Pediatrics

Infant Nutrition (Continued)

Formula feeding amounts

´ Age method
´ Can be used for healthy infants.
´ Amount of milk per feed: 1st day = 10 cc, then increases 10 cc
everyday till the 7th day (70 cc / feed).
´ Then increases 10 cc / feed / week till the age of 4 weeks = 100
cc / feed.
´ Then amount/feed = age in months x 10+100
´ Weight method
´ Amount of milk/feed in cc = wt in kg x 20 + 20
Formula feeding amounts

´ Calorie method
´ Most Accurate
´ Calculate the total caloric needs / day (=C).
´ Calculate the total amount of milk needed/day = ( C )x
100/67 cc.
´ Calculate the amount of milk / feed.
´ Caloric requirements
´0-3 months - 116kcal./kg./d
´3-12 months- 100kcal./kg./d
 Caloric Requirements

Age Form KCal/kg/day

-------------------------------------------------------------
Low Birth wt Infants Enteral 150
Low Birth wt Infants Parental 80-100
Preterm Infants Parental 85-130
1- 7 years Enteral 75- 90
7-12 years Enteral 60- 75
>18 years Enteral 30- 60
BEE (men)= 66 +(13.7*wt)+(5.0*ht)-(6.8*age)
BEE (wom)=665+(9.6*wt)+(1.7*ht)-(4.7* age)
Baby's Growth Charts
´ This is an American system (released in November 2000 and based
on data from the National Center for Health Statistics, U.S. Public
Health Service).
´ Charts are a vast improvement over earlier charts
´ Baby's growth charts can give you a general picture of how ! baby
is developing physically
´ By comparing baby's measurements — weight, length, and head
circumference — to national averages for children of the same age
and sex measurements from previous checkups
´ There are charts for: weight, length, and head circumference.
´ These charts measure baby growth in percentiles.
´ What does "percentile" mean?
Baby's Growth Charts
Weaning
´ Definition: addition of any food other than milk to infant formula.
´ At the time of weaning, the close relationship between the mother
and the baby begins to weaken; so this should be a gradual
process.
´ Why
´ Breast milk on its own is sufficient for most babies until 4-6 months of age,
´ After 6 months of age, the baby's growing body demands are more
than the mother's milk can provide.
´ When
´ The appropriate time for weaning depends on several factors such as
the infant's state psychomotor and psychosocial development,
gastrointestinal function and the relationship of dietary energy to the
volume of feeds given to the infants, deeply held traditions and type of
the community (urban areas start earlier weaning than rural areas).
Weaning; How?
´ To train the baby to chew and become accustomed to new foods, first
give 1-2 teaspoonfuls of freshly peeled mashed fruits e.g. orange,
apple.
´ If the baby is reluctant to take food then he may be willing to try when
he is hungry.
´ Use a spoon to feed the baby as this cleaner and safer than bottle and
hand feeding also to avoid nipple confusion.
´ Gradually increase the amount of food offered. Within about two
weeks basic mixes and then multi-mixes should be introduced.
´ Don’t force the infant to eat and don’t worry if he spits out the food.
´ Once a new food is accepted give it frequently so that it becomes
familiar.
´ As the baby grows he will be encouraged to try a new food and to eat
what he is given, if he is allowed to handle the food and try to feed
himself.
Hazards of faulty weaning
´ Time of weaning
´ Early weaning à distention – colics – diarrhea (maldigestion). Early cessation of breast
feeding may lead to early return of fertility and undesirable pregnancy.
´ Delayed weaning (prolonged exclusive breast feeding): àDecreased calories, proteins
à Malnutrition diseases
´ à Fe deficiency à Anemia.
´ à Vit C deficiency à Scurvy.
´ Amounts of food given
´ Under nutrition
´ Obesity
´ Type of food
´ Food allergy.
´ Low protein + excess CHO; Kwashiorkor (PEM ).
´ Low Vit D; rickets.
´ Contamination; Gastroenteritis.