Breastfeeding and Pediatric nutrition

Question 1

Fair Labor Standards Act

Answer 1

employers must provide reasonable break time and a private non-bathroom location to express breast milk as needed for a nursing child up to 1 year after child’s birth

Question 2

Maternal Breastfeeding Benefits

Answer 2

descreased postpartum bleeding, increased uterine involution, faster postpartum wt loss, lactational amenorrhea, decreased risk of breast and ovarian cancer, decreased risk of postmenopausal hip fx and osteoporosis

Question 3

Baby Breastfeeding benefits - immunological

Answer 3

decreased risk of meningitis, bacteremia, less otitis media, gastroenteritis, wheezing, asthma and allergies, fewer neonatal complications in premature babies

Question 4

Baby breastfeeding benefits - cognitive

Answer 4

neurodevelopment - slightly enhanced performance on cognitive tests, analgesia

Question 5

Baby breastfeeding benefits - lifelong

Answer 5

SIDS, Diabetes - type 1 and type 2, chrons, ulcerative colitis, lymphoma, leukemia, hodgkin disease, celiac disease, obesity, hypercholesterolemia

Question 6

General breastfeeding benefits

Answer 6

convenient, clean, financial - $500-1000 for 6 months - 1 yr, bonding and security for baby and mom

Question 7

Contraindications to breastfeeding

Answer 7

Mom- HIV+, illicit drug use, active TB (can still express, but can’t feed), certain prescriptions, infant - galactosemia, * mom breast surgery of infant clef palate can be difficult

Question 8

NOT contraindications to breastfeeding

Answer 8

Mom with Hep B or C, fever, tobacco, alcohol use if minimal, infant jaundice or hyperbilirubinemia

Question 9

Avoid during lactations

Answer 9

drugs - fluoxetine, haloperidol, metronidzaole, atenolol, aspirin, lithium, phenobarbital, methotrexate

Question 10

drugs ok during lactation

Answer 10

acetaminophen, acyclovir, amoxicillin, limited caffeine, oral contraceptive, ibuprofen, loratadine

Question 11

Infant breastfeeding physiology

Answer 11

infant draws nipple and areola into mouth, nipple compressed and elongated, infant compresses areola with gums to stimulate milk ejection from lactiferous sinus

Question 12

colostrum

Answer 12

milk in first 5 days, lots of antibodies and WBCS, helps develop normal GI flora, high protein, low fat, amber colored

Question 13

transitional milk

Answer 13

5 days - 4 weeks, decreased IG, increased fat and carbs, lightens in color

Question 14

mature milke

Answer 14

1+ month - looks like cow’s milk but thinner, hind milk in the latter part of a breastfeeding session has higher fat content than milk at the beginning of the feeding, odor/taste depends on mom’s diet

Question 15

mature milk has…

Answer 15

energy, lipids, casein (protein), whey, nonprotein nitrogen, lactose, sodium, potassium, calcium, magnesium, iron, zinc, other trace minerals

Question 16

vitamin D

Answer 16

breast fedd - 400 IU drops/ daily, 1+ age - 600 IU through rest of life as needed

Question 17

maternal needs

Answer 17

relax, rest while baby sleeps, extra 500 kcal/day, plenty of fulid, 8 oz of liquid while nursing, avoid alcohol and tobacco, reduce caffeine

Question 18

Expressed breast milke

Answer 18

EBM - stored room temp for 10 hrs, fridge for 1 week, frozen for 1 month

Question 19

mastitis

Answer 19

symptoms - hot/tender breast, visible redness,fever, nausea, fatigue, tx - oral antibiotics, warm compresses and breastfeeding if tolerated by mom

Question 20

infant formula

Answer 20

cow’s milk or soy based, soy - no less allergies, colic

Question 21

bottle feeding amounts

Answer 21

newborn - 2-3 oz every 2-3 hrs, 4 months: 4-5 oz every 4-5 hrs, 6 months: 6-8 oz every 6-8 hrs, babies take in 24-32 oz/ day during first year of life

Question 22

pediatric nutrition statistics

Answer 22

30% of kids obese, 1 parent obese - 50% chence, 2 obese parents - 75% chance

Question 23

weaning

Answer 23

baby-led: pulls away from breast, fusses, interested in solids, 7-9 months can cup feed w/o help or mom-led: work, etc.

Question 24

solids

Answer 24

6+ months old, sits with support and has head control, start w/ rice cereal, then veggies, then fruits, single-ingredient foods and on new food / time with a 3-7 day wait

Question 25

cow’s milke

Answer 25

can start at 1 year old, 2%+ until 2nd birthday

Question 26

foods to avoid in 1st year

Answer 26

egg white, peanut butter, chocolate, citrus fruits, corn, beans, seafood, honey

Question 27

baby chocking hazards

Answer 27

raw veggies, grapes, cherries, berries, raisins, hot dogs or meat chunks, nuts, popcorn, hard candy incl. suckers

Question 28

good finger foods

Answer 28

mild cheese, dry cereals, ripe banana, peeled apple, squash, peas, cubed/ground lunch meats, infant cookies

Question 29

dietary intake for infants 6-12 months

Answer 29

protein - 14 g, calcium - 600 mg, iron - 15 mg all per day

Question 30

juice

Answer 30

only at 6+ months, < 6 oz per day

Question 31

food allergies

Answer 31

2% of adults, 5% of kids, 150 deaths in US / yr, 30,000 ER visits, refer to allergist for management, symptoms- - tingling in mouth, tongue/throat swelling, hives, difficulty breathing, vomiting, ab cramps, diarrhea, drop in BP, loss of consiousness, appear in minutes - 2 hrs

Question 32

food allergies testing

Answer 32

RAST - serum IgE antibodies or prick skin test

Question 33

food allergy tx

Answer 33

avoid, antihistamines, epinephrine

Question 34

FALCPA

Answer 34

food allergen labeling consumer protection act - food labes must list ingredients for - eggs,fish, milk, peanuts, shellfish, soybeans, tree nuts and wheat - 90% of food allergies

Question 35

Advancing diet for toddlers

Answer 35

3 meals + 2 snacks/day, small portions, don’t force food or prepare special foods, no walking and eating