Nutrition for Infants

1. Nutrition for Infants Susan Guthier Child Care Health Consultation Northern Kentucky Health Department

2. Outline • Feeding relationship • Development and feeding skills • Stages of Feeding • Handling Breast Milk

3. Feeding Relationship • Interactions and communication between a caregiver and infant during feeding • Influences the infant’s ability to progress in feeding skills and eat a nutritionally adequate diet

4. Steps to a Positive Feeding Relationship • Observe and be sensitive • Hunger • Satiety • Food Preferences • Be positive • Make mealtime pleasant by calming the infant

5. Development of Feeding Behaviors—0 - 3 months • Reflexes • Rooting, suck • Swallow reflex • Tonic neck reflex • Motor Development • Poor head control • Secures milk with suckling pattern • Tongue projected during swallowing

6. Development of Feeding Behaviors—4 - 6 months • Reflexes • Rooting, biting reflex fade • Tonic neck reflex fades • Motor Development • Suck changes to mature suck • Sucking strength increases • Munching pattern begins • Grasps with palmer grasp • Brings object to mouth and bites

7. Development of Feeding Behaviors—7 - 9 months • Reflexes • Gag reflex • Normal gag • Choking reflex can be inhibited • Motor Development • Munching [solid foods] • Rotary chew • Sits alone • Voluntary release; resecure hold • Holds bottle alone • Develops pincer grasp

8. Development of Feeding Behaviors—10 - 12 months • Reflexes [continue to improve] • Motor Development • Reaches for spoon • Bites nipples, spoons, and crunchy foods • Grasps items and brings to mouth • Drink from a cup [that is held] • Tongue is used to lick food morsels off lip • Finger feeds with pincer grasp

9. Stages of Feeding • 0 to 4 months: Breastmilk and/or formula • 4 to 6 months: Baby is ready for solid foods when… • Birth wt has doubled • Can control head and neck • Sits up with some support • Can turn head/close mouth to show being full • Interest in your food when you eat

10. 6 to 8 months First food = iron-fortified rice cereal Vegetables then Fruits Fruit juice when drinks from a cup [limited amount] 8 to 12 months Strained meats Egg yolks Stages of Feeding [cont.]

11. Signs of Hunger in Infants • Rooting reflex • Hand to mouth activity • Small, fussing sounds • Pre-cry facial grimaces • Crying

12. Signs of Satiety in Infants • Decreased interest in eating more • Increased interest in environment

13. Handling of Breast Milk • Must be clearly labeled with baby’s name and date of collection • Refrigerate immediately • Use refrigerated milk within 48 hours of collection – this assures safety • Put only enough milk in bottle for baby to use – DO NOT WASTE BM

14. Handling of BM continued • Warm under hot water (if desired) • Shake • Throw out uneaten BM • Can be kept: • frozen for 3 months • In a deep freeze for 6 months

15. Child Care Provider Responsibilities • Support breast feeding and the use of expressed human milk • Provide quality BF Support by accommodating mothers who wish to breastfeed or feed expressed breastmilk • “Critical role to play” in supporting employed mothers

16. Caring For Our Children 3: National Health and Safety Performance Standards Breastfeedingsymbol.org encourage, provide arrangements for and support BF “be the mother’s cheerleader and enthusiastic supporter for the mother’s plan to provide her milk” “vigorous efforts…to promote and sustain breastfeeding” Designated place to breastfeed & pump

17. 10 Steps to BF Friendly Child Care Centers 1 Designate an individual or group who is responsible for development and implementation of the 10 steps. 2 Establish a supportive breastfeeding policy and require that all staff be aware of and follow the policy. 3 Establish a supportive worksite policy for staff members who are breastfeeding. 4 Train all center staff to carry out breastfeeding promotion and support activities. 5 Create a culturally appropriate breastfeeding friendly environment. Wisconsin DHS, 2008

18. 10 Steps to BF Friendly Child Care Centers 6 Inform expectant parents, new families and visitors about your center’s breastfeeding friendly policies. 7 Stimulate participatory learning experiences with the children related to breastfeeding. 8 Provide a comfortable place for mothers to breastfeed or pump their milk in privacy, if desired. Educate families and staff that a mother may breastfeed her child wherever they have a legal right to be. 9 Establish and maintain connections with your local breastfeeding coalition or other community resources. 10 Maintain an updated resource file of community breastfeeding services and resources kept in an accessible area for families. Wisconsin DHS, 2008

19. Breastfeeding Quiz The exact nutritional makeup of breast milk: • Is still unknown • Easily duplicated • Was discovered by Louis Pasteur • Is patented

20. What does breast milk have that is missing from formula? • Antibodies • Living cells • Hormones & enzymes • All the above

21. Because human milk is so easy to digest, breastfed babies spit up less often and have less diarrhea and constipation TRUE or FALSE

22. Breastfeeding improves IQ TRUE or FALSE Resource: Playtex MOM Program

23. No stool in a breastfed baby for several days requires immediate medical attention TRUE or FALSE

24. Breastfeeding also benefits the mother and family: TRUE or FALSE Source: www.breastfeedingtaskforla.org

25. How long can you leave a formula bottle out of the refrigerator?

26. Choking—liquid goes into lungs Ear infections—fluid enters the middle ear and cannot drain properly No human contact received, which is necessary to make them feel loved and secure Increased risk of dental problems Avoid Propping a Bottle Because…

27. Presentation adapted from: Wendy Compton, RD, LD

28. Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it is the only thing that ever has. -Margaret Mead

29. Thank you for your attention! Any questions?