Diet During

Infancy
Sherwyn U. Hatab RN.
 Infancy
• Infancy refers to a child not more than 12
months of age.
• A healthy full-term infant weight 6 to 7
lbs ( 2.7 to 3.2 kg)
• Measures 48 to 50 cm (19-20 inches) in
length.
• Head circumference 35 cm (14 inches)
• Skin is moist, elastic and not wrinkled.
• Source: Basic Nutrition and diet therapy
(Caudal 2019)
Infancy
• Physical and mental development are
dependent on the food, and psychosocial
development is affected by the time and
manner in which the food is offered.
• If food is forced on a child or withheld
until the child is uncomfortable or if the
food is presented in a tense manner, the
child reacts with tension and
unhappiness.
Erikson's Theory of Psychosocial
Development
• From birth to 18 months
• Trust vs. mistrust
• During this stage, the infant is uncertain about the world in which they live, and
looks towards their primary caregiver for stability and consistency of care.
• If the care the infant receives is consistent, predictable and reliable, they will
develop a sense of trust which will carry with them to other relationships, and
they will be able to feel secure even when threatened.
• If these needs are not consistently met, mistrust, suspicion, and anxiety may
develop.
• In this situation the infant will not have confidence in the world around them or
in their abilities to influence events.
Feed infants on demand

•Feeding on demand prevents the

frustrations that hunger can bring
and helps the child develop trust in
people.
•The newborn may require more
frequent feedings, but normally the
demand schedule averages
approximately every 4 hours by the
time the baby is 2 or 3 months old.
 • The first year of life is a period of the most rapid growth.
Nutritional • A baby doubles its birth weight by 6 months of age and triples it within
the first year.
Requirements • This explains why the infant’s energy, vitamin, mineral, and protein
requirements are higher per unit of body weight than those of older
children or adults.
Calories

• At birth, the infant requires about 350 to 500 calories, and in one year
from 800 to 1200 calories:
• 120 calories per kg body weight from the second to the 7th month and
100 calories per kg from the 7th to the 12th month.
• The average requirement for growth in the first year is 50 calories per
pound of expected weight.
• 2/3 of this amount is being supplied by milk and 1/3 by added
carbohydrates.
Calories

The calorie
requirements of the A rapid growth rate
infant are high necessitates a
because of the considerable storage
proportionately larger of energy for the
skin surface leads to activity of the infant.
large heat loss.
 Protein
• 1.5 to 2.5 g of per kg of body weight
from 0-6 months
• 1.5 to 2 g per kg of body weight from 6
to 12 months are recommended by
WHO
• In early infancy, protein needs are
satisfactorily supplied by breastmilk or
by infant formulas.
Water

•Usually infant needs 1.5 ml of water per calorie. This is

the same ratio of water to calories as is found in
breastmilk and in most infant formulas.
Essential Vitamins and Minerals

•Essential vitamins and minerals can be supplied in breast

milk, formula, and food. Except for vitamin D, breast milk
provides all the nutrients an infant needs for the first 6
months of life.
•An infant is born with a 3- to 6-month supply of iron. When
the infant reaches 6 months of age, the pediatrician usually
starts the infant on iron-fortified cereal.
Essential Vitamins and Minerals

•Human milk usually supplies the infant with sufficient

vitamin C.
•Iron fortified formula is available, and its use is
recommended by the American Academy of Pediatricians if
the baby is not being breastfed.
•vitamin K supplement are routinely given
Caution

• Care must be taken that infants do not receive excessive amounts of

either vitamins A or D because both can be toxic in excessive
amounts.
• Vitamin A can damage the liver and cause bone abnormalities, and
vitamin D can damage the cardiovascular system and kidneys.
• 0-6 months: Vitamin A 400 mcg.
• 7-12 months: 500 mcg
• 0-12 months: Vitamin D: 400 IU
 Breastfeeding
• Breastfeeding is nature’s way of
providing a good diet for the baby. It is,
in fact, used as the guide by which
nutritional requirements of infants are
measured.
• Breastfeeding has physiologic and
psychologic value for both the mother
and infant. the bonding that occurs
during breastfeeding is unmatched
Breastfeeding

•It provides immunity factor and reduces chance of infection.

•Breastmilk is economical, nutritionally perfect, and sanitary It
is sterile, easy to digest, and usually does not cause
gastrointestinal disturbances or allergic reactions.
Breastfeeding

Breast milk contains less protein and minerals than infant formula,
it reduces the load on the infant’s kidneys.

Breastfeeding also promotes oral motor development in infants and

decreases the infant’s risk of obesity and diabetes.
Breastfeeding

•Breastfeeding helps the mother’s uterus return to

normal size after delivery, controls postpartum
bleeding, and also helps the mother more quickly
return to her prepregnancy weight
•Research has shown a correlation between
breastfeeding and a decreased risk of breast cancer
and osteoporosis in premenopausal women.
Breastfeeding
• Within the first several weeks of life the infant will nurse approximately every 2–4
hours.
• As the infant grows and develops, a stronger sucking ability will allow more milk
to be extracted at each feeding, and the frequency of nursing sessions will
decrease.
• It is recommended that an infant nurse at each breast for approximately 10 to 15
minutes each session.
• Growth spurts occur at about 10 days, 2 weeks, 6 weeks, and 3 months.
• During this time, the infant will nurse more frequently to increase the supply of
nutrients needed to support growth.
Breastfeeding
• One can be quite confident the infant is getting sufficient nutrients
and calories from breastfeeding if
• There are six or more wet diapers a day,
• There is normal growth
• There are one or two bright yellow and soft bowel movements a day
• The breast becomes less full during nursing.
Breastfeeding

• If the mother works and

cannot be available for every
feeding, breast milk can be
expressed earlier, refrigerated
or frozen, and used at the
appropriate time, or a bottle of
formula can be substituted.
• Never warm the breast milk in
a microwave because the
antibodies will be destroyed.
Bottle Feeding

• Bottle Feeding is feeding the infant with

formula designed to match the nutritional
ratio of breast milk composition, diluted
with water to reduce protein and mineral
concentration, and added with
carbohydrate to increase energy value.
• Formulas are usually based on cow’s milk
because it is abundant and easily modified
to resemble human milk
Bottle Feeding

• The formula must be prepared under clean condition and sterilized to

prevent contaminations.
• If the type purchased requires the addition of water, it is essential
that the amount of water added be correctly measured.
• Too little water will create too heavy a protein and mineral load for
the infant’s kidneys.
• Too much water will dilute the nutrient and calorie value
• Formula may be given cold, at room temperature, or warmed, but it
should be given at the same temperature consistently
Bottle Feeding

• The infant should be cuddled

and held in a semi-upright
position during the feeding. To
prevents fluid from pooling at
the back of the throat and
entering tubes from the middle
ear.
Bottle Feeding

•after the feeding, the

infant should be burped
to release gas in the
stomach. Burping helps
prevent regurgitation.
Bottle Feeding

•Infants should not be put to bed with a bottle.

• Saliva, which normally cleanses the teeth, diminishes as the
infant falls asleep.
•The milk then bathes the upper front teeth, causing tooth
decay. Also, the bottle can cause the upper jaw to protrude
and the lower to recede.
•The result is known as the baby bottle mouth or nursing
bottle syndrome.
Supplementary Food

•Mother’s milk is the best of the baby, however , breastmilk

alone cannot meet the baby’s need after 6 months.
•The introduction of solid foods before the age of 4 to 6
months is not recommended. The child’s gastrointestinal
tract and kidneys are not sufficiently developed to handle
solid food before that age
An infant’s readiness for solid foods will be
demonstrated by:
1. The physical ability to pull food into the mouth
rather than always pushing the tongue and food
out of the mouth (extrusion reflex disappears by
4–6 months).
2. a willingness to participate in the process.
3. the ability to sit up with support
4. having head and neck control
5. the need for additional nutrients.
Supplementary Food

•Solid foods must be introduced gradually and individually.

One food is introduced and then no other new food for 4 or 5
days. If there is no allergic reaction, another food can be
introduced, a waiting period allowed, then another, and so
on.
Supplementary Foods

•Second month Liquids like rice

water, vegetable water or
kalamansi juice may be introduced
depending on the infant
acceptance.
•Fourth month- scraped banana or
papaya or thin lugaw or
commercial cereal pop like Cerelac
or Ceresoy.
Supplementary Foods

• Fifth to sixth month, full diet solid food consisting of pureed meat,
egg, fruit, vegetables and cereals can be introduced to the infant.
• When teething begins, chewy foods such as crackers or biskotso are
given not only to soothe the sensitive gums but also to teach the baby
self feeding.
• Rice cereal is the first solid food an infant should received
• It’s easy to digest and associated with few allergies.
• Iron rich food like liver , egg yolk, meat, fish, poultry must be
gradually introduced when iron stores are low.
Supplementary Foods

• Seventh to eighth months, foods are chopped finely not strained to

teach mastication.
• Examples:
• Soft cooked egg with rice porridge
• Soft-cooked rice with boiled fish
• Munggo and leafy vegetables
• Kamote cubes in meat broth
• Mashe liver in green leafy vegetables.
Common Disorders

• Galactosemia is a condition, affecting 1 in 30,000 live births, in which

there is a lack of the liver enzyme transferase.
• Transferase normally converts galactose to glucose.
• When transferase is missing and the infant ingests anything
containing galactose, the amount of galactose in the blood becomes
so excessive that it is toxic.
• The newborn suffers diarrhea, vomiting, and edema, and the child’s
liver does not function normally.
• Cataracts may develop, galactosuria occurs, and mental retardation
ensues.
Diet Therapy for Galactosemia

• Diet therapy for galactosemia is the exclusion of anything containing

milk from any mammal.
• During infancy, the treatment is to feed the baby lactose-free,
commercially prepared formula and can provide supplemental
minerals and vitamins.
• As the child grows and moves on to adult foods, parents must be
extremely careful to avoid any food, beverage, or medicine that
contains lactose.
• Nutritional supplements of calcium, vitamin D, and riboflavin must be
given so that the diet is nutritionally adequate
Common Disorders

•Diarrhea, most frequently caused by bacteria and viruses,

and milk allergy.
•Rice water suffices for mild diarrhea but incase of
dehydration parenteral or oral rehydration solution must be
given.
•Food can be given as early as 8 hours after the beginning of
rehydration.
•Breastfeeding should be maintained, with only few
interruption during the early phase of the therapy.
Common Disorders

•Vomiting, commonly seen in infant during the first few

days.
•Special attention must be given to fluid replacement.
•Other modification may include reducing the number
of feeding, acidifying milk or burping after feeding.
Common Disorders

•Constipation, infrequent bowel movements are not really the

problem, but the pain on the passage of stools, the inability
to complete a movement even the urge is strong.
•To overcome constipation:
•Increase fruit, vegetable and fluid intake
•Moderately restrict milk intake
•Check the reconstitution of milk formula
Indications of Good Nutrition

•Weight gain:
•Steady weight gain of 150 to 240 g/week that slows
down towards the end of the first year to about 120
g/week is considered as the proper weight gain.
•length., baby increases about 25.4 cm or 50% more at
the end of the first year.
Indications of Good Nutrition

• Behavioral development:
• 0-1 month- suckles and smile
• 2-3 months- vocalizes and controls head
• 4-5 months- controls hand and rolls over
• 6-7 months- sits briefly and crawls
• 8-9 months- grasp and pulls up
• 10-11 months, walks with support and stand alone
• 12 months- starts to walk alone