The key nutrients for baby's optimal development

Jenny Douglas from Jumpstart Nutrition gives us the rundown on what key nutrients your baby needs for the best start in life. 

As soon as babies are born, they start sucking or looking for the breast as they know milk is what they need to sustain life outside of the womb (wow, nature is cool!). Your baby is born with an inbuilt ability to regulate how much milk they need to drink to grow and thrive perfectly and in those first few months of life your baby should only need breast milk or formula to meet their nutritional requirements. However, as they get older, they will need food sources for some nutrients. Let’s unpack what these are and how much they need for optimal development. 

BREASTFEEDING

From birth, your baby receives all the nutrients they need from breast milk. Breast milk contains all the calories, protein and nutrients required for growth.  Breastfeeding works on a supply and demand process, which means the more your baby drinks (demand) the more breast milk your body makes (supply). You baby will increase the amount of feeding in anticipation of a growth spurt so that your supply is ready to cater for the increased needs. To give your baby all that they need to grow you should feed on demand, which means any time your baby asks for food using the rooting reflex, you offer them the breast. Anything that interferes with the supply and demand process will affect supply. For example, if you are away from your baby for extended periods of time or if they drink formula or water. 

Breastfeeding is amazing because:

+  It helps develop a strong connection and bond between mum and baby

+  It comes at  the perfect temperature and doesn't require any equipment or need sterilising

+  Breast milk can pass antibodies through to your baby to help fight infection

+  Babies who are breastfed have less respiratory infections, less gut upsets and may have reduced risk of obesity and asthma

+  Not only do babies benefit, but Mum has a decreased risk of ovarian and breast cancer, and breastfeeding helps with the contraction of the uterus after birth to its normal size.

Did you know that breast milk not only contains energy and protein, but all the nutrients for a healthy baby? This includes vitamins A, C, D, E, K, B vitamins, iron, calcium and zinc. Breast milk has over 300 ingredients and your breast milk composition changes depending on how old your baby is. For example, a premature infant’s mother will produce breast milk that is lower in calories but higher in protein, whereas
a mother’s breast milk for an older baby will be higher in calories and lower in protein. Breast milk will also pass antibodies to the baby if they are sick. Research over the Covid pandemic has shown that a mother will pass Covid-19 antibodies to her baby if they both have Covid. To ensure your baby continues to receive all the amazing qualities of breast milk, it is recommended to exclusively breastfeed until around six months, and then continue to breastfeed until around two years old, alongside food.

FORMULA

If you are unable to breastfeed, then formula can be offered to your baby in the same ‘on demand’ style of feeding. Offer your baby the bottle when they ask for this with the rooting reflex and stop feeding once they stop sucking or push the bottle away. You can still develop a strong connection and bond with your baby through bottle-feeding and listening to your baby’s feeding cues that indicate hunger and fullness. Formula must be from a commercial formula company complying with the infant formula guidelines, and alternatives (such as bone broth or homemade milks) should be avoided as they do not contain the nutrients your baby needs to grow. Infant formulas have all the calories, protein and nutrients required for healthy growth and development, but they are not able to replicate breast milk entirely. They may also have other ingredients added such as omega-3, prebiotics, probiotics, and long chain polyunsaturated fatty acids (PUFA’s). These additions are designed to replicate breast milk ingredients as closely as possible. For your formula-fed baby to receive all the nutrients that it needs, they should be fed exclusively formula until around six months and continue formula alongside food until 12 months of age. After 12 months of age your baby can move to standard cow’s milk as a drink.

Are there any specific nutrients that are important for babies? Yes there are...

IRON

Iron is an important nutrient that plays a key role in growth and development in infants and children. Once your baby is six months old, the iron stores they have laid down in pregnancy are starting to reduce, and they are not meeting their iron requirements from breast milk or formula – this is the main reason for starting on solids around the six month mark. Your baby moves from needing around 0.2mg iron per day as a young infant to needing 7mg iron per day at around six to seven months of age. Breast milk does contain a small amount of iron but not enough to meet requirements. The amount of iron in breast milk is around 0.07mg iron per 100mls, so if your baby has around 800mls breast milk, they will receive 0.56mg iron per day. Iron foods to introduce from around six months are beef, lamb, chicken, fish, egg, beans, lentils, and iron-fortified baby cereals. Some foods have higher bioavailability than others, for example red meats are high in haem iron, which is easily absorbed in the body. Other non-meat iron sources, such as lentils/beans and iron fortified baby cereals are non-haem iron and not so easy to absorb. To help absorption, it is a good idea to serve foods high in vitamin C, for example capsicum, tomato, or fruit, alongside these iron foods. To meet iron requirements, you should offer iron foods at most main meals for your baby.

Iron foods you might offer your baby:

+  75g beef: 2mg iron (haem)

+  25g spinach: 0.75mg iron (non-haem)

+  2 tablespoons iron-fortified baby cereal: 2mg iron (non-haem)

+  50g tofu: 2mg iron (non-haem)

+  1 egg: 1mg iron (haem)

VITAMIN D

Your baby is unlikely to need anything but breast milk or formula within the first six months of life, but there are some instances where children may need to be given vitamin D as a supplement within this time. For babies who are breastfed exclusively over the winter months, your baby may require vitamin D drops (giving 400IU per day) if:

+  You and/or your baby have darker skin

+  Your baby has rickets

+  Your baby was born prematurely (born before 37 weeks gestation)

+  You have been diagnosed with low vitamin D during pregnancy

+  You avoid sun exposure (covering most of your body whilst outside)

+  You live in the southern regions of New Zealand

Discuss whether vitamin D drops are required with your midwife, Well Child nurse or GP. Once your baby becomes a toddler and is regularly enjoying outside activity, they are unlikely to need vitamin D supplements (10-15mins of direct sunlight is enough). Some foods can contain vitamin D and interestingly, if you leave your mushrooms in the direct sunlight, the mushrooms  produce vitamin D. Other food sources of vitamin D are fatty fish, cod liver oil (if you are brave enough to drink it!) and fortified oils.

ZINC

Zinc is important for growth and development, to help build a strong immune system, and for skin integrity/healing. By six to seven months of age, you baby needs 3mg zinc per day. There is a small amount of zinc in breast milk, but not enough to meet nutritional requirements as they become older. Foods containing zinc should be introduced from around six months of age. Some high zinc-containing foods are seafood, meat, smooth nut butters, and beans. Many foods that contain iron also contain zinc. To help meet requirements you can offer zinc-containing foods a few times over the week.

Food sources of zinc that you might offer your baby:

+  75mg lamb: 3mg zinc

+  75mg chicken: 2mg zinc

+  1 tablespoon cashew butter: 1mg zinc

+  75g prawns: 2mg zinc

+  1 tablespoon tahini: 1 mg zinc

OMEGA-3 FATTY ACIDS

Omega-3 fatty acids are important for health and are involved in healthy brain development and to aid growth and development in infants. Omega-3 is present in breast milk and will be in higher concentrations when Mum is having good amounts of omega-3 in her own diet. There are three kinds of omega-3 fats, which are ALA (alpha-linolenic acid), DHA (docosahexaenoic acid), EPA (eicosapentaenoic acid). ALA is an essential fat so it must be consumed in the diet. Our bodies can make EPA and DHA from ALA but this is very limited. A high omega-3 fatty acid diet can be beneficial for both Mum and baby, with the aim to offer foods high in omega-3 regularly over the week, such as fatty fish, seafood, and nuts/seeds.

VITAMIN C

Vitamin C is found in fruits (eg kiwifruit, tomato, orange) and vegetables (eg capsicum, kumara) and helps support immune function, acts as an antioxidant in the body and aids the absorption of iron. Breast milk and formula both provide some vitamin C but as your baby gets older, they need around 30mg per day. Vitamin C predominately comes from fruit and brightly coloured vegetables. Babies often have a natural sweet tooth (as breast milk has a natural sweet flavour) and therefore are usually accepting of having fruit in their diet. Offer your baby a fruit portion that is around the size of their fist, twice per day, to help them meet their vitamin C requirements.

PROBIOTICS

Breast milk naturally contains probiotics and prebiotics for a healthy gut. As your baby grows bigger you can introduce probiotic foods, like yoghurt, to help support a healthy gut microbe. There is very little research on whether other fermented foods, such as sauerkraut, kombucha and kefir are safe for babies, so ideally wait until they are over 12 months, or purchase a commercial fermented food that has stringent food safety practises in place to avoid food-borne illness. Probiotic powders can be helpful if your baby is on antibiotics to help reduce the risk of diarrhoea, and there is some evidence for the use of probiotics for aiding eczema.

To help your baby meet all their nutritional requirements, they need a diet that is exclusively breast milk or formula with an introduction of solid foods at around six months that offers a variety of iron-rich foods, grains, fruit, vegetables, and milk products. The focus should be around unprocessed fresh foods that are offered at a texture that is age-appropriate for your baby (eg puree, mashed, chopped up or soft finger foods). The first 12 months of life is an important stage of life to offer a wide variety of different foods (this also includes all allergen foods, such as nut butters, egg, fish, milk, wheat, soy) as this is a time of their life where they are quite accepting of most foods offered.

Jenny Douglas is a Registered Dietitian specialising in children’s nutrition, food allergies and intolerances, and fussy eaters. Jenny offers nutrition consults in Dunedin and throughout NZ online, as well as Starting Solids and Family Nutrition seminars. She has also recently helped produce Nadia Lim’s YUM cookbook. jumpstartnutrition.co.nz.