Feeding children in the first year of life

Breastfeeding

Breastfeeding is called feeding a baby with mother’s milk. In the first months of life (up to 5 months), breast milk is the most favorable food, as it contains all the essential nutrients, including the composition and ratio, which are best digested and absorbed at this age. In addition, breast milk contains enzymes, hormones, specific antibodies and non-specific substances that kill microbes. Babies get sterile milk from their mother’s breasts. When breastfeeding, they develop better, are less likely to get sick, more easily tolerate diseases than infants who are mixed or artificially fed. Taking into account the child’s great need for food and the inability, due to the small size of the stomach and the weak activity of the digestive glands, to receive and digest large quantities of it at once In the first two or three months of life, it is recommended that children be fed frequently and in small portions. As the gastrointestinal tract develops and the digestive glands become more active. The amount of food to the child at one time is gradually increased, and the frequency of feedings during the day is reduced. More correct is the determination of the amount of milk needed by the child on the basis of its weight, condition and need for food ingredients. If the weight of the child meets the average age standards, the amount of milk per day should be for the child from 2 weeks to 2 months 1/5 of his body weight; for a child from 2 to 4 months – 1/6 of his body weight; for a child from 4 to 6 months – 1/7 of his body weight; for a child from 6 to 9 months – 1/8 of his body weight. The data of the volume of food should be taken as an approximate when first prescribed nutrition. In the future, you need to reckon with the appetite of the child, making only a qualitative correction. The missing amount of protein can be replenished with cottage cheese or protein preparations (kazzol, plasmon). The shortage of fat is most advisable to correct fish oil, as well as cream and, at an older age, butter. To compensate for the missing amount of carbohydrates use sugar syrup. In preschool institutions, it is necessary to create conditions for breastfeeding. To this end, for nursing mothers, they will equip a special room where they put a table for placing items needed for breastfeeding (boric acid solution, tweezers, cotton swabs, petroleum jelly, gauze napkins, etc.), a hand washing basin, a cupboard or a hanger for clean bathrobes, changing table. Before feeding a child, a woman should wash her hands with soap, put on a clean robe and scarf, cover her mouth and nose with a bandage consisting of four layers of gauze, wipe the nipple with a cotton swab dipped in a solution of boric acid. Introducing vitamins and mineral salts into the baby’s food. With breastfeeding, all children from one month of age should receive ascorbic acid. Babies who are breastfed should be given ascorbic acid at 30 mg per day, and those receiving donor sterilized milk should be given at least 100 mg per day (50 mg 2 times). Vitamins of group B can be given to babies from 2 months of age in the form of pasta from bakeries. yeast one teaspoon per day; or dry beer yeast hydrolyzate, two teaspoons a day. Vitamins A and D a child receives with fish oil from a month of age, starting with drops (5 drops 2-3 times a day), adjusted to 1-2 teaspoons per day for 10-12 days. When assigning fish oil to a child, it should be remembered that it should be given at the end of feeding, as it, like any other fat, inhibits the activity of gastric secretion. Berry, fruit and vegetable juices should be given to a child from 1-1.5 months old, from 1/2 teaspoon to 40–50 mg per day (in 2–3 doses), from 4 months of age – grated apple, from 1/2 teaspoon to 2 tablespoons per day. B 4.5 For a month, a child can get 1/2 egg yolk per day as a source of phosphorus, calcium, iron, vitamins A, D, B1, B2, PP, as well as high-quality protein and fat. For the purpose of less allergization and prevention of viral diseases, the yolk should be given in a boiled form. By 5-6 months of life in a child the possibility of digesting and assimilating new types of food increases. Breast milk no longer satisfies all of its nutrient needs, and if you do not start feeding in a timely manner, the child may experience growth and developmental delay, metabolic disorders. Earlier (from 4 months), the introduction of complementary foods can be recommended for anemia, rickets, persistent regurgitation, later – in acute gastrointestinal disorders, febrile diseases, intense heat. When introducing supplements, the following basic rules must be followed: feed up before breastfeeding, be introduced gradually, starting with small quantities, go to another type of complementary foods only after the child gets used to the first species; the lure should be homogeneous and not cause the child difficulty in swallowing. With age, you should move to a thicker, and later to a dense food, perhaps earlier teaching the child to eat with a spoon and to chew. The first supplements can be vegetable puree or 5% porridge on vegetable broth in half with milk. Vegetable puree as the first supplement is useful to prescribe to children premature, suffering from exudative diathesis, rickets, hypotrophy, and also due to the fact that after porridge children reluctantly take vegetable puree. After 2 weeks after the introduction of 5% porridge it is replaced by 10% on whole milk, and the semolina must be alternated with buckwheat, oatmeal, rice. Buckwheat porridge is especially useful for children. Butter in the diet of the child is administered from 5.5 months of age. In 10% porridge and vegetable puree add 3 g of butter. At 7 months of age, they give soup in meat broth (not more than 50 ml per day) and a crouton made from white bread. Thus, at 7 months old, a second complementary feed is introduced to the child – a lunch consisting of soup, vegetable puree and pureed fresh apple. From the age of 8 months, the child is prescribed a third supplement – kefir or whole milk with cookies. At the same age, they begin to give meat (up to 30 g per day). Initially, they give minced meat (boiled meat, double-rotated), from 10 months – meatballs, by the end of the year – steam cutlet. It is useful to give the child liver, brains, fish. Assign jelly children of the first year of life should not be, because this dish greatly enriches the food with carbohydrates, and its nutritional value is negligible. It is more advisable to give fresh or canned fruits, berries, juices, rich in vitamins and mineral salts. In areas where, in the summer, the population lacks fresh berries, fruits and vegetables, as well as in winter (in the middle zone of our country), canned food can be prepared specially for baby food from high-quality varieties of products. It is advisable to diversify the lure, but never switch to a new type of food, if the child is not used to the previous one. Increasing the amount of new food given to the child as it gets used, it is gradually replaced by breastfeeding one by one. The total amount of food received by the child for one feed should not exceed 200 ml in the second half of the year. Assigning mixed and artificial feeding is necessary if there are substantial indications for this. However, if there is a shortage of breast milk, it is not necessary to delay the baby being breastfed. Timely appointment of rational mixed and, if necessary, artificial feeding prevents the development of malnutrition. Mixed feeding is conventionally considered to be such feeding, when the mixture is more than 1/5 of the daily diet of the child; with artificial feeding, breast milk is either completely absent, or its amount is less than 1/5 of the total food. Indications for the purpose of mixed feeding are true hypogalactia and some mother’s diseases, when there is no need to completely take the baby away from the breast, but it is desirable to reduce the number of breastfeeding. The reason for transferring the child to artificial feeding is the complete absence of milk and the inability to provide the child with donor milk. When mixed and artificially fed, the staple food is cow’s milk. 100 ml of cow’s milk contains 3 times more protein than female, but it is much worse to digest. This is due to the predominance of casein fractions in cow’s milk. Therefore, when mixed and artificial feeding of protein per 1 kg of weight should be greater than with natural. The fat content in women’s and cow’s milk is about the same, but its different chemical composition determines the harder digestibility and digestibility of cow’s milk fat. Carbohydrate in cow’s milk is 2 times less than in female milk, therefore sugar is added to cow’s milk. Vitamins and enzymes in cow’s milk is significantly less than in female. For some approximation of the quantitative composition of the substances of cow’s milk to the female it is diluted with mucous or flour broth. This is achieved by reducing the amount of foreign protein and fat and increasing the amount of carbohydrates. In order to increase the absorption of the main ingredients of cow’s milk, acidic mixtures have been proposed, the advantage of which is an acidic reaction that inhibits the growth of bacteria and increases the absorption of fat, as well as the fine cotton casein digestion and assimilation. Of all the known types of yogurt, kefir deserves the most attention, stimulating the secretion of digestive juices, bile, containing vitamins and enzymes. Lactic acid, which accumulates in kefir, contributes to the gentle curving of the protein and better absorption of fat. Kefir lactic acid bacteria displace pathogenic intestinal flora, so it is especially indicated for children with unstable stools in summer. To preserve the correct ratio of ingredients and give food a pleasant taste, sugar is added to kefir: for children of the first 5-6 months of life — 10%, for the older ones – 5%. In recent years, for the early mixed and artificial feeding of children, ion-exchange milk, as well as the mixture “Baby” and “Baby” are finding increasing use. Ion milk is obtained from whole cow milk by treating it with cation resin, as a result of which the amount of calcium salts is reduced by 20-22%, the ratio of calcium and phosphorus approaches their ratio in human milk. The amount of albumin fractions in ion-exchange milk is relatively more casein, its spreading occurs with smaller and more tender flakes, which increases the absorption of casein. These advantages of ion-exchange milk allow it to be used without dilution at an early age and thus increase the amount of protein, fat and minerals in the diet of children. It is especially shown for children premature and with manifestations of malnutrition. Ionite milk can also be used to make kefir, acidophilus milk and curd. A mixture of “Baby” and “Kid” has the same advantages over cow’s milk. Due to the optimal ratio of proteins, fats, carbohydrates and other ingredients in these mixtures, it is possible to ensure rational feeding of children – mixed and artificial – starting from the neonatal period. When mixed feeding, nutrition needs to be given only in the really necessary amount and in such a way that the amount and calorie content of food corresponded to the needs of the child. In each case, it is necessary to consider how much breast milk the baby receives from the mother. To do this, in child care facilities, the child is weighed within 1-2 days before and after each feeding. The missing amount of breast milk is filled with mixtures. Supplement is administered gradually so that within 3-4 days to fully cover all the needs of the child in the main food ingredients. Supplements can be either self-feeding, or added to breast milk at each or some feeding. The latter method is more appropriate for hypogalactia in the mother, since regular and quite frequent breastfeeding of the baby contributes to an increase in the amount of milk in a nursing woman. It is also necessary in the first days of introducing the supplement (regardless of the reasons that caused its purpose) and if the child is sensitive to new food. After the child gets used to the mixtures, they can be given as independent feeding, alternating with breastfeeding. However, it is necessary that breastfeeding should be at least three or, at most, two, as with a rare attachment of the baby to the breast, lactation quickly fades away. As a supplement with mixed feeding, it is better to use kefir and only if it is not available, sweet mixes can be recommended. mucous or floury broths made from various cereals: rice, oats, buckwheat, etc. are added to milk. If a child is fed with expressed female milk and kefir, it is better to mix them together in one bottle just before It is easy to add a child to kefir (it can be complete regardless of the child’s age). Children up to 3 months, if the amount of the supplement is large or given as independent feeding, prescribe B-kefir (2/3 kefir and 1/3 broth ). Transfer of a child from mixed feeding to artificial, as a rule, is easily tolerated, since breast milk is ousted from the diet. If a child is transferred to artificial feeding suddenly, then such a transfer must be done very carefully, starting with dilutions. The first dilution, regardless of the age of the child, designate B-kefir or B-rice (1/2 kefir and 1/2 broth) for 4-5 days as a transitional mixture, then B-kefir or B-rice and after 5-6 days , if necessary, you can give whole kefir. The feeding mode for mixed feeding remains the same as for breastfeeding. With artificial feeding, an earlier transition to five times feeding with longer intervals between individual feedings is recommended, since foreign food is retained longer in the stomach. The volume of food, as with breastfeeding, depends on the age and weight of the child. The need for a child in the main food ingredients for mixed and artificial feeding is somewhat different than for breastfeeding. The need for protein depends on the ratio of breast and cow milk. If breast milk is 2/3 of the daily amount of food, the baby should receive 3 g of protein per 1 kg of weight; with an equal amount of breast and cow milk – 3.5 g; with 1/3 of breast milk and 2/3 of cow’s milk – 4g. When artificial feeding, the child should receive 4.5 g of protein. Fats and carbohydrates when mixed and artificially fed children receive in the same amount per 1 kg of weight, as in the case of natural feeding. Foods with mixed and artificial feeding are prescribed in the same sequence as and with natural, but all their species are introduced into the diet a month earlier. Fresh fruit, berry and vegetable juices, grated raw apple, fish oil, yolk are prescribed to children in the same quantities, but 2–2.5 weeks earlier than they receive during natural feeding, ascorbic acid is given to a child at least 100 mg per day. . One of the conditions that ensure the normal development of infants, especially when mixed and artificial feeding, is feeding them according to appetite. In this case, the feeding hours must be strictly observed, and the amount of food in each feeding should be appetite. It is impossible to forcibly give the child all the prescribed amount of food or refuse to supplement it. In cases where the child systematically eats less than prescribed, the doctor must make the appropriate qualitative changes in his diet. How to feed children with mixtures. Mixtures of children should be given with a teaspoon. If the baby is fed from a bottle with a nipple, then the nipples should be with several small holes. The mixture is prepared for one day and kept in a cold and dark place until the baby is fed. Before feeding, the bottle with the mixture is warmed in warm water to a temperature of 40-45 °. During feeding, the child is held on his lap, his head is placed on the left, slightly raised forearm of the nursing mother. With a lack of staff, children can be fed in beds. To prevent abundant regurgitation (vomiting) it is necessary to ensure that the child does not swallow air while receiving food. For this, the neck in the bottle must always be filled with the mixture. After eating, the duration of which should not be less than 8 minutes, it is recommended to hold the child in an upright position for 2–3 minutes in order to better leave the air trapped in the stomach with food. From the first days of a child’s life, it is necessary to strive to ensure that food intake gives him pleasant emotions. Therefore, before feeding, the child should show the bottle with food, talk with him tenderly, teach him to actively nip the lips, while sucking to hold the bottle with handles. После приема детьми пищи соски промывают проточной водой и кладут на час в раствор соды (чайная ложка питьевой соды на стакан кипяченой воды). Только после этого их перекладывают в специально предназначенную сухую посуду.В каждом детском учреждении, которое посещают грудные дети, должны быть соски с несколькими отверстиями для жидких смесей и с одним большим для 5%-ной каши и киселей. Каждый вид сосок хранится в специальной банке или кастрюльке с крышкой. Количество сосок должно быть в полтора раза больше числа детей, нуждающихся в них.Оставшуюся после кормления пищу обязательно выливают, бутылки споласкивают и моют ершом в теплой воде с питьевой содой.Стерилизация и пастеризация молока. Чтобы меньше разрушалось витаминов и ферментов, а также сохранялись свойства белков, желательно молоко не кипятить, а стерилизовать.На больших молочных станциях стерилизация молока проводится в специальных стерилизаторах, в небольших детских учреждениях ее осуществляют в аппарате Сокслета, представляющем собой кастрюлю, в которую вставлена сетка из проволоки с гнездами на 6—12 бутылочек. В этот аппарат помещают бутылочки с молоком, несколько выше уровня молока заливают теплую воду, аппарат закрывают крышкой, воду в нем доводят до кипения; 3—5-минутное нахождение бутылочки в кипящей воде является достаточным, чтобы убить большинство бактерий. Более длительная стерилизация неблагоприятно отражается на физических, химических и вкусовых качествах молока.Еще меньшего разрушения витаминов и ферментов можно достичь при пастеризации, т. е. нагревании молока в течение 30—40 мин при температуре 65-75°.

Feeding children in the first year of life

Dry and canned foods for feeding children in the first year of life

The organization of mixed and artificial feeding of infants is difficult in areas that are poorly supplied with fresh milk and do not have dairy kitchens. In these cases, it is convenient to use industry-produced dry dairy and canned baby food products. Using them makes it easier to organize the feeding of children, while at the same time guaranteeing a high quality diet. The production of dry and canned products is fully mechanized, which, along with the pasteurization of products and the maintenance of all equipment in cleanliness, ensures the absence of bacterial contamination in them. The results of clinical and biochemical studies have shown that when fed with dry and canned foods, the development of children is quite satisfactory. Dry milk is prepared from whole cow’s milk, quickly drying it; at the same time, the quality of the milk constituents remains almost unchanged. Due to the low moisture content (3-6%), dry milk mixes lose the properties of perishable products. Dry milk products, caszol and casein milk, replace cottage cheese, which is so necessary for children. Kazzol is produced from fresh cottage cheese obtained from skimmed milk, casein milk – from skimmed dry cottage cheese, cream and sugar. These drugs are rich in protein (over 70%) and are used in the nutrition of children, especially premature, suffering from malnutrition of various origins, anorexia and other body conditions that require the introduction of an increased amount of protein. In addition to dried milk products, the food industry produces flour from rice, buckwheat and oatmeal, and also flour mix from rice, oatmeal and buckwheat flour. Flour from cereals is needed for making decoctions used in milk mixtures of type B and B. The nutritional value of decoctions from flour is much higher than that of mucous membranes, since the transition of solids to decoction occurs in larger quantities. Dry milk cereals are made from powdered milk, various cereals (manna, oatmeal, buckwheat) and sugar. The food industry produces canned fruit and berry juices, fruit and vegetable puree, vegetable and meat-vegetable soups for baby food. The use of such canned food in children allows to diversify the menu and enriches it with vitamins, salts, vegetable protein and fat, organic acids, pectin. Children’s canned food is made from high-grade vegetables and branded fruit varieties with special machines – homogenizers, providing a high degree of particle size reduction.

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