Breast Feeding And Nutrition 1 Flashcards by Christa Baniqued

6 interventions for reducing child mortality

Exclusive breastfeeding
Timely complementary feeding
Micronutrient interventions
Deworming
ORS Program
Food fortification

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Parts of plan of management of pediatric patients and their components

Diagnostic: labs
Therapeutic: DOC
Supportive: Nutritional intervention

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2 goals of nutrition

Adequate calories

Positive nitrogen balance

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What age will the birth weight double? Triple? Quadruple?

Double 4-5 months
Triple 1yr
Quadruple 2yrs

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Age and explanation for Stage of Adiposity Rebound?

Increase of BMI in preparation for adolescent growth spurt

Age 6-7

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Brain growth spurt

Mid gestation up to 3 yrs old

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Brain weight at birth

400g

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Brain weight at 12months

1000g

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Until when is head circumference measured?

3yrs old

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Number of brain cells and synapses at birth

100B brain cells

50T synapses

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Number of synapses at 1month

1000T (20x increase from birth)

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Explain barker hypothesis

Nutrition during the first 1000 days of life (intrauterine until 3yrs) determines your susceptibility as an adult to NCDs (HPN, obesity, metabolic syndrome)

Regardless of family history

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Parts of nutritional assessment

DCBA
Developmental history
Clinical Examination (PE)
Biochemical or Blood studies
Anthropometry

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How many calories in 1oz of standark milk formula?

1oz=20cal

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How many calories in 1 day if fed 3oz of formula every 3 hours?

3oz x 8 times a day = 24oz

24oz x 20 cal = 480cal

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Pathogomonic sign for vit C deficiency?

Bleeding gums

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Pathogomonic sign for vit A deficiency?

Signs of blindness

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Pathogomonic sign for iron deficiency?

Pallor

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Formula of percentage and the value used for ideal

(Actual/ideal)x100

Ideal value= p50

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Measurement used to determine underweight/undernourished child?

Weight for Age

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Measurement used to determine obese child?

BMI

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Measurement used to determine wasting?

Weigh for length

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Measurement used to determine stunting?

Length for age

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Measurement used to determine brain growth?

Head circumference

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Acute malnutrition term

Wasting

Chronic malnutrition term

Stunting

Measurement used to determine fat stores?

Triceps skin fold (TSF)

Measurement used to determine somatic protein?

Mid-upper arm circumference (MUAC)

Estimation of ideal weight

Ideal weight= age in yrs + 8kg

Computation for degree of wasting

(Actual weight for length/ideal weight for length)x100 Ideal- p50 on chart

Degrees of wasting and their values

Normal >=90 Mild 80-90 Moderate 70-80 Severe <70

Explain frankfort horizontal plane

Orbitale and tragion should form a horizontal line when measuring length with infantometer

Computation for degree of stunting

Actual length for age/ideal length for age)x100

Degrees of stunting and their values

Normal >=95 Mild 95-90 Moderate 90-85 Severe <85

Relationship of HC and CC at birth

HC>CC

When does HC become equal to CC

6 months

When does CC become bigger than HC

1 year

Cut off measurement for severe malnutrition using MUAC?

<11.5cm

Explain wet weight

Normal weight of severely malnourished children due to additional weight from edema

Growth factors in breast milk and their function

Epidermal growth factor: intestinal growth Transforming growth factor: epithelial growth Nerve growth factor: neuronal growth

Enzyme found in breast milk and its function

Platelet activating factor acetylhydrolase: blocks PAF

Role of lactobacillus bifidus

Maintains acidity-inhibiting bacteria

Role of lactoferrin

Binds with fe for better absorption | Inhibits e.coli, staph, candida

Role of lsozymes

Bacteriostatic | Anti-staph, anti- gram (-)

Role of lactoperoxidase

Kills step enterobacter

Executive order 51

National Milk Code | Prohibits advertising of infant formula

RA 7600

Rooming-in and Breastfeeding Act

AO No. 2009-0025

New policies and protocol on newborn care | Nonseparation of mother and newborn

AO No. 2005-2014

National policies on young child breastfeeding All newborns should be breastfed Exclusive 6mos >6mos breastfeeding + complementary

Role of glands of morgagni

Oil glands provides scent that direct baby to nipple and protect skin of nipple and areola durin feeding

Average number of milk ducts per nipple

Main stimulus for milk let-down reflex

Suckling on nipple (oxytocin)

Estrogen and progesterone effect on milk secretion

Inhibitory | These hormones decrease after delivery allowing of initiation of milk secreton

Ideal duration of feeding

15 mins per breast

Explain lactation crisis and hormone involved

Epinepherine may be secreted in the first few days of feeding when the mother is still hesistant (anxious) Epi blocks let-down and may cause lactation crisis.

Rest period before feeding

15-20mins after birth

Breast crawl

Movement made when during skin to skin contact to get to the breast Important to have stepping reflex

Durationof sucking reflex

42wks AOG to 1month

Trigger of sucking-swallowing reflex

Nipple touching hard palate

Minimum feeding times in a day

8x or every 3hrs

Milk supply on day 1

5mL

Day of peak milk secretion

Day 5

Responsible for yellow tinge of colostrum

Carotenoids

Vitamins found in colostrum

A,E,K

When does colostrum, transitional, and mature milk appear?

Colostrum: 2-3days post partum Transitional: 7-14 days Mature >14 days

Two types of mature milk and their composition and role

Foremilk - thin fluid - high water content - source of water and hydration for baby Hindmilk - creamier milk - high fat content - for satiety — makes baby stop feeding

Three types of stool and when they occur

Meconium: 1-3 days after birth Transitional stool: 3-5 days or until 7th day Milk stools >5 days

Cradle/madonna hold

Breast same side as supporting arm

Side-lying or reclined

Used bed as support

Cross-cradle or crossover hold

Supporting arm is opposite of the side of breast

Football hold

Baby is supported at the side of mother

Indications for football hold

Large breast C section Forceful letdown Inverted or flat nipples

Indication for double football hold

Twins

Indication for scissoring technique

Overactive milk let-down

Shelf life of refrigerated breastmilk

24hrs

Shelf life of frozen breastmilk

6months

Absolute contraindication to breastfeeding

Galactosemia

Agent implicated in mastitis

Staph aureus

Define BREASTFEEDING jaundice and duration

Exaggeration of physiological jaundice dt insufficient fluid intake Results in dehydration and hyponat First 3 days to 2nd week of life

Define BREAST MILK jaundice and duration

Dt presence of glucoronyl transferase inhibitors in BM (competes w bilirubin conjugation) Day5/15 and lasts for 3 weeks or months

Proteins found in BM and their percentage

Whey 60% | Casein 40%

Role of Bifidus Factor in BM

Ca and Mg absorption and CNS myelinization

Protein inBM with ability to increase immune respone

Whey

Main type of when in humans and cow’s milk

``` Alpha lactalbumin (human) Beta lactalbumin (cow) ```

Implicated in cow’s milk allergy

Beta lactalbumin (whey)

Vitamins that are lower in human milk compared to cow’s milk

Vit K and B

Risk that comes with low vit K

Hemorrhagic disease of the newborn

What is energy gap and when does it emerge?

Amount of energy that needs to be provided by complementary feeding to cover the deficiency of pure breastfeeding Emerges at 6 months

Main determinant of food choice

Taste

How many attempts of new food before acceptance is achieved?

8-10x

Feeding frequency during complementary feeding?

6-8 mos: 2-3x 9-11 mos: 3-4x 12-24: 5-7x (3 meals 2 snacks)

At what age is it appropriate to give freshly squeezed fruit juice and at what amount?

1-6 years old | 4-6oz a day

Extrusion reflex definition and duration

Tongue only moves back and forth so baby will spit out any solids 0-4months

Age where dietary patterns are set for life

2 years old

Explain “No no period” and age it appears

Child is picky and does not want to try new food. Harder to introduce vegetables. 3yrs old