Infant Nutrition Requirements and Options

Excerpt

Infancy is a period of rapid growth second only to the fetal period. There is a pressing need to optimize nutrition to ensure adequate growth and organ development. With much emphasis placed on the developmental origins of health and disease, pioneered by the Barker hypothesis , maintaining optimal nutrition is one of the vital aspects of infancy. Under-nutrition during the fetal period due to placental, maternal, or fetal conditions can lead to intrauterine growth restriction (IUGR) with impaired organogenesis and decreased birth weight. While fetal nutrition is not usually compromised until an extreme degree of maternal malnutrition occurs, postnatal growth restriction in neonatal and post-neonatal period is predominantly an acquired condition due to inadequate nutrient intake. Continued undernutrition during infancy is hence prone to growth failure or failure to thrive (FTT) and metabolic disturbances that can persist into adult life.

Low birth weight and rapid compensatory weight gain are independently linked to multiple morbidities in addition to altered growth, including increased risk of childhood and adult obesity, insulin resistance, increased leptin levels, and thus type 2 diabetes mellitus, as well as higher mortality in the future. Besides, epigenetic modifications resulting from dietary and environmental influences in infancy have the potential to change long term health outcomes into adulthood, as seen in infants and children with over-nutrition developing metabolic syndrome as adults.

Preterm infants are particularly at high risk of postnatal growth failure due to the inherent challenges faced due to prematurity. Improved care of preterm infants, including current advances in neonatal and infant nutrition, has been shown to improve growth and development in this high-risk population. This topic covers defining nutritional requirements in infancy, appropriate measurement of growth, and provides an overview of common nutrient categories. The nutritional needs of preterm infants and common clinical pearls of preterm infant nutrition are discussed briefly.