Objectives
    • Normal growth patterns in infancy
    • Nutritional requirements of healthy term 
       infants*
        – Macronutrients
        – Micronutrients
    •  Benefits of human-milk
    •  Practical guidelines for complementary feeding
    • Summary
        Case Presentation
  • A mother brings in her 2 month old healthy term 
    infant who is exclusively breast fed for a well visit
    How would you answer these nutritional questions: 
     Can she eat cereal now?
     Mom heard that human-milk has less iron than 
     formula, should the baby be on an iron 
     supplement?
     What about other supplements?
     How fast should she be growing?
       When will she double, triple her birth weight?
 GROWTH PATTERNS IN INFANCY
     Growth Patterns in Infancy
   • The first year of life is a period of very rapid growth
      - Healthy 1 month old gains~ 1 cm/week and 20-30 g/day
      - By 12 months of age gains 0.5 cm/week and 10 g/day
   • Average newborn weight is 3.5 kg, weight is 
    doubled by 4-6 months and tripled by 12 months
   • Nutrition during infancy can influence risk factors 
    for disease in adult life
     Fun Fact: If a person who was born 8 lbs. and 20 in. at birth 
    continued growing at the same rate as he does the first year, by 
    the time he reached 20, he’d be 25 ft. tall and weigh nearly 315 
                   lbs!
                              Growth Charts
        •  April 2006 WHO international growth charts**
             – Growth standard – describe growth of healthy children in optimal 
                conditions (e.g. exclusive breastfeeding for 4 mo, continued to 12 
                mo)
             – Includes children 0-20 yrs
             – AAP recommends using WHO growth charts between 0-24 mo
        •  May 2000 Chronic Disease Prevention and Health Promotion 
           and Center for Disease Control*
             – Growth reference –how children grew in a particular place and time
             – Includes children 0 to 20 years of age
             – AAP recommend susing CDC growth charts between 2 and 20 yrs
        •  Both growth charts include
             – Weight, length/height, head circumference, body mass index for age
              Normal growth reflects nutritional status and overall 
              wellbeing; poor growth is always a cause for concern 
                            and should be evaluated promptly