Breast-Feeding is Best
There is little doubt that mother's milk is the best food for infants. Human milk offers an ideal balance of nutrients and also contains a rich supply of protective factors which the human infant requires. Cow's milk is dissimilar to human milk in all respects. Although commercially prepared formulas, made from cow's milk or soy beans, have progressed over the years toward a more "human" composition by significant processing of the milk and addition of nutrients, these formulas remain inferior to human milk.; Both cows' milk and soy milk have health risk attached. Many argue that only a small percentage of infants become ill on these formula, but I disagree.
Among the benefits of mother's milk is a generous supply of IgA, the protective antibody which the infant bowel lacks. This antibody helps to protect the infant from bacterial infection and probably reduces the entry of antigenic food protein fragments, reducing the incidence of food allergy. Breast feeding an infant for six months or longer appears to significantly reduce the incidence of infection and food allergy.
Infant Nutritional Requirements
In the first six months of life, infants are dependent upon breast milk or formula; for their nutrients. Infant growth is rapid and a continuous supply of nutrients is required. The infant's energy needs can be supplied by an average intake of 100-120 Kcal/Kg/day in the first four months, decreasing, as growth slows, to about 100 Kcal/Kg/day for the last six months of the first year. An infant should double birth weight at six months, and triple birth weight at one year.
One ounce (oz) of breast milk is about 20 Kcal/oz or 7 Kcal/10 mL. Infants begin consuming about 20 oz/day in Month 1 and progress to about 40 oz/day in Month 6. Water is important to infants and should supplement breast or formula feedings. A nursing mother must maintain a high intake of water (2-3 liters/day) to provide adequate dilution of her milk. She should avoid dehydration with diuretic substances, including alcoholic beverages (AB), teas, coffee, licorice, and herbal teas. Nursing mother's should take a well-balanced multivitamin-mineral supplement that includes Vitamin D, Calcium, iron, and zinc. The advice to mothers to drink extra cow's milk may be harmful to the infant who may develop milk protein allergy.
Food Allergy & Breast Feeding; One problem with mother's milk is that it may contain allergens which the mother has absorbed intact. Allergens derived from cow's milk may appear in the mother's milk and sensitize her child. The circuit of milk proteins through a mother's body, through the breast into the milk, into the infant's GIT, and into the infant's body is a remarkable biological fact! This free passage of food proteins through many body filters and defense systems demonstrates how porous we are to macromolecules.
Since food allergens from the mother's diet may appear in her breast milk, the lactating mother may have to modify her diet to protect her infant. Her restrictions may include the avoidance of milk products and other highly allergenic foods like eggs, peanuts, citrus fruits, chocolate, nuts, and, sometimes, cereal grains, certain meats, and fish. Breast-feeding mothers should avoid ingesting food and beverages with drug-like or toxic properties - alcoholic beverages, tea, coffee, chocolate, herbs, and spices. Breast-feeding and smoking do not go together. Infant sensitization in utero and with breast feeding is not a simple matter, however, and even the most conscientious maternal avoidances will not assure complete protection against infant food allergy.
The effects of food antigens on an infant reflect a delicate and complex balance between tolerance and sensitivity. There are some apparent paradoxes involved. The infant who is fed large quantities of cow's milk will show tolerance to the acute effects of milk allergy - vomiting, abdominal pain, swelling, and shock - but, will manifest the more delayed results like eczema, colds, and diarrhea. The infant with little exposure will show less tolerance to the allergen and will react with the more dramatic acute responses, but may avoid the chronic delayed symptoms. Thus, the breast fed infant of a very careful mother has a greater risk of acute responses when allergenic foods are introduced than the casually fed infant with chronic symptoms. This is a distressing paradox, not confined to the infant immunological response, but observed in older children and adults as well.
Dr. John Gerrard, an authority on food allergy, reported this effect in his study of 19 children with IgE-mediated immediate reactions (IMD.E1) to milk, peanut, and/or egg. He stated: "Breast feedings recommended because it provides optimal nutrition for most babies and, with placentally transferred antibody, protects the infant from a number of common infections: it also facilitates bonding between the mother and child. Breast feeding has also been said to protect the infant from the development of atopic diseases in general and eczema in particular. The degree of protection is not complete, for atopic diseases can develop in breast fed babies to foods ingested by the mother. It has been suggested that restricting the mother's intake of foods, such as cow's milk and egg will increase this protection; whereas increasing her intake of these and other foods will reduce this protection."
Dr. Gerrard's observations showed that the amount of a food eaten by the mother during pregnancy does not determine the sensitization of the infant - that acute allergic responses often occurred with the first ingestion of a food. If the mother is to significantly reduce food allergy in her infant, it appears that she must follow a rather vigorous hypoallergenic diet during her pregnancy and lactation. Half measures may reduce the infant risk, but do not eliminate it. If either of the parents have a history of infant food intolerances, vomiting, diarrhea, eczema, bronchitis, or asthma, the mother may consider it advisable to abstain from all dairy products, eggs, peanuts, and soya protein in an effort to minimize these potential problems in her infant.
The advice of a physician skilled in food allergy management is always desirable when preventive efforts are contemplated or infant feeding problems are encountered. Mother's nutrition can, and should, be supported by computed nutrient analysis and careful nutrient supplementation.
Introduction of Solid Foods
Infant feeding fashions change as we learn more about nutrition and food allergy. There is a consensus that solid foods may be a problem if introduced too early. In an adequately breast-fed infant, other foods are seldom required before five months and adequate nutrition can be readily maintained for six months. Iron, fluoride, and vitamin D may be supplemented in the mother's diet for the breast-fed infant. Cow's milk should probably be avoided during the first six months, although, in a pinch, boiled milk or formula made with condensed or evaporated milk may be acceptable. Commercial infant formulas are improvements over plain cow's milk and contain desirable amounts of added micronutrients, some of which are absent in cow's milk alone.
The infant bowel has matured sufficiently by five to six months for complex foods to be digested and absorbed with less risk of sensitization to antigenic food proteins. Infants of this age also should be able to sit with support, control head movements, and have adequate swallowing reflexes to ensure safe feeding. Solid foods may be slowly introduced and provide a critical transition from milk to other sources of nutrients.
Premature introduction of solid foods has some risk
The infant has an immature GIT. From the allergy point of view, the infant GIT has limited defences against food proteins and other antigens, and is permeable to macromolecules. Absorption of large molecules from the bowel may trigger a variety of delayed allergic responses like eczema, bronchitis, or asthma, and may expose the infant to a high risk of immune-complex disease with serious target organ damage, and life-long food allergy.
The introduction of "solid" foods is begun slowly and gradually with soft or pureed foods. In a healthy, tolerant infant, new foods are best introduced one at a time at weekly intervals. One new food per week allows mother to detect both immediate and delayed adverse reactions to the new food and to discontinue it, if she is concerned. New foods are introduced by teaspoon quantity, and the serving size is progressively increased, as the infant becomes accustomed to the new food.
Hypersensitive infants may not tolerate many foods or such a fast pace of introduction. A few foods from the Phase 1 of the Alpha Nutrition Program list may be all an infant can handle during the first year. Nutritional support with a hypoallergenic formula or Alpha ENF may be required if the infant cannot breast feed.; A variety of food introduction schedules have been suggested. Infant cereals mixed with milk are the usual North American practice. A rice cereal (with iron added) has some advantages over wheat-based cereals. Gluten allergy or intolerance is common in the food-sensitive child, and wheat products are avoided at first. Oats and barley may be the best tolerated cereal grains, but their acceptability is not assumed (all 4 cereal grains - wheat, rye, oats, and barley are excluded on the Alpha Nutrition; Program). Pureed vegetables should be introduced before fruits. Egg white (albumin) and nuts are avoided in the first year.