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FEEDING OF INFANTS AND CHILDREN Myrna D.C. San Pedro MD, FPPS
SPECIFIC OBJECTIVES ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
SPECIFIC OBJECTIVES ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
RELATION OF  MATERNAL & FETAL NUTRITION ,[object Object],[object Object],[object Object],[object Object]
AT BIRTH & NEONATAL PERIOD ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
GENERAL GUIDELINES ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
REASONS FOR AN INFANT’S CRY OTHER THAN HUNGER ,[object Object],[object Object],[object Object],[object Object],[object Object]
BREAST-FEEDING ,[object Object],[object Object],[object Object]
BREAST STRUCTURE ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
WHAT HAS CHANGED? ,[object Object]
PHYSIOLOGY OF LACTATION ,[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],About 600 ml in 1 st  mo to 800 ml in the 6 th  mo after which falls to 25-400 ml on the 2 nd  yr By end of 1 st  month of lactation  MATURE ,[object Object],[object Object],[object Object],Increases to <600 ml From 4 th -10 th  day to 1 st  month  TRANSITIONAL ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],10-40 ml/day 1 st  2-4 days  COLOSTRUM CHARACTERISTICS QUANTITY TIMING TYPE
FACTORS INFLUENCING COMPOSITION ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
DETERMINING ADEQUACY ,[object Object],[object Object],[object Object],[object Object]
ADVANTAGES OF BREAST-FEEDING ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
ANTI-INFECTIVE PROPERTIES ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
CONTRAINDICATIONS ,[object Object],[object Object],[object Object],[object Object],[object Object]
REASONS FOR NOT OR  STOPPING BREAST-FEEDING ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
ANTENATAL TECHNIQUES ,[object Object],[object Object],[object Object],[object Object],[object Object]
POSTNATAL PROCEDURES ,[object Object],[object Object],[object Object],[object Object],[object Object]
Less digestible Softer, smaller  ,[object Object],High ratio of methionine to cystine, higher levels phenylalanine & tyrosine Low ratio of methionine to cystine, lower levels phenylalanine & tyrosine ,[object Object],Mostly   -lactoglobulin, some   -lactalbumin & traces of lactoferrin  -lactalbumin (40%) lactoferrin (25%) lysozyme (0.08%), albumin (0.08%), IgA, IgG, IgM (0.15%) ,[object Object],20:80 60:40  ,[object Object],3.3%  1-1.5%  Proteins Both have water content of 87-87.5%  w/ sp. gr. 1.026-1.036 average being 1.031  Water content & Specific gravity Both have pH 6.8-7.4 w/ average of 7  pH COW’S MILK BREAST MILK CONTENT
4.8%  7%  Carbohydrates  mainly lactose  Steatorrhea may occur  Contains bile-salt stimulated lipase plus specific fatty acids, hence, more efficient  ,[object Object],4-5% of fat calories, hence, better source of this   ,[object Object],9%   1.3%  ,[object Object],Twice as much of the more absorbable olein ,[object Object],3.5% but varies w/ maternal diet   Fats  COW’S MILK BREAST MILK CONTENT
Lesser More vitamin C   ,[object Object],More thiamine & riboflavin   More niacin  ,[object Object],Both contains large amounts of vitamin A, minimal vitamin D   & should be given vitamin K to prevent hemorrhagic disease of the newborn   ,[object Object],Vitamins   Lower & lesser absorbed Although low, sufficient because better absorbed   ,[object Object],Neonatal hypocalcemia may occur 2:1  ,[object Object],Hypertonicity & acidosis common   Hypotonic dehydration  ,[object Object],Need for extra water  Ensures free water   ,[object Object],0.7-0.75%   0.15-0.25%   Mineral content   COW’S MILK BREAST MILK CONTENT
WET NURSING ,[object Object],[object Object],[object Object],[object Object]
ARTIFICIAL FEEDING ,[object Object],[object Object],[object Object],[object Object]
MILK FORMULAS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
MILK FORMULAS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
MILK FORMULAS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
MILK FORMULAS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
MILK FORMULAS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
MILK FORMULAS ,[object Object],[object Object],[object Object],[object Object],[object Object]
MILK FORMULAS ,[object Object],[object Object],[object Object],[object Object],[object Object]
NOT RECOMMENDED FOR INFANTS   ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
SUPPLEMENTARY AND COMPLEMENTARY FEEDINGS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
WEANING ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
DEVELOPMENTAL READINESS  FOR WEANING ,[object Object],[object Object],[object Object],[object Object]
WEANING FOODS ,[object Object],[object Object],[object Object],[object Object],[object Object]
WEANING FOODS ,[object Object],[object Object],[object Object],[object Object],[object Object]
WHAT IS A “HEALTHY” DIET? ,[object Object],[object Object],[object Object],[object Object]
WHAT IS A “HEALTHY” DIET? ,[object Object],[object Object],[object Object],[object Object]
 
Very Active Moderately Active (30–60 min of vigorous activity/day)   Inactive (<30 min of vigorous activity/day)  Needed by a  6-yr-old Boy 5 5 4 Meat, beans (oz/day) 3 3 2 Milk (cups/day) 1.5 1.5 1.5 Fruits (cups/day) 2.5 2 1.5 Vegetables (cups/day) 6 5 5 Grains (oz/day) 1,800 1,600 1,400 Energy (kcal/day) Daily Intakes of Each Food Group
WHAT IS A “HEALTHY” DIET? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
a  Based on EER from IOM DRIs macronutrients report, 2002, calculated by gender, age and activity level for reference-sized individuals. &quot;Reference size,&quot; is based on median height and weight for ages up to 18 yr and median height and weight for that height to give a BMI of 21.5 for adult females and 22.5 for adult males. b  Sedentary means a lifestyle that includes only light physical activity associated with typical day-to-day life. c  Moderately active means a lifestyle that includes physical activity equivalent to walking about 1.5-3 miles/ day at 3-4 miles/hour, in addition to the light physical activity associated with typical day-to-day life d  Active means a lifestyle that includes physical activity equivalent to walking >3 miles/day at 3-4 miles/hour, in addition to the light physical activity associated with typical day-to-day life. Estimated Amounts of Calories a 1,600-2,000 2,000-2,600 2,800-3,200 3,000 2,800-3,000 2,400-2,800 1,400-1,600 1,800-2,200 2,400-2,800 2,600-2,800 2,400-2,600 2,200-2,400 1,400 1,800 2,200 2,400 2,200 2,000 4-8 9-13 14-18 19-30 31-50 51+ 1,400-1,800 1,800-2,200 2,400 2,400 2,200 2,000-2,200 1,400-1,600 1,600-2,000 2,000 2,000-2,200 2,000 1,800 1,200 1,600 1,800 2,000 1,800 1,600 4-8 9-13 14-18 19-30 31-50 51+ Male Female 1,000-1,400 1,000-1,400 1,000 2-3 Child Active d Moderately Active c Sedentary b Age (years) Gender
As point of reference: 3 ounces lean beef (the size of a deck of cards) or poultry = 25 g protein; 3 ounces fish or 1 cup soybeans = 20 g protein; 1 cup milk or yogurt = 8 g protein; 1 egg or 1 ounce cheese=6 g protein; 1 cup legumes=15 g protein; cereals, grains, nuts and vegetables = 2 g protein per serving 0.85 (or 46 g/day of protein) 0.80 (or 46 g/day of protein) 14-18 yr (RDA) 19-30 yr (RDA) Females 0.85 (or 52 g/day of protein) 0.80 (or 56 g/day of protein) 14-18 yr (RDA) 19-30 yr (RDA) 1.2 16-19 yr Males 1.5 7-15 yr 0.95 (or 34 g/day of protein) 9-13 yr (RDA) 2 3-6 yr 0.95 (or 19 g/day of protein) 4-8 yr (RDA) 2.5 1-2 yr 1.05 (or 13 g/day of protein) 1-3 yr (RDA) 3 6-11 mo 1.2 (or 11 g/day of protein) 7-12 mo (RDA) 3.5 0-5 mo  1.52 0-6 mo (AI) 1978 FNRI Publications, Daily Requirements of Filipinos  (g/kg BW/day) 2005 Dietary Reference Intakes, U. S. Food and Nutrition Board, National Academy of Sciences  (g/kg BW/day) Daily Protein Requirement
 
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Feeding Of Infants And Children

  • 1. FEEDING OF INFANTS AND CHILDREN Myrna D.C. San Pedro MD, FPPS
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  • 42. Very Active Moderately Active (30–60 min of vigorous activity/day) Inactive (<30 min of vigorous activity/day) Needed by a 6-yr-old Boy 5 5 4 Meat, beans (oz/day) 3 3 2 Milk (cups/day) 1.5 1.5 1.5 Fruits (cups/day) 2.5 2 1.5 Vegetables (cups/day) 6 5 5 Grains (oz/day) 1,800 1,600 1,400 Energy (kcal/day) Daily Intakes of Each Food Group
  • 43.
  • 44. a Based on EER from IOM DRIs macronutrients report, 2002, calculated by gender, age and activity level for reference-sized individuals. &quot;Reference size,&quot; is based on median height and weight for ages up to 18 yr and median height and weight for that height to give a BMI of 21.5 for adult females and 22.5 for adult males. b Sedentary means a lifestyle that includes only light physical activity associated with typical day-to-day life. c Moderately active means a lifestyle that includes physical activity equivalent to walking about 1.5-3 miles/ day at 3-4 miles/hour, in addition to the light physical activity associated with typical day-to-day life d Active means a lifestyle that includes physical activity equivalent to walking >3 miles/day at 3-4 miles/hour, in addition to the light physical activity associated with typical day-to-day life. Estimated Amounts of Calories a 1,600-2,000 2,000-2,600 2,800-3,200 3,000 2,800-3,000 2,400-2,800 1,400-1,600 1,800-2,200 2,400-2,800 2,600-2,800 2,400-2,600 2,200-2,400 1,400 1,800 2,200 2,400 2,200 2,000 4-8 9-13 14-18 19-30 31-50 51+ 1,400-1,800 1,800-2,200 2,400 2,400 2,200 2,000-2,200 1,400-1,600 1,600-2,000 2,000 2,000-2,200 2,000 1,800 1,200 1,600 1,800 2,000 1,800 1,600 4-8 9-13 14-18 19-30 31-50 51+ Male Female 1,000-1,400 1,000-1,400 1,000 2-3 Child Active d Moderately Active c Sedentary b Age (years) Gender
  • 45. As point of reference: 3 ounces lean beef (the size of a deck of cards) or poultry = 25 g protein; 3 ounces fish or 1 cup soybeans = 20 g protein; 1 cup milk or yogurt = 8 g protein; 1 egg or 1 ounce cheese=6 g protein; 1 cup legumes=15 g protein; cereals, grains, nuts and vegetables = 2 g protein per serving 0.85 (or 46 g/day of protein) 0.80 (or 46 g/day of protein) 14-18 yr (RDA) 19-30 yr (RDA) Females 0.85 (or 52 g/day of protein) 0.80 (or 56 g/day of protein) 14-18 yr (RDA) 19-30 yr (RDA) 1.2 16-19 yr Males 1.5 7-15 yr 0.95 (or 34 g/day of protein) 9-13 yr (RDA) 2 3-6 yr 0.95 (or 19 g/day of protein) 4-8 yr (RDA) 2.5 1-2 yr 1.05 (or 13 g/day of protein) 1-3 yr (RDA) 3 6-11 mo 1.2 (or 11 g/day of protein) 7-12 mo (RDA) 3.5 0-5 mo 1.52 0-6 mo (AI) 1978 FNRI Publications, Daily Requirements of Filipinos (g/kg BW/day) 2005 Dietary Reference Intakes, U. S. Food and Nutrition Board, National Academy of Sciences (g/kg BW/day) Daily Protein Requirement
  • 46.  
  • 47. The positive thinker sees the invisible, feels the intangible, and achieves the impossible. Thank You!