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NUFS 356 > L8 Infant Formula and Introducing Solid Foods > Flashcards

L8 Infant Formula and Introducing Solid Foods Flashcards

1
Q

Why not other milk?

A

infant formulas modified to resemble breastmilk composition as much as possible

  • infant formula contents and formulation regulated (Food and Drug Regulations)
  • unmodified cow milk (and other milks) poorly suited to infant’s needs
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2
Q

What are the only proper substitutes for breast milk?

A

iron fortified formula until 9-12 months and pasteurized breast milk from donors that have been screened and tested.

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3
Q

What are some comparisons to cows milk?

A

In general the nutrient composition is different.
higher protein in cows = potential for kidney dysfunction
cows milk is less bioavailable = possible iron deficiency

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4
Q

infant formulas are categorized by protein source. What are they?

A

Cow milk
Soy
Non-intact (hydrolyzed or elemental)

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5
Q

What is the nutrient content in formula?

A 
almost identical to breastmilk
energy: 0.67 kcal/g
protein: 9-13%
fat: 45-50%
CHO: 39-45%
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6
Q

How is cow’s milk formula available?

A

Mostly powder, concentrate and ready to feed

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7
Q

What are the protein, CHO and lipid sources for cow’s milk?

A

protein: when and casein, some 100% whey
CHO: lactose
lipid: veg oils like coconut, palm, soybean, sunflower, safflower)

some additional AA and DHA, nucleotide, and probiotics

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8
Q

What are the sources of protein, CHO, and lipids for soy based formulas?

A

protein: soy protein with methionine
CHO: corn, sucrose in some
Lipids: veg oils (coconut, palm, sunflower, soybean, safflower)

Additional AA, DHA, nucleotide, probiotics

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9
Q

When is a soy based formula a good choice?

A

vegans, galactocemia, congenital lactase deficiency

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10
Q

Why is soy formula not recommended when there is an allergy to cows milk?

A

15-40% are allergic to both

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11
Q

Why islactose free cows milk formula not recommended for children with galactosemia or congenital lactase deficiency?

A

There can be some residual galactose. Uses glucose instead but no known benefit.

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12
Q

Why use elemental formula?

A

Only under medical supervision.

An allergy to cow milk protein or malabsoprtion of proteins, CHO, or lipids

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13
Q

What are the sources for protein, CHO, and lipids for elemental formula?

A

protein: peptides, amino acids
CHO: corn, sucrose, monosaccharides
Lipid: veg oils (coconut, palm, sunflower, soybean, safflower) and some with medium chain fats

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14
Q

What are some issues with elemental?

A

May inhibit digestive capacity. May not be able to transition to solid foods at 6 months

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15
Q

What are 3 other formulas?

A

Thickened rice starch formulas (swallowing issues)
Follow up formulas (just marketable)
Preterm formulas (higher energy density)

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16
Q

When to transition to solid foods?

A

6 months with breastfeeding or formula. (less risk of allergies)

17
Q

Why is timing important in the transition to solid foods?

A
  • to facilitate developmental skills
  • ensure nutritional requirements
  • minimize risk to allergies
18
Q

Why would you not transition to solid foods before 6 months?

A
  • risk of decreased growth due to decreased breastmilk bc less hungry)
  • risk of nutrient deficiencies (iron = less absorption with other foods)
  • associated with increased risk of allergy, obesity, and chronic disease
19
Q

Why not transition to solid foods later than 6 months?

A
  • risk of developmental feeding problems
  • nutrient deficiencies (fetal hemoglobin was recycles and stores start to decrease about 6 months but iron is still needed for growth)
20
Q

How much energy should be from breastfeeding at 6-11 months?

12-24 months?

A

= 50%

= 1/3

21
Q

What are some examples of first foods?

A

single grain iron fortified cereals (rice, barley, oatmeal), and meat and meat alternatives

22
Q

How does the solid texture progress with age?

A

6 months - semi solids (purees, mashed)
6-8 months - soft solids (finger foods, dissolvable solids)
9-12 months - harder textures (cheerios, crackers)
6 -10 months - mashed-soft-hard)

23
Q

How often do you introduce a new food?

A

every 1 -2 days for allergies

24
Q

When do you introduce dairy and alt.?

A

9-12 months

25
Q

Why dont foods marketed to children under 2 years disclose type of fat content?

A

dont want to discourage/limit fat intake

26
Q

What are 3 food goals at 1 year?

A
  • drinking from a cup rather than bottle
  • eating same food as family at meals
  • self feeding
27
Q

What are some food safety concerns?

A

choking hazards like raisins, popcorn, peanuts, grapes. delay intro until 4-5 years and always sit to eat.
no honey for 1 year = botulism

28
Q

What are the energy recommendations and how do they vary?

A

birth to 6 months: 100kcal/kg
7-12 months: 80kcal/kg
varies on growth rate, sleep/wake cycle, physical activity, temp, climate, health status, recovery from illness

29
Q

What are the CHO recommendations for infants?

A

mostly lactose to facilitate calcium absorption.

increases variety and consumption of more complex CHO with age

30
Q

What are the protein recommendations for infants?

A

higher protein per kg than in adults
AI 0-6 months: 1.5g/kg/d
RDA 7-12 months: 1.2g/kg/d
Premature infants: 4g/kg/d

31
Q

What are the fat recommendations for infants?

A

about 50%
not restrictions under 2 years
e.f.a.’s and cholesterol are important for brain development.
LCPUFA’s are important for the CNS from 3rd trimester to 18 months (1.5 year critical period)

32
Q

What are the recommendations for meeting the micro nutrient needs of an infant?

A

breast milk with n-dense foods at 6 months

  • 400IU vitamin D brith - 12 months for full or partial breast fed
  • iron rich first foods
33
Q

What did 3 meta studies determine about obesity and breastfeeding?

A

breastfeeding decreased risk of childhood obesity (even in comparison to formula) and decreases risk with longer duration

34
Q

What are some thoughts on why breastfeeding decreases obesity/

A

Neonatal Growth Hypothesis: b.f. babies grow slower, insulin and IGF-1 are lower in b.f babies

Response to hunger and satiety cues which carry on into late life

Neuroendocrine programming during critial period of growth

NUFS 356 (24 decks)

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