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Final Exam Notes – NUTR 2050.docx

Course Code
NUTR 2050
Simone Holligan
Study Guide

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Final Exam Notes – NUTR 2050
Breastfeeding Recommendations
Recommend exclusive breastfeeding for first six months
Supplemental vitamin D is recommended for breastfed infants (400 IU)
First complementary foods should be iron-rich
oMeat, meat alternatives, and iron-fortified cereal
First year of life
From birth to 12 months of age
Energy Needs
Energy (calories)
o108kCal/kg/day from birth to 6 months
o98kCal/kg/day from 6-12 months
Absolute calorie needs are higher from 6-12 months, but relative amounts are lower
Factors that Influence Caloric Needs
Growth rate
Sleep/wake cycle
Temperature and climate
Physical activity
Metabolic response to food
Health status
Growth Spurts
Typically three weeks and three months
Do not signal a need for solid foods or formula if breastfeeding
Feed on demand as much as required
Protein needs
o2.2kg/kg/day from birth to 6 months
o1.6g/kg/day from 6 to 12 months
Fat needs
oAI about 30g/day – no change from birth-6 months and 6-12 months; restriction not recommended
oInfants need cholesterol for brain development
oBreast milk contains about 55% calories from fat
oBreast milk contains short-chain and medium-chain fatty acids (in addition to the long-chain)
Short and medium-chain fatty acids are easier to digest and utilize
Carbohydrate needs
o65 g/day from birth to 6 months
o90g/day from 6-12 months
Metabolic Rate, Calories, Fats and Proteins

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Metabolic rate of infants is highest of any time after birth
oThe higher rate is related to rapid growth and high proportion of muscle
oLow CHO and/or energy intake results in protein catabolism impacting growth
Key Vitamins and Minerals
o0.1mg/day birth to 6 months
o0.5mg/day 6-12 months
oSupplement at 6 months unless provided with fluoridated water
oFluoride is incorporated into enamel of forming teeth
Vitamin D
oBreastfed babies need supplement of 400IU/day from birth until 1 year
o0.27mg/day birth to 6 months
o11mg/day 6-12 months
oAnemia uncommon in infants because of prenatal iron stores of the mother; high bioavailability in
breast milk
oMore common in low-income families
oIron-fortified cereals recommended at 4-6 months
Cow’s Milk During Infancy
Whole, reduced fat or skim cow’s milk should not be used before 9 months
Iron-deficiency anemia linked to early introduction of cow’s milk
Anemia linked to
oGastrointestinal blood loss
oDisplacement of iron-rich foods
Soy Protein-Based Formula During Infancy
Soy protein in place of milk protein should be limited in its use
There is little scientific evidence for benefit of increase soy over milk-based
Use of soy formula is not recommended
oFor managing infant colic
oAs an advantage over cow’s milk formula for preventing allergy in healthy at-risk infants
Infant Development
Like building blocks
Predictable sequence
Intrinsic influence
oChild’s health, nutrition, brain function, temperament
Extrinsic influence
oFamily, environment, cultural norms
Five Domains of Development
1) Motor
a. Voluntary muscle movement: gross and fine influenced by sensory system
2) Sensory
a. Information from environment
3) Cognitive/mental
4) Language and communication

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5) Social, adaptive, emotional
Hear and move in response to familiar sounds
CNS is immature – subtle cues for hunger and satiety versus later cues
Strong reflexes, especially suckle and root
Reflexes replaced by purposeful movement
oAutomatic response triggered by specific stimulus
Rooting reflex
oInfant turns head toward the cheek that is touched
oReflex causing tongue to move forward and backward
Motor Development
Ability to control voluntary muscles
Motor development is top down – controls head first and lower legs last
oMuscle development from central to peripheral
Influences ability to be fed, feed self and the amount of energy expended
Starts with head and trunk control, then lower legs
Development of Infant Feeding Skills
Infants born with reflexes and food intake regulatory mechanism
Inherent preference for sweet taste
At 4-6 months, reflexes fade – infant begins to purposely signal wants and needs
At 4-6 months, infants move tongue from side to side indicating readiness for solid foods
At 9-12 months, infants develop motor skills allowing them to feed themselves
Breast is best but if you bottle feed:
Cuddle when feeding
Look into each other’s face
Support head, higher than rest of body
Touch nipple of bottle to lips or show to get response
Hold bottle still, do not tip
Let infant control pace
Only burp if seems full of air – they will stop eating and may seem uncomfortable
Talk to them while they are eating, sing etc. but be calm and quiet
Knowing when done with eating
oSlowing down on sucking
oTurning away from bottle
oClosing lips
oSpitting out bottle
oTaking interest in other things
Ellyn Satter and Younger Infants
Division of responsibility
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