Nutrition In Newborns

Nutrition in newborns

Over the years, medical advances have improved their guidelines as soon as the nutritional support of newborns; At present there is sufficient evidence to support that adequate nutrition in the newborn helps to reduce morbidity and mortality and improve its somatic and psychomotor development in this critical period.

The adequate nutrition for the neonate has been defined as the one that gives rise to normal growth and development without exceeding its metabolic and excretory abilities; The objective of nutrition must be to achieve an appropriate postnatal growth to gestational age, defined not only by anthropometric parameters, but also by the variation of body composition and retention of different nutrients.

Goals:

• Identify the correct guidelines of nutritional status in neonates for proper development.
• Analyze the relationship of the nutritional status of the newborn with its subsequent growth.
• Know how to properly select anthropometric indicators to evaluate the neonate.
• Take normal intrauterine growth into account.

Nutritional clinical evaluation:

The neonatal period is defined, as the time elapsed from birth to the first 28 days of life; classifying them according to gestational age as:

• Immature (< 2 8 semanas)
• Premature/preterm: < 37 semanas
• Term infants: 37 to 42 weeks
• Postérmina (> 42 weeks)

The nutritional evaluation is composed of food history, clinical findings, anthropometric parameters and biochemical tests; In the newborn, birth weight is one of the most important anthropometric indicators, which allows predicting the probability of perinatal super experience and growth, the most sensitive indicator of post native health.

Classification of the newborn according to birth weight:

• Macrosomic:> 4,000 g
• Normal weight: 2 500 to 3 999 g
• Under weight: < 2 500 y >1,500 g
• Very low weight: anthropometric evaluation constitutes a fundamental part of the non -invasive clinical evaluation of the nutritional state. An important part of the neonate anthropometric evaluation is based on the indices that allow estimating the magnitude of energy reserves. Hence, neonates with nutritional risk require the evaluation of different indicators such as weight, cephalic perimeter, length and other growth measures that include brachial perimeter and cutaneous folds.

Growth assessment

 Growth is the most sensitive health index and a fundamental parameter for nutrition evaluation. An adequate growth pattern in the first years of life is essential to guarantee a normal neurosensorial development. For the growth assessment, it must be carried out by means of the weight, length and cephalic perimeter up to 24 months of age, using the corrected gestational age up to 2 years for all referred parameters.

After birth there is a weight loss and a delay in the speed of growth with respect to the fetus of equal pregnancy, with recovery of the birth weight between 10 and 30 days later, this weight loss is greater the lower the weight and the weight and the gestational age. Subsequently, growth is accelerated, but without recovering the loss in its entirety.14 If it is broken down into daily goals, the preterm RN must obtain approximately 16 to 18 g/kg/day or 20 to 30 g/day; 1 cm/week of length and cephalic perimeter.

Body composition analysis

The analysis of body composition in neonates allows us to differentiate between the amount of body mass of fat and lean tissue. Obtaining body composition measurements is not always easy to perform, but there are different methods that include: Pletismograph due to air displacement (PDA), total dilution of body water isotopes (ACT), total body electrical impedance analysis ( IBT, for its acronym in English), X -ray absorbing dual energy (DXA) and magnetic resonance (RM) (RM).

Anthropometric Indices of Nutritional Evaluation

Gómez classification:

It is the index that defines the severity of the clinical diagnosis or type of protein-energy malnutrition (DPE), is based on the weight/age indicator: (the child’s weight compared to that of a normal child (50 percent) of the same age. It is useful for population screening and public health evaluations.

• Percentage of the reference weight for age = [patient weight) /(weight of the normal child of the same age)] * 100
• PONDERAL INDEX (IP)
• Total energy expenditure (GET)
• Energy requirements for children from zero to 12 months of age

These requirements were calculated from the measurement of the GET and adding the energy need for the growth that differ from previously established (FAO/WHO, 1985).

Determining the newborn get requires that the nutritionist decides the formula to use, ideal formulas cannot be established since each one presents strengths and limitations.

Daily energy requirements for children of 1 month born

Age (months) fed maternal breast fed by formula all

Average boys average girls boys average girls

Conclusions

• The nutrients present in milk come from the mother’s diet or their nutrient reserves.
• Breast milk is the best food for newborns and infants, it has a fairly constant composition and the mother’s diet only affects some nutrients.

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