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Home , Cyanocobalamin, Nutrient, Pyridoxine

egg ; egg yolk; liver, liver, egg yolk, liver; liver; infant formula; formula; infant infant formula; formula; infant egg yolk, nuts), butter, nuts), butter, egg yolk, yogurt, legumes Major Sources infant formula, formula, Breast , infant egg yolk, , fish, poultry, , Infant formula, formula, Infant fish, (activation fatty in the of 7-dehydrocholesterol ) formula, , infant green and dark egg yolk, liver, and deep yellow Breast milk; oils; green leafy vegetables; butter; whole-grain breads, cereals, fortified or enriched and other germ grain products; Breast milk; whole-grain breads, cereals, fortified or enriched and other corn; potatoes; grain products; legumes; fruits; vegetables formula, Breast milk, infant (, dairy -rich products, margarine, cream, salad oils and dressings, cooking meat - - Toxicity Symptoms Toxicity monemia Azotemia; acidosis; hyperam Azotemia; nosis vertigo; night sweats; Fatigue; headache; dry and fissured skin; lips; hyperpigmentation; bone pain; growth; retarded jaun - abdominal pain; vomiting; dice; hypercalcemia with K interfere May prolonged activity leading to and bleeding time; in clotting , suppresses the normal response to hematologic Abnormally high Abnormally retarded (hypercalcemia), nephrocalci vomiting, growth, - - - - dermato ; anemia in the prema Deficiency Symptoms liver; retardation of growth of growth retardation liver; Kwashiorkor-edema; reddish Kwashiorkor-edema; pigmentation of hair and skin; fatty in children; - lympho sis; decreased T-cell with increased secondarycytes infections; poor Night blindness, dry eyes, resis impaired bone growth, papillary infection, tance to of the skin hyperkeratosis Hemolytic hyporeflexia, ture and newborn; and spinocerebellar retinal degeneration Ketosis in rate growth Eczema; low resistance in lowered infants; hair loss infection; costo (symptoms: Rickets chondral beading, epiphyseal enlargement, cranial bossing, open legs, persistently bowed fontanelle) anterior - - - protein protein fatty acids; fatty Function Anabolism of tissue ; Anabolism of tissue proteins; helps maintain fluid balance; of formation energy source; immunoglobulins; maintenance of acid-base balance; important part of enzymes and hormones Major energy source; energy source; Concentrated sparing; insulation for protein maintenance; temperature supplies essential Necessary the formation for the of normal bone; promotes of calcium and phos absorption of epithelial Preserves integrity for of rhodopsin cells; formation vision in dim light; necessary and healing, growth, wound for normal immune function function as an May a also have in the tissues; may as a coenzyme; neuromus role cular function sparing; necessary normal for is the ; the of energy for sole source also pro sources brain; many vide A, carries fat-soluble D, E, K phorus in the intestines Fat Protein Vitamin Appendix C: Nutrient Chart - Function, Deficiency and Toxicity Symptoms, and Major Food Sources Toxicity Symptoms, Deficiency and Appendix C: Nutrient Chart - Function,

190 INFANT AND FEEDING I N F A N T N U T R I T I O N A N D F E E D I N G 191 -

- - egg yolk; egg yolk; liver, liver, egg yolk, liver; liver; infant formula; formula; infant infant formula; formula; infant infant formula; formula; infant formula; infant lean formula; infant egg yolk, nuts), butter, nuts), butter, egg yolk, yogurt, legumes Major Food Sources fats Major Food Sources meat; whole-grain breads, infant formula, formula, Breast milk, infant egg yolk, meat, fish, poultry, cheese, Infant formula, formula, Infant fish, sunlight (activation fatty in the of 7-dehydrocholesterol skin) formula, Breast milk, infant green and dark egg yolk, liver, and vegetables deep yellow fruits Breast milk; oils; vegetable green leafy vegetables; butter; whole-grain breads, cereals, fortified or enriched and other wheat germ grain products; Breast milk; whole-grain breads, cereals, fortified or enriched and other corn; potatoes; grain products; legumes; fruits; vegetables formula, Breast milk, infant (meats, dairy foods protein-rich products, margarine, cream, salad oils and dressings, cooking meat Infant formula, vegetable oils, vegetable formula, Infant pork, green leafy vegetables, liver formula, Breast milk, infant fruits (especially citrus fruits, , strawber , (potatoes, ries), vegetables cabbage) breast milk, formula, Infant cheese, meat, fish, poultry, liver egg yolk, Breast milk; green leafy vegetables; liver; legumes; whole-grain breads, cereals, and fortified or en legumes; riched grain products; oranges; cantaloupe; lean Breast milk; liver; grain products; cereals, or other legumes; potatoes Breast milk; wheat germ; whole-grain pork; and enriched breads, cere grain products; als, and other legumes; potatoes ------ane anemia; hyper Toxicity Symptoms Toxicity Toxicity Symptoms Toxicity monemia Azotemia; acidosis; hyperam Azotemia; nosis vertigo; night sweats; Fatigue; headache; dry and fissured skin; lips; hyperpigmentation; bone pain; growth; retarded jaun - abdominal pain; vomiting; dice; hypercalcemia with interfere May prolonged activity leading to and bleeding time; in clotting anemia, suppresses the normal iron response to hematologic Abnormally high blood calcium Abnormally retarded (hypercalcemia), nephrocalci vomiting, growth, sive ataxia; photosensitivity sive Possible hemolytic Possible bilirubinemia (jaundice) diar Nausea, abdominal cramps, of kidney possible formation rhea, stones - Masking of B12 deficiency symp in those with pernicious toms with progres Sensory neuropathy mia not receiving mia not ------ane

- dermato diarrhea; anemia in the prema anemia; neurologic anemia; neurologic anemia; Deficiency Symptoms liver; retardation of growth of growth retardation liver; Deficiency Symptoms Kwashiorkor-edema; reddish Kwashiorkor-edema; pigmentation of hair and skin; fatty in children; - lympho sis; decreased T-cell with increased secondarycytes infections; poor Night blindness, dry eyes, resis impaired bone growth, papillary infection, tance to of the skin hyperkeratosis Hemolytic hyporeflexia, ture and newborn; and spinocerebellar retinal degeneration Ketosis in rate growth Eczema; low resistance in lowered infants; hair loss infection; costo (symptoms: Rickets chondral beading, epiphyseal enlargement, cranial bossing, open legs, persistently bowed fontanelle) anterior - - Prolonged bleeding and prothrom Prolonged manifesta bin time; hemorrhagic tions (especially in newborns) peripheral hemor pinpoint Scurvy, bleeding gums, osmotic rhages, diarrhea Pernicious deterioration megaloblastic growth; Poor mia (concurrent deficiency of vi tamin B12 should be suspected); cellular immunity impaired Microcytic irritability convulsions; Beriberi, neuritis, edema, failure cardiac ------pro protein protein fatty acids; fatty Function Function amino acids and unsatu Anabolism of tissue proteins; Anabolism of tissue proteins; helps maintain fluid balance; of formation energy source; immunoglobulins; maintenance of acid-base balance; important part of enzymes and hormones Major energy source; energy source; Concentrated sparing; insulation for protein maintenance; temperature supplies essential Necessary the formation for the of normal bone; promotes of calcium and phos absorption of epithelial Preserves integrity for of rhodopsin cells; formation vision in dim light; necessary and healing, growth, wound for normal immune function function as an antioxidant May a also have in the tissues; may as a coenzyme; neuromus role cular function sparing; necessary normal for glucose is the metabolism; fat the of energy for sole source also pro sources brain; many vide dietary fiber vitamins A, carries fat-soluble D, E, K phorus in the intestines fatty acids from essential acids from fatty Catalyzes prothrombin synthesis; Catalyzes prothrombin in the synthesis of other required synthesis by factors; blood clotting bacteria intestinal Essential in the synthesis of col lagen (thus, strengthens tissues healing wound and improves infection);iron and resistance to and transport;absorption - functions in soluble antioxidant; metabolism folacin of Essential for nucleic acids and nucleoproteins; involved maturation; cell blood red central metabolism; with metabolism nervous system Essential in the biosynthesis of nucleic acids; necessary the for normal maturation of red blood cells Aids in the synthesis and break ; es - sion of to normal growth sential for Combines with to (TPP) thiamin pyrophosphate form of necessary metabolism for essen and fat; carbohydrate, tein, normal appetite, growth, tial for nerves digestion, and healthy down of down rated conver acids; essential for fatty Fat Protein Nutrient Vitamin A Vitamin Vitamin E Vitamin D Carbohydrate Folacin ( Folate) Thiamin Nutrient Vitamin K ( ) (Cobalamin, (Cobalamin, (Vitamin B1) ( ) Ascorbic Acid Ascorbic Cyanocobalamin)

190 INFANT NUTRITION AND FEEDING I N F A N T N U T R I T I O N A N D F E E D I N G 191 egg egg yolk; egg yolk; infant formula, formula, infant formula; infant formula; infant formula; infant water egg yolk; oysters oysters egg yolk; liver; legumes; whole- liver; liver; Major Food Sources and other seafood; whole-grain seafood; and other forti - breads, cereals, and other fied or enriched grain products; legumes Breast milk; meat; dairy products; legumes; green vegetables; whole-grain breads, cereals, and fortified or enriched grain products Breast milk; meat; poultry; fish; whole-grain breads, cereals, and fortified or enriched grain products; yolk formula, Breast milk, infant yogurt, cheese, fortified or some enriched grain products, (such as green leafy vegetables greens, mustard kale collards, (if and turnip greens), tofu made with calcium ), salmon sardines, Breast milk; meat; grain breads, cereals, or forti - fied or enriched grain products; green vegetables and dark Breast milk; meat; Fluoridated formula, Breast milk, infant (table ) ------vomiting; lethargy vomiting; Toxicity Symptoms Toxicity Transient due to the vasodilat due to Transient ing effects of niacin (does not occur with niacinamide)-flush ing, tingling, dizziness, nausea; abnormalities; hyperu liver ricemia; decreased LDL and increased HDL cholesterol calcification of bone; Excessive calcification of softhy tissue; percalcemia; hemosidero Hemochromatosis; sis. upset; gastrointestinal Acute dizziness; sweating; vomiting; deficiency pos discolored teeth; Mottled, sible increase in bone density; calcified muscle insertions and exotosis - - - ane anemia, diarrhea, diarrhea, Sodium dental caries Deficiency Symptoms diarrhea, growth failure, failure, growth diarrhea, Photophobia, cheilosis, glossi Photophobia, poor tis, corneal vascularization, growth dermatitis, Pellegra: dementia – abnormal develop Rickets ment of bones. microcytic Hypochromic irritability; mia; ; lethargy pallor, anorexia; healing, Decreased wound mild hypogonadism, hair acuity, decreased taste loss, skin changes Increased sodium by Usually accompanied see depletion; - - - - Function fatty acids fatty Essential for growth; plays plays growth; Essential for in tissue respira enzymatic role tion and acts as a transporter of FMN of synthesis ions; and FAD Part for of the enzyme system energy release; nec oxidation, essary synthesis of for and the synthesis break of down Builds and maintains bones of essential in clotting teeth; blood; influences transmission cell membranes; of ions across in nerve transmission required of the formation Essential for trans hemoglobin and enzyme of many Component and insulin systems against teeth Helps protect minimize bone may decay; tooth loss - acid-base equi Helps regulate pressure librium and osmotic of of body fluids; component gastric juices port; increases resistance to functions as partinfection; in tissue of enzymes involved respiration. Iron Niacin Calcium Nutrient Chloride (Vitamin B2)

192 INFANT NUTRITION AND FEEDING I N F A N T N U T R I T I O N A N D F E E D I N G 193 - - - - -

meat; poultry; meat; fish; infant formula; formula; infant formula; infant formula; infant egg yolk; egg yolk; Major Food Sources Meat; whole-grain breads, cere fortified or en als, and other brewer’s riched grain products; corn oil ; poultry; kidney; shellfish; Liver; legumes; whole-grain breads, grain prod cereals, and other ucts formula, Breast milk, infant iodized salt seafood, Breast milk; whole-grain breads, cereals, tofu; grain products; and other legumes; green vegetables Whole-grain breads, cereals, le grain products; and other (leafy) gumes; fruits; vegetables Organ meats; breads, cereals, dark grain products; and other legumes vegetables; leafy green Breast milk; cheese; Breast milk; fruits especially juice, bananas, and dried fruits; yogurt; potatoes; poultry; products; soy vegetables fish; whole-grain breads, cere grain products; als, and other legumes - -

copper de Toxicity Symptoms Toxicity Goutlike syndrome Goutlike posits in the cornea; cirrhosis of posits in the cornea; cirrhosis - of neurologi deterioration liver; cal processes enlargement thyroid Possible transient Diarrhea; hypocalcemia from high exposure In extremely - psychiat contamination: severe disorders ric and neurologic Hypocalcemia (when parathy Wilson’s disease – fully functioning) gland not roid - - - Deficiency Symptoms Glucose intolerance; impaired impaired Glucose intolerance; peripheral neuropathy; growth; balance; de negative creased respiratory quotient depressed thy Endemic goiter; function; cretinism roid Muscle tremors; convulsions; hyper-or irritability; tetany; hypoflexia abnor skeletal growth; Impaired malities; neonatal ataxia unusual depletion – effects renal, neuromuscular, as as well systems skeletal blood chemistries decreased Muscle weakness; and distension; tone intestinal respiratory arrhythmias; cardiac failure Pallor, retarded growth, edema, growth, retarded Pallor, anorexia ------protein and protein Function dental caries mones; important in regulation and growth of cellular oxidation muscle contrac sions, and for tion energy metabolism Required for normal glucose for Required insulin metabolism; the function of many Facilitates be an may enzymes and iron; partintegral of RNA, DNA mol hor thyroid Helps regulate coenzyme many for Required oxidation-phosphorylation reac tions, nervetransmis impulse enzyme partEssential several of in involved systems Part of the enzymes xanthine oxidase, and aldehyde oxidase possibly helps reduce incidence of Builds and maintains bones of nucleic ac component teeth; ids, phospholipids; as coenzyme functions in energy metabolism; buffers intracellular fluid - acid-base equi Helps regulate pressure of librium and osmotic body fluids; influences muscle especially cardiac activity, muscle ecules Copper Nutrient Phosphorus Molybedenum

192 INFANT NUTRITION AND FEEDING I N F A N T N U T R I T I O N A N D F E E D I N G 193 - liver, liver,

egg infant formula; formula; infant Major Food Sources egg yolk, yeast, bananas, yeast, egg yolk, Whole-grain breads, cereals, fortified or enriched and other ; meats; grain products; dependent on seafood; content– vegetables Sodium chloride (table salt), except abundant in most foods Breast milk; meat; fish; poultry; liver; whole-grain breads, yeast; yolk; grain prod cereals, and other ucts; legumes; vegetables formula, Breast milk, infant meat, strawberries, most vegetables, grapefruit, , water retention water Toxicity Symptoms Toxicity Diarrhea; Diarrhea; - Deficiency Symptoms Myalgia; muscle tenderness; muscle tenderness; Myalgia; increased myopathy; cardiac fragility of red blood cells; de generation of pancreas vomiting; Nausea; cramps; exhaustion; dizziness; apathy; possible respiratory failure dermatitis; ; Seborrheic nausea; insomnia; Fatigue; disturbances; Fatigue; nausea; muscle cramps; loss of coordination; impaired antibody production - - - protein amino acids Function May be essential to tissue be essential to May with fat respiration; associated and vitamin E; acts metabolism as an antioxidant - acid-base equi Helps regulate pressure librium and osmotic role in a of body fluids; plays normal muscle irritability and contractility; influences cell permeability in the synthesis and Functions vital body of many breakdown essential in the compounds; intermediary of metabolism and fat, carbohydrate, of en Essential component zymes; important in reactions the lengthening of car involving bon chains; coenzyme carrier of an impor plays dioxide; of in the metabolism tant role acids and fatty Sodium Nutrient Pantothenic Chart revised from first edition using following references: 2004. USA: Elsevier, 11th ed. Therapy. and Nutrition, Food, Krause’s Escott-Stump S. Maher LK, 2004. Academy of Pediatrics, American IL: Village, Elk Grove 5th ed. Nutrition Handbook. Pediatric editor. In: Kleinman RE, Vitamins.

194 INFANT NUTRITION AND FEEDING I N F A N T N U T R I T I O N A N D F E E D I N G 195