module 3: infancy Flashcards
What have the LEAP and LEAP-On studies taught us about allergy prevention in children?
- LEAP:
Regular consumption of peanuts starting in infancy resulted in an 81% lower rate of peanut allergy at age 5 when compared to the children who avoided consuming peanuts. - LEAP-On :
The effect of early introduction of peanuts (before 11 months) was not reversed by the removal of peanuts from age 5 to 6 years.
Describe an infant’s growth rate from birth to one year. How does this relate to the energy requirements of an infant?
At 1 year of age, an average infant has tripled birth weight.
Energy requirements from 1 to 6 months of age increase greatly with physical activity.
Why, evolutionarily speaking, is human breast milk different in composition than cow’s milk?
Human breast milk is adapted to the needs of an immature newborn. Humans will adapt their breastmilk to complement and offset the immaturity of the newborn by secreting bioactive components.
Cow milk lacks these factors because there was no evolutionary pressure on the cow to develop them.
What are the generally observed differences between formula fed and breastfed babies? Why?
Formula fed infants have more body fat (between 3-18 months) due to growth factors in breast milk, different endocrine responses to feeding, control of food intake, and nutrient composition of food (it is the same in formula but evolves continuously in breast milk)
Breastfed infants have more bifidobacteria (immune response) and lactobacillus
Formula fed infants have more bacteroides and clostridia
How are infant formulas modified, in terms of macronutrient composition, compared to breast milk? What are some other ways infant formulas are modified compared to breastmilk (aside from macronutrient composition)?
There is equal energy density in breast milk and formula (~ 670kcal/l, 20 kcal/oz)
Breast fed infants will consume less energy because not all CHO and proteins in breast milk are digestible, but they can also better regulate intake
Lactose is the main component: major energy source for brain – galactose + glucose, where galactose is used for CNS development in cerebrosides.
LPUFA: absent in cow milk since calf synthesizes them, essential and found in breast milk and improves vision and brain development (AA + DHA is added to formula as well)
There is also pasteurization which disrupts order and prolongs digestion. Differences in amino acids
Explain the protein intake hypothesis:
Breast-fed infants were found to have lower plasma insulin levels from 6 days of age
Protein intake at 1 year of age predicts overweight at age 5 years (excess protein causes increased circulation of insulin releasing amino acids which results in more insulin and IGF-1… increases adipogenesis and programs for higher weight, thus obesity)
Formula fed infants have way more protein (70% more) than breast-fed
What is Baby-led weaning? What is required for it to be possible?
Infant is given graspable foods during family meals so that they eat independently. Can be started after 6 months of age. Need to make foods and choose infants how much to eat.
- developmental milestones are required for BLW: motor skills, interest and physical stamina, oral motor function *
When should first foods be introduced? Which foods should be introduced first and in the first year?
4-6 months
– iron rich foods, variety of fruits, veggies, grains, and animal protein… lots of textures
How do we assess development in infants?
- Height
- Weight
- Head Circumference
How can we assess development in infants in terms of nutrition?
Exclusive breastfeeding for the first 6 months, feeding on demand, proper weight gain
How are stool patterns indicative of nutrition status?
Black: normal in newborns <1 week old, internal bleeding if older
White: liver issues
Brown/Orange: normal in formula fed babies
Yellow: normal in breastfed babies
Red: seek medical advice and usually due to blood in stool
Green: can be due to medication, diet, or allergies
What is the First 1000 days and why is it important?
Starting from conception to age 2.
Nutrition interventions in the first 1000 days can lead to the building of brains, health, and prosperity. Influenced by: healthy diet, supplements, term birth, vaginal delivery, breastfeeding, healthy complementary foods, biodiversity, high dietary fibers
What are the differences in terms of breastmilk and formula?
Energy intake
Equal energy density in breastmilk and formula
Breastfed infants typically consume less volume
Protein differences
Formula fed babies get more protein (more casein) than breastfed (more whey)
what supplements do breastfed babies need
vitamin D drops
Cow’s milk protein allergy
Exposed by: cow’s milk formula or being breastfed by a mother who drinks cow’s milk
Can cause skin changes, GI changes, irritability, poor growth
Management
Remove cow’s milk from diet
If mother is breastfeeding, dairy and soy elimination diet for 2-4 weeks
Not sure about probiotics
Formula alternatives
Extensively hydrolyzed cow’s milk formula
Elemental cow’s milk (amino acid based)
Soy-based
Partially hydrolyzed rice-based formula
NO GOAT FORMULA
