chapter 11 - infants Flashcards
infants react to parents emotions feeding
if food forced on child, withheld until uncomfortable, or presented in tense manner child reacts w tension and unhappiness
if parent relaxed an infant mealtime can be pleasurable for both parent and child
feeding on demand
prevent hungers frustration can bring and help bay realize their needs are being met
newborn have more frequent feeings but normal is approx every 4 fours when baby 2-3 mo old
baby body weight in first month
6 months - body weight double
year - triple
how many cal per kg during firsy year
98-108 cal per kg (2-3x adult requirement)
protein for infants
6 months - 2.2g per kg
6-12 months - 1.6g per kg
water for infant
1.5mL of water per cal
what supplement should nebworbsm be given
vitamin K
what can excess vitamin A cause
damage to liver and bone abnormlaities
what can excess vitamin D cause
damange to cv system and kidneys
benefits of breast milk
temporary immunity
economial
nutritionally perfect
sanitary
sterile
easy to digest
doesnt cause gi disturances or allergic reactions
reduced load on kidneys (breast milk contains less protein and minerals than infant formula)
how long shouold infants nurse
at each breast for approx 5-10 min each session
when do growth spurts occur for infants
10 days, 2 weeks, 6 weeks, and 3 months
how o know if infant is etting suffucient nutrients and caloreis
6 or more wet diapers daily
normal growht
one or two mustard colored bowel movements a day
breast beocmes less full during nrusing
benefits of breasfeeding for mothers
uterus retur to nomral size
controls postpartum bleeding
helps mother more quickly return to prepregnancy weight
decreased risk of breast cancner and osteoporosis
breastfeeding percents in 2011
newborn - 79%
6 months - 49%
12 months - 27%
healthy people 2020 goals for breastfeeding rates
newborn - 81.9%
6 months - 60m6%
1 year - 34.1%
how to hold baby during feeding
semi upright (less inclined to develop middle ear infection bc prevent fluid pool at back of throat and entering tubes from iddle ear)
burp babies during feeding to release gas and prevent regurgitation
what is synthetic milk made from and who are they for
for infants extremely sensitive or allegic o infant formulas
made from soybeans
hypoallergenic formulas w predigested proteins are used for infants unable to tolerate all other tpyes of formulas
how long does ready to feed/ mixed formula stay good
remain in bottle for an hour
fresh formula is good for 24 hours
ready-to-feed or from concentate is good for 48 hours
why is it imortant to measure water when preparing formula
too little and there is too much protein and mineal for kidneys
too much water will dilute nutrient and calorie vlaue so infant will not thrive + brain edema or seizures
why shouldnt children under 1 be given regular cows milk
protein is more difficult and slower to digest = gi blood loss
kidneys are challenged by its high protein and mineral content and dehydration and even damange to cns
fati s less bioavailable meaning its not absorbed as effcienly as in human milk
what temp should formula be
cold, room temp, or warmed (lukewarm)
consistent temp
warm formula for feeding by placing bottlie in saucepan of warm water or a bottle warmer, shaking the bottle occassionally
why shouldnt infants be put to bed w a bottle
saliva dimisniehs as infant falls asleep meaning milk bathes upper front teeth = tooth decay
baby bottle mouth or nursing bottle syndrome - upper jaw to protrude and lower to recede
feed infant bedtime bottle, cleanse teeth and gums, then put to slee
how long should infant diet be limited to breast milk or formula
unitl 4-6 mo and then as primary food source until 1 yo
6 months if appropriate supplements of iron and vitmain d and possble vitamin c and fluoride
why no early intro of solid food
gi tract and kidneys arent developed to handle solid food
early introduction of sold foods many icnrease likelihood of overfeeding and development of food allegies
how to know when god is reeady for solid food
physical ability to pull food into mouth rather than push tongue and food out of mouth (extrusion reflex)
willingnessto particpate in rocess
ability to sit up w support
head nac neck control
need for additioanl nutrients (over 32 oz of formula or nurse 8-10 x in 24 hours an is at least 4 months)
how to introduce solid food
1 food is introduced every 4-5 days
no allergi reaction = next food
start w single grain cereal (iron-fortified oat, wheat, barley, or rice cereals, then introduction of mixed cereals)
cooked and purred veg, then cooked and pureed fruits, egg yok, finely ground meat
2-4 tbsp of each variety of food per mezl
btwn 6-12 mo toast, zwieback, teething biscuits, cherios in small amounts
NO HONEY bc botulism
after 6 months sip of water and less tan 4 oz 100% juice
signs of hunger
fussy
cry
types of crying
sucing on her hands
moving head toward spoon
reaching food
sounds or words indiciating hunger
cooking during feedings
sign of fullness
play w nipple on bottle or breast
look around and no long open their mouth to solid food
push food away or clenching mouth
playing w food and shaking head to signal no
foods to avoid bc choking hazard
hot dogs, nuts, whole peas, grapes, popcorn, smal lcandies, small pieces of tough meat, raw veg
what is weaning
first given food from a spoon then progresses as child shows interest in and abiltiy to drink from a cup
child will ulitamtely discard bottle or refuse breast
what charter to use for growth standard charts
WHO for younger than 2
CDC for 2-20
premature infants
before 37 weeks
sucking reflex not develpoed until 34 weeks so infants born earlier need parenteral nutrtion, tube feeds, or bolus feeding
mothers breast milk for preemie bb has more protein, sodium , immunologic properites
conersn with preemies
low birth wt, underdeveloped lungs, immature GI tact, inadequate bone mineralization, lack of fat reserves
what is cystic fibrosis
inherited idesase
body produces abn thick sticky secretions within cels lining organs uch as lungs and pancrease
obstructs pancrease, preventing enzymes from reachign intestines to helpbreak down and digest food
what percent of chidlren with CF have exocrine pancreatic insuffiency
85
what is the recomended total caloric itnake of fat percentage?
35-40%
infant w CF
digstive enzyme takein in capsule form during meals
supplementation of fat-soluble vitamins during meal times
water-miscible form of fat-soluble vitamins if normal levels cant be maintained w use of only fat-soluble vitamins
malnourishment is common
one oslution is nightime tube feedings
infants with failure to thrive
determiend by plotting growth on standardized growth chart w considerations for genetic and ethnic variations
what are the parameters affected when an infant fails to thrive
weight for hieght
heigh and head circumernece
slow development
lack f physica lskills like rolling over, sitting, stnading and walking
mental and social skilsl are also delayed
babies grow most in first 6 nonths and this is when their brain udnergoes crucical development so could affect their livesc
causes for failure to thirve
watered-down formula
congential abnormalities
AIDS
lack of bonding
child abuse
neglect
what is cleft lip and palate
baby lip or roof of palate doesnt develop properly
maeks it difficult to feed or speak
surgery to fix before 12 months
cleft lip and feeding
cant cerate suction to pull milk from bottle or breast
imperative to find correct feeding modality for cleft lip so nutrirtion eeds are met
use special cleft nursrers or a Pigeon or Haberman special needs bottle
what are inborn errors of metabolism
inabiltiy to metabolize specific nutrients due to mutations in the genes
face common danger of damage to CNS bc abnormal body chemistry = mental retardation and retarded growth
early diagnoss + diet therapy increases chance of preventign retardation
can be discovered thorugh amniocentesis
what is galactosemia
affect 1 in 30000 live births and caused by lack of liver enzyme transferase (convert galactose to glucose)
lacks transferase = excessive amt of galactose when ignesting anything containing galactose = toxic levels = diarrhea, vomiting, edema, and abn liver fucntion, cataracts, galactosuria, mental retardation
diet therapy for galactosemia
exclusion of anythign contianing milk
during infancy parent feed bb lactose-free comemerically prepared formula and as they get old must avoid food, beverage, or med containing lactose
take calcium, vitmain D, ribofavlin supplements
if liberal diet then baked or process food sw small amoutns f milk
what is phenylketonuria
lack liver enymzes phenyl aline hydroxylase which is necessary to metabolize phenylalanine
infants become hyperactive, suffer seizures b tw 6-18 mo, mentally retarded
public law requires new bon testing for phenylketouria
1 in 10,000-15000 births
diet for PKU babies
Lofenalac infant formula (95% phenylalanine removd so only enoug for basic needs)
monitor diets for cal and nutrient content + adjut as needs change bc most foods contain protein and phenylalaninew
what are synthetic milk for older kids
Phenyl-free and PKU-1,2, or 3
used as beverages, in puddings, and baked goods
special formula,p low=rpotein food
lieflong adherence to diet si low
monitor to avoid metnal retardation and to control hyperactivity and aggressive haviro
what is maple syrup urine diseas
congential defect resulting in inabiltiy to metablize three amino acids: leucine, isoleucine, valine
odor of uring
1 in 100,000-300,000
when infant ingest food protein, increased blood levels of these amino acds = ketosis
hypoglycemia, apathy, and convulsions occur very early
child can die from acidosis and could develop mental retardation
diet therapy for maple syrup urine dsease
sufficient cal and nutrent w extremely restirced amt of leucine, isoleucine, and valine
special formula and low-protein food
dietar therapy thorughout life
