Breastfeeding and complementary feeding practices in infant nutrition

Nutrition During Infancy and Toddlerhood

According to the World Health Organization (WHO) (2010) adequate nutrition during infancy is essential for lifelong health and well-being. Malnutrition can be linked to 35% of the disease burden for children under five. Adequate infant and toddler nutrition is vital to improving child survival and promoting healthy growth and development. The first two years of a child's life are particularly important, as optimal nutrition during this period will lead to reduced morbidity and mortality, to reduced risk of chronic diseases, and to overall better development. In fact, optimal breastfeeding and complementary feeding practices are so critical that they can save the lives of 1.5 million children under five every year.

Pediatric Nutritional Recommendations

Infants should be exclusively breastfed for the first six months of life to achieve optimal growth, development and health (World Health Organization, 2010). Thereafter, to meet their evolving nutritional requirements, infants should receive nutritionally adequate and safe complementary foods, while continuing to breastfeed for up to two years or more.

Cow's milk is not recommended during the first 12 months of life (Allen & Myers. 2006). However, fortified cow's milk is an important dietary component of a toddler's diet because of its high-quality protein, calcium, and vitamins A and D. Calcium is involved in bone growth, tooth development, and muscle contraction, and it may play a role in the regulation of blood pressure and body fat. One study showed that children who consumed milk with the noontime meal were the only group to meet or exceed 100% of the daily Dietary Reference Intake for calcium (i.e., 500 to 800 mg). Two or three servings of milk or dairy products per day are recommended to meet these requirements. Some toddlers are poorly weaned from an all-milk diet and consume more than the recommended number of servings; this "milk diet" is high in fat and total calories and inadequate in iron.

Factors that Contribute to Obesity in Later Life

Studies indicate that children that are breast feed have a lower rate of obesity (U.S. Department of Health & Human Services, NDI). There are various theories to explain this phenomenon. Bottle formulas expose children to complex sugars and fats which predispose them to weight gain later on in life. Breast feeding may promote healthier eating habits because breast fed infants may eat until satiated, whereas bottle fed babies may be encouraged to eat until they have consumed all of the formula. Breast feeding also may expose babies to more variability in terms of nutrition and tastes since formula fed infants have experience with only a single flavor, whereas breastfed infants are exposed to a variety of flavors from the maternal diet that are transmitted through the milk. This translates to a greater acceptance of a variety of foods later on in life and a more nutritionally balanced diet.

Children who are obese may suffer both immediate and long-term health problems. Obese youth are more likely to have risk factors for cardiovascular disease, such as high cholesterol or high blood pressure. In a population-based sample of 5- to 17-year-olds, 70% of obese youth had at least one risk factor for cardiovascular disease. Furthermore, children and adolescents who are obese are at greater risk for bone and joint problems, sleep apnea, and social and psychological problems such as stigmatization and poor self-esteem.

Conclusion

An important change in nutritional habits occurs during the transition from infancy to toddlerhood at about one year of age. During this time, toddlers gain independence by developing self-feeding skills and increasing control over food choices. The transition is accompanied by improved motor skills, awareness of table behavior, appreciation for tastes and preferences, and increased energy and nutrient requirements. Caregivers for children at this age need to provide appropriate foods in a proper setting, structuring mealtimes, and encouraging behaviors and habits that will ensure survival and promote healthy growth and development.