Life Cycle: Maternal and Infant Nutrition

BIOL 103, Chapter 12-2

Today’s Topics

• Lactation• Resources for Pregnant and Lactating Women

and their Children• Infancy

Lactation

• Breastfeeding trends

• Healthy People 2020 goals– To increase the proportion of newborns who

are initially breastfed to almost _____%– Current stats:

• 74% of infants breastfed initially• 44% of infants still breastfed at 6 months

Physiology of Lactation

• Changes during adolescence and pregnancy– Increased ____________– ___________ of structure

ducts/glands and _________ cells are formed

• After delivery– Milk production and

secretion

• Colostrum:

Physiology of Lactation• Hormonal controls

stimulated by______ ________________:– Prolactin: stimulates

milk _____________– Oxytocin: stimulates

milk _____________

• “Let-down” reflex – release of milk from breast tissue in response to oxytocin.

Summary of Lactation Physiology

•Infant suckling pituitary gland release prolactin milk tissue production

•Infant suckling pituitary gland release oxytocin release milk

•Thus, giving water or infant formula to the baby reduces the time spent nursing at the breast ___________________ declines

Nutrition for Breastfeeding

• Energy and protein– _________ needs than during pregnancy– Well-nourished pregnant women will ______

weight slowly 1 ¾ lbs/month after ~6 months. • Vitamins and minerals

– Most are ____________ as during pregnancy– Iron and folate needs are ___________

• Water– AI for total water = 3.8 liters/day

Nutrition for Breastfeeding

• Food choices– ___________ Daily Food Plan for Moms– ~2,200–2,800 Kcal/day– Choose foods high in vitamins and minerals

and low in added sugar and solid fats• Supplementation is generally not

necessary, unless…– ________ for vegans– ________ for women with irregular sun

exposure• Practices to avoid during lactation

– Smoking, Alcohol, Drugs

Benefits of Breastfeeding (PS12, Q3a)

• Benefits for infants1. Optimal nutrition2. Builds stronger __________ system:

protects infant from infections and illness including diarrhea, ear infections, pneumonia, and asthma

3. Convenience

Benefits of Breastfeeding (PS12, Q3b)

• Benefits for mother1. Enhanced recovery of __________ size2. Help women return to ____________ weight

faster3. Convenience

• Contraindications to breastfeeding– Infant or maternal ____________________– Damaged breast ducts– Drug use

Resources for Pregnant and Lactating Women and their Children

• Promote health of pregnant and breastfeeding women and their children

• Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)– Service of _________________– Provides food assistance– Provides nutrition education– Provides referrals

Infancy

• Infancy: 0 -1 years old• _______ is the best marker of nutritional status

– Evaluated using __________________1.Weight gain

• Double birth weight by _______ months• Triple birth weight by _____ months

2.Length gain (not height B/C infants can’t stand)• Increase length by 50% by _____ months

3.Head circumference measures _________ growth and development

Energy and Nutrient Needs During Infancy

• Requirements based on composition of _______________________– Energy and Protein

• Highest needs of any life stage• 2x adult’s needs

– Carbohydrate and fat• Both are ______________ source• Carbohydrates as simple sugars

– Water • Supplemental water feeding is ______ necessary

for healthy infants who are exclusively breastfed (or receive properly mixed formulas).

– This is true even in _____________ weather.– Once solid foods are introduced, additional water may be

required.

Energy and Nutrient Needs During Infancy

• Key vitamins and minerals– Vitamin __: need adequate sunlight exposure– Vitamin __: produced by gut bacteria

• Single dose of vitamin K since gut is sterile at birth

– Vitamin ___: problem for a strict vegetarian mom

• Folate metabolism and cell division

– Iron: if formula fed, need iron-fortified formula– Fluoride: at 6 months

Energy and Nutrition needs during Infancy

• Newborn Breastfeeding – Recommended as the ______ method of

feeding infants to achieve optimal growth and development.

• Feedings 2-3 hours for a total of 8-12 feedings/day• 10-15 minutes/breast

– AAP recommends that NO supplements of formula or water be given to breastfed neonates unless medically indicated

Energy and Nutrient Needs during Infancy

• Alternative feeding: Infant Formula1. Standard infant formula

• Cow’s milk base• “imperfect copy” of breastmilk

2. Soy-based formula• Soy protein base• Switched to soy-based if formula-fed

infants are having feeding problems (vomiting and diarrhea).

Energy and Nutrient Needs during Infancy

– Special formula for formula-fed infants who are:• ________ to milk/soy• ________ babies• Have rare defects in

metabolic pathway

• Use medium-chain triglycerides as the fat source

Energy and Nutrient Needs during Infancy

• How much is enough?– Guidelines for feeding infant

1. 6 or more wet diapers per day

2. 3 or more stools per day

3. Regain to birth weight within the first week

– Best indicators that baby has enough to eat: _____________, ___________ elimination patterns, and satisfied demeanor.

Introduction to Solid Foods• Readiness for complimentary foods at ~___ months

_______________ to breast milk/infant formula• Infants show:

1. Physiological readiness:• Digestive ___________________• Ability to maintain __________________• Depletion of iron stores

2. Developmental readiness:• Lack of ____________________ – young infant’s

response to thrust tongue forward when a spoon is put into the mouth.

• Head and body control– Examples:

The Start Healthy Feeding Guidelines• Feeding schedule for the first two years

Feeding Problems during Infancy

1. ______________– Crying and distress, perhaps from abdominal

cramping– No clear effective treatment

2. Early childhood dental caries– Associated with putting baby to bed with a

bottle (milk, juice, etc.)

3. Iron-deficiency anemia– For ______________ infants who do not eat

enough iron-rich foods.

Feeding Problems during Infancy

4. Gastroesophageal reflux - backflow of stomach contents to espophagus– ~3% of newborns, usually male– Usually disappears within 12–18 months

5. Diarrhea– Requires increased _____________

6. Failure to thrive (FTT)– Poor growth in absence of ___________– Can be due to shortage or improper preparation

of appropriate foods