4 months
Breast
feeding or iron fortified formulas
only for the first 4 to 6 months
nursing 8 to 12 times per day, normal at
first, reduce to about 4 to 6 times by 4
months (depends of growth patterns)
formula-6 to 8 feedings, 2 to 5 oz. per
feeding, with age number of feedings
decrease, amount increase to 6 to 8 oz.
Shopping for baby foods
First
step
Second step
Third step
6 months
Solids can be stated when birth weight has doubled
Do not eat out of jars, put small serving in separate bowl
Rice cereal usually first, only 1 to 2 spoonfuls
Juice at 6 mo.: Only 4 to 6 oz. per day
From cup not bottle
OR start solids when they drink 8 oz. of formula in a
sitting and are hungry in less than 4 hours
start solids if infant nurses 8 or more times per day, or
consumes more than 32 oz. formula per day
6 to 9 months
Start
veggies first
Add strained fruits, vegetables, and juices,
only 1 new food every 7 days
usual serving is 2 to 3 T. 2 times/day
Only 2 ounces baby juice from cup
only 30 to 32 oz. of formula or 3 to 5
feedings
9 to 12 months
Add strained or finely chopped meats
only 1 new meat a week
egg yolks only
plain toast and crackers added once teeth are
present
cheese, cottage cheese, yogurt, can be added
but not cow’s milk
soft chopped vegetables and fruits
formula or breast milk 25 to 30oz., 3 to 4
nursings.
1 to 2 years
Add
whole milk at 1 year
add egg whites at 1 year
avoid foods that may cause choking: hot
dogs, sausages, popcorn, nuts, round
candy, uncooked vegetables, apple
chunks, grapes, nuts, seeds, peanut butter
wait for full set of teeth for above foods
Special problems
Nursing
bottle caries-can be caused by
sleeping with bottle of juice, formula or
breast milk
water recommended if bottle is needed at
bedtime
extra water only needed if newborn is at
high risk for dehydration: heat, humidity,
diarrhea, etc.