Infant Nutrition Health Article

Infant Nutrition

The first year of life is a period of very rapid growth. An infant's birth weight doubles after about five months and triples by the first birthday, by which time the infant's length increases by half. Adequate and appropriate nutrition is essential during this period, for infants that do not receive sufficient calories, vitamins, and minerals will not reach their expected growth.

Nutrient Requirements

An infant's requirement for calories is determined by size, rate of growth, activity, and energy needed for metabolic activities. Calorie needs per pound of body weight are higher during the first year of life than at any other time. Since there is variation among infants, a range of recommended calorie intakes have been developed. For the first four to six months of life, breast or formula feeding can provide sufficient calories. Measuring weight and length, and plotting it on a standardized growth grid, can determine the adequacy of an infant's calorie intake.

The calories in an infant's diet are provided by protein, fat, and carbohydrates. Protein is a basic part of every cell. Of the protein requirement, 50 percent is used for growth in the first two months of life, a figure that declines to 11 percent by two to three years of age. Fat provides 40 to 50 percent of the calories supplied during infancy and is a source of essential fatty acids. Carbohydrates, primarily lactose, are the principal source of dietary energy. Water requirements for the first six months are met when adequate amounts of breast milk or infant formula are consumed.

Breast milk from a well-nourished mother will supply adequate amounts of most vitamins and minerals, as will an iron-fortified formula. Vitamin D is also recommended for the breastfed infant, particularly infants who live in northern urban areas who are dark-skinned, who are kept covered due to cultural practices, or whose mothers have an inadequate intake of vitamin D. In places where the water supply is severely low in fluoride (less than 3 parts per million), fluoride supplementation might be considered for breastfed infants over six months of age.

Breastfeeding

All professional and international health organizations are in agreement that breastfeeding is the recommended method of infant feeding. Although breastfeeding is clearly essential for infants born in less industrialized countries, benefits are substantial in industrialized countries as well. In less industrialized countries, breastfeeding reduces infant mortality and morbidity.

Breast milk is nutritionally superior to formula, and it contains antibodies that reduce the risk of infection for the newborn baby. Breastfed infants have a decreased incidence of respiratory, gastrointestinal, and ear infections. The cost of feeding the infant is reduced, and the very nature of breastfeeding supports the mother-infant bond. There is also evidence that breastfed infants develop fewer allergies, and when tested at eighteen months of age they score higher on intelligence tests.

It is not advisable for an infant to receive whole cow's milk before one year of age. Feeding cow's milk before one year has been associated with the development of iron deficiency. If breastfeeding is discontinued before one year of age, an iron-fortified, commercially prepared infant formula is recommended.

Formula Feeding

The governments of most countries have developed nutrient standards for commercial infant formulas. These guidelines ensure that a formula has nutrients similar to the breast milk from a well-nourished woman. Most infant formulas are made from either modified cow's milk or soy, and both types will meet an infant's nutritional requirements. Standard infant formula comes in both a low-iron and iron-fortified form. Iron-fortified formula is always recommended, except in very specific circumstances. A third category of formulas has been developed for children with severe allergies, gastrointestinal problems, or other medical complications. These are classified as elemental formulas, and are prescribed when an infant cannot tolerate any other type of formula.

The newborn infant will feed between eight to twelve times a day. As weight is gained, the infant will take more at each feeding and the number of feedings per day will decrease. An infant who is receiving adequate feeds will have at least six wet diapers a day, will appear satisfied after a feeding, and will follow the established growth curve.

In less industrialized countries, or in situations where formula costs are too high, infant formulas made from evaporated milk have been used. This is not recommended, however, since an infant would require more vitamin and mineral supplementation, and there is also a risk of incorrectly prepared formula. When any type of formula is prepared, it is essential that the water, bottles, and all the equipment used are sanitized, that hands are washed during preparation, and that the formula is kept refrigerated.