NUTRITIONAL REQUIREMENTS
The first year of life
is a period of the most rapid growth in one’s life. A baby doubles its birth
weight by 6 months of age and triples it within the first year. This explains
why the infant’s energy, vitamin, mineral, and protein require-ments are higher
per unit of body weight than those of older children or adults. It is important
to remember, however, that growth rates vary from child to child. Nutritional
needs will depend largely on a child’s growth rate.
During the first year,
the normal child needs 98 to 108 calories per kilo-gram of body weight each
day. This is approximately two to three times the adult requirement. Low-birth-weight
infants and infants who have suffered from malnutrition or illness require more
than the normal number of calories per kilogram of body weight. The nutritional
status of infants is reflected by many of the same characteristics as those of
adults (see Table 1-2).
The basis of the
infant’s diet is breast milk or formula. Either one is a highly nutritious,
digestible food containing proteins, fats, carbohydrates, vita-mins, minerals,
and water.
It is recommended that
infants up to 6 months of age have 2.2 grams of protein per kilogram of weight
each day, and from 6 to 12 months, 1.56 grams of protein per kilogram of weight
each day. This is satisfactorily supplied by human milk or by infant formulas
(Figure 12-2).
Infants have more water per pound of body weight than do adults. Thus, they usually need 1.5 ml of water per calorie. This is the same ratio of water to calories as is found in human milk and in most infant formulas. Essential vitamins and minerals can be supplied in breast milk, formula, and food. Except for vitamin D, breast milk provides all the nutrients an infant needs for the first 4 to 6 months of life. An infant is born with a 3- to 6-month supply of iron. When the infant reaches 6 months of age, the pediatrician usually starts the infant on iron-fortified cereal.
Human milk usually
supplies the infant with sufficient vitamin C. Iron-fortified formula is
available, and its use is recommended by the American Academy of Pediatricians
if the baby is not being breastfed. The pediatrician can prescribe a vitamin D
supplement for infants who are nursed and who are not exposed to sunlight on a
regular basis. Newborns lack intestinal bacteria to synthesize vitamin K, so
they are routinely given a vitamin K supple-ment shortly after birth. In
addition, some pediatricians prescribe fluoride for breastfed babies or for
formula-fed babies living in areas where the water, such as well water,
contains little fluoride.
Care must be taken
that infants do not receive excessive amounts of either vitamins A or D because
both can be toxic in excessive amounts. Vitamin A can damage the liver and
cause bone abnormalities, and vitamin D can damage the cardiovascular system
and kidneys.
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