Breast feeding, fortified formulas boost children's growth

Debbie A. Lubis, Contributor, Jakarta

Parents should be alert if their children suddenly lose their appetites, since early eating habits could have lifelong effects on their health. A proper diet is definitely part of a healthy lifestyle that impacts the children's subsequent physical, as well as mental, growth and development.

Many scientists believe that nutritional intake in the first five years determines a child's subsequent survival and ability to deal with life's challenges.

It's no wonder there are numerous food supplement products, such as tablets, syrups and formula milk on the market these days, encouraging parents to boost their children's growth.

The critical stage in a child's development is while they are still in utero. Physical impairments and flawed brain development that may result in mental retardation often occur during this stage due to lack of nutrition.

"Zero to two years into infancy are the golden ages for the development of a child's brain and body. During this stage, they need plenty of calories, proteins and essential fats," said Fransiska R. Zakaria, a researcher at the Department of Food Technology and Human Nutrition at the Bogor Institute of Agriculture (IPB).

An infant's brain grows dramatically during the first four months, reaching up to two-thirds the volume of an adult brain. Fransiska suggests mothers who breast-feed their babies to pay attention to their nutritional intake.

Sharing Fransiska's view, Samsuridjal Djauzi, an immunologist at the Medical School at the University of Indonesia, said that exclusive breast-feeding remained critical for the first six months of life, because it enabled the infant's intestinal membrane to absorb useful dietary substances during the transition to a broader diet. Protein that cannot be absorbed will go directly into the bloodstream and trigger an allergic reaction.

"Breast milk has excellent nutrients for building a healthy body and brain. It is the most powerful prevention against malnutrition and infectious diseases," he said, emphasizing that breast-feeding should be maintained up to two years of age. Babies fed with breast milk show better health, immune responses, as well as motor and cognitive development.

However, some mothers are unable to breast-feed for various reasons. Samsuridjal said workplaces in many developing countries, including Indonesia, had yet to provide facilities for working mothers to breast-feed. Also, if a mother is HIV- positive, breast-feeding is not recommended, as the virus can be transmitted from the mother to the child.

Comprehensive research has been undertaken to try and improve or enhance formula milk products currently available, so that they can provide the same nutritional content as breast milk. Many formula manufacturers claim that their products contain alpha linolenic acid (ALA), eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA) and arachidonic acid (AA) -- all omega 3 fatty, long chain acids -- that can boost the children's brain development.

Irawan Mangunatmaja, a pediatrician at the Child Neurology department of Cipto Mangunkusumo General Hospital, said an infant's growth and development could be spurred by formula milk fortified with iron, iodine, vitamin B12 and DHA, which is found naturally in breast milk.

"Iron is useful in preventing anemia and enhancing the distribution of nutritious substances in the bloodstream, while DHA is essential for brain and visual growth and function," he said.

Sixty percent of the human brain is fat, of which 25 percent is DHA, which is found in the gray matter of the brain, nerves and retinal membranes. DHA is thus one of the vital nutrients during pregnancy and infancy, since it helps the normal development of the brain and eyes in fetuses and infants.

Researchers have found that a lack of DHA is connected to intrauterine growth retardation, prematurity, impaired visual and cognitive development among infants and children, and other neurological conditions. DHA supplements helps children's psychomotor and visual development, and reduces those symptoms related to Attention Deficit Hyperactivity Disorder (ADHD).

Irawan said existing formula milk does not have any negative side-effects. "I believe all of the DHA-fortified formula manufacturers have followed the WHO recommendation on the minimum DHA amount for infants," he said, referring to the World Health Organization.

The WHO recently recommended that infants with a normal body weight be given a supplement of 20 milligrams DHA per kilogram, and 40 milligrams per kilogram for premature infants.

Irawan, however, stressed the importance of breast-feeding and cautioned mothers not to rely on formula milk and to always consult pediatricians to determine the recommended amount of formula milk.

"Good nutritional intake is a must for pregnant women and post-natal mothers. Infants initially receive DHA from the placenta and breast milk before obtaining it from dietary sources."

Fransiska reminds mothers to augment the nutritional content of their breast milk by eating fish, meats, eggs and seafood, which have proven to be effective in enhancing both cognitive and motor growth and development. "Those who already have a balanced nutritional intake do not need any supplements, since excessive fat can cause degenerative diseases like coronary diseases, cancer and diabetes," she said.