18. LIFE STAGES Flashcards
This module covers: • The dietary requirements for different population groups. • How to support clients through lactation and infant weaning. • Nutrition through childhood and adolescence. • Factors affecting food choices for the ageing population. • Healthy ageing and longevity.
Outline the benefits of breast milk for infants
- Provides
vitamins,
minerals,
carbohydrates,
proteins and
fats
in the right proportions for healthy baby development. - Contains bifidobacteria and prebiotic oligosaccharides to help colonise the digestive tract and build the immune system.
- Breastfeeding ensures best possible health, developmental and psychosocial outcomes.
- Reduces the risk of conditions such as eczema, asthma and food allergies.
Outline the benefits of breast milk for mothers
- Breast milk is cheap and convenient.
- Delays the return of regular ovulation, lengthening birth intervals (prolactin inhibits GnRH release).
- Conserves iron stores (↑ energy & cognition).
- Studies show protection against breast and ovarian cancer (↓oestrogen & ↓ovulation).
- Aids post-birth weight loss due to increased energy expenditure.
- Supports the mother-baby relationship (oxytocin release).
- Assists in a swifter recovery from symptoms of postpartum depression (PPD). Homeopathy is recommended for PPD.
What is the macronutrient composition of breast milk?
The macronutrient composition of breast milk is as follows:
- 88% Water
- 6-7% Carbohydrate: Lactose; easily digested by infants and enhances calcium absorption.
- 3-5% Lipids: Linoleic and Linolenic acid as well as arachidonic (AA) acid and DHA.
- Less than 1% Protein: Mostly alpha-lactalbumin and whey.
- Enzymes: Specific for digestion of proteins, fats and carbohydrates. Certain enzymes also serve as transport for other nutrients such as zinc, selenium and magnesium.
(Rolfes et al. 2006)
Breast Milk: Immune Protection
what is colostrum?
During the first two or three days after delivery, the breasts produce COLOSTRUM, a pre-milk substance containing mostly with:
1) serum with
2) antibodies (Secretory IgA) and
3) white blood cells.
Breast Milk: Immune Protection
Functions of COLOSTRUM?
Its functions:
- Protects the infant from infections against which the mother has developed immunity.
- Contains maternal antibodies to inactivate pathogenic bacteria within the infant’s digestive tract. This is partly the reason why breast-fed infants have fewer intestinal infections than formula-fed infants.
- Has a laxative effect to expel wastes that accumulated in the digestive tract during foetal development.
Breast Milk: Immune Protection
How many species of bacterial microbiota is contained in Breastmilk and colostrum?
700
Breast Milk: Immune Protection
Whats the impact on breastmilk if mother is overweight?
Considerably less diversity of species than normal-weight mothers
Breast Milk: Immune Protection
What impact on breastmilk if caesarean birth?
LESS diversity in breastmilk microflora than in vaginal birth mothers (-> stress?)
Birth/breastmilk play role of early bacterial colonisation in the GIT
Various research confirms that an infant’s bacterial profile is directly related to that of its mother; the role of ‘friendly’ (or commensal) bacteria includes digestive support and immune modulation.
Breast Milk: Immune Protection
What is high in Colostrum?
Secretory IgA
Vitamin A
Zinc
also provides bifidus factors which favour growth of friendly bacterium LACTOBACILLUS BIFIDUS in GIT which prevents harmful bacteria gaining a foothold.
Breast Milk: Immune Protection
What’s the name of iron-binding protein in breastmilk which prevents bacteria from accessing iron?
LACTOFERRIN
It also aids iron absorption and kills some bacteria directly.
Breast Milk - Immune Protection
Name the protein in breastmilk which fights off the virus that causes infant diarrhoea (rotavirus)?
LACTADHERIN
Several other growth factors and enzymes stimulate
the development of t
Breast Milk: Immune Protection
Breastfeeding prevents or delays the
occurrence of atopic dermatitis,
cow milk allergy and wheezing in early
childhood when compared to formula-fed
infants, according to research.
What condition is mentioned where breastmilk offers protection?
Cardiovascular disease
(possible links to oxytocin release which causes vasodilation) breast-fed infants have lower blood cholesterol as adults.
Even the most advanced formulas cannot imitate the unique nutrient component of breast milk
Breast Milk: Minerals
The calcium content of breast milk is
ideal for what?
infant bone growth
Breast Milk: Minerals
Zinc has also high bioavailability, thanks to the presence of what?
Zinc-binding protein
Breast Milk - Minerals
Breast milk is low in sodium, which is
a benefit for what?
Immature Kidneys
Breast milk - minerals
Breast milk contains relatively small
amounts of iron, but the iron has a high
bioavailability. Historically, how did this fact help baby get more iron?
by delaying cord clamping
Lifestages pg 10
Breast milk - iron
when is Iron transferred to the baby across the placenta ?
in the third trimester.
Breast milk - iron
Pre-term babies have less iron per kg than full term, true or false?
true
Breast milk IRON
Iron stores are used up in infancy as blood volume increases with body size
true or false?
True
Breast milk - iron
How much of baby’s blood is outside its body at birth?
1/3
Life stage pg 11
breast milk - iron
what happens by delaying umbilical cord clamping?
By delaying umbilical cord clamping until it stops
pulsating, babies can get 30% more iron-rich blood,
oxygen, erythrocytes, leukocytes and stem cells.
Leave the navel to air dry and let the stump fall of on its own
Lifestages pg 11
Breastmilk - the perfect baby food
What period is recommended to exclusively breastfeed?
6 month
and continue up to 2 years or more
Human breast milk compliments and boosts the immune system as long as it
Breastfeeding also provides feelings of love,
comfort and protection and can contribute
to a toddler’s feeling of self-esteem
Breast Milk: The Perfect Baby Food
Breastfeeding mothers also benefit from
being near their child. The physical contact
increases oxytocin, what does it support?
which supports bonding,
and also has mild anti-inflammatory effects.
Establishing Successful Lactation
Guidance to support your clients:
- Consider hiring a doula or lactation consultant
straight after birth to help start your
breastfeeding journey and address any issues. - Familiarise yourself with local breastfeeding
support (‘milk spots’) in your area. - Spend the first week postpartum at home with
your baby with plenty of skin-to-skin contact. - Feed on demand (especially at night).
- Consider pumping one feed in order for
the mother to get some rest between feeds.
Key Postpartum Nutrients
Key Postpartum Nutrients include:
Protein, what is it needed for?
Protein
* Needed to replenish reserve.
* Needed for breast milk production
to support growth: extra 11g / day.
Beans, lentils, quinoa,
fish, organic eggs.
Key Postpartum Nutrients
What’s iron needed for as a key postpartum nutrient?
Iron
* ↑blood volume (anaemia is common
in pregnancy).
* ↓iron = fatigue, altered cognition.
Almonds, kale, spinach
poultry, sunflower/
pumpkin seeds, algaes.
Key postpartum nutrient
What’s zinc needed for as a key postpartum nutrient?
Zinc * Involved in production of ovarian
hormones; has a high trace of
mineral concentration in the brain.
* ↓ zinc can contribute to PPD.
Pumpkin seeds, whole
grains, sprouts, egg
yolks, oysters, organic
liver, seafood
Key postpartum nutrients
What’s B vitamins needed for as a key postpartum nutrient?
B Vitamins
* ATP production (B1, B2, B3, B5)
* B2 PPD protection.
* Folate depleted with lactation.
* B12 cofactor for DNA
production, myelination (nervous
system development). Can be
depleted by nitrous oxide in labour.
Lentils, leafy greens,
whole grains, organic
eggs, seeds and nuts,
liver, avocado,
banana, asparagus,
beans, legumes,
mushrooms, peanuts.
Life stages pg 52
Key Postpartum nutrients
What’s EPA/DHA needed for as a key postpartum nutrient?
EPA/DHA
* Essential for neural and eye
development of foetus.
* ↑ need postpartum, mother at risk of
losing DHA from brain tissue as
passed to foetus / breastfed infant.
Flaxseeds, hemp
seeds, chia seeds, oily
fish (salmon, mackerel
etc) anchovies,
sardines, herring).
Lifestages pg 15
key postpartum nutrient
What’s MAGNESIUM needed for as a key postpartum nutrient?
Magnesium
* Mg needed to convert ADP to ATP
(essential for energy postpartum).
* Absorbed by foetus in pregnancy &
lactation.
* ↓ levels can contribute to PPD.
Dark leafy
greens;
pumpkin
seeds,
almonds,
molasses.
key postpartum nutrients
What’s MAGNESIUM needed for as a key postpartum nutrient?
Vitamin C
* Co-factor for collagen synthesis (aids in
wound healing postpartum).
* Increases absorption of non-haem iron.
* Depleted in times of stress (adrenals).
* Synthesis of thyroxine and adrenal steroid
hormones (postpartum thyroiditis).
Broccoli,
blackcurrant,
peppers,
pineapple,
strawberries,
oranges.
Lifestages pg 16
key postpartum nutrients
What’s Vitamin D needed for as a key postpartum nutrient?
Vitamin D
* Diet and lifestyle changes in pregnancy
(e.g. lack of dietary intake and avoiding sun
exposure / excess sunscreen) can
predispose women to low vitamin D levels.
* Vitamin D has a role in commensal
bacterial colonisation.
* Reduces risk of PPD. (Abedi et al., 2018)
Sunlight,
mushrooms,
egg yolk,
wild-caught
oily fish,
sunflower
seeds.
key postpartumnutrients
What are probotiotic foods needed for as a key postpartum nutrient?
Probiotic Foods
* Babies receive beneficial bacteria from the
mother (from birth and breastfeeding).
It is especially important if born by
caesarean or if given antibiotics during /
after labour.
Yoghurt,
kefir, miso,
kombucha,
sauerkraut.
Lifestages pg 17
Nutrition During Lactation
Energy requirements during lactation are high. So what can you recall from pg 23?
- Daily nutrient requirements during lactation
are higher than during pregnancy. - Breastfeeding benefits are dependent
on mother’s nutritional status. - Inadequate maternal nutrition may
leave the mother depleted. - Severe energy restriction may
hinder milk production. - The postpartum period is not the time to go
on a weight loss diet to lose the baby weight! - Do not skip meals, especially breakfast.
Erratic eating triggers the body’s stress
response which can affect milk production. - Eat to satisfaction: oxytocin triggers the milk
ejection reflex and also more enzymatic activity
in the intestines ( better digestion). Chew food well. - Drink to thirst — no over/under drinking. Filtered water
is best. Constant thirst can be a symptom of EFA
deficiency. Over-drinking may affect milk supply. - Avoid cold foods and drinks, especially if
experiencing low milk supply or if prone to mastitis. - Focus on whole, fresh, organic produce.
- Well-cooked and energetically neutral foods (e.g. round grain rice,
potato, sweet potato) are easily digested by both mother and child. - Every woman is different and will require different nutrition
according to her constitution refer back to Energetics lecture. - Include probiotic foods (e.g. sauerkraut, kimchi, kefir) and prebiotic
foods (e.g. asparagus, Jerusalem artichoke, dandelion greens,
onions, garlic (may cause gas in baby) to support the microflora. - Include sources of EPA / DHA: flaxseeds, hemp, oily fish, algae.
- Avoid salted, sweetened foods, sugary drinks, cow’s dairy
products and microwaved foods.
Nutrition During Lactation
**Avoid caffeine and other stimulants:
Caffeine enters breast milk to make the
infant irritable and wakeful.
* Large doses of caffeine interfere with the
bioavailability of iron from breast milk and
impair the infant’s iron status.
* Coffee consumption should be eliminated.
* Chocolate, soft drinks and tea also
contain caffeine, so it is recommended
to avoid these.
Avoid alcohol as it easily enters breast milk
and significantly diminishes the amount of
breast milk consumed by the infant.
- It changes the taste of the breast milk.
- Even low doses of alcohol are not metabolised
efficiently by the infant which suppresses
feeding and causes sleepiness. - Alcohol interferes with lactation by
inhibiting the hormone oxytocin. - Alcohol consumption also interferes with
the ability to look after your baby
Nutrition During Lactation
Eliminate smoking — it reduces milk
volume, so smokers may produce too little
milk to meet their infant’s
energy needs
- The milk contains nicotine which
alters its smell and flavour. - Infants of breastfeeding mothers
who smoke gain less weight. - They are also at higher risk of
sudden infant death syndrome.
- Medicinal drugs: Some medicines are
contraindicated with breastfeeding —
always check with your GP.
Contraindicated: anti-cancer drugs,
lithium, oral retinoids, amiodarone,
codeine, decongestants, aspirin. - Illicit drugs: Are **always harmful **
and can cause irritability, tremors,
hallucinations and even death in
infants. It can also impact the
mother’s ability to care for her baby.
Nutrition During Lactation
- Feed on demand. Your baby tells you when it is
hungry — follow baby’s needs. Each baby is different. - If milk supply is low, try galactagogues fenugreek or
fennel seed tea; 2–3 cups/day, and stay hydrated. - Milk supply increases with the demands of the baby.
The best way to increase milk supply is to feed more. -
Stress can lower breast milk production.
If stressed, drink chamomile or lemon balm tea. - Additional fluid is usually not needed for breast-fed babies.
- In hot weather, or when the baby has a temperature or diarrhoea,
filtered water can be added. Never give juice or sugary drinks.
When breast milk does not agree with the baby:
* Babies can develop GI symptoms towards any
foods in mother’s diet. Investigate and eliminate!
* Infants who develop food allergy symptoms
may be more comfortable if the mother’s diet
excludes the most common offenders:
cow’s milk, eggs, fish, peanuts, tree nuts.
* Go for a leisurely walk in natural surroundings;
this will also help your baby.
* Include a daily relaxation practice (e.g. mother and baby yoga or
baby massage with sesame / almond oil, according to constitution).
Lifestages pg 31
Tradition postpartum care
Many cultures practise postnatal techniques to
nourish, nurture and revitalise the mother after
childbirth as well as to help her with additional
demands of breastfeeding and caring for a newborn.
- China: one month confinement — nourishing warm foods,
no visitors, no leaving the house, rest and feeding the baby. - Korea: 21 days — mother sleeps, eats and nurses the baby at
this time. Large amounts of hot tea and seaweed soup is given. - India: mother is kept warm for 10–40 days by a fire, she is
fed warming rich foods containing almonds and pistachios. - Nepal: new mother spends first 11 days with baby in darkened
room, nourishing foods include ghee and caraway soup.
Lifestage pg 18
Korean Seaweed Birthday Soup
Serves 6–8. Traditional Korean postpartum soup, eaten by
children on their birthdays. Seaweed — rich in calcium and
iron, promotes lactation and calms the nervous system. recipe to follow->
- In a medium pot, sauté ½ chopped onion in 2 tablespoons
sesame oil until lightly browned. Add 1 chopped garlic clove,
115g of organic beef sirloin OR 1 cup of dried anchovies
(omit if vegetarian). Stir and cook until browned. - Add 2 litres of broth of your choice, 30g of dried
seaweed (dulse / wakame or kelp) which has
been rinsed and 6 shiitake mushrooms.
Reduce heat and simmer for 40 minutes. - Eat warm and store leftovers in fridge for up to three days.
Lifestages pg 20
Brown Rice Congee
Serves 4–6.
A food of rebirth — replenishes Spleen Qi.
Requires minimal effort to digest, is gentle and nourishing, recipe to follow->
- In a medium pot, bring 390g of soaked brown rice with 1 litre
of water to a boil over a high heat. You may also use organic
vegetable or chicken broth to make it more flavourful. - Reduce heat to a simmer and cook until the
grains soften and open. Stir often and keep
checking and adding water if it’s been absorbed. - Serve hot with toppings such as black sesame
seed paste / picked vegetables / boiled egg / adzuki beans. - Store leftovers in the fridge for up to five days or portion freeze.
Name TWO allergenic foods to consider when weaning.
- eggs
- fish
- wheat
- cow’s milk
- peanuts
- tree nuts.
Lifestages pg 31
Describe TWO reasons each for Vitamin C and Magnesium being important nutrients for a client who is 1 month postpartum.
Vitamin C
- Co-factor for collagen synthesis (aids in wound healing postpartum).
- Increases absorption of non-haem iron
- Depleted in times of stress (adrenals).
- Synthesis of thyroxine and adrenal steroid hormones (postpartum thyroiditis).
Magnesium
- Mg needed to convert ADP to ATP (essential for energy postpartum).
- Absorbed by foetus in pregnancy & lactation.
- ↓ levels can contribute to PPD.
