Weight gain, rapid growth, sugar control, maternal nutrition, and infant feeding are major factors in infant growth regulated by infant nutrition. Federal agencies and governments are focusing on devel- oping infant nutrition programs, advice on maternal diets, and breastfeeding schedules [ 80– 82 ] . Preclinical and clinical evidences now strongly suggest mother milk during fi rst 6 months, continued breast feed during 1–2 years with added dietary supplements including dietary nucleotides [ 80 ] , lipid- based nutrients [ 83 ] , lamb-based infant food [ 84 ] , long chain fatty acid and fi sh oil-rich foods [ 85– 89 ] , osteogenic vitamin D and minerals [ 90– 95 ] , iron [ 96– 100 ] , zinc [ 101, 102 ] , fl uoride [ 103 ] , iodine [ 104 ] . Very recently, dietary supplements in disproportion have been identi fi ed as risks to infants including iodine de fi ciency [ 104 ] and anthocyanins [ 105 ] . With experience, preclinical studies on infants suggest new evidences of new emerged nutritional factors as responsible of risks for obesity [ 106, 107 ] , ion transport and enterocyte proliferation [ 108 ] , weight gain, malnutrition, heart [ 109 ] , and neuropsychological risks [ 110 ] . Moreover, such empirical association has implications for the management of infants born small for gestational age and suggests that the primary prevention of obesity could begin in infancy [ 107 ] . Breast feeding still serves as gold standard of protective measure in infancy against in fl ammation [ 111 ] and obesity [ 112 ] . Infant feeding schedule with right mixing solid foods approach plays a signi fi cant role to keep low risk of obesity [ 113– 115 ] . In future, federal and nongovernment agencies will play signi fi cant role in designing and implementing food pro- grams for maternal nutrition including pregnant, lactating mothers at care centers with improved infant feeding schedules during 6 months, 6–12 months, and 1–5 years in order to keep low risks of diseases and health consequences during infancy, childhood, and adolescence. Present time chal- lenge is growth acceleration as a consequence of relative over nutrition in infancy with increased risk of later obesity [ 116 ] . In recent report, fat mass was main determinant in early growth promotion and later body composition in infants born small for gestational age [ 107 ] . Report showed a subset of children ( n = 153 of 299 in study 1 and 90 of 246 in study 2) randomly assigned at birth to receive either
a control formula or a nutrient-enriched formula (which contained 28–43% more protein and 6–12%
more energy than the control formula) at 5–8 years of age. Fat mass was measured by using bioelec- tric impedance analysis in study 1 and deuterium dilution in study 2. Fat mass was lower in children assigned to receive the control formula than in children assigned to receive the nutrient-enriched for- mula in both trials (mean (95% CI) difference for fat mass after adjustment for sex: study 1: −38%
(−67%, −10%), P = 0.009; study 2: −18% (−36%, −0.3%), P = 0.04). In this nonrandomized analysis, faster weight gain in infancy was associated with greater fat mass in childhood [ 107 ] . Infant mortality and keeping low risks of common induced diseases still remains a challenge since four decades and it needs attention to develop protective measures to keep low risks of them. In a review report, rise in ischemic heart disease in England and Wales was associated with increasing prosperity, and mortality rates are highest in the least af fl uent areas [ 117 ] . Of the 24 common causes of death, only bronchitis, stomach cancer, and rheumatic heart disease were related to infant mortality. Ischemic heart disease was strongly correlated with both neonatal and postneonatal mortality. These diseases are associated with poor living conditions in present time and infant mortality from them is declining due to role of nongovernment organizations and effective social service network. It is suggested that poor nutrition in early infant life increases susceptibility to the effects of an af fl uent diet.
Conclusion
Growing infant in fi rst 6 months has very high demand of nutrients. In third world countries, infant growth is related with socioeconomic-geographical factors. More than two-third breast-fed infants in rural population further require vitamin D and iron supplementation with commercially available cereal or milk formulas during fi rst 6 months due to poor nutrition of lactating mothers. Additional requirement of fl uoride supplementation is needed throughout childhood if water supply does not have fl uoride. In premature or small-for-date infants require special infant diet preparation and nutri- tion planning. For infant growth, meal service etiquettes, motivation and additional factors play a great role in reducing risks:
Calm environment and social interaction encourage the infants to serve themselves.
•
With growth, switching to solid foods between 4 and 6 months according to baby size and
•
appetite.
A plain rice cereal diluted to thin gruel fed without sugar is good choice of solid food.
•
Cereals may be added to other solid vegetables and fruit foods according to the baby’s physical
•
development and eating skills.
Egg yolk and strained meats or beans mixed with custard to provide adequate vitamin, minerals,
•
and proteins as nutrients.
Motivation to chew and swallow strained solid commercial strained foods. Modifi cation in foods
•
provides adequate vitamin, minerals, and proteins as nutrients.
Inadequate feeding may cause malnutrition and loss of appetite while overfeeding may be a risk of obesity, weight gain, and excessive load on intestinal and kidneys. Lactating mothers need awareness:
After fi rst year of age, infants are ready to shift from formula to whole milk and to learn drinking
•
from a cup, eat chopped food. The transition to table food needs supervision of parents but it is a risk if highly nutrient-enriched diet in infancy can also increase fat mass later in childhood.
Faster early weight gain may also result a later risk of obesity.
•
Management of infants born small for gestational age needs awareness that the primary preven-
•
tion of obesity could simultaneously begin infancy.
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