Infant Transitional Foods

Nikki Finkenthal, Sarah Fredericks, and Michelle Maire

KNH 432B, Miami University

Professor Sockju Kwon

INFANT TRANSITIONAL FOODS 1

Abstract

In this group dissertation, we examined the diet and nutrition standards of infant

transitional food. We focused on the population concerns, nutrition-related concerns, and

nutrition intervention and treatment options for both infants and toddlers respectively. We

explained how Healthy People 2020 initiatives have set goals for each age group and how these

goals are important in transitioning infants from formula and breast milk to solid foods. The

nutrition-related concerns regarding transitional foods for both age groups were also researched.

We explored the positive and negative effects during this vital period, and how parents can

transition their childs food intake in a safe and healthy manner. A discussion on choking

hazards, allergies, and possible deficiencies are found in this piece. The nutrition intervention

and treatment options for both age groups were studied. Included in this section are physical

abnormalities and mental disabilities, and what mechanisms are useful in providing the necessary

care for children with these issues. Overall, infant-aged humans transitioning to toddler-age

require the proper nutrition and care in providing transitional foods for their health.

As a child transitions from infant-aged to a toddler-aged, changes in their diet must

transition with them. Its important for mothers to understand how to help their baby transition

the foods they are consuming, as it cannot be done too quickly or too soon. This is a vital time in

the babys growth; the way the transition is done, and what foods are incorporated and

consumed, play an essential role in the babys future health and eating habits. Because of this,

focusing on population concerns for both infants and toddlers is principal, as is their nutrition-

related concerns, and nutrition intervention and treatment options, if there is difficulty during this

transitional period.
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Healthy People 2020 is a national health promotion and disease prevention initiative that

focuses on improving the health of all Americans at all ages. For infants, the main concerns for

this population are their mortality rates, birth rates, breastfeeding, and newborn screening. Health

People 2020 is focusing on reducing all infant deaths within 1 year; reducing preterm births;

increasing the proportion of infants who are put to sleep on their backs; reducing the proportion

of breastfed newborns who receive formula supplementation within the first two days of life;

increasing the proportion of infants who are ever breastfed; and increasing the appropriate

newborn blood-spot screening and follow-up testing.

These steps in improving infant health and survival is crucial in raising a healthy baby.

Newborns and infants do not yet have a fully developed immune system which causes them to be

more susceptible to disease, illness, and death. One of the most important population concerns

nutritionally is breastfeeding. The American Academy of Pediatrics recommends that

breastfeeding continue for at least twelve months, and thereafter for as long as the mother and

baby desire (CDC). The proportion of infants who are ever breastfed is too low, and needs to be

increased, as the Healthy People 2020 initiative plans. Breastfeeding infants is dynamic in that it

improves their growth on all levels: physical, immunological, and physiological. Human milk

provides optimal nutrition to the infant due to its composition and the appropriate balance of

nutrients. Since human milk is isosmotic, it meets the infant's requirements without other forms

of food or water. Infants that are breastfed are protected against infection; this is huge when it

comes to mortality. When it comes to gastrointestinal disease, the binding proteins in human

milk bind protein and vitamin B12, making the nutrients unavailable for pathogens to grow in the

infants gastrointestinal tract. Breastfed infants also have fewer acute and chronic illnesses and

are less likely to become overweight than infants fed with human milk substitute (HMS). When
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infants are breastfed, it offers an easier process in transitioning them to more solid foods, and

eventually, toddler-aged foods.

With these initiatives in mind, its also important to understand Healthy People 2020s

goals for toddlers. For toddlers, the main concerns are consumption of fruits, vegetables, and

whole grains, and the reduction in consumption of fats and sodium. Healthy People 2020 is

focusing on increasing the following: contribution of fruits, vegetables, dark green vegetables,

orange vegetables, legumes, whole grains, and calcium in the diets of the population aged two

years and older. Healthy People 2020 is focusing on reducing the following: the consumption of

calories from solid fats, calories from added sugars, saturated fats, and sodium in the diets in the

population aged two years and older. Adequate intake of energy and nutrients is necessary for

toddlers to achieve their full growth and developmental potential. Undernutrition during this

critical time can cause failure to thrive and cognitive impairment. Foods that are considered

choking hazards can also seriously affect a childs safety. When transitioning from infant to

toddler, its important to keep these things in mind as the infant is being introduced to new foods,

solid foods, and more independent eating.

The transition and weaning process from breast milk and/or formula to the introduction

of semisolid and solid foods in an infants life is an extremely critical part of growth and

development. By the age of four to six months an infant is typically ready to accept solid foods.

Their reflexes and other learned components must be properly developed through the action of

sucking and chewing by oral stimulation. The transition is from breastmilk and formula to solid

foods has a critical impact on the nutrition of the child. Many concerns take place during the

transition period and every infant has a different rate of acceptance throughout the process. By

four to six months iron stores that an infant is born with can be depleted, which increases the
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need for iron in solid foods, if not the risk of iron deficiency anemia increases. Along with the

decrease in iron supply, a mothers breast milk can no longer solely provide the required amounts

of protein an infant needs to grow and develop properly. These two nutrients are of the most

concern right before the weaning process.

For infants that have a delayed introduction to solid foods later than six months, they can

also be at the risk of iron deficiency anemia as well as other micronutrient based deficiencies. In

a case study of older weaned children they were found to be, ingesting less than the

recommended level of fat. Decreases in iron and vitamin E intake between 12 and 18 months

resulted in intakes well below reference standards. Zinc intake was also well below

recommended levels (Grueger, 2013). Another concern for children with later food introduction

is the possibility of them becoming poor eaters, which will overall effect their growth and

development.

Other nutrition related concerns during the transition process include, dehydration, poor

weight gain, the possibility of choking and allergic reactions. The reason for dehydration and

poor weight gain is most likely attributed to abrupt weaning, where the infants body was not

prepared and/ or ready for the process. Choking possibilities is related to a new technique of

weaning called baby led weaning. In this alternative method infants are giving finger-sized foods

and feed themselves instead of being fed by an adult. This process increases the possibility of

choking due to the baby's inability to properly feed themselves. Lastly allergic reactions can

occur based on the type of foods that are presented to the infant. Starting the infant of with

hypoallergenic, pureed foods is the safest approach to avoid allergic reactions in a child. If a

baby does have an allergic reaction to a certain food a parent can identify it based on diarrhea, a

rash or vomiting after the consumption of certain foods.

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There are many nutrition related concerns during this period of transition from breast

milk or formula to solid food, and most of the time there are treatment possibilities. Even with

setbacks like cleft palate, swallowing or chewing difficulties, and iron deficiencies, there are

many treatments to help the child maintain a normal nutritional status especially during the

period of transition from infant to toddler as nutritional needs increase. Cleft palate is a

deformity in babies where the roof of the babys mouth is not open due to the growth plates not

closing properly. When treating an infant with cleft palate it is important to remember that failure

to thrive, feeding difficulties, flow of milk through the nose, and certain dental problems all need

to be treated in a child with this deformity. To prevent failure to thrive and malnutrition, it is best

to feed the child from a bottle in a more upright position (Cleft Palate and Lip, 2015). In this

position it creates a more direct pathway to the esophagus, and prevents the formula from

entering the nasal cavity. Breastfeeding a child with cleft palate is very difficult, and usually ends

with the child not receiving all the macronutrients needed. There are also many types of bottles

with specialized nipples to help in the feeding process. The pigeon nipple has one side that hard

for the roof of the mouth, and a softer side for the tongue. There is an area for excess air to

escape from to prevent choking, and nutritional deficits. The Haberman feeder is a system that

does not need suction, and only needs to compressed for the baby to get the milk. Surgery is also

very common for babies with cleft palates, and with this, the child will reach what is an almost

normal mouth and nutritional status. Because this surgery cannot be performed at birth, the child

will also face the difficulty of spoon-feeding and transitioning(Cleft Palate Instructions, 2015).

This can be very difficult because the child can get food stuck in their nasal cavities, but learning

to adapt can fix this easily due to many childrens natural inclinations. Sneezing, drinking a

liquid, or swallowing can get the stuck food out of the palate. A bulb syringe can also be used to
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suck the food out, but when the food is sucked out, the child is not receiving the nutrients from

that food (Cleft Palate Instructions, 2015). Most children with the deformity are able to

compensate for the cleft palate making the transition smooth without accommodating nutrient

needs.

Some children are born with swallowing and chewing difficulties, which can affect their

nutritional status, but there are many ways that can treat or intervene this delay. After learning

how to suckle on a breast or nipple, the child develops muscle tone in their mouths that allow the

child to swallow, and eventually swallow. Some children struggle to swallow due to different

conditions like neurological conditions, or tongue-tie (Dysphagia in Children, 1997). A child

with a neurological condition such as Cerebral Palsy that does not have proper muscle tone may

struggle to swallow foods putting them in a nutritional deficit. Babies with swallowing issues can

often be treated with therapy, to help improve muscle tone. If it is very severe, some babies may

need feeding tubes. At such a young age, it is very important to learn how to swallow so these

are not used very often. Starting slow is often a good idea transitioning from formula or breast

milk to pureed food instead of moving straight to solid foods to avoid choking and confusion.

Current methods, which is controversial discusses allowing the toddler to actually choke on a

small piece of food so that the child learns what it is like to choke, and how to avoid it. This goes

against the motherly instinct of keeping your child safe, so many mothers would rather do this

transition in a slower safer way. In the end, these problems usually do not cause too many

nutritional deficits except for those cases with neurological damage or delays, which may need

therapy or other techniques.

Iron deficiency as discussed earlier is a very common deficiency especially in infants

during the food transition period. To treat iron deficiency a screening is first necessary. If a
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positive screening arises, treatment involves iron therapy. Iron therapy usually consists of 3

mg/day of iron in the form of a syrup for example. The absorption of iron is improved when a

source of vitamin C is consumed with it. This iron therapy usually lasts around 3 months. When

a child begins eating solid foods, foods with more iron content can also be incorporated into the

diet like red meat, dark green vegetables, and even cooking in an iron skillet. Transitioning from

formula or breast milk to solid foods can be a difficult transition (Kazal, 2002). To prevent an

iron deficiency it is important to remember that transitioning in a timely manner is beneficial

because as a baby begins to get older and grow, their nutritional needs also grow.

A child transitioning from formula or breast milk to solid foods is a very vital time in an

infant or toddlers life. During this period nutritional needs and growth of the child both increase,

and decide future nutritional habits. During this period there are many concerns including

allergies, deficiencies, and even deformities. It is important to recognize these concerns early on

to create a treatment plan, and be educated on the different concerns and interventions.

Transitioning foods is a very important topic that more parents should be educated on to create

the easiest, and safest transition for their children.

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Works Cited

Frequently Asked Questions. (2015, June 16). Retrieved November 9, 2015, from
http://www.cdc.gov/

Grueger, B. (2013). Weaning from the breast. Paediatrics & Child Health, 18(4), 210-211.

Switching To Solid Foods. (2012). Retrieved November 9, 2015, from

https://www.healthychildren.org/English/ages-stages/baby/feeding-nutrition/Pages/Switching-
To-Solid-Foods.aspx

Cleft Lip and Palate. (2015). Retrieved November 29, 2015, from
http://adoptionnutrition.org/special-needs/cleft-lip-and-palate/

Cleft Feeding Instructions. (2015). Retrieved December 1, 2015, from

http://www.seattlechildrens.org/medical-conditions/chromosomal-genetic-conditions/cleft-lip-
palate-feeding/

Feeding and Swallowing Disorders (Dysphagia) in Children. (1997). Retrieved November 18,
2015, from http://www.asha.org/public/speech/swallowing/Feeding-and-Swallowing-Disorders-
in-Children/

Kazal, L. (2002, October 1). Prevention of Iron Deficiency in Infants and Toddlers. Retrieved
November 25, 2015, from http://www.aafp.org/afp/2002/1001/p1217.html#