Exam 2 - Infant Nutrition

Question 1

What physical measurements are taken at each routine doctor’s visit to assess growth of an infant?

Answer 1

Height, length, and head circumference

1st week of life 5-10% of body weight will be lost; just fluids and is normal.. regain in a couple of weeks

Question 2

Describe growth rate / BMR during infancy. By how much does an infant’s length and weight increase during infancy?

Answer 2

Length increases by 50%, head circumference increases by 30%

measure weight, length, and circumference over time to see how you are growing
breastfed infants: tend to grow slower than formula fed.. takes about 2 years to see if child is overweight or not

1st year: weight increases about 3 times
Healthy newborns: double weight in 4-6months

Question 3

Based on recommended kilocalories for an infant, what are the approximate daily kilocalories recommended for 4 month-old who weighs 10 pounds?

Answer 3

total kcal is 454.55 kcal, protein 6.82 kcal, and fat is 227.28 kcal

multiply weight 4.54kg by 100= kcal; 4.54 X 1.5 for protein; 454.55kcal X 50% for fat

Question 4

An infant’s birth weight would be considered healthy between what percentiles on a CDC growth curve?

Answer 4

5 and 85

above 95 is obese!

Question 5

If an infant’s growth declines more than 2 major percentile lines on a CDC growth chart and is plotted near or below the lowest percentile for weight and length, what condition would you suspect?

Answer 5

Failure to Thrive (5-10% of children in clinics have this; 1st 2 years of life.. inadequate growth, inability to maintain growth, SYMPTOM not diagnosis)

example: if a child has on more than 2 occasions being below the 3rd percentile then failure to thrive, short stature does not mean failure to thrive because of genetics)
due to:
MAJOR is inadequate intake then 2. environment (poverty), 3, inability to proper utilize nutrients (excessive loss:gastric reflux, malnourished) not being fed enough, infection, inorganic problem between child and caregiver (postpartum depression, environment (poverty), excessive energy (burn more than take in)

Question 6

What DRI standard is used for expressing nutrient recommendations in infants?

Answer 6

first 6 months of life: 108kcal/kg of body weight

6-12months: 98kcal /kg

USE AI (average number of nutrients a baby receives from well nourished mother) instead of RDA

Question 7

What are the recommendations for energy, protein and fat during infancy? How do these recommendations compare to adult recommendations?

Answer 7

a. Infant: Energy – 100 kcal/kg. Protein 1.5g/kg. Fat – 50% of total kcal. (high)
b. Adults: Energy – 40 kcal/kg. Protein 0.8g/kg. Fat - 35% of total kcal.

Question 8

During infancy, what nutrients are needed in significantly higher amounts compared to adults, pound for pound? (There are 5 that are obvious)

Answer 8

Vitamin A, D, E, C, Calcium, Iodine

E: high basal metabolic rate
C: matrix of bones are made of protein
iron and magnesium are lowered

Question 9

During early infancy, how often does an infant generally want to nurse or bottle feed?

Answer 9

Generally every 2 hours

Question 10

What is the rooting reflex?

Answer 10

Sucking and swallowing (light touch a baby will move towards it)

Question 11

How does breast milk compare to infant formula (cow) in protein carbohydrates and fats? What are the advantages of breast milk compared to formula?

Answer 11

a. Breast milk – protein 7%, Fat 55%, 38% carbs curds are softer, carb is lactose, fats: polunsaturated and long chain
b. Cowmilk formula- protein 9%, 49% fat, 43% carbs curds are harder, carb could be lactose or corn syrup solids, fat: veg. oil

c. Breastmilk advantage: antibodies, intimacy, softer curds
Breastmilk also contains protective factors and immunological aspects: bifidus factor (increase growth in large intestine), immunoglobins, leukocytes, lysozyme, lactoferrin, bioactive

Question 12

Why is protein added to soy formula?

Answer 12

Protein added because it is not as bioavailable

Question 13

What type of formula(s) is (are) appropriate for the following conditions?  Why?
Lactose Intolerance
Cow's milk protein allergy
Feeding intolerance to protein
Prematurity

Answer 13

a. Lactose intolerance – Lactose-free formula
b. Cow’s milk protein allergy – Soy Formula; bc wont get enough protein and could potentially become dehydrated
c. Feeding intolerance to protein – Protein Hydrolysates, Elemental Formula; unable to break down protein so digest pre-hydrolyzed
d. Prematurity – Premature formula, Preterm Discharge Formula, may need more vitamin supplementation

Question 14

What are the percentages of casein / whey in breast milk versus cow’s milk formula?

Answer 14

a. Breast milk – 60% whey, 40% casein, soft curds

b. Cow’s milk – 40% whey, 60% casein

Question 15

At what age is it appropriate to serve cow’s milk to infants? Why? (Hint : nutrient differences)

Answer 15

12 months; cows milk is poor source of iron

Question 16

The American Academy of Pediatrics recommends that a mother breastfeed her child for how long?

Answer 16

Up to 1 year

Question 17

What are some hunger cues of young babies?

Answer 17

Hungry: hand in mouth, sucking motion, body movements, sounds, cries or fusses

Question 18

What is the extrusion reflex?

Answer 18

Tongue goes forward, food comes back out

Question 19

At what age should an infant start solid foods? Why?

Answer 19

At around 6 months, normal flora start to develop

4-6 months.. before 6 months pureed is best

Question 20

How do you know if an infant is ready to eat solid foods?

Answer 20

Decreased extrusion reflex, opens mouth for spoon

Question 21

What are appropriate/ inappropriate foods and textures for an infant during the first year of development?

Answer 21

Newborn – Breast milk/formula,

4-6 months – strain/pureed, infant cereal (rice bc hypoallergenic) single first foods: (iron fortified cereals, strained meat fruits and veggies)

6-8months: same as before but also now mashed foods and 100% juice but limit juice

8 months – mashed/soft foods,

10 months – finely chopped soft foods,

12 months bite-sized, softer foods begin weaning child off breast milk to cows milk (whole) till 2 years old

Question 22

When feeding an infant it is recommended that you introduce new foods one food at a time over a 2 – 4 day period. Why?

Answer 22

The order isnt critical; in order to rule out possible food allergies

Question 23

At what age does an infant generally crawl? At what age does an infant generally walk?

Answer 23

Crawl – 8-10 months

Walk – 10-12 months

Question 24

Honey should not be fed to infants who are under 12 months of age. Why?

Answer 24

Can cause botulism because of spores

bacteria is a large toxin that can be fatal; this bacteria is killed when ingested by adults because we produce enough acid in our stomachs to kill it

Question 25

What vitamin supplements / fortified foods are recommended for breast fed versus formula fed infants (0 -1 year old)?

Answer 25

a. Breastfed – Vitamin D, Iron(4-12months), Fluoride
(VD is 400IU to reduce rickets)

b. Formula – Iron(0-12months), Fluoride
* both require fluoride at 6 months because teeth beginning to develop
* B12 is mom is vegan and nursing

Question 26

The American Academy of Pediatrics recently came out with a new recommendation for iron supplementation in breast fed infants. At what age should iron supplementation begin in these infants?

Answer 26

4-6months

Question 27

What is organic and inorganic failure to thrive?

Answer 27

Organic: biological/ medical health problems: (infections, gastric reflux)
healthy preterm infants are more at risk

Inorganic: environmental problems: (not fed enough, lack of infant mother bonding) inorganic reasons are more common

Question 28

What is colic and how long does it generally last?

Answer 28

colic: sudden onset of irritability, fussy and crying (starts 2 -6 weeks after birth) subsides for about 12-16 weeks

Question 29

Why is infant diarrhea a serious problem that needs immediate attention?

Answer 29

can relate to a food disorder or result from malabsorption and lead to possible dehydration. breast milk doesnt really cause this so thats why its something else and could be more serious (bacterial infection/ food intolerance/ allergy)

Question 30

Why is vitamin K given as a single dose at birth?

Answer 30

Promote blood clotting

To prevent excessive bleeding

Question 31

What foods typically cause choking in infants?

Answer 31

peanut butter, popcorn, raisins, grapes, nuts, hotdog pieces, coarsley hard cut meats, hard/raw veggies

Question 32

What are the concerns with feeding large amounts of juice to infants?

Answer 32

High levels can cause diarrhea because of high sorbital

particular with apple and pear juice
in night bottle: increase bacteria and cause tooth decay

Question 33

If an older infant became iron deficient what are some possible causes? What are the symptoms of iron deficiency?

Answer 33

causes: high cows milk consumption in early infancy, mom didnt introduce iron rich foods when starting eating solid food at 4 months, mother was deficient during 3rd trimester of pregnancy
symptoms: iron deficiency anemia: impariment of growth development, cognitive factor