Nutrition in the Infant: Practice and Procedures (Greenwich Medical Media)

This book is a comprehensive account of nutrition in the infant, written by a team of international experts. It is divided into a number of sections (i) assessments, incidence and diagnosis of nutritional disorders; (ii) enteral and parenteral nutrition; (iii) micro- and macro-nutrients; (iv) diet and support in disease; (v) developmental, theoretical and educational aspects; and each chapter is divided into key areas for ease of quick reference. A unique feature of the book is a series of summary tables which identify treatment regimens, formulations, doses and step-by-step practical guidelines.

This new textbook focuses on providing a "precise and practical" framework for the evaluation and treatment of abnormal nutritional states in infants in industrialized countries. Many traditional textbooks deal with abnormal nutritional states mainly from a Third World perspective, so the three editors of Nutrition in the Infant -- two from the United Kingdom and one from the United States -- offer a complementary approach. To accomplish their aim, the editors have assembled an international team of 61 authors representing 14 countries and 5 continents, including a number who are acknowledged experts in the field. Although the authorship is global, the book consistently focuses on problems and issues facing health care professionals in industrialized countries. The book covers a comprehensive and balanced set of general categories related to infant nutrition, including malnutrition, assessment of nutritional states, parenteral and enteral nutrition, micronutrient and macronutrient requirements, nutritional issues related to children with a variety of special needs, and developmental and educational perspectives. The quality and style of writing vary, as might be expected in a multiauthored book, but the contributions have been edited in a fairly crisp style, and the book is easy to read overall. The format also varies a bit from chapter to chapter, but the central feature in each chapter is a section called "Practice and Procedures," which describes a concise, practical clinical approach to the particular topic. Although the title of the book is Nutrition in the Infant, a more accurate title might be Nutrition in the Infant and Child, since many of the chapters review topics that are more relevant to children than to infants. These chapters include discussion of dietary fiber, the use of low-fat diets, and nutrition in children with conditions such as intestinal transplants, diabetes mellitus, and Crohn's disease. There is also a brief section on the diagnosis and management of childhood obesity. The chapters generally provide up-to-date reviews of important topics and uniformly place primary emphasis on practical elements of the current practice and procedures in industrialized countries. The references for most chapters offer some historical perspective as well as including a limited list of important recent citations and pertinent reviews, but some chapters contain much more encyclopedic lists. There are numerous tables and figures that are used well to enhance the narratives, but photographs are used only rarely. Despite the attempt at comprehensiveness, several topics are conspicuously absent. No chapter covers the theories and practice of feeding the premature infant, which is an important problem in industrialized countries. The rationale and recommendations for advancing the diet during the first year of life are not covered, and no chapter is devoted to the potential problems of weaning -- a major issue in both the industrialized and developing worlds. In future revisions of this textbook, the editors may also wish to consider including a section on the effects of abnormal nutrition in the infant, especially the effect on intellectual development. In addition, some coverage of the special issues related to abnormal nutrition in children in developing countries might provide a broader perspective from which to view the problems of infants in industrialized countries. Although one chapter deals with the promotion of breast-feeding, none presents a practical approach to successful nursing and methods of overcoming commonly encountered problems. Perhaps because of space constraints and attendant cost constraints, the editors did not include sections of graphics illustrating anthropometric measurements or tables of the nutrient composition of formulas for preterm infants or the nutrient requirements of term and preterm infants. An alternative to adding such sections would be the inclusion of an appendix with a list of Web sites that supply this information. Overall, the editors have succeeded in putting together a "precise and practical" textbook on infant and childhood nutrition. The book will be a useful resource for medical and nursing students, residents, dietitians, and health care practitioners who deal with young children. John Snyder, M.D.
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