Infant Nutrition Flashcards
Breastfeeding recommendations
Exclusive breastfeeding for first 6 months (26 weeks)
Introduce solid foods at 6 months
Breastfeeding should continue past 6 months along with solid foods
Breastfeeding in demand - as often as the child wants day and night
Don’t use bottles, teats, and pacifiers as it can confuse the baby when trying to latch onto breast
Nutritional value of breastmilk
Provides 750 kcal/L
Rich in essential fatty acids, especially long chain essential fatty acids like arachidonic acid
Also contains lipase enzyme to help fat absorption
Protein - whey:casein ratio is 60:40
Whey is easily digested and soluble
Lactoferrin also present
Carbohydrate - lactose is main carb, digested to galactose and glucose
Why is breastmilk the best form of nutrition
Adapts according to the infants age
First few days - colostrum, thick yellow milk rich in protein (antibodies), amount is low and flow is very slow to allow baby to learn how to coordinate sucking, breathing, and swallowing reflex . Contains lactoferrin which is an iron binding protein which inhibits growth of iron-dependent bacteria in GIT
Transitional milk - day 4-10, less protein, more fat and sugar, volume of milk increases
Mature milk - after day 10
Health benefits of breastmilk for the baby / advantages for the baby
Optimum neurological development
Stimulates proper growth of mouth and jaw, fewer malocclusions
Protection against RTI, otitis media, allergic rhinitis, gastroenteritis, and necrotising enterocolitis
Benefits which last into childhood - lower risk of childhood obesity and improved IQ
Easier for the baby to digest compared to formula
Reduced risk of chronic diseases like type 2 diabetes, cancer, obesity
Bonding with mother through skin to skin contact
Components of breastmilk which provide immune protection
White blood cells
Maternal antibodies
Viral fragments - stimulate infants immune system without causing infection
Oligosaccharides - complex sugars which serve as probiotics, promote growth of good bacteria in gut
Transfer factors eg bifidus -good bacteria, healthy gut microbiome
Lactoferrin - iron binding protein which inhibits growth of iron dependent bacteria in gut
Anti inflammatory molecules eg cytokines - regulate immune response
Benefits of breast milk for the mother
Reduced risk of ovarian, uterine, and breast cancer
Delayed return to fertility means better birth spacing (prolactin suppresses ovulation)
Enhanced opportunity for post party’s weight loss - uses up to 400 kcal/day
Releases oxytocin which causes uterus to return to normal size more quickly
Clear association between breastfeeding and reduced maternal depression
Release of oxytocin will help reduce stress and promote feeling of relaxation and wellbeing
Convenience and cost savings - available at right temp and no prep required, saves money on buying formula
Benefits of breastfeeding to the environment and economy
Saves costs on treating preventable diseases, less GP consultations
Production of formula produces lots of greenhouse gases
Main ingredient of formula is cows milk which involves dairy farming - produces methane
Land needed for cattle - deforestation
Feed cattle - pesticides and fertilisers
Manufacture of formula requires energy to produce, package, and distribute
Formula often comes in non recyclable packing
Barriers to breastfeeding
Cultural norms which discourage long term breastfeeding - lack of support, conflicting advice, lack of role models, lack of knowledge, lack of facilities to breastfeed in pubic
A widespread misconception that formula milk can release breast milk without any harm
A lack of postnatal care and trained support to help women get breastfeeding off to a good start - easily hospital discharge, lack of prenatal education, lack of support immediately after birth
Formula company marketing which normalises bottle feeding and undermines breast feeding
Difficulties with breast feeding
Not enough milk or too much milk
Breast engorgement
Mastitis
Thrush
Sore/cracked nipples
Management of too milk milk/too little milk
Low supply - increase skin to skin contact, feed on demand, do not top up feeds within formula, express after feeds to upregulate, avoid pacifiers until feeding is established
Oversupply - express prior to feeding until milk slows down, be vigilant for feeding cues, feed from one breast to reduce supply, lying on back when feeding, avoid pumping between feeds
Management of breast engorgement
Feed on demand
Simple analgesia
Massage breasts before and after feeds
Express milk to relieve full breasts
Heat pack/warm shower before feeding
Ice pack after feeding
Avoid restrictive clothing
Management of mastitis
Caused by blocked ducts - readjust positioning of baby while feeding
Start feed from affected breast as this is when they will suck the hardest - will be sore
Keep feeding or express milk
Warm flannel or cold cabbage may help
Management of thrust
Baby - white patches in mouth with red sore areas, can be fussy during feeds, if over 4 months can give miconazole gel, sterilise pacifiers
Mother - burning, itchy nipple, flaking or shiny skin on nipple or areola, stabbing pains
Miconazole cream for 2 weeks and continue after lesions have disappeared
Management of sore cracked nipples
Use a nipple cream regularly
May be a consequence of poor latch so this should be observed by specialist
Use nipple shields
Express milk and apply to nipple
Continue breastfeeding if possible
2 types of infant formula milk
Whey based - first milk
Whey:casein ratio 60:40 (similar to breast milk)
Casein based - second milk
Whey:casein ratio 20:80 (similar to cows milk)
