Principles for Feeding Infants

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Principles for Feeding Infants

Infancy is a period of rapid growth. Plenty of energy and nutrients are needed for the new tissue development. When it comes to feeding infants, parents universally agree that breast milk is the best. Not only is breast milk superior nutritionally, it also contains all the immunological properties that formulas can never contain. Breastfeeding ideally should continue for at least 12 months and thereafter for as long as mutually desired. But for some reason if breastfeeding is not possible for medical, psychological or practical reasons, it is of paramount importance to ensure sufficient nourishment for your baby by responding appropriately to the nutritional guidelines and also understanding the trick of translating nutritional advice into infant foods on the table. An appropriate diet for infants under the age of one should provide all the essential energy and nutrients needed for normal growth and development, whilst including a variety of foods and tastes.

During the early months, concern about the well being of the child is acute, so the anxiety (specially for first time parents) reigns supreme. Confusion over what is suitable for children has been fuelled by a heightened awareness of the need for a healthy diet.

Following guidelines can be applied while choosing infant foods -

Pediatricians recommend using prepared infant formulae containing iron and vitamins for the first year. Infant formulae are considered as nutritionally complete meals for babies until about six months of age so it is recommended to wait till then to start solid foods. If pureed foods are started earlier, a baby is likely to spit it out, as they are not neurologically ready to accept solids by then.

0-6 months - Infant formula or cow's milk or goat's milk.
6 months onwards - Dal water, diluted rice water, mashed banana, fruit juice etc.

Home cooked foods can provide variety of tastes and textures when started. Milk products, yoghurt and custard can be introduced. Gluten containing cereals should be delayed till the infant is six months of age. Single grain cereal is often the first one added. New foods should be added one at a time to allow them to get used to the flavour of the food and also get him to agree with it. The most important thing to remember when starting solid foods is to use your common sense.

A few children may have food intolerances like milk intolerance. Alternative products like soy based infant formula can be used for them.

Avoid These - Some foods like nuts are unsuitable for children as they might lead to choking. Also it would be wise not to include honey as it contains microorganisms to which small infants are particularly sensitive.

Do Not Compare - Infant appetites vary. No two babies would require to be fed the same amount of food. Their feeding pattern would vary considerably so comparing your child's intake with another will not give you any accurate indications. As long as your child's growth is as per the schedule and he is not cranky, there is no reason for you to worry about his intake even if small amounts are being eaten.

Reference body weights and heights of infants according to National council of health statistics (NCHS) are as below-

AGE	BOYS		GIRLS
(yrs)	HEIGHT	WEIGHT	HEIGHT	WEIGHT
	(cm)	(kg.)	(cm)	(kg.)
0	50.5	3.3	49.9	3.2
3months	61.1	6	60.2	5.4
6months	67.8	7.8	66.6	7.2
9months	72.3	9.2	71.1	8.6
1	76.1	10.2	75.0	9.5

Source - ICMR

Focus should be on food quality. Emphasis should be on preparing infant foods with adequate calories, fat and other nutrients. Because their digestive and excretory systems are immature, easily accessible energy sources like fat and sugars are important. Fat is necessary for proper cognitive and behavioural development and babies need up to 50% of energy from fat because of their large energy requirements and small stomach capacity. Sugars are also an easily digestible source of calories so do not unnecessarily curb on these.

Following are the Energy and Protein requirement of infants -

AGE KCAL/KG G/KG

0-3months 116 2.3

3-6months 99 1.85

6-9months 95 1.65

9-12months 101 1.5

Avg. during 1st year 103 kcal/kg.

Source - ICMR

Give a highly varied diet to ensure enough fibre in the diet. A diet excessively high in fibre may be too low in calories and may also interfere with the absorption of minerals. Fruits and vegetables can be introduced gradually in the first year of life provided they do not replace energy dense foods but compliment them.

Infants are born with enough stored iron for four to six months. After that iron is more likely than any nutrient to be lacking in the infant's diet. The early use of cows milk (Cow's milk should not be used as a main drink before the age of one year because it has low iron content), early weaning and weaning onto a diet low in iron have all been implicated as causes of iron deficiency in children. Foods that contain easily absorbed sources of iron and zinc (meat and poultry and manufactured infant cereals) should be provided to rule out potential deficiencies.

During the latter half of infancy adequate vitamin D and calcium are also important for attainment of an optimal bone mass. Good sources are butter, margarine, adequate exposure to sunlight and oily fish. In case of doubt about vitamin D status supplements can be started from one month of age. Other vitamin supplements can be delayed till one year for bottle fed infants consuming at least 500ml of infant milk per day.

Moderate salt intake by choosing low salt foods and avoiding addition of extra salt during food preparation should be ensured.

Apart from meeting the nutritional requirements, emphasis should be placed on learning to enjoy food. Mealtime for them should be an interesting occasion, a time they look forward to. This can be achieved by keeping the atmosphere relaxed and easy during meals.

All parents want to give their children the best start in life.
So if you help your child start on the right track, it will pave the way for a healthy attitude to food as well as a healthy diet later in life.

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