Infant Food
Next to the foetal periods, the infant’s first year is the time of most rapid growth.
Healthy child doubles his birth weight (3.2 kg) by six months. His weight becomes three
times by the time the child is one year old. The normal birth length of 50 to 55 cm
increases by another 23 to 25 cm during the first year. With increase in length the body
proportion also change.
At birth the child has 75% water and 12-15 % fat. By the end of the one year the
water content decrease to 60 % and fat increases to 25 %. Muscles would be
comparatively well developed at the end of the year.
Infants have rapid heart rate,120-140 per minute at birth the hemoglobin level of a
well nourished infant is 17-20 gm per 100 ml. this provides a reserve foe expansion of the
blood circulation and adequate oxygen-carrying capacity to the growing tissues during
the first 4-6 months.
The full term infant to digest protein, emulsified fats and simple carbohydrates
such as lactose. Salivary secretion and gastric acidity are low infants under three months.
Kidney reaches their full functional capacity by the end of the first year. During
the first few months the glomerular filtration rate is somewhat lower and therefore the
excretion of high concentration of solutes is more difficult
The increase in the number of brain cells is most rapid during foetal life and in the
first 5-6 months after birth
Nutritional Requirements
Caloric Requirements
Experts recommend that from birth to at least age 1, an infant's diet consist of
breast milk. Non-formula cow's milk is not recommended especially prior to 1 year of
age. This is due to its ability to cause allergies, gastrointestinal tract bleeding, and
because it lacks sufficient vitamins and essential fatty acids vital for infant development.
If formula must be used, limit it to 1/3 of the day's total caloric intake. Caloric
requirements for infants are 80-140 kcal/kg/day
Vitamin A
Vitamin A (retinol) is available in liquid form and is also added to most baby
formulas. Occasional supplementation in infants and children is recommended if
deficiency is suspected. Research has shown a single dose of 100,000 IU (International
Units) in children under 12 months of age and 200,000 IU in children over 12 months of
age can reduce the risk of death from measles and, according to a study on Brazilian
children, can help treat severe diarrhea.
Vitamin B's
Vitamin B is passed to the fetus and to the baby (via breast milk) by the mother.
Thus, if the mother is deficient so to can the baby become deficient. In the case of
mothers with vitamin B deficiencies (more common in vegetarians and vegans),
supplementation may be necessary for mother and child.
Vitamin D
Vitamin D is another vitamin in which there may be a deficiency. Generally, a
deficiency is most common when the mother is a vegetarian and/or lacks adequate sun
exposure. In both cases, supplementation of the mother and infant is recommended. Like
vitamin K, vitamin D is usually given to infants at the time of birth.
Vitamin K
In some infants and neonates, including those with certain malabsorption
disorders, vitamin K deficiency may occur. This can cause unexpected hemorrhagic
disease (bleeding). Almost always, babies are given intramuscular vitamin K shots at
birth to prevent this condition.
Iron
According to the American Academy of Pediatrics, women should breast feed
until at least the age of 1 year and should not feed infants under 1 year cow's milk. Doing
this can lead to deficiencies of iron. Generally speaking, iron supplementation is not
recommended for infants; excess iron can cause retardation of growth, increased bacterial
replication in infections, and can also compete for uptake with other essential minerals in
the gut.
Zinc
Zinc deficiencies can occur in infants whose mothers are deficient in zinc or if
there exists a problem with zinc uptake from the mammary glands in the mother's breasts.
Zinc deficiencies are also common in premature infants and children with malabsorption
syndromes. Zinc deficiencies are generally not found in infants who breast feed,
assuming the mother is not deficient.
Recommended Dietary Allowance
Nutrients 0-6 Months 6-12 Months
Body Weight (Kg) 5.4 8.6
Energy (Kcal) 108 98
Protein (g) 2.05 1.65
Calcium (mg) 500 500
Iron(mg/kg) 1
Vitamin A (mcg) 350 350
Beta carotene 1400 1400
Thiamine (mcg/kg) 55 50
Riboflavin (mcg/kg) 65 60
Pyridoxine (mg) 0.1 0.4
Ascorbic Acid (mg) 25 25
Vitamin B12(mcg) 0.2 0.2
Infant Formula
According to Codex Alimentarius the definition of infant formula Infant formula
means a breast-milk substitute specially manufactured to satisfy, by itself, the nutritional
requirements of infants during the first months of life up to the introduction of
appropriate complementary feeding. Infant formula is so processed by physical means
only and so packaged as to prevent spoilage and contamination under all normal
conditions of handling, storage and distribution in the country where the product is sold.
The term infant means a person not more than 12 months of age.
Although infant formula is not as perfect a food as breast milk for infants (it is
harder for them to digest and is not a chemical replica of human milk), formula does
provide all the nutrients a baby needs to grow up healthy. The United States Food and
Drug Administration (FDA) regulate infant formula under the Federal Food, Drug, and
Cosmetic Act (FFDCA). The FDA sets the minimum amounts of 29 nutrients that must
be present in infant formula and sets maximum amounts for 9 other nutrients. Some of
these nutrients include Vitamins A, D, E, and K, and calcium. Some formulas contain
iron, while others do not.
Essential Composition
Infant formula is a product based on milk of cows or other animals and/or other
ingredients which have been proven to be suitable for infant feeding. The nutritional
safety and adequacy of infant formula shall be scientifically demonstrated to support
growth and development of infants. All ingredients and food additives used shall be
gluten-free.
Essential and semi-essential amino acids in breast milk
For an equal energy value the formula must contain an available quantity of each
essential and semi-essential amino acid at least equal to that contained in the reference
protein. Infant formula prepared ready for consumption in accordance with instructions of
the manufacturer shall contain per 100 ml not less than 60 kcal (250 kJ) and not more
than 70 kcal (295 kJ) of energy.
Isolated amino acids may be added to Infant Formula only to improve its
nutritional value for infants. Essential and semi-essential amino acids may be added to
improve protein quality, only in amounts necessary for that purpose. Only L-forms of
amino acids shall be used.
Optional Ingredients
Some ingredients may be added in order to provide substances ordinarily found in
human milk and to ensure that the formulation is suitable as the sole source of nutrition
for the infant. Only L (+) producing lactic acid cultures may be used.
Vitamin Compounds and Mineral Salts
Vitamins and minerals added should be selected from the Advisory Lists of
Mineral Salts and Vitamin Compounds for Use in Foods for Infants and Children
(CAC/GL 10-1979).
Specific Prohibition
The product and its components shall not contain commercially hydrogenated oils
and fats and shall not have been treated by ionizing radiation.
Food Additives
In this standard part the permitted food additives are grouped as thickening
agents, emulsifiers, pH adjusting Agents, Antioxidants and packaging gas (propellants).
Contaminants
The standard sets a maximum level of lead of 0.02 mg/kg (in the ready-to-use
product)
Hygiene
The product should comply with the appropriate sections of the following codes:
Recommended International Code of Practice - General Principles of Food
Hygiene (CAC/RCP 11969, Rev. 3 - 1997),
Recommended International Code of Hygienic Practice for Foods for
Infants and Children (CAC/RCP 21-1979).
Principles for the Establishment and Application of Microbiological
Criteria for Foods (CAC/GL 21-1997)
Types of Infant Formula
There are different types of infant formula are available in the market. Substances
used in infant formulas must be foods on the approved Generally Recognized as Safe
(GRAS) list. Facilities for manufacturing infant formula are regularly inspected by the
FDA, and the manufacturer must keep process and distribution records for each batch of
formula. Every container of formula must show an expiration or use by date. The FDA
must be informed of any changes made to the formula.
Infant formulas are either cow’s milk based or soy based. Infants who show signs
of lactose-intolerance (colicky, restless, gassy, spitting up) usually do well on soy-based
formula.
Formula comes in three styles:
Ready-to-feed - This is the easiest type of formula to use. It can be poured
straight from the can into a bottle. It is also the most expensive form of formula.
Concentrated liquid - This needs to be mixed with an equal portion of water.
Concentrated liquid is less expensive than ready-t0-feed.
Powder- This needs to be mixed with water. Advantages are that it is the least
expensive formula and that it keeps longer than the liquid varieties. The main
disadvantage is that it requires accurate measuring of powder and water.
Milk-Based Infant Formula
The most common infant formulas consumed by infants are made from modified cow’s
milk with added carbohydrate (usually lactose), vegetable oils, and vitamins and
minerals. Casein is the predominant protein in cow’s milk. Since the primary protein in
breast milk is whey protein, rather than casein, some milk-based infant formulas have
been altered to contain more whey. Despite that alteration, the protein in infant formula is
significantly different from that in breast milk because of their different amino acid and
protein composition. In milk-based infant formulas, about 9 percent of the kilocalories
are provided by protein, 48–50 percent by fat, and 40–45 percent by carbohydrate. These
infant formulas are lower in fat and higher in carbohydrate, protein, and minerals than
breast milk.
Toddler Formulas
Toddler formulas are appropriate for toddlers between 1 and 3 years of age. They
are designed to supplement, not replace, food intake.
Specialty Infant Formulas
Allergy: Extensively hydrolyzed formulas ("Predigested")
If your baby develops rashes, is colicky or is extremely fussy, make sure to see a
pediatrician right away as these may be symptoms of allergy. To manage cow's milk
protein allergy, the AAP recommended the use of extensively hydrolyzed formulas.
These types of formulas are usually referred to as "predigested" formulas. The protein
content of these formulas have been broken down or "predigested". Extensively
hydrolyzed formulas are usually 3 times more expensive than standard formulas. In more
extreme cases, completely predigested formula (amino-acid based) such as Neocate is
required.
Soy-based formulas:
These formulas are made using soy proteins. They do not contain lactose. The
American Academy of Pediatrics recommends soy formulas for parents who
do not want their child to eat animal protein, and for infants with galactosemia
or congenital lactase deficiency.
Soy-based formulas have not been proven to help with milk allergies or colic.
Babies who are allergic to cows' milk may also be allergic to soy milk.
Hypoallergenic formulas (protein hydrolysate formulas):
This type of formula may be helpful for infants who have true allergies to
milk protein, and for those with skin rashes or wheezing caused by allergies.
Hypoallergenic formulas are generally much more expensive than regular
formulas.
Lactose-free formulas:
These formulas are used for galactosemia, congenital lactase deficiency, and
primary lactase deficiency. Lactase deficiency most often begins after a child
is 12 months old. The condition is diagnosed using special tests.
A child who has an illness with diarrhea usually will not need lactose-free
formula.
Special formulas that should be used only under a health care
provider's supervision:
Reflux formulas are pre-thickened with rice starch. They are usually needed
only for infants with reflux who are not gaining weight or who are very
uncomfortable.
Formulas for premature and low-birth weight infants have extra calories and
minerals to meet the needs of these infants.
Special formulas may be used for infants with heart disease, malabsorption
syndromes, and problems digesting fat or processing certain amino acids.
Breast Feeding vs. Formula
It's important for the new mother to understand the significance breast milk has on
their baby's health. A great number of studies have consistently shown babies fed breast
milk (compared to formula) are significantly healthier with a much lower incidence of
various infections and diseases.
Breast Feeding Reduces Infant Illnesses
A recent study has shown that breast feeding significantly reduces the occurrence
of common infant illnesses such as respiratory tract infections, pneumonia, ear infections,
and gastrointestinal disorders. In the 2 year study of 977 babies, a community program
was implemented which urged women to breastfeed their infants rather than use baby
formula. The program resulted in a significant increase in breastfeed babies - 54.6%, up
from 16.4%. During this time, the number of babies who developed pneumonia in the
first year of life declined by 33% and the cases of gastroenteritis decreased by 15%.
According to researchers, their results suggest that "breast milk itself or the
process of breast feeding provides protection against infant illnesses." The American
Academy of Pediatrics recommends that mother’s breastfeed their babies for at least one
year, "and longer if mutually desired by the mother and child."
Breast milk is better for premature infants
Experts believe breast milk contains a number of immune-boosting compounds
which "jump-start" the infants immune system and assist the infant in fighting off
infections. In this study, researchers found that preterm infants fed breast milk developed
significantly fewer infections. 212 preterm, very low birth weight infants (under 3
pounds) were fed either breast milk or formula. After adjusting for all other factors,
researchers determined that infants fed breast milk decreased their odds of infection by
57% - a dramatic decrease. Also, many immune system agents normally found in breast
milk are in higher concentrations in the breast milk of mothers who deliver prematurely
compared with mothers who delivery at term.
The American Academy of Pediatrics has long advocated the use of breast milk as
the primary food source of newborn, full-term infants.
Breast milk lowers occurrence of diarrhea
Diarrhea is common in infants and small children. When diarrhea is severe or
present with other symptoms the child should be evaluated by a doctor. Diarrhea can be
naturally and safely treated in many cases by supplementing with either normal flora (the
naturally occurring intestinal flora which becomes depleted with diarrhea and
gastrointestinal infection). Also, bovine colostrums can be fed to infants to provide added
natural immunity. Both supplements are safe and increase immunity within the
infant/child.
Breast milk lowers occurrence of middle ear infections
This infection of the middle ear has been shown to respond to chiropractic care in
many cases. Nutritionally speaking, children who breast feed dramatically lower their
chances of suffering from otitis media. In one such study, infant’s breast fed for 4 months
or more decreased their incidence of otitis media by 50% compared with non-breast fed
infants. Also, in those infants who did suffer from a bout of otitis media, subsequent
recurrence was twice as common in non-breast fed infants.
Breast feeding enhances intellectual development
Research has shown breast feeding can enhance intellectual development. In a
study of 229 healthy infants, those breast fed infants consistently scored higher on
psychomotor skills.
