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Nutritional Requirements in Babies

By Lucy Jackman

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Something that can cause parents a lot of stress is knowing if their little one is getting enough nutrition. 

The following table shows the requirements we use in clinical practise to ensure that a little one is getting everything they need to grow and develop in the first year of life.  Note that these figures are for the term infant – different requirements may apply to premature bubs. The key thing to be aware of is the fluid requirements as this helps you understand a suitable volume of milk feed for your little one.

Fluids

0 – 6 months of age150 ml/kg
7 – 12 months of age120 ml/kg

Energy

1 – 2 months of age96 – 120 kcal/kg
3 – 4 months of age96 kcal/kg
5 – 6 months of age72 – 96 kcal/kg
7 – 12 months of age72 kcal/kg

Protein

0 – 3 months of age2.1 – 2.6 g/kg
4 – 6  months of age1.6 – 1.8 g/kg
7 – 9 months of age1.5 – 1.7 g/kg
10 – 12 months of age1.1 – 1.6 g/kg

An illustrative example:

An 11 month old weighing 8.7 kg requires:

  • 1,044 mls of fluid per day
  • 626 calories per day
  • 9.57-13.92 grams of protein per day

*** Remember, if a dietitian is seeing a baby it’s because there is a concern of some sort, so we do look at numbers in a little more detail. ***

How do you know if a breastfed baby is getting enough?

If you’re feeding directly from the breast, you have no way to measure the volume of milk your little one is receiving. This can often cause concern for parents, and for those who may be expressing milk as well and seeing small volumes it can set off alarm bells. The first thing to remember, however, is that you tend to produce more milk when it is breast to baby vs expressing, so aim to directly feed the baby where you can, which also helps with milk production. Also, regular expressing helps stimulate more milk production – it works on supply and demand. Aim to express little and often to keep the production going.

To help reassure you, there’s plenty of other ways to understand whether bub is getting enough:

  • Wet nappies – if your little one is having regular wet nappies this is a sign they are having enough fluid
  • Dirty nappies – If your little one is having regular dirty nappies (poops!), this is a sign they are taking in enough
  • Growth trajectory – this is looking at which line on the centile chart (in your red book) your little one is following and if they are in proportion for weight and length. Please ask your GP, health visitor, paediatrician or dietitian to plot BOTH weight and length as this is the only way we can really understand if a little is growing appropriately. Ideally weight and length centiles should be within 1 centile line of each other.

When should I be concerned about weight? 

Not all babies grow at the same rate, especially over the first year of life. You will notice they tend to not follow 1 centile line, but track within a centile space (the gap between two centile lines), this is totally normal.  

It’s also normal for a baby to lose a little weight after birth, and most of the time they get back to their birth weight after a couple of weeks. After that, your little one’s weight is measured at routine intervals by your health visitor unless they’re concerned and think bub needs a bit of extra monitoring. We don’t want to weigh too often which can cause unnecessary worry – this is the current recommendations:

  • 2 weeks to 6 months: no more than once a month 
  • 6-12 months old: no more than once every two months 
  • Over 12 months old: no more than every three months

We would be concerned if there was a sustained drop through 2 or more centile spaces. This could be due to many reasons so try not to be too alarmed, but seek advice from your GP, health visitor, paediatrician or dietitian. Most of the time, babies who are slow to gain weight are healthy and catch up eventually with no underlying illness or difficulties. Whilst important to monitor, weight is only one aspect of your baby’s health and development. 

Sometimes however, little ones don’t gain weight in the expected trajectory, and this is referred to as “faltering growth”. This could be because they’re not getting enough calories (either not enough are being provided, the bub isn’t taking enough, or they are expending the energy they are taking in). It could also be due to an underlying health issue or problems with their digestive system such as reflux, coeliac disease or cow’s milk protein allergy (the latter is fairly common). I help lots of little ones with these digestive issues in my clinic so do please get in touch if you’d like some support with this. 

What portion should I be serving to my baby when it comes to solids?

When you start weaning around the 6 month mark (or when baby is showing signs of being ready) it’s important to remember that it’s more about the exposure and experience at this stage rather than food for nutritional benefit. For this reason, there are no recommendations for portion sizes under 12 months of age. Milk (either breast or formula) continues to meet the majority of nutritional requirements for your little one.

Try not to compare what you’re giving your little one to other babies – all children take solids at different rates and eat different portions. Some prefer to eat little and often, whereas others will devour a whole meal at breakfast, lunch and dinner. 

Top tip:

If they don’t finish everything on the plate, that is fine. Avoid forcing them to eat if they are clearly showing signs they have had enough (turn their head away, distracted in the highchair, clamping their mouth shut).  Force feeding can lead to aversion and fussier eating behaviours later on. 

I’ll do a separate post on weaning to include some more advice and tips on this popular topic!

Summary

Whilst weight tracking and knowing requirements can be helpful, I recommend avoiding getting too hung up on numbers, as this can cause unnecessary stress. Trust your gut, and contact your GP, health visitor, paediatrician or dietitian if you are concerned about your baby’s weight. This is especially important if you think they might be dehydrated, which can be serious for young bubs.

If you do have concerns about your little one’s intake, get in contact, we can work through it together.

Lucy is a paediatric gut specialist dietitian with in-depth experience in both NHS and private healthcare settings. Lucy has specialist interest in and extensive experience with gastrointestinal food allergy and intolerance. Her expertise also includes faltering growth, gastro-oesophageal reflux disease (GORD), Inflammatory Bowel Disease (IBD) including the use of exclusive enteral nutrition to induce remission.

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