Nutritional Programs for Infancy


  • Daily Nutrient Program – Infant and Toddlers





    We might as well begin with the beginning of life. The time preceding birth, when the baby is still inside its mother, is an important period of growth and development, and at that time as well as after birth, the baby’s health is very dependent on the mother’s nourishment. Even the several months before a woman becomes pregnant are important. She must eat good amounts of wholesome foods to have enough energy and nutrients for her child and herself, both before and after birth.


    Nutrition is the key to growth and development. Baby’s first food is mother’s milk, which is uniquely formulated to meet his or her growth needs, provided mother eats an adequate diet. Initially, breast milk colostrum has the fluid and nutrient levels, such as zinc, that correlate with the baby’s needs. As initial milk comes in, it is higher in fat and fatty acids, important to early developmental needs of the brain and the immune and nervous systems. Later, its fat content decreases and the protein and carbohydrate levels increase to meet the nutritional needs for general growth and development. With a good diet, mother’s milk exclusively can support the baby for six months or more. Besides eating well, the mother should also avoid pharmaceutical drugs when possible and chemicals such as nicotine, alcohol, and caffeine. Occupational and even home chemical use should be avoided as well. Pesticides, such as DDT and more recently used chemicals, may contaminate food and get into breast milk, so whenever possible, organic or homegrown produce is ideal.


    There are many reasons why breastfeeding is the best thing for both mother and baby. Initially, breastfeeding stimulates uterine contractions, reducing bleeding and bringing the uterus back to its normal size. It provides the intimate bonding of the mother and baby, so connected for the previous nine months, and it is convenient because mother always has baby’s food with her; it is also less expensive, but above all breastfeeding is the healthiest choice for the child. Also, the output of calories to baby helps the mother to bring her weight back toward its pre-pregnancy level.


    For baby, breast milk provides the right nourishment. It has more available iron, vitamins A and C, niacin, potassium, and the right amino acids for growth than any natural or formulated substitute. It not only has nutritional advantages but immunological ones as well, as the mother can pass her protective antibodies to her child. Recent studies show that breastfed babies are healthier than bottle-fed babies—they have fewer allergies, they are leaner, and they have lower cholesterol levels—and this remains true in later years as well.


    More than 95 percent of mothers can breastfeed if they wish. Many of those who have trouble can find help and reassurance from a breastfeeding support group such as La Leche League or from a midwife friend, or a neighbor who has breastfed. Relaxation and increased fluid intake will also facilitate breastfeeding. Luckily, the number of mothers who breastfeed has been increasing over the last couple of decades, even among career-oriented women.


    There are really not many good substitutes for mother’s milk. It has been shown that 100 percent whey formula is probably the best choice. Goat’s milk, slightly diluted, can also be used if the whey formula is not tolerated. A little soy milk can also be used after three or four months. Cow’s milk is best avoided; it has a different amino acid balance than other substitutes, has more fats, and is more allergenic. The whey formula is very low allergenically, even less than goat’s milk and soy milk. Formulas may be used in an emergency, but I generally do not recommend them because of their unnatural and synthetic makeup.


    A common problem during the first six months is infant colic. It is more common in first children but may occur in any. Some psychological stresses may influence colic, but it may also be affected by the mother’s diet. Cow’s milk consumed by the mother may be a factor; excessive sugar or salt intake may also worsen colic. Often a decrease in the mother’s milk product consumption will reduce the colic symptoms. Some extra B vitamins, calcium, magnesium, and potassium taken by the mother may help reduce colic in the baby as well as reduce mother’s intestinal gas. Also, mother must constantly remember to eat well so that she does not become depleted during nursing.


    Babies need more calories and protein per pound than any other age group. Goat’s milk, and even cow’s milk, with their protein, fat, and calorie content, are potentially valuable foods in moderation (if tolerated well) for rapidly growing babies (after eight to ten months) and children. The “dairy” problem comes in when adults continue to use milk and its products as a regular part of their diet. Lifelong use of milk is one of the biggest misconceptions and mistakes in nutrition. Consumption of dairy products should be greatly curtailed by the adult population, and by those children and teenagers sensitive to milk. If infants and children develop any recurrent congestive problems, such as excessive nasal mucus or ear infections, it is suggested they go off all cow’s milk products for a time (several weeks) to see if their problems improve.


    When and what to feed infants is a rather controversial issue as well. Some parents try to feed solid foods to their little babies at four months or sooner. This is a big mistake. Infants will do fine on milk alone. The trend is returning to later rather than earlier feeding. Premature feeding can lead to poor digestion, increased allergy, and obesity. There may appear to be increased growth, but it could be just increased fat. Skin-fold measurements are used now along with growth and development charts to show whether this is the case. Increased fat at this time can lead to increased numbers of fat cells, which will increase the likelihood of adult obesity. Premature feeding may also influence later eating habits. Five to six months is the earliest and six months probably the best time to begin feeding that little being any solid foods. Waiting until six months of age gives baby time to develop his or her digestive tract and immunological system to reduce the likelihood of allergy.


    Initial foods should be simple, natural, and pureed to assist digestion. The true flavors of food are best; avoid the use of sweetened or salted foods, especially refined sugar and refined flour foods. First foods may be pureed or cooked fruits, cooked and pureed vegetables, and cooked cereal grains (formulated for baby). These foods along with mother’s milk will provide the proper nourishment for this time of rapid growth. Egg yolks can also be added to the diet, but avoid egg whites as yet, as the albumin protein is more allergenic.


    At seven to eight months, a few teeth may start to appear. Toast can be used for teething. Some meats can be added now; these should be baked or broiled and then finely chopped or pureed. Potatoes, baked or boiled and mashed, along with other vegetables, may also round out the menu.


    From eight months to one year, babies may do some serious eating. They may be more independent, adventurous, and enthusiastic with food. They will try more new foods, and the diet can become more well-rounded. Whole eggs may be used as a good source of protein now. Milk consumption may be reduced, but it is still a regular source of nourishment. Infants may wean at this time, though many mother-baby teams will continue nursing for another year or more, especially with the aid of a breast pump for working mothers. Foods and meals should be simple. Make as much of your own foods as possible; jars and cans of foods should not be used exclusively.


    After one year, the infant’s diet may shift. Food needs for growth are less now as the rate of growth slows down. Many parents become concerned because it appears that the child isn’t eating, but this is usually fine. Eating habits may change, food likes and dislikes develop. Try not to make eating a battle, and avoid games and rewards. Let the child eat; he or she will communicate his or her needs. Just offer nourishing foods and avoid sweet treats. Balance the diet over days, not at each meal, so that meals can be simple. Most healthy children eat only what their bodies need.


    In regard to supplements to the diet in the first two years, most parents are more comfortable with a moderate insurance formula that at least covers the child’s Recommended Daily Allowances (RDAs). Some parents and pediatricians feel that for healthy babies on breast milk and infants eating a good diet, additional supplements are not really needed.


    When a vitamin formula is used, it is often a liquid supplement in the first year, and after that a flavorful chewable. For toddlers, the multiple should contain all of the B vitamins, vitamins C, E, and A. Basic minerals such as calcium and iron, as well as zinc, magnesium, manganese, and even a little chromium and selenium can also be included. I suggest more natural, chemical-free supplements, without sugar and artificial food colorings and flavors. The bigger companies with inexpensive vitamins may not believe that synthetic, treated chemical formulas are of concern, but many doctors and parents nowadays would certainly rather avoid those products.


    The following chart shows the levels of vitamins and minerals suggested for this age group at the beginning of life. Some values are slightly higher than the RDAs to provide that extra margin of safety, particularly to cover those infants who may need more of some nutrients than others or for those who might be sick and need higher amounts of certain vitamins or minerals. Later sections suggest what nutrients might be needed in higher amounts in specific health situations; do not, however, use the levels suggested for adults. Talk to your doctor or refer to specific literature to find appropriate dosages for specific age groups.


    Infants have been overdosed on some vitamins because of parents’ misunderstanding of authors’ suggestions. Vitamin A toxicity is probably most common. Do not overuse vitamin A or D or cod liver oil, which is high in both, or the minerals calcium, phosphorus, or iron. Breastfed babies can get a bit deficient in vitamin D unless they get a little sunlight exposure. Babies need a balanced diet and lifestyle, too.


    Breast milk is usually low in fluoride, and though fluoride use is still debatable, it appears relatively safe to supplement, and thus many parents and doctors use fluoridated vitamins to protect against tooth decay. However, if mother drinks fluoridated water, it is now recommended NOT to give fluoridated vitamins to breastfed babies since it comes through the milk. Also, no fluoride supplements should be used at any age if the water is fluoridated.




    Daily Nutrients – Infants and Toddlers




































































































    Birth–6 Months 6 Months–1 Year 1–2 Years
    Calories115/kg. 105–110/kg.1,200–1,400
    Protein (grams)2.2 g./kg. 2.0 g./kg.22–25 g.
    Vitamin A2,000 IUs 2,000 IUs2,500 IUs
    Vitamin D400 IUs 400 IUs400 IUs
    Vitamin E5 IUs 6 IUs8 IUs
    Vitamin K15 mcg. 25 mcg.30 mcg.
    Thiamine (B1)0.4 mg. 0.6 mg.0.8 mg.
    Riboflavin (B2)0.5 mg. 0.7 mg.0.9 mg.
    Niacine(B3)6 mg. 8 mg.10 mg.
    Pantothenic acid (B5)3 mg. 3 mg.4 mg.
    Pyridoxine (B6)0.4 mg. 0.6 mg.1.0 mg.
    Cobalamin (B12)1.0 mcg. 2.0 mcg.2.5 mcg.
    Folic acid40 mcg. 60 mcg.100 mcg.
    Biotin50 mcg. 50 mcg.50 mcg.
    Vitamin C40 mg. 60 mg.100 mg.
    Calcium400 mg. 600 mg.800 mg.
    Chloride0.6 g. 1.0 g.1.2 g.
    Chromium50 mcg. 60 mcg.80 mcg.
    Copper 0.7 mg. 1.0 mg.1.5 mg.
    Fluoride0.3 mg. 0.6 mg.1.0 mg.
    Iodine50 mcg. 60 mcg.80 mcg.
    Iron10 mg. 15 mg.15 mg.
    Magnesium70 mg. 90 mg.150 mg.
    Manganese0.7 mg. 1.0 mg.1.5 mg.
    Molybdenum60 mcg. 80 mcg.100 mcg.
    Phosphorus300 mg. 500 mg.800 mg.
    Potassium0.7 mg. 1.0 mg.1.5 mg.
    Selenium40 mcg. 60 mcg.80 mcg.
    Sodium0.3 g. 0.6 g.0.9 g.
    Zinc4 mg. 6 mg.10 mg.

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    Elson M. Haas MD Written by Elson M. Haas MD

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