CPS nutrition Flashcards
Growth charts
WHO 2006 - from 6 different countries
weight for height < 2 years > 97% is overweight > 99.9% is obese BMI > 2 - 5 years > 97% overweight >99.9 obese
BMI 5 - 19years
>85% overweight
>97% obese
BF benefits
infection - meningitis, gastro, AOM, UTI decreased type 1, type 2 DM decreased malignancy (leukemia, lymphoma) decreased IBD improved congnitive decreased obesity later decrease SIDS prevent mothers - ovarial and breast cancer help post partum weight loss economical
BF initiatives
written BF policy give HC skils and knowledge place babies direct skin to skin following birth assist mothers to BF and lactation 24hr rooming in support exclusive BF first 6months cue-based BF
Infant feeding recommendations
exclusive BF 6months
vitamin D 400 IU (BF infants)
complementary feeding - gradually increase #/day Fe fortified.
Lumpy textures by 9 months
Cow’s milk - delay until 1 year old no more than 750ml/day
No honey to child < 1 year old
BF composition
colostrum high in IgA
hind milk higher fat than fore milk
BF 40/60 casein/whey “whey better”
contraindications BF
maternal HIV, HTLV 1, 2 active TB - delay 2 weeks Rx brucellosis - until treated galactosemia mastoiditis active HSV lesions (can pump
Human milk banking
donor screen: no meds, smoke, drinking serology q6mo
(Hepatitis B, C, HIV, HTLV virus)
proper collection, storage, pasteurization, culture
risk of allergic reaction - small
written consent
ankyloglossia types
4 - 10% incidence
Type 1 - insert at tip of tongue
type 2 - insertion slightly behind tip
type 3 - posterior ankyglossia with thickened frenulum
management ankyloglossi
parental education
lacatation consultant
some evidence that frenectomy can improve feeding
ENT or physician with practice
complications - bleed, infection, injury to Wharton duct Scarring can worsen
Weaning breast milk
slow progressive, natural wean if possible
begin substitute child least favorite BF feeding with complementary food
no more than 24oz (720ml) between 1 - 2 years old
drinking cup and water @ 6mo
limit juice 4 -6oz/day
Picky eaters
most children gain 1 -2kg/year and 6-8cm/year
reassure - normal to dec appetite age 2 - 5 years
provide TYPE, they choose amount
eating time 20mins, then take away and no food until next scheduled eating
soy formula
not recommended for recommended except for cultural reasons
C/I only if non-IgE mediated CMPA (due to cross reactivity)
Infant colic
Rome III criteria
< 4 months old
paroxysms of irritability, fussiness, crying that start/stop without obvious cause
episodes >3hr/day x3/week for at least one week
NO failure to thrive
Rx - if severe, can try eliminate cow’s milk from maternal diet. If no benefit, resume. Avoid soy as frequent allergen
at risk infants (allergies)
epi and risk factor
food allergy prevalence 7%
at risk - first degree relatives
with atopia (allergy, atopic dermatitis, asthma, allergic rhinitis)
Dietary exposures
BF exclusively first 6 months
do not restrict maternal diet
possible early introduction (4-6mo) can be protective
limited evidence that extensively hydrolyzed cow milk forma prevent atopic dermatitis
