7.2 Infant Nutrition and Breastfeeding

Breast milk is nature's perfect food for babies. It provides essential nutrients, boosts immunity, and promotes bonding between mother and child. Understanding its composition and benefits can help new parents make informed feeding choices.

Introducing solid foods marks a significant milestone in an infant's development. Knowing when and how to start solids, along with common challenges in infant feeding, can help parents navigate this exciting but sometimes tricky phase of their baby's growth.

Benefits and Composition of Breast Milk

Benefits of breastfeeding

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• Infant benefits:
  • Enhanced immune system transfers maternal antibodies to infant
  • Reduced risk of infections lowers incidence of respiratory and gastrointestinal illnesses (pneumonia, diarrhea)
  • Lower risk of Sudden Infant Death Syndrome (SIDS) decreases by about 50%
  • Decreased likelihood of obesity in later life due to self-regulation of intake
  • Improved cognitive development boosts IQ scores by 3-5 points on average
• Maternal benefits:
  • Faster postpartum recovery helps uterus contract to pre-pregnancy size
  • Reduced risk of postpartum depression promotes emotional well-being
  • Lower risk of certain cancers decreases breast and ovarian cancer rates
  • Natural form of birth control (lactational amenorrhea) suppresses ovulation
  • Promotes bonding with infant releases oxytocin enhancing mother-child relationship

Composition of breast milk

• Macronutrients in breast milk:
  • Proteins contain whey and casein in optimal ratios for easy digestibility
  • Fats provide essential fatty acids for brain development (DHA, ARA)
  • Carbohydrates supply lactose as primary sugar and oligosaccharides for gut health
• Micronutrients:
  • Vitamins and minerals tailored to infant needs (vitamin D, calcium)
  • Iron in highly bioavailable form absorbs more efficiently than formula
• Bioactive components:
  • Antibodies (immunoglobulins) protect against infections (IgA, IgG)
  • Growth factors promote organ development (epidermal growth factor)
  • Enzymes aid in digestion and nutrient absorption (lipase, amylase)
• Changing composition:
  • Colostrum in early days rich in antibodies and growth factors
  • Transitional milk increases in volume and fat content
  • Mature milk stabilizes in composition around 2 weeks postpartum
• Adaptation to infant's needs:
  • Changes in fat content throughout a feeding hindmilk richer in fat
  • Adjustments based on infant's age and development protein decreases over time

Infant Feeding Practices and Challenges

Introduction of solid foods

• Timing of solid food introduction:
  • Recommended around 6 months of age aligns with WHO guidelines
  • Signs of readiness in infants include sitting up, loss of tongue-thrust reflex
• Importance of proper timing:
  • Gut maturity and enzyme production ensures better digestion of solids
  • Developmental readiness for swallowing solids reduces choking risk
• Selection of first foods:
  • Iron-fortified cereals provide essential nutrients (rice, oatmeal)
  • Single-ingredient purees allow for allergen identification (sweet potato, banana)
  • Soft, easily mashable foods promote self-feeding skills (avocado, cooked carrots)
• Introducing food groups:
  • Vegetables and fruits offer variety of nutrients and flavors
  • Protein sources introduce essential amino acids (pureed meats, legumes)
  • Grains provide energy and fiber (whole grain pasta, quinoa)
• Allergen introduction:
  • Current recommendations for early introduction suggest between 4-6 months
  • Common allergenic foods to introduce include peanuts, eggs, fish
• Feeding progression:
  • Texture advancement moves from purees to soft chunks to finger foods
  • Increasing variety of foods expands nutritional profile and palate
• Avoiding certain foods:
  • Honey (risk of botulism) should be avoided until 12 months
  • Choking hazards include whole grapes, nuts, popcorn

Challenges in infant feeding

• Breastfeeding challenges:
  • Latching difficulties:
    1. Assess baby's position
    2. Ensure wide mouth opening
    3. Aim nipple towards roof of mouth
  • Sore nipples often caused by improper latch or thrush
  • Low milk supply can be addressed with frequent feeding or pumping
  • Engorgement relieved by frequent feeding and cold compresses
• Infant feeding challenges:
  • Reflux managed with upright positioning and smaller, frequent feedings
  • Food allergies or intolerances require identifying trigger foods (milk, soy)
  • Picky eating addressed through repeated exposure and involvement in food prep
• Solutions for working mothers:
  • Pumping and storing breast milk maintains supply (refrigeration, freezing)
  • Maintaining supply while away from infant through regular pumping sessions
• Supplementation concerns:
  • When and how to supplement if necessary based on pediatrician advice
  • Choosing appropriate formula if needed (iron-fortified, hypoallergenic)