Professional Documents
Culture Documents
Sinad Feehan
Department of Nutrition & Dietetics A.M.N.C.H.
August 2009
Overview
Assessing growth
Requirements
Breastfeeding
Formula Feeding
Introducing Solid Foods
Iron & Vitamin D
NB standardisation of measurements
Centile Charts
Reference Nutrient
Intakes
Age
(months)
Weight Fluid
(kg)
(mls)
Energy
(kcals/kg)
Protein
(g/kg)
0-3
4.4
150
115 110
2.8
4-6
7.2
130
95
1.8
7-9
9.0
120
95
1.5
10 12
10.0
110
95
1.5
WHO RECOMMENDATION
Breastfeeding Benefits
Immunological:
Breastfed babies are at lower risk of
infection.
Nutritional:
Easy to digest, optimal blend of nutrients,
low risk of contamination.
Psycho/social:
Bonding, pain relief, maternal confidence &
empowerment.
Financial:
Milk is always available: shorter hospital
stay.
Benefits
Immunological advantages
Bifidus factor
Antibodies
Anti-trypsin factor
Possible Contraindications
Medications
IV Drug Abuse
HIV
Galactosaemia, Alactasia
Colostrum
Vitamins
and minerals
67 -70 kcals/100mls
Formula Feeding
No immunological/enzymic properties
I n f a n t F o r m u la
W hey Based
C a s e in B a s e d
Standard Products
Follow-on Formulae
Follow-on milks
Cow & Gate Follow-on Milk
Farleys Follow-on Milk
Milupa Aptamil Follow-on Milk
Anti-regurgitation Formula
Enfamil AR
SMA Staydown
Lactose-free Formula
Enfamil 0-Lac
SMA LF
Soya milks
Prescribable Specialised
Formulae
Nutrient dense
Hydrolysed
Neocate
LBW/ Premature
Elemental
Disease specific
Volumes
Feed on demand
Initially small frequent feeds
Volumes increase, frequency decreases
Example
4 week old infant weighing 4.3kg
Fluid requirement 150mls/kg = 645mls/day
80mls 3 hourly x 8 or
95mls 3.5 hourly x 7 or
110mls 4 hourly x 6
All suitable, baby dictates, dont restrict hungry
baby
Formulae :
Possible Problems
Over-concentration
Over-dilution
Excess volume
Hygiene
Safefood: How to prepare your babys bottle
feed
Weaning
? by 6 months:
-increasing energy & nutrient needs
-decreased body stores : Fe & Zn
-aids chewing & speech development
-food refusal less likely
Weaning contd
- puree meat/chicken/fish
- offer variety of tastes & textures
Next foods:
-introduce wheat, gluten, eggs*,citrus fruit
Weaning contd
Gluten
Vegetarian
Not recommended
Vegan
Suitable Drinks
No additions to bottles
NB dental care
Current Practices:
Tarrant et al 2006
Current Practices:
Tarrant et al 2006 (contd.)
By 1 year.
Common feeding
problems
FALTERING GROWTH
Faltering Growth
Possible Causes:
-inadequate dietary intake
-malabsorption/excessive losses
-increased nutrient requirements
-inability to utilise nutrients, e.g. metabolic
conditions
-psychological problems, e.g. poor parenting skills
Faltering Growth :
Management
3 - 4.5g protein/Kg
Iron Deficiency
Anaemia
Definition: Hb < 11g/dl, Ferritin < 10microg
Symptoms include - apathy, poor appetite,
poor growth, psychomotor delay
Possible causes are prematurity and
inadequate weaning diet
Inhibitors of iron are tannins, phytic acid,
phosphoproteins
Prevention = Breast milk/Fe fortified formula
Weaning foods rich in haem iron
Adequate vitamin C
Vitamin D
Re-emergance of rickets
Low vitamin D levels in normal population
Risk factors
Infant Nutrition