Introduction
A child is not a small adult: per kilogram, an infant needs about three times the energy and water of an adult, because it grows fast, has a high metabolic rate and a large body surface for its weight. Good nutrition in the first 1000 days (from conception to 2 years) shapes growth, brain development and later health.
Daily needs
Supplements for every infant: vitamin K at birth (1 mg IM) against vitamin K deficiency bleeding, and vitamin D 400 IU a day through the first year, especially when breastfed.
Breastfeeding
WHO advises exclusive breastfeeding for 6 months, then breastfeeding alongside other foods to 2 years or beyond.
Why breast milk is best
- Protection: secretory IgA, lactoferrin, lysozyme, human milk oligosaccharides (feed bifidobacteria) and white cells. Fewer gastroenteritis, otitis, respiratory infections, necrotising enterocolitis in preterms, and less sudden infant death.
- Easy to digest: whey proteins, lipase in the milk, a low solute load for immature kidneys.
- For the mother: faster uterine involution, lactational amenorrhoea, less breast and ovarian cancer; bonding; free and always at the right temperature.
When not to breastfeed
- Classic galactosaemia in the baby (lactose → galactose).
- Maternal HIV where safe formula is available, HTLV-1, active untreated TB (until treated), herpes lesions on the breast.
- Chemotherapy, radioactive isotopes, illicit drugs. Most ordinary medicines are compatible: check first.