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Nutritional Requirements of Infants

Infancy is a period of rapid growth & development & thus warrants good nutrition to support the same. Kids at this age have unique nutritional needs to be catered to.

Maintaining optimal nutrition is one of the most crucial requirements of infancy. WHO reports, 45 % of child deaths are due to undernutrition. Dietary and environmental influences in infancy have a direct impact on their long-term health. It thus becomes important to understand the nutritional requirements of infants.

Calorie Requirements and Energy Expenditure

As per WHO, energy requirement during infancy is defined as the amount of energy needed to balance total energy expenditure at a desirable level of physical activity and to support optimal growth and development with long-term health.

Several factors determine an infant’s caloric intake. Few of these include energy expenditure for basal metabolic processes, physical activities & unexpected increased energy utilization during illness. A healthy child up to 1 year of age should receive around 100 kcal/kg/day. Caloric requirements of neonates are higher about 110–135 kcal/kg/day.

Of the total energy requirement, the basal metabolic rate of a healthy infant utilizes about 40-60 kcal/kg/day. Thermoregulation contributes massively to the energy expenditure in early infancy due to the minimal store of subcutaneous fat.  Often up to 30-50 kcal/kg/day is required for various physiological processes like digestion, absorption, storage, and elimination.

ICMR Recommendations for Calorie Requirements:

 

Age  Calories (Kcal/ kg/day)
0-3 months 120
4-6 months 115
6-9 months 110
9-12 months 105
1 year 100

Proteins 

Proteins are building blocks of the body. They tplay a significant anabolic role in muscle and tissue building. Lack of proteins can hamper cellular growth & repair. Structurally, proteins are large molecules composed of chains of amino acids joined by peptide bonds. 

Protein in neonates is primarily consumed as whey or casein proteins.  Exclusive breastfeeding meets the protein and amino acid requirements during the first 4–6 months of life. In whey methionine content is less whereas cysteine content is less in casein. Breast milk is an excellent source of both whey & casein. The bioavailability of protein in breastmilk is higher thus making more protein available to breast fed infants.

ICMR Recommendations for Protein Requirements:

 

Age  Protein (g/kg/day)
0-3 months 2.2
4-6 months 1.8
6-9 months 1.8
9-12 months 1.5
1 year 1.5

Lipids (Fats)

Fats are concentrates of energy & serve as the main source of energy for infants.The n-6 and n-3 long-chain polyunsaturated fatty acids are essential for normal growth and development & most importantly for e neuronal & retinal maturation. During the fetal period, lipids are transferred from the mother to the fetus across the placenta as fatty acids. In breastfed babies, 40–55% of total dietary energy intake is derived from fats & triglycerides account for up to >90% of all lipid intake, with phospholipids and cholesterol acting as minor sources. 

Carbohydrates

Carbohydrates are the main source of energy & provide 40-55% of daily caloric needs. Lactose is the main digestible carbohydrate in human milk, providing about 40% of the energy content. A type of carbohydrate that is not digested by human digestive enzymes is called dietary fiber. An average daily intake of 200-300 mg/kg of dietary fibers is recommended in children.

Micronutrients

The micronutrient supply of an infant is mostly derived from human milk. This is further dependent on maternal micronutrient intake and lifestyle, such as tobacco smoking, alcohol intake or drug consumption. In formula-fed infants, micronutrient availability  depends on its content and bioavailability.

A  few of the most important micronutrients apart from the vitamins include minerals like iron, zinc, calcium, sodium & copper.

ICMR Recommendations for a Balanced Diet in Infants: 

Following aspects should be considered while designing a diet for infants:

  • Calories derived from carbs, fats & proteins should be as follows:

Carbs – 55-60%

Proteins- 10- 15%

Fats- 30-35%

  • The  ratio of proteins derived from cereals to proteins derived from pulses should be 4:1.
  • A minimum of 50gms of green leafy & other vegetables should be consumed daily.
  • The energy derived from jaggery & refined sugars should be limited to 5% of total calorie intake.
  • Adequate water should be consumed.
  • The economic, cultural & geographic differences should be taken into consideration & the food items should be affordable, acceptable & available.

Optimal growth & development of a child can thus be achieved with optimal nutrition & the right balance of various nutritional components.

Please Note:

The above excerpt has been taken from INFS’ Kids and Adolescent Nutrition Course.

The INFS Kids and Adolescent Nutrition Course is launched with the aim of helping you learn about the nutritional requirements during all the stages of childhood, starting from infancy to adolescence.

It helps you understand children’s eating behaviour. It also teaches you how to build a healthy lifestyle in adolescents. Various food allergies and intolerance are also addressed in the course.

In addition to all the information revolving around kids’ nutrition and well-being, you will also receive several tips and practical advice that aid in the healthy growth of children. The course is designed for parents, child caregivers, and all those aiming to work for children’s healthcare.

Click here to know more about the course.

References:

  1. https://www.ncbi.nlm.nih.gov/books/NBK560758/
  2. Aruchamy Lakshmanaswamy, Clinical paediatrics – History taking & case discussion.3rd edition.p.174 -198.
  3. B Koletzko, Paediatric nutrition in practice.2nd edition. P.6 -13.
  4. Ronald E. Kleinman, Paediatric nutrition. P.723 -774.
  5. https://www.cdc.gov/nutrition/infantandtoddlernutrition/index.html
  6. https://onlinelibrary.wiley.com/doi/full/10.1111/j.1740-8709.2010.00262.x
  7. https://www.who.int/health-topics/infant-nutrition#tab=tab_1

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