Infant, feeding abnormalities

Modifications of Infant Diets. Major modifications of the nutrient composition of an infant s diet should be made only under the supervision of a physician or a nutritionist For example, abnormalities in the metabolism of one or more nutrients may make it necessary to restrict the diet of an infant to special foods or formulas. These conditions are relatively rare and usually require special diagnostic tests for their detection. Thus, skim milk alone is not suitable for infant feeding, except when prescribed by a doctor for an infant that has an intolerance to dietary fat normally, it should be used only in formulas or mixtures that contain added fats such as vegetable oils. 

Metabolic bone disease in children receiving parenteral nutrition manifests primarily as osteopenia and, on occasion, fractures (5). The etiology is multifactorial calcium and phosphate deficiency play a major role in the preterm infant but the part played by aluminium toxicity in this population is unknown. Lack of reference values of bone histomorphometry in the premature infant, as well as lack of reference data for biochemical markers of bone turnover in these patients, contributes to the uncertainty. Other factors that may play a role in the pathogenesis of bone disease associated with parenteral nutrition include lack of periodic enteral feeding underljdng intestinal disease, including malabsorption and inflammation the presence of neoplasms and drug-induced alterations in calcium and bone metabohsm. However, the true incidence and prevalence of parenteral nutrition-associated bone abnormalities in pediatric patients are unknown. 

Of 17 infants born of mothers taking valproate, 12 had possible withdrawal effects (irritability, jitteriness, abnormal tone, seizures, feeding problems), which correlated with the dosage of valproate during the last trimester, and four of the affected children also had hypoglycemia (SEDA-18, 70). 

While most children with physiologic GER will naturally outgrow the reflux, those children with underlying abnormalities will not (Boix-Ochoa and Canals 1976). The initial treatment for GER is most commonly thickening of the infant s formula, feeding smaller amounts per meal and maintaining the... 

Knowledge of metabolic pathways of phenylalanine and tyrosine has been obtained by study of certain inborn errors of metabolism in man (see Chapter 5). Of particular interest in human nutrition is the relationship of ascorbic acid and folic acid in the metabolism of these two amino acids. In premature infants or in persons with scurvy, the feeding of high protein diets or the administration of tyrosine leads to hydroxyphenyluria. Both ascorbic acid and folic acid (large doses) will prevent the excretion of abnormal quantities of hydroxyphenyl derivatives. Recently, Sealock... 

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