>> Now let's take a look at how you fuel that physical development and growth
or nutrition during infancy and toddlerhood.
So breastfeeding and breastmilk is considered the ideal nutrition for infants.
It is rich in nutrients and also provides antibodies from the mother
that help protect against illness.
It's the easiest food to digest because it is made specifically for humans,
and it's even adjusted to things like prematurity.
So, if you have a baby early, your breast milk adjusts to give them the nutrition
to fuel the growth that they need to catch up to
where they would have been had they been born full term.
It has lots of health benefits both for the baby and the mother.
So the baby gives the antibodies.
The mother, it helps, it uses calories
so it helps the mother lose weight gain during pregnancy.
It helps get the uterus back to its prepregnancy shape
because of the hormones that it stimulates.
There are evidence that it reduces risks of certain cancers later in life for mothers,
and there's different research out there that really shows
that it is the most beneficial nutrition for infants when it's safe and feasible for mothers.
It's recommended for at least six months, but in the U.S.,
most mother's stop by about six to eight weeks.
And it is challenge for some mother's, and you can talk to mother's such as myself
where it was the goal, and it just didn't work for lots of different reasons,
and there are actually health reasons that some mother's shouldn't breast feed.
So if you are HIV positive, that's something that can be transmitted
in breastmilk, so you should not breastfeed.
Certain medications are dangerous for babies,
and so you shouldn't breastfeed if you're on those.
So there are valid reasons not to breast feed, and breast feeding doesn't work for everybody.
So, if breast feeding doesn't work, you have the option to use formula,
and the book goes into a little bit about how the nutrition is kind of created to kind
of mirror what breastfeeding provides, with the exception of antibodies.
We have no way of providing those through formula.
And I think it's important to note that both breast fed and bottle fed babies have been shown
to adjust equally well emotionally.
There tends to be very strong feelings on the breastfeeding topic,
and so I think it's important to note that we should always encourage mother's to breastfeed
for their benefit as well as the baby's, but also support them
in whatever choices they make to, you know, provide their baby.
There's also a movement called Fed is Best, right.
We want babies to be fed.
So what about solid foods.
How do we know when it's time to introduce solid foods.
So at about six months, excuse me, we begin to see signs of readiness.
Before this time period, they have a reflux called the tongue thrust reflex
that makes it really hard to feed them.
Anything that you put in their mouth tends to be pushed back out with the tongue.
So, six months is usually when they show the ability to keep food in their mouth,
to show that they want more food, and you know, show hunger and those types of things.
Historically, we used to say, you know, you need to introduce foods in a specific order.
Now we know that's not really the case.
By seven to eight months, the foods that you can be feeding your babies that are soft
or pureed or mashed would include cereals.
Different meats and proteins, those you would want to be really careful with to make sure
that they weren't a choking hazard.
Fruits and vegetables, grains, yogurt, soft cheeses, and more.
So, again, as long as it's soft enough that they are not going to swallow it an choke on it,
there aren't a lot of prohibitions.
There are some foods we wait a little bit longer,
and it's a good idea to offer one food at a time.
They say ideally wait three to five days to see if there's any allergies that develop
or any problems with a specific food so that you can quickly identify what caused the problem
and eliminate it, whereas if you feed a variety of foods you will have to go through
and reintroduce them one by one to be able to see which one caused the problem.
So, it might be helpful to look at the infant meal patterns that are provided
by the United States Department of Agriculture, USDA Food and Nutrition Service.
And this is to provide guidance for childcare programs specifically,
but I thought it would be helpful to see kind of how often we expect to feed and how much.
So you can see zero to five months.
It's completely on demand.
So, four to six ounces of breastmilk or formula as often as they need it.
So, probably every two to three hours.
Six to 11 months, once you start introducing solid foods,
you can see they've got some different recommendations there of how to provide meals.
And then once they become toddlers, their breakfast choices expand a little bit,
and so you can see kind of some portion sizes that are suggested for one
to two years, children from one to two.
Sometimes there are issues with nutrition, right.
So we call this malnutrition.
Some of these are concerns here in the U.S. Some of them don't tend to be concerns
in the U.S. There is the concern of wasting,
which is not having enough nutrition to sustain health and growth.
So Marasmus is starvation due to a lack of calories and protein.
So, if you don't get enough nutrition, you lose your fat and muscle
until your body can no longer function.
Babies that are breast fed are much less at risk for marasmus, and then if there are children
that just have diet deficiency and protein specifically, they could, I don't even know how
to say that word, I've read it many times, Kwashiorkor, I'm going to say,
and I'm probably not saying that correctly.
Or the disease of the displaced child.
And so the picture is of a child with that particular condition,
and you can see they get a big tummy,
but the rest of their body doesn't have the muscle and fat that it should.
Most of these are not concerned, neither of these tend to be concerns
in the U.S. But, the next two are or can be.
So, about nine million children in the U.S. are malnourished, and more than that even suffer
from milk anemia, which is because of milk consumption leading
to a lack of iron in the diet.
And so if a child drinks too much milk, the calcium can actually interfere
with the absorption of iron, and so it's important to recognize that you don't want
to replace nutrition with milk for that particular reason.
And then failure to thrive, or FTT,
is essentially when the nutritional intake isn't sufficient
for supporting normal growth and weight gain.
It's typically present before two years of age when growth rates are the highest.
This can be exhibited with picky eating habits, poor weight gain, smaller size.
It's often identified by pediatricians, and it can be caused by physical or mental issues,
so things like issues with their metabolism, acid reflux, diarrhea, cystic fibrosis,
[inaudible], things like cleft palate or tongue tie, milk allergies,
etc. But it can also be caused by caregiver actions or environmental,
so not having enough breast milk, not providing enough food or enough feedings, and neglect.
And they actually can co-exist.
And a child who is not getting sufficient nutrition may actually act content
so they don't offer more feedings, and so it's important that intervention happens there.