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Nurturing newborns? Check out this list of neonatal nutrition essentials | Health

Your baby is born with enormous potential to grow and expect your baby to double his/her birth weight by 5-6 months but for this amazing period of growth, they need a lot of nutrients. Health experts point out that the rapid growth and organ development in newborns creates a challenge in nutritional management.

Nurturing newborns? Check out this list of neonatal nutrition essentials (Photo by Twitter/Yan Krukau)

In an interview with HT Lifestyle, Dr Nitasha Bagga, Consultant Pediatrician and Neonatologist at Rainbow Children’s Hospital in Hyderabad’s Banjara Hills, recommended 7 commandments to help grow your babies to their best potential –

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1. Stick to Exclusive Mother’s Own Milk (MOM): MOM (=WOW), is the best and irreplicable source of complete nutrition for a newborn and is the perfect food for a baby’s digestive system, has all the nutrients and antibodies to prevent infections.

2. Consider Vitamin D Supplementation: Breast milk might not provide enough vitamin D, which helps your baby absorb calcium and phosphorus- nutrients necessary for strong bones. Breastfed babies should begin vitamin D supplements within the first few days of life, continuing until 1 year of age.

3. Acknowledge Cues of the Baby: Feed your baby depending on hunger signs (demand feeds) rather than keeping an eye on the clock. Most newborns need 8 to 12 feedings a day.

4. Premature Babies (born<37 weeks) Need Special Nutrition: Premature or sick babies are fed using their MOM, some babies who are very low birthweight might need to feed nutrition through a vein called total parenteral nutrition (TPN). These babies will need more nutrients in addition to breast milk and are given supplements like breast milk fortifiers, calcium, phosphorus, vitamin D, and iron.

5. Consider Donor Human Milk as the Second Best Choice: For preterm and sick newborns where MOM is not available, reach out to human milk banks, instead of formula feeds.

6. What Not to Feed: With rare exceptions, if breastfeeding isn’t possible, use infant formula. Don’t feed newborns with cereal, water, juice, cow’s or buffalo’s milk, honey, or other fluids.

7. Know When to Ask For Help: If you’re having trouble breastfeeding, ask a lactation consultant or your baby’s doctor, especially if every feeding is painful or your baby isn’t gaining weight.

Hold your newborn close during each feeding, look in their eyes and consider each feeding a time to bond with your newborn. Dr Deepak Ugra, Consultant Pediatrician at PD Hinduja Hospital in Khar, suggested, “Breastfeeding is the best nutrition for newborns and it should begin within the first hour of a baby’s life, even in case of caesarean section. Early skin-to-skin contact between mother and baby helps in bonding and stimulates breastfeeding behaviour in the baby. During the first couple of days, a mother gets thick milk that comes as few drops, called colostrum. This small volume of colostrum is sufficient for newborn babies for the first few days. Mother usually starts getting good milk flow on the third or fourth day. Demand feeding is preferred. It is left to the infant to decide the frequency and length of feeds.”

For preterm babies, he advised, “Milk from the infant’s mother is the first choice. Human milk can be stored at room temperature for up to 24 hours after expression for colostrum and up to 6 hours for mature milk. If it needs to be stored beyond that, it should be stored at 3-4°C before use. If not used for more than 5 days, it should be frozen. The expressed breast milk can be given by bottle/spoon. The preterm formula is the only acceptable alternative if human milk from the preterm infant’s mother is not available. Human milk fortifier is indicated in preterm infants < 31 weeks and/or < 1500 gm and discontinued when the infant has established full breastfeeding. Vitamin D supplement is given to all infants. Multivitamin supplements for preterm infants are started when he has established full oral feeds, and iron is started when the infant has doubled their birth weight (usually at 2 months). MCT oil can be supplemented for preterm infants who fail to thrive.”

Asserting that dietary nutrition is vital for the development of infants, Dr Deepak Ugra said, “Human milk is the preferred source of nutrients for newborn infants and the most important nutrient for energy is carbohydrates. Human milk contains the required amount of carbohydrate that is needed for the brain. Fat plays a vital role in milk, contributing about half of the energy required for infants. Human breast milk is composed of roughly 50 different types of fatty acids and serves as a natural reservoir of medium-chain fatty acids (MCFAs).MCFAs are very important for infants with an immature digestive system. Docosahexaenoic acid (DHA), an omega-3 fatty acid found in breast milk, has many health benefits for the baby.”

He added, “Human milk contains whey protein complex which has several health benefits. Components of whey, including lactoferrin, β-lactoglobulin, α-lactalbumin, glycomacropeptide, and immunoglobulins, have immune-enhancing properties. In addition, whey has antioxidant properties. Human milk also has carnitine, which is essential for infants. Free amino acids, Glutamine and Taurine are also present in human milk. Human milk also provides important minerals and vitamins to the newborn infants.”

Bringing his expertise to the same, Dr Kumar Ankur, Associate Director and HOD NICU of Centre For Child Health at BLK Max Super Speciality Hospital, said, “Breastfeeding is one of the most effective ways to nurture newborns which ensures child health and survival. WHO and UNICEF recommend that children initiate breastfeeding within the first hour of birth and be exclusively breastfed for the first 6 months of life – meaning no other foods or liquids are provided, including water. Provision of mothers breastmilk to infants within the first hour of birth that contains colostrum, is considered the first immunisation for the kid. Infants should be breastfed on demand – that is as often as the child wants, day and night. No bottles, teats, or pacifiers should be used. That means essentially you don’t need any multivitamins or any supplements except for vitamin D3 starting from day one of life and iron supplementation starting from 4th month of life.”

However, contrary to this, WHO recommendations, he revealed, “Fewer than half of infants under 6 months old are exclusively breastfed. Breastmilk is the ideal nutrition that contains antibodies that help protect against many common childhood illnesses. Breastmilk provides all the energy and nutrients that the infant needs for the first months of life, and it continues to provide up to half or more of a child’s nutritional needs during the second half of the first year, and up to one-third during the second year of life. Infants who are breastfed, are more intelligent, are less likely to be obese, and less prone to diabetes later in life. Women who breastfeed also have a reduced risk of breast and ovarian cancers. Inappropriate marketing of breast milk substitutes and many so-called nutritional essential products continues to undermine efforts to improve breastfeeding rates.”

Echoing that optimal nutrition for a newborn or a neonate is crucial for appropriate growth and development in the early stages of life, Dr Preetha Joshi, Consultant, Neonatal, Pediatric and Cardiac intensivist at Kokilaben Dhirubhai Ambani Hospital in Mumbai, credited breastfeeding as a gold standard that should be initiated within the first hour of birth and provided exclusively for six months. She shared, “It can be continued for up to two years or beyond, with the addition of appropriate complementary foods. This is one of the key pillars, in setting a strong nutritional foundation in the first 1000 days (from conception to 2 years of age), which has a tremendous effect on the brain, physical growth, and immune system, way into the future of a child- right up to adulthood. Breastfeeding is uniquely tailored to meet the intricate nutritional needs of newborns with essential vitamins, antibodies, and appropriate fat content required for a baby’s growth and nervous system development (Cognitive and motor development as well as emotional and mental health).”

She pointed out, “Research suggests that breastmilk boosts the immune system and protects the baby by providing antibodies against diarrhea, pneumonia, ear infections, and multiple viral infections, all of which are very common in early infancy. When exclusively breastfed up to 6 months, it also protects the growing child against childhood obesity, type 2 diabetes, and inflammatory bowel disease in adulthood. Therefore, most healthcare organizations recommend that it’s best to feed the baby only breast milk for at least 6 months. Moreover, it also protects the mother against postpartum depression, breast cancer, and ovarian cancer in addition to, helping mothers lose weight faster. However, in conditions where breastfeeding may not be feasible due to any serious reason, formulas, meticulously engineered to mimic the nutritional composition of breast milk can be used.”

Dr Preetha Joshi concluded, “Your pediatrician would be the best guide to help you choose the right formula. Indian foods, that can be introduced after 6 months of age, include lentils or dal in the form of a light soup: “khichdi”, mashed fruits as well as vegetable purees. Consult your pediatrician for a nutritional approach tailored to your baby’s needs. This will help give the newborn the best foundation for healthy physical, emotional, and mental wellbeing.”

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