Life Cycle: Maternal and Infant Nutrition

1. Life Cycle: Maternal and Infant Nutrition BIOL 103, Chapter 12-2

2. Today’s Topics • Lactation • Resources for Pregnant and Lactating Women and their Children • Infancy

3. 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

4. Physiology of Lactation • Changes during adolescence and pregnancy • Increased ____________ • ___________ of structure  ducts/glands and _________ cells are formed • After delivery • Milk production and secretion • Colostrum:

5. 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.

6. 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

7. 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

8. 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

9. Benefits of Breastfeeding (PS12, Q3a) • Benefits for infants • Optimal nutrition • Builds stronger __________ system: protects infant from infections and illness including diarrhea, ear infections, pneumonia, and asthma • Convenience

10. Benefits of Breastfeeding (PS12, Q3b) • Benefits for mother • Enhanced recovery of __________ size • Help women return to ____________ weight faster • Convenience • Contraindications to breastfeeding • Infant or maternal ____________________ • Damaged breast ducts • Drug use

11. 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

12. Infancy • Infancy: 0 -1 years old • _______ is the best marker of nutritional status • Evaluated using __________________ • Weight gain • Double birth weight by _______ months • Triple birth weight by _____ months • Length gain (not height B/C infants can’t stand) • Increase length by 50% by _____ months • Head circumference measures _________ growth and development

13. 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.

14. 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

15. 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

16. Energy and Nutrient Needs during Infancy • Alternative feeding: Infant Formula • Standard infant formula • Cow’s milk base • “imperfect copy” of breastmilk • Soy-based formula • Soy protein base • Switched to soy-based if formula-fed infants are having feeding problems (vomiting and diarrhea).

17. 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

18. Energy and Nutrient Needs during Infancy • How much is enough? • Guidelines for feeding infant • 6or more wet diapers per day • 3 or more stools per day • Regain to birth weight within the first week • Best indicators that baby has enough to eat: _____________, ___________ elimination patterns, and satisfied demeanor.

19. Introduction to Solid Foods • Readiness for complimentary foods at ~___ months _______________ to breast milk/infant formula • Infants show: • Physiological readiness: • Digestive ___________________ • Ability to maintain __________________ • Depletion of iron stores • 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:

20. The Start Healthy Feeding Guidelines Feeding schedule for the first two years

21. Feeding Problems during Infancy • ______________ • Crying and distress, perhaps from abdominal cramping • No clear effective treatment • Early childhood dental caries • Associated with putting baby to bed with a bottle (milk, juice, etc.) • Iron-deficiency anemia • For ______________ infants who do not eat enough iron-rich foods.

22. Feeding Problems during Infancy • Gastroesophageal reflux - backflow of stomach contents to espophagus • ~3% of newborns, usually male • Usually disappears within 12–18 months • Diarrhea • Requires increased _____________ • Failure to thrive (FTT) • Poor growth in absence of ___________ • Can be due to shortage or improper preparation of appropriate foods