Some Guidelines for Infant Feeding During the First Year of Life

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Mother and child
Breast-feeding fulfills maternal needs

The best food for babies is mother’s milk. This wonderful food is specially designed for babies. Human milk contains immune protective factors, a balance of amino acids, not found in other milks, fatty acids, lactoferrin for biotic health, and other enzymes and micronutrients not remotely duplicated in formula. Human milk changes in its constituents as babies progress from birth to toddler hood to provide the right balance of nutrients. Formula is static. A large and evolving body of research has demonstrated immediate and long-term benefits of breast-feeding to infants. These benefits include enhanced resistance to colds, flu, upper respiratory diseases, bacterial and viral infection, lower risk of long term allergies, such as asthma, improved central nervous structure and function, as suggested by higher IQ. In some parts of the world, breast-feeding during the first year of life increases infant survival rates more than twenty fold.

Formula Cost and Composition

New parents are recipients of unsolicited largess from Abbott laboratories, Mead- Johnson, and other pharmaceutical and agribusiness producers of infant formulas. New parents regularly receive promotional cans of Similac, Enfamil, and Isomil. Promotional gifts pay off for the conglomerates –the free can given at birth may promote a habit to buy the same brand formula. The cost for typical, milk-based powdered formula for a formula-fed infant averages slightly more than a hundred dollars a month for the first year or 1, 318 dollars per month. The cost for ready-to-feed formulas average more than 3, 000 dollars per year, and specialized formulas, such as soy based Isomil, somewhere in-between. The formula business is big business with retail expenditures between three and six billion dollars annually in the United States alone.

The nutritional value of formula composition is variable. Abbot laboratories’ Isomil, a soy-based formula, is 42.5 % corn syrup, 10.5% sugar, 11.7% safflower oil, 8.6% coconut oil, 8.3% soy oil, 14.1 % soy protein isolate, along with 1.8% calcium phosphate, 1.2 % potassium citrate, and the remaining 1% a mixture of vitamins. The nutritional composition is instructive. Isomil, along with other formula, attempts to approximate the composition of human milk for its gross constituents. The Isomil formula is approximately 53% carbohydrate from non-lactose simple sugars, 28.6 % fat, 14.1 % protein, 3 % calcium and potassium, and about 1% vitamins. Mead-Johnson’s Enfamil formulation is somewhat more obscure. Calculated from gram weight, the Enfamil formula is approximately 58% carbohydrate, 28% fat, 11% protein, and 2.7% calcium, potassium, and added vitamins. Enfamil’s carbohydrate is from lactose, its protein, from whey and milk, and its fat, from palm, soy, coconut, and sunflower oil.

Weaning

Weaning describes the period of transition from liquid food delivered through sucking by breast-feeding or bottle-feeding to semi-solid or solid foods imbibed by the coordinated action of mouth, tongue and larynx. Weaning involves change of food, and it involves change in how the food is assimilated. Weaning ends when the infant, now a probably a toddler, is able to select, hold, chew, and swallow –with no assistance by an adult. Digestive processes also must progress with the elaboration of digestive enzymes, including sufficient amylase in the salvia to promote digestion of common grains. Bacteria in the colon need to shift from a milk economy to a more diverse regime. Therefore, weaning is complex and involves biochemical and physiological changes, along with changes in self-management and parental behavior, over a prolonged period of time. Weaning usually begins sometime around the fourth to sixth month and continues until twelve to eighteen months or beyond.

Milk during Weaning

In most cultures, milk is a staple before, during, and after weaning –until the end of early childhood. During the period of weaning, a baby is far better off with breast milk than with formula –and if formula-fed, with a milk-based, rather than soy-based formula. Since fewer babies display an allergic response to goat’s milk than cow’s milk, goat’s milk is preferable to cow’s milk as a milk staple or supplement to nursing.

When milk is given as a supplement to breast milk or formula, milk should always be non-homogenized, full fat milk. Organic is preferable to commercial milk. The milk should be non-homogenized so the baby has the opportunity to digest the fat globules. Otherwise, homogenized fat passes into the blood stream undigested. The milk should be full fat because babies are building their brains and nervous system. The largest constituent of the brain is cholesterol, so babies greatly benefit from fat rich foods. The milk should be organic because commercial milk may be contaminated with steroid hormones, pesticide residues, and chemical elements to which the infant’s developing nervous system is particularly vulnerable.

In addition, the Weston Price Nutritional Foundation argues that milk should be unpasturized. Unpasturized milk is far richer in enzymes that aid digestion and promote healthy assimilation of protein –but unless farm-fresh, unpasturized milk may spoil quickly. Unpasturized milk requires extra care in food handling.

Problematic Foods during Weaning

First do no harm. Eliminate foods that are problematic from your infant’s diet. Some foods do more harm than good. Such foods tend to have a cumulative effect when part of the regular diet. Occasional use of such foods is unlikely to cause any lasting problems and may be even be beneficial. The benefit arises from stimulation of the body’s defenses. If the food is met in the future, the body is prepared to cope.

Soy foods

Not only are soy foods allergenic for many children, but a variety of studies suggest extreme caution in soy use for human food. Concerns about the safety of soy revolve around plant estrogens that may impact sexual and nervous system development, phylates that block uptake of some necessary minerals, and dangerously high concentration of manganese.

High Acrylamide foods

Recent research reveals that high carbohydrate foods that have been prepared at high temperature are high in acrylamide. Acrylamide is a potent carcinogen. In particular, crackers, French fries, potato chips, and most prepared breakfast cereals are to be avoided. Parents may substitute carrots and celery sticks for crackers. To avoid acrylamide production, crackers, cookies, fries and baked potatoes may be prepared through low temperature baking at 200 F.

Partially Hydrogenated Fats

Hydrogenation often improves food texture and shelf life. Many fats in foods are partially hydrogenated. Partially hydrogenated foods often contain significant portions of trans fatty acids. Trans fatty acids disrupt cellular metabolism. Avoid foods that contain partially hydrogenated fats.

Avoid or rotate allergenic foods

Approximately 3 to 4 percent of infants display overt allergic responses to cow’s milk and soy products. The allergenic properties of cow’s milk and soy are cautionary for all babies. Allergies are notoriously elusive and often difficult to diagnose, and take multiple forms, including allergies of the central nervous system. Allergies have been implicated in disorders from asthma to hyperactivity. Allergies arise in part because the immature digestive system permits allergens to cross into the blood stream unaltered by digestion. The digestive system is sufficiently mature to “denature” most allergenic foods around nine months to one year of age, but digestive maturity continues to increase until the end of early childhood. Therefore prudence advises that parents limit the infant’s feeding of allergic foods for the first 9 to 12 months or longer if necessary.

Interestingly, many allergenic foods are associated with Western cuisine. Western cuisine involves the ubiquitous use of wheat, milk and milk products (cheese), and eggs in breakfast, lunch and dinner. These food products are found in breads, noodles, fast foods, desserts, and sauces. Other potent allergens, soy, tree nuts, peanuts, shell fish are present in Asian Chinese diet. However these foods are restricted by tradition during breast-feeding and early weaning.

The common foods with high allergenic potential are cow’s milk, eggs, tree nuts, peanuts, soy, fish, shellfish, and wheat. If the infant is allergic, specific allergies may be identified by observation of the child’s reaction after eating the allergenic food. Foods to which the baby is allergic should be eliminated from the diet for the nine months to one year and then gradually reintroduced. After reintroduction of a former allergenic food, the baby should be observed for four days for any signs of allergy. The food may be continued if no allergic reaction results; otherwise the food must be discontinued and again may be introduced after three to six months until it is tolerated without allergic reaction. Other allergenic foods to which the child is not allergic should be fed to the child on a rotation basis –about every three days. Rotation reduces the likelihood of sensitization to allergens.

Be Cautious about High Glycemic Foods

During the last decade, a major area of investigation in the nutrition literature has been the glycemic index (GI). The glycemic index is a measure of the body’s insulin response to foods. By definition, pure sugar has a glycemic index of 100. Protein and fat elicit minimal insulin response and so have a glycemic index near zero. White bread has a glycemic index that is about 76. Milk, and cherries, apples, pears and vegetables are in between, but sometimes values are surprising. Ripe melons, for example, may have a glycemic index near that to white bread. Widely used tables for food GI are available on the inter-net. Foods with high GI have been implicated in a wide variety of disorders, ranging from diabetes to cancer and heart disease.

In the infant nutrition literature, little attention has been paid to the role of foods with high GI to later health. The high sugar content in infant formula should be a cause for concern, although the admixture of fat and protein in formula attenuates glycemic response. The GI for human milk is approximately 30. Since human milk provides a recognized “gold standard” for infant and early childhood nutrition, infant meals should have a glycemic index that approximates human milk.

The GI for the commonly recommended “first food” refined rice cereal is between 60 to 90. Unless mixed with low glycemic foods, this may be like eating sugar from a spoon. Therefore rice cereal should not be served as a stand-alone meal. As a general rule, sweet foods need to be balanced with fat and/or protein. High GI foods are acceptable so long as these foods comprise only a portion of the meal’s calories and are mixed or pureed with foods that have moderate or low glycemic values. Some healthy examples are fruit mixed with unsweetened yogurt, sweet potato with butter, banana with apples and full-fat breast or goat milk. Cow’s yogurt generally may be safely introduced at an earlier age than cow’s milk because the bacterial action of the yogurt culture aids digestion.

Healthy Foods during Weaning

Sound principles, techniques of food preparation, and basic recipes for weaning and foods for the young child are provided in Annabel Karmel’s excellent primer, First Meals (New York: DK Publishing, 1999).

As a rule, fresh food is more desirable than cooked food, providing that the food is free of bacteria. In some parts of the world, almost all foods, other than fruits, need to be cooked to avoid bacterial illness. Canned foods lose a significant portion of their vitamins. Frozen food retains a higher portion of food value than other methods of food preservation. In many instances, infants during weaning may eat the same food eaten by adults so long as it is properly prepared (pureed) and not spicy. However until the end of the first year, most carbohydrates should be from lactose in human, goat, or bovine milk or formula.

Provide fatty meals

During the first year of life, the brain more than doubles in size! The brain and nervous system need the right food to grow. Baltic republic Europeans feed infants liver and brains. These organ meats provide healthy fat and protein constituents. Very high in cholesterol, calf’s brain contains all the essential building blocks for human brain. Whenever possible, organ meets, especially liver, should be organic since liver tends to concentrate toxins. Other fatty meals include full-fat milk and egg yokes. Finely grated, tree nuts and seeds in casseroles and tortes –along with nut and seed butters and milks — may be gradually introduced after nine months to one year of age.

Add supplemental extension foods

Supplemental extension foods greatly augment nutrition from ordinary foods. These foods should be added after the eight month when the digestive system has reached relative maturity. Some of these foods may elicit an allergic reaction, so add one at time, and allow four days before the introduction of the next extension food. As with all foods once the food has been introduced, rotate every three days.

To basic purees and meals, add ¼ teaspoon spirulina once to twice daily every two to three days (more for vegetarian and heavier babies). Rotate with other green foods, such as broken cell cholera. Spirulina or broken cell cholera provide a wide range of micronutrients, amino acids, and fatty acids for growth and development. On a rotation basis, add 1/8 to ¼ teaspoon nutritional yeast for DNA/RNA and B vitamins. On a rotation basis, add 1/8 to ¼ teaspoon flavored or non-flavored Norwegian Cod Liver Oil for DHA and EPA. Organic flax oil may be substituted for allergic children. Other nut and seed oils, such as almond oil and sunflower oil, packed in nitrogen in opaque containers that are dated for freshness may be given. On a rotation basis, add 1/8 to ¼ wheat germ for B vitamins, vitamin E, oil, and protein. On a rotation basis, sprinkle foods with kelp powder for minerals. On a rotation basis, serve tahini, and other organic, non-hydrogenated seed butters for fatty acids. On a rotation basis, serve boiled egg yoke for cholesterol.

In addition, infants may benefit from prescription vitamin drops that contain B and C vitamins. The B and C vitamins are water-soluble and are quickly eliminated by the kidneys and hence require constant replacement. Vitamins A, D, and E are oil-soluble and may be stored in body fat. Hypervitaminosis has been demonstrated only for vitamins A and D.

After word

The suggestions aim to increase the health and growth of your infant. Your child’s well-being is too important to be trusted to the pharmaceutical industry. These guidelines take the nutritional components of breast – milk as the ideal nutritional regime for the infant. This means that the major nutritional components are mimicked in terms of high fat and relatively high calorie foods, but with a glycemic value that approximates human milk. This means that “sweets” and readily assimilable carbohydrates must be balanced. Children need to avoid what is demonstrably problematic such as high acrylamide, partially hydrogenated, and soy based foods. Care must be taken to avoid allergic reactions. On the other hand, infants benefit from freshly prepared foods that are richer in vitamins and nutrients than canned foods. Since the body and the brain are undergoing rapid change, the continuous bioavailability of all the nutrients — with supplementation by modest amounts of vitamins, and the addition of selected fatty and nutritive rich foods — is highly beneficial.

THE SUGGESTIONS IN THIS PAPER ARE NOT INTENDED TO DIAGNOSE OR TREAT DISEASE OR DISORDERS. BEFORE FOLLOWING SUGGESTIONS IN THIS PAPER, CONSULT YOUR PRIMARY CARE HEALTH PROVIDER.