Children’s Nutrition Flashcards
Whan is the development of the human digestive system complete?
The final development of human digestive system is complete by the 10th/12th month - 2nd year of life
Sucking reflex:
24th week of pregnancy
Swallowing-sucking coordination:
- 4 sucks per 1 swallow
- No coordination in babies with birth weight <1700g
Gastro-esophageal sphincter sufficiency development:
- Till 6th week of modified gestational age
- Feeding in semi-sitting position and maintaining upright position after feeding for first 6 weeks of life
Emptying of stomach:
- Neonates and young infants
- fast phase (within 20 mins accounting for 75% of stomach capacity)
- Slow phase (180 mins)
Period of intestinal passage:
- Premature babies and neonates: 8 - 96 hours
- Adults: 8-12 hours
Physiological insufficiency of the anus:
Decreased tonus of the anal sphincter during the first 10 hours of life
Look at the tables
page 4
Minimum breastfeeding period
6 months ideally
Composition of breastmilk
changes throughout the day
How is the breastmilk initially?
sweet and watery
How is the breastmilk over time?
more fatty and protein rich
Breastmilk - 0-5 days:
- colostrum
- antibodies
- neutrophils
- macrophages
- lymphocytes B and T
- interferon
- lysozyme
- growth factors
Breastmilk - 5 -14 days:
intermediate milk which is protein rich
Breastmilk - from 2nd week:
mature milk, high fat and lactose content, less protein content
Breast milk composition:
- Proteins: mostly whey during first week to equal whey and casein quantity by 8th months
- Carbs: lactose, oligosaccharides
- Low mineral component
- Low ratio calcium:phosphorus (2:1) preventing hypocalcemia and hyperphosphatemia
Absolute contraindications to breastfeeding:
In child
- galactosemia
- innate lactose intolerance
Relative contraindications to breastfeeding:
In child
- cleft palate
- some heart anomalies
- cachexy
What are the contraindications for a mother to breastfeed?
- Active TB (non-treated or <2nd week of treatment)
- Infectious stage of VZV infection
- HIV infection
- HTLV-1 and HTLV-2 infection
- Mother treatment with some drugs
What is not a contraindication for breastfeeding for a mother?
Acute infection in mother
- Hep A (mother requires gamma-globulin infusion)
- Hep B (mother requires gamma-globulin infusion and first dose of vaccine)
- Hep C (no additional infections)
- CMV, EBV HSV (unless over the breast)
- Mastitis and irritable breast
- Jaundice
- Delivery by C-section
- Silicone implant
- PKU in infant - requires supplementation with low-phenylalanine modified milk
See table
page 5
Vitamin D recommendations for mothers:
Mothers in 3rd trimester of pregnancy - 400 IU/day
Vitamin D recommendations for full-term breastfed babies:
- 400 IU/day in mothers who were NOT supplemented
- 400 IU/day since the beginning of the 3rd week in mothers who WERE supplemented
Vitamin D recommendations for full-term bottle-fed babies
Full-term bottle-fed babies require no supplementation
Vitamin K recommendations - Healthy breastfed babies:
25 mcg/day between 2nd week and 3rd month
Vitamin K recommendations - Babies with jaundice:
50 mcg/day
Vitamin K recommendations - Bottle-fed babies:
no requirement
