Community
Dr. Samar
Body Composition:
•
Fat increases throughout the infancy from 14% to 23% by first
year of age.
•
Free fat body mass (FFBM) decreases from 86% to 77% by first
year of age.
•
Decreasing in water.
•
The proteins, minerals & CHO are constant.
•
Organ function: brain, heart, liver & kidney.
•
Muscle mass.
•
Fat mass: energy reserves if dietary inadequate.
•
Extracellular fluid.
•
Supporting structure: connective tissue & bone (calcium,
phosphate and others).
•
Body proteins: major organ and muscle mass.
Growth:
o
Growth is increasing in the weight, length and head
circumference.
o
1 month of the infant:
1)Grows (1) cm/week.
2)Gains (20 – 30) g/day.
o
12 months of the age:
1)Grows (0.5) cm/week.
2)Gains (10) g/day.
o
New born weight: (3.5) kg.
o
4 months of age: x 2.
o
12 months: x 3.
Growth: during early postnatal:
➢Hyperplasia: increasing in the cell divisions.
➢Hypertrophy: increasing in the size of the cells.
➢All organs grow and mature at rapid rate.
➢Brain doubles in size by first year of the age.
➢Energy or nutrition deficiencies may limit cell growth.
Organ Maturation:
GIT: nutrient intake processing absorption??
▪ Mature sucking and swallowing.
▪ Risks of reflux reduce gastric volume, delayed
gastric empty, maturity of enzymes and hormones.
Kidney water and electrolyte excretion:
▪ Full number of nephrons but low GFR in the first 48
hours.
▪ High excretion of sodium.
Plan For Introducing Of Solid Foods:
❖
(1 – 4) months: breast milk or formula.
❖
(4 – 6) months: iron fortified cereal.
❖
(6 – 7) months: fruits.
❖
(7 – 8) months: vegetables.
❖
(8 – 9) months: finger food (banana).
❖
(9): meat citrus food.
❖
(10): Bite – size cooked food.
❖
(12): All of food.
Disadvantages of introducing solid foods before (4 – 6)
months:
•
Poor oral motor coordination till (4 – 6) months.
•
Insufficient nutrients replacement to breast milk.
•
Increased risks of food allergies.
•
Increased renal solute load and hyperosmolarity.
•
Increased infant desiring to sugar.
Guide lines for introducing solid foods:
1)Begin single ingredient food.
2)Begin with (1 – 3) tsf and increases gradually.
3)Adding new foods every (3 – 5) days.
4)Offer wide variety of foods.
5)Avoid mixing solid foods with the fluids.
6)Never put baby in the bed with bottle in his mouth or sucking
flood.
7)Iron fortified baby cereals.
8)Rice cereals because it has fewer allergies.
9)Avoid eggs and meats till (6 – 9) months.
Finger Foods For Infant (6 – 12) months:
➢Increasing interest in self-feeding and ability to grasp food.
➢Bread.
➢Fruits without seeds.
➢Meat, fish or chicken without bone.
➢Vegetables cooked.
Carbohydrates:
▪ (35 – 65)% of total energy intake.
▪ Inform of disaccharides or glucose polymer.
▪ Brain uses glucose.
▪ Inadequate CHO leading to ……..
▪ Lactose in most formula like breast milk.
▪ Lactose free formula useful in the primary and secondary
lactose intolerance.
Fats:
(30 – 55)% of the energy.
Carry fat soluble vitamins.
Provide essential fatty acids.
Proteins:
o
(7 – 16)% of the energy.
o
Provide nitrogen and the amino acids.
Vitamins:
❖
Preterm infants: Vitamins D, E, folate & iron.
❖
Term infants: Vitamin D.
❖
Infants > 6 months: vitamin D, iron & fluoride.
Iron:
•
Iron deficiency is the most common causes of anemia in the
infants.
•
There is no need for exogenous iron between birth and 4
th
month.
•
Infant diet: no meat so it is non haem-iron.
•
Ascorbic acid enhances the absorption of the iron.
•
Bran, tannets in tea.
Printed By: Ahmed Riyadh