Transcript Formula-feeding

NUTRITION-2
BREAST FEEDING
Breast feeding, one of the most important influences on children’s health
worldwide , provides optimal nutrition
for the normal infant during the early
months of life ( first six months) (except
vit D)
 Always available at the proper temperature and requires no preparation time.

BREAST MİLK
The protective effects of breast milk
against enteric and other pathogens
result in less morbidity.
 They probably account for the lower
incidence of diarrhea as well as otitis
media, pneumonia, bacteremia, and
meningitis during the 1st yr of life in
Breast-Fed infants.

BREAST MİLK

Human milk contains bacterial and viral
antibodies, including relatively high
concentrations of secretory Ig A that
prevents microorganisms from adhering
to the intestinal mucosa. Contains some
substances that inhibit growth of many
common viruses. Provide local GIS
immunity.
BREAST FEEDING
Numerous immunologic factors in BM
(secretory IgA, lysozyme, lactoferrin,
bifidus factor, macrophages, complement, antistaphylococcal factor,interferon) help to provide protection against
GI tract and upper respiratory infections
 Allergic diseases are less common in
breast-fed infants.

BREAST FEEDİNG
 BM
contains lactoferrin, an ironbinding whey protein. Has an
inhibitory effect on the growth of
Escherichia coli in the intestine.
 The lower pH of the stool of breastfed infants……>favorable intestinal
flora of infants fed BM vs. formula
(more Bifidobacteria and lactobacilli)
BREAST FEEDİNG
 İf
the maternal vit D intake is
inadequate, 10 mikrog/g of Vit D is
recommended.
 The vitamin K content of BM also is
low and may contribute to
hemorrhagic disease of the newborn.
Parenteral administration of 1 mg of
Vit K1 at birth is recommended for
all infants.
BREAST FEEDING
Breast feeding offers increased opportunity for close contact between mother
and infant.
 Nutrient composition: 85 % water
70 kcal /100 ml
1-1,5 gr/100ml prt(%60 whey,%40 casein
Low prt content but adequate for the normal infant. CM-3.3%(18/82)

BREAST FEEDING
7 gr /100 ml carbohydrate (1.2% gr/dl
oligosaccaride)CM 4.5% 0.1gr/dl oligosa
 4 gr/100 ml fat;( essential fatty acids
LCFA )CM 4%
 0,15-,025 % mineral; low Na and solute
load, Ca/P ratio 2/1 is adequate ,very
favorouble absorbtion of Ca, Fe, Zn.CM
0.75% Ca/P 1/1

BREAST FEEDING
COLOSTRUM: The secretion of breasts
during the latter part of the pregnancy
and for 2-4 days after delivery.
 Deep lemon yellow collor (high ß-caroten). High protein (sIg A).Density :10401060. Less carbohydrate and fat. High
minerals and vitamins.
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BREAST FEEDING
Contraindications of breast feeding:
 Septisemia, eclampsia, profuse hemorrhage, active tbc, typhoid fever, malaria,
chronic poor nutrition, debility, severe
neuroses, postpartum psychoses, AIDS,
active hepatitis.
 Radioactive compounds, antimetabolites, lithium, diazepam, chloramphenicol,
antithyroid drugs, tetracycline

BREAST FEEDİNG
 Transmission
of HIV by breastfeeding is well documented.
 CMV,
rubella virus, Hepatitis B
virus and Herpes simplex virus
also have been demonstrated in
BM.
BREAST FEEDING

Technique of breast feeding: breast feeding
can be started after delivery as soon as both
mother and baby are stable.
 Both breasts should be used at each feeding
in the early weeks to encourage maximal
production of milk.
 Infants empty a breast in 5-20 mins.
 The newborn is generally fed every 2-3 hrs =>
The most satisfactory stimulus to the secretion
of human milk is regular and complete
emptying of the breasts.
Nutrition
Special dietary products: infant formulas
(adapted to BM) # to the infants who can
not take BM.
 Weaning: can take place according to
needs and desire of both infant and
mother. Starts after 4-6 months.Any new
food should be initialy offered once a day
in small amounts.

Feeding during the first 6 mo of life other
than BM.
 Formula-feeding;
adopted,
half adopted to BM,
follow-up formulas
 Bovine
milk; (not recommended before
at least 1 year of age if possible)
FORMULA-FEEDİNG
Normal dilution 30cc water/1 spoon.
 Boil the water at least for 10 minutes.
Than wait until it gets cooler.
 First 1-2 wk: 7-10 times…50-70 ml.
2-6 wk:
6-8 times…..75-110 ml.
2 mo:
5-6 times…110-180 ml.
3 mo:
5 times….170-220 ml.
6 mo:
4 times….220-240 ml.
7-9 mo:
3-4 times….240-260 ml.
9-12 mo:
3 times….240-260 ml.
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Preparation faults of formulas

Concentrated formulas;
high osmotic load……> high fluid loss by
urine……..>too much cry because of
thirst……..>mother thinks infant is
hungary….>GİVES MORE FORMULA…
Result is…….>Hypertonic dehidratation
- Diluted formulas; can lead to
malnutrition
DISADVENTAGES OF BOVİNE
MİLK
Includes high protein and electrolites than
BM….> 3 fold high renal solute load
 Includes Beta-lactoglobulin (none in BM),
 Inappropriate Ca/P ratio, ineffective Ca
absorption.
 Poor linoleic acid and nucleotid content.
 Contains no protective antibodies and
probiotics.
 Poor absorbtion of Fe and fat-soluble vita.

BOVİNE-MİLK
Should have to be boiled,
 Dilute with water for the first 4 months;
-1.mo: 1 milk/1water
-2.mo: 2 milk/1water
-3.mo: 3 milk/1water
-4.mo: 4 milk/1water
 Add 5% table sugar and 3% vegetable oil.
 100ml. dilute CM+1 sp sugar+1 tsp oliveoil
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WEANİNG
1) the beginning of a process of gradual
introduction of solid foods, 2) the
complete cessation of breastfeeding.
 Cereal; contains Fe and B complex vit.
 Fruits; strained or pureed
 Vegetables; good source of Fe and other
minerals.
 Meat; egg, starchy food; introduced
about 6 month of age
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COMPLEMENTARY FOODS
Should be introduced in a stepwise
fashion beginning about the time the
infant is able to sit unasisted.
 Cereals, a good source of iron, should
usually be the first. Vegetables and fruits
are introduced next, followed shortly by
meats and finally eggs. Only one new
food should be introduced at a time.
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FEEDİNG DURİNG LATER
CHİLDHOOD
 After
2 years of age, a child’s diet
should not differ from that of the rest
of the family.
 Food Pyramid Guidelines.
Encouraged for all children age 2
years and older. Nutritional habits
are formed early in life.
PRUDENT DIET

National Cholesterol Education Program
 1)
Total fat content less than 30% of
caloric intake, saturated fatty acids
to less than 10% of energy.
Polyunsaturated fatty acids should
supply 7-8% of energy and
monounsaturated fatty acids should
supply 12-13%.
PRUDENT DIET
 2)
Cholesterol intake should be less
than 100 mg/ 1000 kcal/d to
maximum of 300 mg/d
 3) carbohydrates should provide
60% or more of daily caloric intake
with 50% or more in the form of
complex carbohydrates A high fiber
diet is also recommended.
PRUDENT DIET
4) The diet should be nutrionally complete,include a variety of foods and be adequate for optimal growth and activity
 5) A low salt intake is advised.


The American Heart Association Step
One Diet, is recommended to decrease
atherosclerotic hearth disease in
adulthood,limits the develop.of OBESİTY
PRO/PRE/SYNBIOTICS

PROBIOTICS: Live microbial food supplements which affect the health of the
host by maintaning a balanced intestinal
flora and stimulating its immune system.
Probiotic microorganism are mostly from
the Lactobacillus and Bifidobacterium
family.
PRO/PRE/SYNBIOTICS

Benefical health effects; shortening the
duration of rotavirus diarrhea, relief of
signs and symptoms of lactose intolerance, decreasing the risk of allergy in atopic individuals, cancer prevention, lowering the serum cholestrol levels, prevention urogenital infections, synthesis and
enhancement of the biovailability of
nutrients.
PRO/PRE/SYNBIOTICS

Probiotic bacteria may compete with
pathogens for nutrients and mucosal
adherence, produce antimicrobial substances and modulate mucosal immune
functions.
PRO/PRE/SYNBIOTICS
PREBIOTICS: Indigestible oligosaccharides that promote the growth or activity
of a limited benefical bacteria in the gut.
 Fructo / galactooligosaccharides, inulin,
oligofructose, xylo-oligosaccharides,
acidic oligosaccharides are some of the
typical prebiotics.

PRO/PRE/SYNBIOTICS
The breakdown of prebiotic molecules by
bacterial enzymes in the large bowel
yields lactate and short chain fatty acids
(acetate, butyrate and propionate) as
end products.
 SCFA; crucial for gut integrity and
function, modulation of the immune
system, Ca Mg absorbtion, maintenance
of normal serum cholesterol levels.
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PRO/PRE/SYNBIOTICS

SYNBIOTICS: nutritional supplements
which contain probiotics & prebiotics
combination.