DEGREE BTLE COURSE NO.

PROGRAM
SPECIALIZATION HE COURSE Food and Nutrition
TITLE
YEAR LEVEL TIME FRAME WK NO. IM NO. 7

I. UNIT TITLE/CHAPTER TITLE: Nutrition in Infancy

II. LESSON TITLE: Nutrient Adjustments for Infants and its Characteristics

III. LESSON OVERVIEW

Infancy is a period of rapid growth second only to the fetal period. There is a pressing
need to optimize nutrition to ensure adequate growth and organ development.

IV. DESIRED LEARNING OUTCOMES

At the end of the lesson, the students should be able to:

a. describe characteristics of the normal full term infant
b. explain the nutrient requirements of infants
c. give and discuss feeding method of infants plan and demonstrate food of infants

V. LESSON CONTENT

Characteristics of a Premature Infant

Appearance. A term baby is one born between 37 and 42 weeks’ gestation. The
dermis is well formed and the skin is usually smooth, with adequate subcutaneous fat
and good muscle tone. The skin is generally well perfused although transient mild
blueness of the feet and hands is normal at birth. The skin should be free from
blemishes. Injuries such as cuts, bruises, marks from forceps blades or ventouse cups
must be recorded. Movements, including chest wall movement, are symmetrical.
Asymmetrical limb movement may indicate skeletal, muscle or nerve damage. The
infant will be vigorous and the cry lusty, not weak or high-pitched.

Physiology. The average weight at birth is 3.5 kg, with a normal range of 2.7–4.6 kg.
The average length is 50 cm and the average occipitofrontal head circumference is 35
cm. The heart rate is between 110 and 160 beats/minute. The respiratory rate is 30–
50 breaths/minute. Respiration is noiseless; respiratory ‘grunting’ must be investigated
at once. The average systolic blood pressure is 75–100 mg/Hg, and the circulating
blood volume is 85–90 mL/kg. The normal body temperature range is from 36.5 to
37.4°C (axillary).

Feeding the Infant

An infant can be fed by one of the three methods: breastfeeding, bottlefeeding,
and mixed feeding. The choice is entirely up to the mother since her decision should
take into consideration her own nutritional status and the physical state.
 1. Breastfeeding. Research shows that breastfeeding provides many health
benefits for you and your baby. But it also can be difficult to manage
breastfeeding in today’s hurried world. Learning all you can before you give
birth can help. The decision to breastfeed is a personal one. As a new mom,
you deserve support no matter how you decide to feed your baby.

When you breastfeed, you give your baby a healthy start that
lasts a lifetime. Breastmilk is the perfect food for your baby. Breastfeeding
saves lives, money, and time. It is one of the most effective ways to ensure
child health and survival. However, nearly 2 out of 3 infants are not
exclusively breastfed for the recommended 6 months—a rate that has not
improved in 2 decades
.
Breastmilk is the ideal food for infants. It is safe, clean and contains
antibodies which help protect against many common childhood illnesses.
Breastmilk provides all the energy and nutrients that the infant needs for the
first months of life, and it continues to provide up to half or more of a child’s
nutritional needs during the second half of the first year, and up to one third
during the second year of life.

Breastfed children perform better on intelligence tests, are less likely

to be overweight or obese and less prone to diabetes later in life. Women
who breastfeed also have a reduced risk of breast and ovarian cancers.

Contradictions to Breastfeeding
Some mothers are not advised to breast-feed because of the reasons listed
below:
 The mother’s milk production is inadequate
 The mother is not healthy
 The mother is pregnant
 The mother has tuberculosis or other contagious diseases
 The mother’s nipple is inverted
 The mother is a chain smoker, an alcoholic or a drug user
 The mother is under mental or emotional stress
 The mother is taking contraceptive pills

Proper Way of Breastfeeding

The baby should be fed every three hours one or two days after he is born to
prepare the breasts for sufficient milk production. The mother should drink plenty of
milk, juices, soups or liquids to sufficient supply of milk. She should have adequate rest,
drink a lot of milk and water, and eat a balanced diet
 Bottlefeeding. According to some surveys, the practice is gaining momentum in
the rural and urban areas. Artificial or bottlefeeding is only recommend if the
mother cannot breastfeed her baby. Sometimes the newborn baby lacks
enzymes that are needed to digest milk. If this is the case, bottlefeeding is the
most advisable form of feeding the baby.
 Mixed Feeding. This kind of teaching is a mixture of bottle and breastfeeding,
either one of which is predominant. The feeding is complemental if the baby is
bottlefed after breastfeeding because the mother milk is inadequate. If the
mother is out of the house for a long time and bottlefeeding is used to take the
place of breastfeeding, the method is termed supplemental.

Weaning your Child from Breastfeeding

Weaning is a natural stage in your baby’s development. It is the gradual

process of giving your baby other foods while continuing to breastfeed.

Weaning can come with a lot of mixed emotions. You may feel excited at the new
independence you and you baby can both enjoy, as well as some sadness as your baby
moves to another stage in her life. This is completely normal.
 At about 6 months, your baby will be ready for other foods. He will also need
other foods to meet his growing nutritional needs. As you introduce your baby to new
foods, you are encouraged to continue to breastfeed.

Weaning can be either natural (child-led) or planned (mother-led).

Natural weaning or “child-led weaning” happens when your baby starts to

accept more—and different types—of solid foods while still breastfeeding on demand.
With this type of weaning, you watch your baby’s cues and wean at her pace. Babies who are
weaned naturally usually stop breastfeeding completely sometime between 2 and 4 years of
age.

Planned weaning or “mother-led weaning” happens when mothers

decide to start the weaning process.

A “partial wean” means substituting one or more feedings with a cup or bottle
and breastfeeding at other times. This can work well if you are going back to work or school,
but still want to breastfeed. Early morning, evening and night feedings can continue even if you
are separated from your baby during the day.

Nutrient Needs of Infants

Estimates of energy and nutrient needs in infancy have been made from intakes of
infants growing normally and from the nutrient content of human milk. These are only
guidelines, and each individual infant will have individual requirements at different stages of
infancy. The Recommended Dietary Allowances (RDAs) are planned to provide a margin of
safety to allow for maximum protection, and the newer Dietary Reference Intakes for infancy
are based on observed levels that appear to be adequate. Because of the declining growth
rates during the latter part of the first year, recommended intakes have been set for two 6-
month periods, from birth to 6 months and from 6 months to 1 year.

Energy. Current RDA for energy intake in infancy is 108 kcal/kg/day from birth through 6
months of age, and 98 kcal/kg/day for the second half of the first year. These values were
estimated from WHO data on intakes from healthy infants with an additional 5% allowance for
underestimation of intake. Energy requirement is higher in the first weeks of life, but it was
determined that data was insufficient to establish more precise breakdowns. A recent review of
studies of well nourished infants found that current recommendations are significantly higher
than actual energy requirements and could lead to overfeeding if they were closely adhered to.
Breastfed infants have lower requirements for total energy expenditure and energy cost of
growth than formula fed infants.

Protein and Amino Acids. Infants require protein for synthesis of new body tissue during
growth, as well as synthesis of enzymes, hormones, and other physiologically important
compounds. Increases in body protein are estimated to average about 3.5 g/day for the first 4
months, and 3.1 g/day for the next 8 months. The body content of protein increases from about
11.0% to 15.0% over the first year. The recommended intake is 2.2 g/kg for the first 6 months
and 1.6 g/kg from 6 to 12 months.

Fat. The most calorically concentrated energy nutrient, supplies between 40% and 50% of the
energy consumed in infancy. The energy provided by fat spares protein for tissue synthesis. Its
caloric concentration is an asset during periods of rapid growth when energy demands are
great. Fat provides about 50% of the energy when human milk or commercial infant formulas
are the only source of nutrients. Fat provides 47 to 49% of the energy content of commercial
formula and about 52% of the energy content of human milk.

In the second half of infancy, as foods become increasingly important in the infant diet,
nutrient and energy content of those foods must be considered. Excessive consumption of
traditional high carbohydrate weaning foods such as cereal, vegetables, and fruits may
compromise both energy and nutrient intake for some infants. It is common for the percent of
energy from fat to drop precipitously between 6 and 9 months, and then to rise again as infants
begins to eat more high fat family foods. This pattern of food and energy consumption may
pose a problem for children with health or developmental concerns that interfere with the ability
to eat or digest foods or for children from vegan or health-conscious families who exclude
higher fat, nutrient dense foods from the diet. Growth failure has been reported in some infants
and toddlers when fat intake is inadequate.

Water. Infants require more water per unit of body size than do adults. A larger percentage of
water is located in the extracellular spaces. As noted before, young infants have an immature
kidney. These two factors make the infant vulnerable to water imbalance. The water
requirement is determined by water loss, water required for growth, and solutes derived from
the diet.

Minerals and Vitamin. Need for minerals and vitamins are influenced by growth rates,
mineralization of bone, increases in bone length and blood volume, and by energy, protein,
and fat intakes. Recommended intakes have been established for nutrients for which there is
adequate information. Starting in 1997 the Food and Nutrition Board of the National Research
Council began to publish the results of a new approach to nutrient recommendations. New
Dietary Reference Intakes (DRIs) have been established for thiamin, riboflavin, niacin, vitamin
B6, folate, vitamin B12, pantothenic acid, biotin, and choline as well as calcium, phosphorus,
magnesium, Vitamin D, and ,vbmc fluoride. New DRIs for antioxidant vitamins and minerals
are under consideration. In general, with the exception of vitamin K and possibly vitamin D,
healthy infants who receive human milk or commercial infant formula do not need vitamin
supplements.

VI. LEARNING ACTIVITIES

Name: ______________________________________ Year/ Section:_________

LABORATORY EXERCISE NO. 8

NUTRITION IN INFANCY

I. INTRODUCTION

Infants are born with the ability to digest and absorb nutrients from human
milk or formula. The digestive system matures during infancy so that a wide
variety of foods can be used by the end of the first year. Infant feeding behavior
follows a defined developmental sequence.

II. OBJECTIVES
 Discuss the importance of human milk
 Give and discuss the good eating habits in infants
 Discuss the nutrients in the growth and development of infants

III. STUDY QUESTIONS

1. Why is the first year of life the most important in terms of nutrition?
2. Give recommendations on how to develop good eating habits in infants
3. State the role of the major nutrients in the growth and development of infants

VII. ASSIGNMENT
1. Which is better, breastfeeding or bottlefeeding? Support your answer
 VIII. EVALUATION

IX. REFERENCES

Butte NF. Energy requirements of infants. [Link]. 2012; 50Suppl1:S24-36.

Fomon SJ. Nutrition of Normal Infants. St. Louis: Mosby-Year Book, Inc., 2006.

Food and Nutrition Board IoM. Dietary Reference Intakes for Calcium, Phosphorus,
Magnesium, Vitamin D, and Fluoride. Washington, D.C.: National Academy Press

Hernell O BL. Human milk bile salt-stimulated lipase: functional and molecular aspects.
J Pediatr 1994;125:S56-S61