Infant Nutrition

Question 1

What is the age range of neonate and infant?

Answer 1

Neonatal- up to 28 days old

Infant (babies)- are up to 1-year old

Question 2

Explain vitamin K deficiency bleeding?

Answer 2

Vitamin K Deficiency Bleeding (VKDB) can occur during the first week to a small number of neonates (0.3 to 1.7 %) who do not receive vitamin K treatment. In most cases it is not lethal.

VKDB is more severe when it happens later in infants up to 6 months of age and then it may be lethal.

Babies can be perfectly healthy one day then suddenly become neurologically ill the next day. The cause of death is either cerebral or intestinal hemorrhage.

Question 3

What has been done to prevent VKDB?

Answer 3

The American Academy of Pediatrics has recommended vitamin K1 injections for newborns in order to prevent VKDB

1. Vitamin K is mostly injected (1 mg) but concerns are raised.
2. Vitamin K can also be given orally which is more complicated:

a. It has to be given in multiple doses (parents may forget).
b. Full dose might not be absorbed (baby spits it out).
c. Has to be given after food intake for better absorption

Question 4

What is vitamin K? Where is it found? What is it used for?

Answer 4

A lipid soluble vitamin that is needed for efficient blood clotting

From plants: phylloquinone K1

From bacteria: Memaquinone K2

Drug: Menadone K3

Question 5

Why are neonates vitamin K deficient?

Answer 5

1. Vitamin K2 is lacking in the newborns
sterile intestine (no bacteria).

2. Human milk is very low in vitamin K.
   Formulas are now vitamin K supplemented.
3. Vitamin K1 is mainly found in green vegetables which are not part of the neonatal diet.

Question 6

What dietary modifications are used for infants LDLR than 6 months?

Answer 6

Supplementation with mashed solid foods in addition to milk or formula

Question 7

What puréed food are rich in vitamins and minerals?

Answer 7

• Avocado:
– Rich in fatty acids and minerals.

• Banana:
– Electrolytes and calcium.

• Carrots, peas, green beans, broccoli: – b-carotene and minerals.

• Squashes, sweet potato:
– Easy to digest carbohydrates.

• Pears:

– Least acid fruit, Vit K and copper.

Question 8

What significance is the infant nutrition after 6 months of age?

Answer 8

Infant nutrition has to provide iron after 6 months of age

• During pregnancy the mother provides iron for an increased iron depot to the fetal liver which will supply the baby up to six months after birth.
• Dietary iron uptake is needed in the 6-month-old baby.
• Human milk is low in iron (0.35 mg/L) and infants need about 11 mg of iron per day which surely cannot be provided by milk alone.

Question 9

Which food for infants is rich in iron?

Answer 9

Spinach puree is often given to infants because it is
rich in iron but the bioavailability is low.

Inorganic iron has to be in the ferrous state for uptake into intestinal mucosal cells.

In addition, the phytates and polyphenols in spinach bind iron and reduce the non-heme iron uptake.

Meat puree is often given to infants because it contains heme-iron which is better absorbed.