Nutrition

    Nutrition

     

     

    Approach

    (by Dr. Manis, Feb 2010)

    General Principles

    • Start solids btwn 4-6mo
      • Careful of allergies:
        • Add only one food every 3-4d to watch for allergies.
        • Start foods in the morning
    • Start with thin textures and gradually thicken.
    • Food quantities on demand: (i.e. if finishes 2 tsps of cereal and wants more, given more)
    • Give solids before breastmilk/formula.

     

    Food Groups

    • Start with single grain infant cereals
    • Rice first then add Barley, Oats, Wheat, one at a time every 4 days (wheat is usually not found in single grain, usually "mixed grain of 4 cereals").
    • After starting all grains add pureed vegetables.
    • Give orange vegetables first (carrots, squash, sweet potato) and then move on to others.
    • Feel free to make your own, not all veggies are availble as baby food.  Feel free to mix with cereal.
    • After trying most or all vegetables add fruit one at a time.
    • Example feeding schedule:
      • Breakfast - cereal/fruit.
      • Lunch - veggie/fruit (creal if desired)
      • Dinner - cereal/veggie (fruit if desired)
      • Give breastmilk or formula before meals and before bed (milk intake will diminish as eats more solids)
    • At 8-9mo introduce pureed meats at lunch or dinner  (ok to mix with other pureed foods) can also add baby yogurt (i.e. minigo)
    • Start transitioning to pieces of solid food btwn 10-12mo.  Keep pieces small to avoid risk of choking.
    • Avoid honey until 1year of age (infant botulism and dental hygeine).  
    • Careful if family nut allergies.

    Homo Milk

    • Do not give milk until 9-12mo - otherwise causes GI irritation, microscopic bleeding, worsening anemia.
    • When taking cows milk, limit to 18oz/day (16-24 oz/day) (1 cup = 8oz)

    Vitamin D

    • 400IU/day, Use drops into mouth or on nipple.
    • Sometimes formulas fortified.

     

    Calories

    • Average neonatal requirements are 100-120 cal/kg/day (preterm 115-130 and VLBW 150).
    • Average wt gain is ~30g/day

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