NNI Knowledge Series

This series contains the transcripts, abstracts and reviews of key nutrition sessions and topics.

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The period from 2 to 5 years of childhood marks rapid cognitive, social, emotional, and motor development. Nutrient requirements in children are quite high during this period, both in terms of quality and quantity. Most often, high-energy, low-quality foods are offered to children belonging to this age group because of their unpredictable eating behaviours, thereby increasing the risk of nutritional deficiencies and thus contributing to childhood obesity. A good supply of macronutrients as well as micronutrients, such as iron, calcium, vitamin A, and vitamin C, is essential to support rapid growth and development. Growing-up milk can be a good source of these key micronutrients that support the high and changing nutritional needs of children, and thus bridge the nutritional deficiencies.

Infantile colic, otherwise known as excessive crying, is one of the most common reasons for parents to consult their pediatricians, especially during the first few months of their infants’ life. Apart from causing considerable stress to parents, management of colic also presents as a significant challenge for the caregivers. Although the exact cause of infantile colic is unknown, various factors may act in tandem, leading to gastrointestinal tract disturbances that result in excessive, inconsolable crying in infants. The composition of gut microbiota is strongly associated with infantile colic, and altering the gut microbiota may be one of the potential ways to resolve colic in infants. Probiotics, such as Lactobacillus reuteri, has shown to be effective in treating infantile colic because of their ability to alter the gut microbiota.

Toddlers are children, during this growing phase, they have specific nutritional requirements. If these specific requirements are not met, they are at an increased risk for multiple nutritional deficiencies or malnutrition. It is, therefore, necessary to have a healthy balanced nutritional diet during infancy and toddler-hood. Growing-up milk (GUM) or nutritious milk for a growing toddler is one such way of making sure that toddlers have the appropriate nutrition in the required amount.

Early dietary behavior, right from the complementary feeding period, influences the food preferences and health outcomes later in life. Complementary feeding practices are important to ensure an adequate nutrition for a child from 6 to 24 months of life, which is a critical window for optimal nutrition. Understanding the frequency of feeds, consistency of food, the need for nutrients, and the eating behavior not only helps in providing the required nutrition but also molds healthy eating habits in later life. Unhealthy eating habits, on the other hand, can not only increase the risk for non-communicable diseases in adulthood, but can also have adverse long-term consequences on intelligence quotient and cognitive development.

Functional gastrointestinal (GI) disorders are considered common today, especially during the 12 months of life.1 Many aspects of infant gut comfort are based on the intake of long-chain saturated fatty acids in infants, fat composition of the milk, the whey:casein ratio, and lactose intake. Knowing how each of these affects infant gut comfort could lead to a better management of common functional GI tract disorders.

Breast milk is the gold standard for infant nutrition. Because of its unique composition, particularly the quality and quantity of proteins, breast milk provides the ideal nutrition to support an infant’s healthy growth and development. The first 1000 days of an infant’s life is a critical window for development, and nutrition during this period can influence metabolic programming. An excess of certain types of amino acids required in early nutrition can cause early weight gain and lead to obesity. Therefore, a right quality and quantity of proteins is important for an optimal development.

Exclusive breastfeeding is recommended for the first 6 months of life and should be continued up to first 2 years. Breast milk is the gold standard for the infant that is enriched with all the essential nutrients required for proper growth and development of the infants. This article covers what makes breast milk so unique, the evolution of alternate feeds and the common substitutes for human milk in India.

Obesity is now an epidemic worldwide. Early nutrition can have a significant impact on the growth and weight gain in infants, leading to obesity in adulthood. Protein intake during infancy and childhood plays a significant role in influencing obesity in later life. The effect of protein intake on the rapid weight gain during infancy is mediated by the insulin-like growth factor 1, which can be an important target for intervention to tackle obesity early in its course.