NEW BORN AND INFANT NUTRITION FOR bsc n.pptx

TO KNOW ABOUT INFANT NUTRITION

1. INFANT NUTRITION

2. breast feeding Breastfeeding is the first fundamental right of child. It greatly improves the quality of life by providing unique nutritional, immunological , economic, ecological, psychological and child spacing benefits. Breastfeeding also enhances maternal health. Exclusive breastfeeding for first six months of life is the most effective child survival intervention in developing countries.

3. EXCLUSIVE BREASTFEEDING Only breast milk, no other food or drink even water PREDOMINANT BREAST FEEDING Main source of nutrition is breast milk but child is also receiving other fluids like water or water based drinks such as juices PARTIAL BREASTFEEDING Giving a child non human formula or cereal based foods in addition to breast milk.

4. ADVANTAGES OF BREASTFEEDING BENEFITS TO BABY Nutritional benefits : It contains the right kind of proteins, fats, lactose,vitamins , Iron, minerals , water and enzymes in the amount necessary for the baby. It meets all the nutritional needs of the baby for the first six month.

5. Iron in breast milk is better absorbed thus protecting against iron deficiency anaemia . Breast milk contain plenty of Vit -A and C and can largely fulfil their needs even in the second year of Life.

6. Immunological benefits: Breast milk contains a no. of protective factors such as immunoglobin , mainly secretory IgA , macrophages , lymphocytes , lactoferrins , lysozymes and interferons . Breastfed babies are less likely to develop infection. A breast fed baby is 14 times less likely to die of diarrhoea and almost 4 times less likely to die of respiratory infections.

7. Breast milk contain number of growth factors, enzymes,and hormones. It promotes growth and development of baby. Breastfeeding enhances brain development and breastfed babies have been shown to have a higher intelligence quotient(IQ). It is clean, free from pathogenic bacteria and has no chances of contamination.

8. It is easily digested and assimilated. Breastfed babies do not suffer from constipation. It enhances the emotional bond between the child and the mother and provides warmth, love and affection to the baby.

9. BENEFITS TO THE MOTHER It reduces anaemia due to reduction in postpartum bleeding and reduced blood loss because of delayed menstruation. It is convenient, needs no preparation and is readily available at the right temperature.

10. It helps the mother to regain her normal figure. It promotes early uterine involution. It has a protective effect against breast and ovarian cancers. Breastfeeding helps in delaying another pregnancy.

11. BENEFITS TO THE SOCIETY Breastfeeding is economical and hardly costs the family anything extra. Breastfeeding lowers healthcare costs to the society by reducing illness among children. BF is eco-friendly and does not cause any environmental pollution.

12. ADVANTAGES OF BREAST FEEDING B - Best for babies R - Reduced incidence of allergies E - Economical A - Always available S - Stool is inoffensive T - Temperature is always ideal

13. F - Fresh Never Goes Sour E - Emotional Bonding E - Easy Once Established D - Digested Easily I - Immediately Available N - Nutritionally Optimal G - Gastroenteritis Greatly Reduced

14. Breastfeeding recommendations Initiate BF immediately after birth. The first feed should always be mother’s milk. Give breast feed on demand. Baby should exclusively be breast feed for six months. Complementary feeding should begin in all babies at six months of age. Continued BF along with complementary feeding should be done till at least 2 years of age. Mothers and family should be motivated, educated and supported regarding healthy feeding practices for maintaining and sustaining healthy infant feeding practices.

15. Composition of breast milk Colostrum Milk secreted during the initial 3-4 days after delivery, small in quantity,yellow and thick, contains large amount of antibodies and immune competent cells and vitamins A,D,E,K. Transitional milk Milk secreted after 3-4 days until 2 weeks. Immunoglobulin and protein content decreases while fat and sugar content increases.

16. Mature milk Follows transitional milk, thinner and watery but contains all the nutrients . Preterm milk Milk delivered before 37 weeks, contains more proteins, sodium, iron, Immunoglobulins and calorie .

17. FOREMILK Secreted at the start of feed Is watery and rich in protein, sugars ,vitamins , minerals and water Quenches baby’s thirst HINDMILK Comes later towards the end Rich in fat that provides more energy and a sense of satiety

18. Signs of good attachment Baby’s mouth is wide open Most of the nipple and areola in the mouth, only upper areola is visible not the lower one. The baby’s chin touches the breast The baby’s lower lip is everted

19. Effective suckling Baby suckles slowly and pauses in between to swallow ( suck, suck, and swallow) Baby’s cheek are full and not hollow or retracting during suckling .

20. Contraindications of breastfeeding Infants with Special Dietary Requirements Galactosemia Phenylketonuria – may be partially breastfed Maternal Infectious Disease Cytomegalovirus – may or may not breastfeed depending on individual circumstances Herpes – if active on breast, may use other breast if not affected HIV – may or may not breastfeed depending on individual circumstances Tuberculosis – if not contagious or may resume feeding after two weeks of treatment

21. Maternal Drugs Chemotherapy agents – certain agents, discontinue breastfeeding for as long as they remain in the milk Drugs of abuse – discontinue breastfeeding until drugs are out of maternal system Primaquine and Quinine – contraindicated if either infant or mother has G6PD Metronidazole – discontinue breastfeeding until at least 12-24 hours after medication Sulfa drugs – may be a problem in infants with jaundice or G6PD, stressed or premature Radioactive isotope – discontinue breastfeeding for as long as the radioactivity is in the milk

22. Preparation of the mother Motivation Care of breast Techniques of breast feeding Feeding schedule

23. Indications of adequacy of breast feeding Let down sensation in mothers breast Breast is full before feed and softer after feeding the infant Baby sucks vigorously with audible swallowing sound during feed Infants urinate six or more than six times in 24 hrs. Baby gain weight 15-30 g per day Baby will pass 4-8 soft motions in 24 hrs. Baby sleeps well does not cry frequently. Baby has healthy skin,good muscle tone and shiny skin.

24. Artificial feeding Supplementary feeding: Supplementary feeding are given in place of breastfeeds Given when mother has severe illness and cannot feed her baby Each feed missed by the infant will interfere with establishment of lactation Complementary feeding: Is given along with breast feeding Necessary for babies who are small for date, lethargic and difficult to attach. Feeding given when you know that breast feeding alone is not enough

25. METHODS OF FEEDING

26. WEANING Breast feeding alone is adequate to maintain growth and development up to 6 months. And complementary feeding should be given to maintain their growth and development according to age. So it is necessary to introduce more concentrated energy rich nutritional supplements by this age. Infant also need iron containing food supplements to prevent iron deficiency anaemia.

27. DEFINITION Complementary feeding or weaning is the process of giving an infant other foods and liquids along with breast milk after the age of 6 months as breast milk alone is no longer sufficient to meet the nutritional requirements of growing baby. It is the process by which the infant gradually becomes accustomed to adult diet.

28. WHY START AT SIX MONTHS Infant’s intestinal tract develops immunologically with defence mechanisms to protect the infant. The infant’s ability to digest and absorb proteins, fats, and carbohydrates, other than those in breast milk increases rapidly.

29. The infant’s kidneys develop the ability to excrete the waste products. The infant develops the neuromuscular mechanisms needed for recognizing and accepting variation in the taste and colour of foods.

30. Signs of readiness Hold his/her head straight when sitting down. Opens his/her mouth when others eat Is interested in foods when others eat. Receives frequent breast feed but appear hungry soon after. Is not gaining weight adequately

31. Principles of weaning Practice exclusive breast feeding from birth up to 6months and introduce complementary feeding after 6 months of age. Continue frequent on demand breast feeding until 2 years of age.

32. Feed infant slowly and patiently and encourage them to eat but do not force them. Practice good hygiene and proper food handling to reduce the risk of diarrhoea. Start with small amounts of food and increase the quantity as child gets older.

33. Gradually increase food consistency and variety as the child grows older. Increase the number of times the child is fed complementary food, as the child gets older. Feed a variety of nutrient rich foods to ensure that all needs are met.

34. Give micronutrient rich complementary foods or vitamin and mineral supplements to the infant as needed. It is advisable to start one or two teaspoons of new food at first which should be given when baby is hungry, just before regular feeding, during the day time.

35. Preparation of weaning food Wash hands. Keep food in clean utensils. Separate raw and cooked food. Cook food thoroughly. Keep food at safe temperatures. Use safe water and raw material. Give freshly prepared food. Keep the cooked food covered.

36. Qualities of weaning food Weaning food should be liquid at first, then semi solid and solid food to be introduced gradually. Clean, fresh and hygienic, so that no infection occurs. Easy to prepare at home with the available food items and not costly.

37. Easily digestible, easily acceptable and palatable for infants. High in energy density and low in bulk viscosity and contains all nutrients necessary for the baby. Based on cultural practice and traditional beliefs. Well – balanced, nourishing and suitable for the infant

38. Quantity and frequency of weaning foods Age Energy Needed in Addition to milk Consistency Frequency Amount at Each meal 6 – 8 Month 200 Kcal/day Start with liquid and proceed 2 – 3 times per day Start with 2 - 3 table spoons per feed and increase to about 125 ml 9 – 11 months 300 Kcal/day Finely chopped or Mashed food 3 – 4 times a day Half cup of 250 ml cup 12 – 23 months 550 Kcal/day Solid family foods, chopped or mashed. 3 – 4 times a day 1/4 th to full 250ml cup

39. Weaning at different age ……. 4 to 6 months Weaning to be initiated with fruit juice. Within one to two weeks new food to be introduced with suji , biscuit socked with milk, vegetable soup, mashed banana, mashed vegetable. Each food should be given with one or two teaspoon at first for 3 to 6 times per day.

40. 6 to 9 months Food item to be given at this period include soft mixture of rice and dhal, khichidi , pulses, mashed and boiled potato, bread or roti soaked with milk or dhal, mashed fruits, egg yolk, curd. Amount of food should increase gradually. 9 to 12 months More variety of household food can be added. Fish, meat, chicken can be introduced. Food need not to be mashed but should be soft and well cooked.

41. 12 to 18 months The child can take all kind of cooked food. The amount and frequency should increase gradually.

42. Problems of weaning If on starting weaning, breast feeding is stopped suddenly, it can have adverse psychological effect on the child. Weaning food, if prepared unhygienically or not digested properly can cause diarrhoea. If weaning food are not nutrient rich, the child can develop malnutrition. Children may develop indigestion, abdominal pain, diarrhoea or rashes if they are allergic to certain foods.