NUTRITION2 BREAST FEEDING l Breast feeding one of

NUTRITION-2

BREAST FEEDING l Breast feeding, one of the most important influences on children’s health worldwide , provides optimal nutrition for the normal infant during the early months of life ( first six months) (except vit D) l Always available at the proper temperature and requires no preparation time.

BREAST MİLK l The protective effects of breast milk against enteric and other pathogens result in less morbidity. l They probably account for the lower incidence of diarrhea as well as otitis media, pneumonia, bacteremia, and meningitis during the 1 st yr of life in Breast-Fed infants.

BREAST MİLK l Human milk contains bacterial and viral antibodies, including relatively high concentrations of secretory Ig A that prevents microorganisms from adhering to the intestinal mucosa. Contains some substances that inhibit growth of many common viruses. Provide local GIS immunity.

BREAST FEEDING l Numerous immunologic factors in BM (secretory Ig. A, lysozyme, lactoferrin, bifidus factor, macrophages, complement, antistaphylococcal factor, interferon) help to provide protection against GI tract and upper respiratory infections l Allergic diseases are less common in breast-fed infants.

BREAST FEEDİNG l BM contains lactoferrin, an ironbinding whey protein. Has an inhibitory effect on the growth of Escherichia coli in the intestine. l The lower p. H of the stool of breastfed infants……>favorable intestinal flora of infants fed BM vs. formula (more Bifidobacteria and lactobacilli)

BREAST FEEDİNG l İf the maternal vit D intake is inadequate, 10 mikrog/g of Vit D is recommended. l The vitamin K content of BM also is low and may contribute to hemorrhagic disease of the newborn. Parenteral administration of 1 mg of Vit K 1 at birth is recommended for all infants.

BREAST FEEDING l Breast feeding offers increased opportunity for close contact between mother and infant. l Nutrient composition: 85 % water 70 kcal /100 ml 1 -1, 5 gr/100 ml prt(%60 whey, %40 casein Low prt content but adequate for the normal infant. CM-3. 3%(18/82)

BREAST FEEDING l 7 gr /100 ml carbohydrate (1. 2% gr/dl oligosaccaride)CM 4. 5% 0. 1 gr/dl oligosa l 4 gr/100 ml fat; ( essential fatty acids LCFA )CM 4% l 0, 15 -, 025 % mineral; low Na and solute load, Ca/P ratio 2/1 is adequate , very favorouble absorbtion of Ca, Fe, Zn. CM 0. 75% Ca/P 1/1

BREAST FEEDING l COLOSTRUM: The secretion of breasts during the latter part of the pregnancy and for 2 -4 days after delivery. l Deep lemon yellow collor (high ß-caroten). High protein (s. Ig A). Density : 10401060. Less carbohydrate and fat. High minerals and vitamins.

BREAST FEEDING l Contraindications of breast feeding: l Septisemia, eclampsia, profuse hemorrhage, active tbc, typhoid fever, malaria, chronic poor nutrition, debility, severe neuroses, postpartum psychoses, AIDS, active hepatitis. l Radioactive compounds, antimetabolites, lithium, diazepam, chloramphenicol, antithyroid drugs, tetracycline

BREAST FEEDİNG l Transmission of HIV by breastfeeding is well documented. l CMV, rubella virus, Hepatitis B virus and Herpes simplex virus also have been demonstrated in BM.

BREAST FEEDING Technique of breast feeding: breast feeding can be started after delivery as soon as both mother and baby are stable. l Both breasts should be used at each feeding in the early weeks to encourage maximal production of milk. l Infants empty a breast in 5 -20 mins. l The newborn is generally fed every 2 -3 hrs => The most satisfactory stimulus to the secretion of human milk is regular and complete emptying of the breasts. l

Nutrition l Special dietary products: infant formulas (adapted to BM) # to the infants who can not take BM. l Weaning: can take place according to needs and desire of both infant and mother. Starts after 4 -6 months. Any new food should be initialy offered once a day in small amounts.

Feeding during the first 6 mo of life other than BM. l Formula-feeding; adopted, half adopted to BM, follow-up formulas l Bovine milk; (not recommended before at least 1 year of age if possible)

FORMULA-FEEDİNG l Normal dilution 30 cc water/1 spoon. l Boil the water at least for 10 minutes. Than wait until it gets cooler. l First 1 -2 wk: 7 -10 times… 50 -70 ml. 2 -6 wk: 6 -8 times…. . 75 -110 ml. 2 mo: 5 -6 times… 110 -180 ml. 3 mo: 5 times…. 170 -220 ml. 6 mo: 4 times…. 220 -240 ml. 7 -9 mo: 3 -4 times…. 240 -260 ml. 9 -12 mo: 3 times…. 240 -260 ml.

Preparation faults of formulas l Concentrated formulas; high osmotic load……> high fluid loss by urine……. . >too much cry because of thirst……. . >mother thinks infant is hungary…. >GİVES MORE FORMULA… Result is……. >Hypertonic dehidratation - Diluted formulas; can lead to malnutrition

DISADVENTAGES OF BOVİNE MİLK l Includes high protein and electrolites than BM…. > 3 fold high renal solute load l Includes Beta-lactoglobulin (none in BM), l Inappropriate Ca/P ratio, ineffective Ca absorption. l Poor linoleic acid and nucleotid content. l Contains no protective antibodies and probiotics. l Poor absorbtion of Fe and fat-soluble vita.

BOVİNE-MİLK l Should have to be boiled, l Dilute with water for the first 4 months; -1. mo: 1 milk/1 water -2. mo: 2 milk/1 water -3. mo: 3 milk/1 water -4. mo: 4 milk/1 water l Add 5% table sugar and 3% vegetable oil. l 100 ml. dilute CM+1 sp sugar+1 tsp oliveoil

WEANİNG 1) the beginning of a process of gradual introduction of solid foods, 2) the complete cessation of breastfeeding. l Cereal; contains Fe and B complex vit. l Fruits; strained or pureed l Vegetables; good source of Fe and other minerals. l Meat; egg, starchy food; introduced about 6 month of age l

COMPLEMENTARY FOODS l Should be introduced in a stepwise fashion beginning about the time the infant is able to sit unasisted. l Cereals, a good source of iron, should usually be the first. Vegetables and fruits are introduced next, followed shortly by meats and finally eggs. Only one new food should be introduced at a time.

FEEDİNG DURİNG LATER CHİLDHOOD l After 2 years of age, a child’s diet should not differ from that of the rest of the family. l Food Pyramid Guidelines. Encouraged for all children age 2 years and older. Nutritional habits are formed early in life.

PRUDENT DIET l National l 1) Cholesterol Education Program Total fat content less than 30% of caloric intake, saturated fatty acids to less than 10% of energy. Polyunsaturated fatty acids should supply 7 -8% of energy and monounsaturated fatty acids should supply 12 -13%.

PRUDENT DIET l 2) Cholesterol intake should be less than 100 mg/ 1000 kcal/d to maximum of 300 mg/d l 3) carbohydrates should provide 60% or more of daily caloric intake with 50% or more in the form of complex carbohydrates A high fiber diet is also recommended.

PRUDENT DIET l 4) The diet should be nutrionally complete, include a variety of foods and be adequate for optimal growth and activity l 5) A low salt intake is advised. l The American Heart Association Step One Diet, is recommended to decrease atherosclerotic hearth disease in adulthood, limits the develop. of OBESİTY

PRO/PRE/SYNBIOTICS l PROBIOTICS: Live microbial food supplements which affect the health of the host by maintaning a balanced intestinal flora and stimulating its immune system. Probiotic microorganism are mostly from the Lactobacillus and Bifidobacterium family.

PRO/PRE/SYNBIOTICS l Benefical health effects; shortening the duration of rotavirus diarrhea, relief of signs and symptoms of lactose intolerance, decreasing the risk of allergy in atopic individuals, cancer prevention, lowering the serum cholestrol levels, prevention urogenital infections, synthesis and enhancement of the biovailability of nutrients.

PRO/PRE/SYNBIOTICS l Probiotic bacteria may compete with pathogens for nutrients and mucosal adherence, produce antimicrobial substances and modulate mucosal immune functions.

PRO/PRE/SYNBIOTICS l PREBIOTICS: Indigestible oligosaccharides that promote the growth or activity of a limited benefical bacteria in the gut. l Fructo / galactooligosaccharides, inulin, oligofructose, xylo-oligosaccharides, acidic oligosaccharides are some of the typical prebiotics.

PRO/PRE/SYNBIOTICS l The breakdown of prebiotic molecules by bacterial enzymes in the large bowel yields lactate and short chain fatty acids (acetate, butyrate and propionate) as end products. l SCFA; crucial for gut integrity and function, modulation of the immune system, Ca Mg absorbtion, maintenance of normal serum cholesterol levels.

PRO/PRE/SYNBIOTICS l SYNBIOTICS: nutritional supplements which contain probiotics & prebiotics combination.