NutritionAAP recommends breast milk or formula as major source of nutritionfor first 12 monthsof lifeNo wateror any other liquid except formula/breastmilk until 12 monthsoldoCan’t regulate electrolytes – fluid overload easily hyponatremicNewborns eat 8-12 timesper day and on queoDon’t let them go any longer than 4 hoursOlder infants: every 3-4 hoursCan introduce solids (purees) at 4-6 monthsBreastfeeding vs FormulaBreastfeeding is bestoSupplement with Vitamin DoNo iron supplementation is needed for breastfed babies until 6 monthsoEasier to digestoMaternal antibodiesIron fortified formula second bestSome children may need special formulas oInborn error of metabolismoDigestive difficultiesWhat does breastmilk have that formula does not?oMaternal Antibodies (immunoglobulins)oEspecially IgAoWBCs (neutrophils most common)oOmega-3 Fatty Acids, DHAoHighly absorbable ironoBreastfed babies and bowel movements?Yellow mustard & seedy poopBenefit - has little to no odorBreastmilk is freeoCons – work & pumping, experiences, only mom can feedBenefits of BreastfeedingDose depended – more & longer baby is breastfed = more protection
Preparation of Formula or Breast milkDo not give extra water!oMalnourishment, electrolyte imbalancesMix according to manufacturer’s directionsDo not heat in a microwave- scalding Do not bottle prop – let bottle sit in mouthoAspiration, dental problems, ear infectionsDo not give bottle in bedDiscard one hourafter bottle startedIf giving pumped breastmilk in hospital setting, RN double checkand other procedures requiredoNurse, tech, pt family memberSolid Foods: Assessing for ReadinessExtrusion Reflex(tongue thrust)oStops 4-6 monthsHead controlSit with supportInterest in Parents’ foodSolid FoodsRice cereal first, few allergensoPowdered/simple grain – soupyoCream of wheat – see if interested, can they swallowoDON’T put in bottle – no nutrition, don’t do without doctor order… bad4-6 months, better to wait until 6 months. Why?oDon’t fill belly with less nutritional stuffoReflex – spit food outBaby foods (pureed food) may be introduced after rice cerealoGreen beans, peas, then fruitsAdd a new food only every 2-3 daysoLooking for reactionsto foodFruits or Veggies first?oDoesn’t matter but do veggies first, fruits taste better – reluctant to take veggies afterFoods to AvoidAllergenic Foods???oUsed to.
oHas opposite effects, need them to be exposed! Can have whenever, introduce them earlyoException if strong family hx of food allergiesoEggs oStrawberriesoNutsSolid foods – no grapes, hotdogs, peanuts, etc.oDiced up foods, cereal, meat closer to age 1oNo nuts – choking hazardNo honey or cow’s milk until 1 year old. Why?