Infant Toddler Development Training
Module 6, Lesson 1
Feeding and Related Issues
Breastfeeding has significant health benefits that make it superior to formula feeding for the majority of infants. Please refer to the AAP Policy on Breastfeeding.
The composition of breast milk is the model for infant formulas. It is lower in protein compared to cow's milk, but higher in carbohydrate and fat. Breast milk contains good cholesterol that is necessary for brain growth. Breast milk is lower in iron, but the iron that is present is bound to a transport protein that is easily digested by the baby. In addition to providing the nutrients that help the baby to grow, breast milk contains immunoglobulins and t cells that confer a protective immunity to the infant. This helps the infant ward off infections, particularly those related to gastrointestinal infections.
If the breastfeeding experience is successful, it can promote maternal and infant bonding and if it is not, it can actually become a source of stress and embarrassment to the mother. Pain relief and relaxation are important considerations to success. Sometimes an effective intervention is arranging for a breastfeeding coach through the La Leche League.
It is typical to have occasional spit ups especially with formula feeding because the volumes consumed are usually greater and stay in the stomach longer than breast milk. The segment of the esophagus, at the juncture of the stomach and esophagus acts like a valve. If the segment is relatively lax, there can be a lot of spitting up and this is called gastro-esophageal reflux (GER). Reflux is usually not present at birth, but gradually becomes apparent and worsens with increasing volumes of milk/formula ingested in the first month of life. The reflux is usually not forceful as it is in another condition, that of pyloric stenosis which can result in projectile vomiting and requires surgical intervention. Routine reflux usually improves by six (6) months of age and disappears by one (1) year of age. If there are frequent and severe episodes, one might observe apnea (short period of not breathing), wheezing or choking. One might also observe pain from the esophagitis, and fussiness from the same or from hunger and failure to gain weight. These situations require prompt attention especially if the child is showing a failure to grow.
It is important for the ITDS to recognize that there is a difference between routine regurgitation (spitting up) and vomiting. How would the ITDS differentiate between the two?
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