Infant and Toddler Nutrition: Breastfeeding to Weaning

Introduction to Infant and Child Nutrition

Babies and toddlers need a nutrient-rich diet for healthy development. Nutrients play a vital role in developing the brain, eyesight, and overall growth of the child (Phoebe, Fetherston, & Nilson, 2019). Breast milk contains all the nutrients a baby needs until the baby is six months old. After six months, babies and toddlers should be given additional nutrients—vitamins, fiber, and minerals—found in a range of foods such as vegetables, fruits, dairy, meat, grains, and meat alternatives. Until the baby is 12 months of age, they should continue to receive breast milk even after weaning begins. Breast milk continues to offer valuable immunological protection and nutrition for two years and beyond.

According to Phoebe et al. (2019), exclusive breastfeeding means the baby is fed only breast milk, including expressed breast milk, with no infant formula or non-human milk provided during the first six months after birth. Good nutrition is critical to support the constant growth and development of children. It also gives children the energy they need to focus, learn, and play (Black, D'Onise, McDermott, Vally, & O'Dea, 2017). Children can be protected from chronic diseases and premature death when they are given a balanced and varied diet.

Parents should be careful about the foods they buy. In many cases, parents purchase products labelled "low-fat," "containing fruit," or "no added sugar," assuming they are healthy. Reading food labels provides essential information about how healthy a product actually is. Parents should pay close attention to sugar and fat values to guide better choices.

This portfolio covers the following areas: breastfeeding advice, weaning, common feeding supplements, parenteral nutrition, and parent support and education.

Breastfeeding Advice and Latching

Breastfeeding is a partnership formed between the mother and the baby (Brown et al., 2019). The partnership takes time to establish successfully. New mothers need time to gain the confidence required to breastfeed, and they should be supported during this period. Nurses provide the new mother with advice and assistance after birth to help her learn how to breastfeed. Ideally, a baby is first fed as soon as they demonstrate readiness after birth, and in most cases this happens within the first hour (Arora et al., 2017). Midwives and nurses present during delivery will help the mother recognize when the baby is ready for the first feeding. The mother is shown how to breastfeed, and strategies to ensure the baby latches fully onto the nipple are provided. Nurses should educate the mother on the importance of breastfeeding during the first few days after birth. Colostrum is produced during this period and is highly beneficial to the baby (Connolly et al., 2019). It contains antibodies that protect the baby against illness and infection.

As a nurse, you should be skilled in assisting the mother to consistently achieve correct infant positioning and attachment at each breast (Brown et al., 2019). A hands-off approach can be used to demonstrate proper positioning and attachment. The mother is advised to find a comfortable position to avoid muscular strain. She should place a hand between the baby's shoulder blades to support the head and neck while keeping the baby free to move toward the breast and latch. Effective communication is vital in nursing practice, as established by the Nursing and Midwifery Board of Australia (NMBA, 2017) standards 2.2 and 2.4.

A mother's breast milk contains all the necessary nutrients needed by the baby for the first six months (Arora et al., 2017). Mothers are therefore encouraged to breastfeed exclusively for six months. Breast milk includes expressed milk. A common concern among many mothers is an insufficient milk supply; however, mothers should be advised that breastfeeding works on a demand-and-supply basis. The more the baby breastfeeds, the more milk the mother will produce. Mothers should therefore be encouraged to breastfeed as often as possible to increase their supply (Daniels et al., 2018).

Breast milk comprises approximately 87% water, 1% protein, 7% carbohydrate, and 4% lipid. It also contains many vitamins and minerals, including sodium, calcium, magnesium, phosphorus, and potassium (Connolly et al., 2019). Breast milk is high in cholesterol, which is involved in brain development and serves as a precursor to hormones.

Weaning: Timing and Considerations

It is recommended to exclusively breastfeed for six months to encourage the baby's growth and development. After six months, the baby can be introduced to other foods to provide the additional nutrients needed to support continued growth. As the baby grows, their nutritional needs increase beyond what breast milk alone can provide, which is why weaning to other foods begins—alongside continued breastfeeding (Brown et al., 2019). Mothers should not stop breastfeeding when weaning begins. Weaning is the period during which the baby receives a combination of other foods with breast milk, ending only when the baby no longer breastfeeds. Breastfeeding should not be stopped abruptly; it should be done gradually so that both the baby and the mother can adjust (Daniels et al., 2018).

Breast milk continues to be produced, and if the baby is not suckling, the breasts may become engorged and begin to leak. To gradually reduce milk production, mothers should be advised to reduce daily breastfeeding frequency over time. NMBA standards 3.2 and 6.4 guide the nurse in educating and informing the mother about how to wean the baby (The Nursing and Midwifery Board of Australia, 2017).

Holtzman and Usherwood (2018) state that a baby is ready for weaning when they can hold their head up and sit upright, close their mouth around a spoon, have doubled their birth weight, and can move food from the front to the back of their mouth. These guidelines help ensure the baby is not weaned too early and is not at risk of choking on solid food.

The baby should be fed pureed vegetables such as squash or peas, fruits such as apples, peaches, and bananas, pureed meat, and semi-liquid cereals. Rice should be avoided as it poses a choking risk. When starting to wean, feed the baby tiny amounts—around 1 to 2 teaspoons—and gradually increase quantities to 1 to 2 tablespoons as the weeks progress. By the eighth month, the baby can begin eating bite-sized, soft-cooked vegetables and fruit cut into small pieces. To encourage growth, the baby should be fed protein-rich foods and iron-fortified cereals (Williams Erickson et al., 2018).

Conclusion

Proper nutrition plays a vital role in the growth and development of healthy babies. Mothers should breastfeed their newborn babies immediately after birth to stimulate milk production and to ensure the baby begins receiving colostrum. Colostrum is a yellow liquid produced during the first days before full breast milk production begins. It contains essential nutrients to boost the baby's growth and antibodies to protect against illness. In the first six months after birth, all the nutrients needed by the baby can be found in breast milk, making additional feeds unnecessary. Babies should be exclusively breastfed for the first six months, with weaning beginning after this point.

Weaning involves the introduction of solid foods, which must initially be pureed. Parents must ensure they offer the baby a balanced diet to provide all the nutrients needed to support healthy growth. If the baby does not receive adequate nutrients through food, they can receive them intravenously or through supplements. Preterm babies receive all the nutrition they need through parenteral nutrition—delivered intravenously into the bloodstream—since their immature gut cannot yet process milk feeds. Intravenous feeding ensures these babies receive the nourishment required to support their growth and development. Finally, parents should be educated on how to feed their baby and which foods offer the best nutrition. As the baby grows, parents should increase food quantities to ensure the baby receives adequate nourishment at each stage of development.

References

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