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N7515 > Exam 2 Review - Nutrition, Breastfeeding, Dental, Newborn, Infancy > Flashcards

Exam 2 Review - Nutrition, Breastfeeding, Dental, Newborn, Infancy Flashcards

1
Q

Weight gain / week at 2 months (oz per week)

A

4-7 ounces per week

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2
Q

height growth per month at 2 months (cm/month)

A

3.5 cm per month

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3
Q

OFC increase in CM/month from 0-6 months of age

A

1-2cm/month OFC

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4
Q

Breastfeeding benefits for infant

A

provides ideal nutrition and promotes best possible growth and development
significantly decreases the incidence of diarrhea, lower respiratory tract infections, OM, botulism, UTI
may be protective against inflammatory bowel disease, leukemias, certain DM1
lowers the risk of obesity
promotes healthy neurological development
may reduce incidence of atopic illness such as eczema
promotes close mother-infant connection

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5
Q

breastfeeding benefits for mother

A

increases oxytocin = less postpartum bleeding
earlier return to pre pregnancy weight, increased child spacing, reduced risk premenopausal breast cancer
lactation amenorrhea promotes recovery of maternal iron stores depleted during pregnancy
breastfeeding lowers risk for maternal chronic disease such as HTN, DM2, CAD

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6
Q

in most children the 20 primary teeth are fully erupted by what age

A

2 years old

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7
Q

Shedding and replacement of primary molars by permanent premolars is usually completed by what age

A

12 years old

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8
Q

when should children have first dental visit

A

before 12 months or within 6 months of first tooth eruption

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9
Q

clinical findings of early tooth decay

A

white or brown horizontal line or spots along central gum line or gingival margin

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10
Q

clinical findings of advanced tooth decay

A

cavitations in teeth

initial lesion appears as pinhole surrounded by a white opaque halo

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11
Q

birth to 3 year vitamin D supplementation dose

A

400 IU

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12
Q

4-18 years vitamin D supplementation dose

A

600 IU

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13
Q

vitamin D supplementation in BF infants vs formula fed infants

A

all breastfed infants should receive 400 IU vitamin D supplementation - per bright futures start at 2 month visit

all FF infants that receive fortified formula at least 32oz/day do NOT need vitamin D supplementation

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14
Q

iron supplementation in BF infants vs FF infants

A

term healthy infants have enough iron stores to make it to 4 months

BF: rec 1mg/kg/day iron drops starting at 4 months until iron/zinc foods introduced (ex: iron fortified cereal)

FF: infants who receive 17oz/500mL fortified formula do NOT need iron supplementation

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15
Q

when should solids be introduced

A

6 months or when infant is developmentally ready

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16
Q

developmental signs baby is ready to introduce solids

A
  • tongue thrust reflex disappears (infant uses tongue to move food out of mouth)
  • looks interested in food/eating (opens mouth, leans forward)
  • elevating tongue - helps move food forward/back in mouth (usually starts between 4-6 months)
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17
Q

what type of solids should you introduce first?

A

-start with thinned out pureed foods with no chunks/lumps - ex: liquify iron fortified cereal with some breast milk or formula

can then slowly introduce thicker pureed foods as baby further develops - ex: at 6 months can sit independently and grasp food with palms –> may be ready to try thicker pureed or mashed solids; at 9 months can use jaw/tongue to mash food and may be ready for pureed foods with lumps

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18
Q

when should you start finger foods? what are good food options?

A

7-9 months: pincer grasp develops - should have 2 finger pincer grasp down by 12 months
any food baby can pick up = finger foods
good foods to try: dissolvable (ex: iron fortified cereal, crackers)

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19
Q

foods to avoid in infants

A

nuts, grapes, hotdogs, popcorn, honey (botulism), carrots, candy, cows milk, egg whites, peanut butter

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20
Q

how frequently should you introduce a new food? how much?

A

one new food every 3-5 days

start with 1tsp; advance to 1 tbsp

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21
Q

nutritional norms 1-4 years

A
  • after first year, appetite decreases - diminished intake but foods with higher caloric density for growth
  • picky eating normal
  • introduce 3 meals with 2-3 snacks
  • can introduce cows milk/soy milk - rec 2-3 cups/day
  • limit juice to 4-6oz
  • independence important - encourage finger foods, give spoon 12-15 months even if still feeding baby
  • choking risk
  • do NOT allow grazing
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22
Q

anticipatory guidance picky eating

A
  • picky eating is normal during toddler years and foods jags normal
  • do not offer alternatives - food jags will usually disappear by school age if parent offers variety of foods
  • parents = role models - still need to tell what foods are healthy / make choices surrounding food while allowing independence
  • do NOT allow grazing
23
Q

when should you introduce spoon?

A

12-15 months - introduce and let infant play with spoon even if parent still doing the feeding

24
Q

common feeding concerns age 1

A

constipation, lactose intolerance, picky, anemia, choking, dental caries, growth lag

25
Q

common feeding concerns toddlers

A

food jags
grazing
liquid intake
elimination

26
Q

nutritional norms school age (5-10)

A
  • 3 meals per day with 2-3 snacks
  • able to help more with food prep
  • energy and protein needs vary
  • role model good nutrition and eating behaviors
  • family meals important
  • at risk for deficiencies- vitamin A, calcium, iron - may need multi vitamin
27
Q

recommended calcium intake 1-8 years old

A

800 mg/day

28
Q

recommended calcium intake 9-18 years old

A

1300 mg/day - critical period for bone development during this time

29
Q

recommended calcium intake 19-21 years

A

1000mg/day

30
Q

daily recommended intake iron for females and males age 9-13 years?

A

8mg/day for males and females

31
Q

daily recommended intake for iron for females and males age 14-18 years?

A

F: 15mg/day
M: 11 mg/day

32
Q

daily recommended intake of iron for males and females age 19-21 years

A

F: 18mg/day
M: 8mg/day

33
Q

average weight gain 0-6 months

A

4-7 oz/week

34
Q

average weight gain 6-12 months

A

3-5 oz per week

35
Q

average height increase 0-3 months

A

3.5cm/month

36
Q

average height increase age 3-6 months

A

2cm/month

37
Q

average height gain 6-12 months

A

1.2-1.5cm/month

38
Q

average OFC increase 0-6 months

A

1-2cm/month

39
Q

average OFC increase 6-12 months

A

0.5-1 cm/month

40
Q

how much percent body weight does newborn lose and over what period?

A

5-10% over first few days of life

41
Q

breastfeeding contraindications

A

infant with galactosemia
maternal dx human T cell lymphotropic virus
maternal dx and tx of cancer
maternal exposure to radioactive material
maternal use of illegal drugs
herpetic lesions on mother’s nipple/breast
HIV positive mother

42
Q

colostrum vs breastmilk

A

colostrum: begins at 20 wks gestation; lower calorie/fat content; rich in immunoglobulins, rich in Na/K/Cl/Fat soluble vitamins/cholesterol

BM: more fat; replaces transitional milk by wk 2; 90% water; 3.8% fat; 0.9% protein (whey, casein); lactulose is primary carb; vitamins K/A/C/E/B1/B2

43
Q

BF frequency

A

feed Q2-3 hours - 10 minutes on each breast
approximately 8-12 feeds per 24 hours
(may be more often during growth spurts)

44
Q

BF duration for each feed

A

10-15 minutes each breast

45
Q

normal infant elimination

A

6+ wet seedy yellow diapers / day - most infants stool after each feed

6-8 wet diapers / 24 hours - light yellow, no odor

46
Q

maternal nutrition while breastfeeding

A

300 extra calories
3.4L water per day
healthy diet with adequate calcium and vitamin D
Avoid excessive etoh - wait 2-3 hours after to feed
-mod caffeine (1-2 cups) ok - avoid excessive intake until baby can metabolize caffeine at 2-4 months

47
Q

what is mastitis

A

infection of breast; usually staph

48
Q

management of mastitis

A

empty breast - frequent feeds/pumps - continue
increase fluids
abx may be needed
warm shower
do NOT wean abruptly - may progress to abscess

49
Q

engorgement management

A

avoid long stretches between feeds
pump if feeding will be missed
hot shower/warm comrpess
massage

50
Q

how to calculate infant energy needs from birth - 6 months (amount formula needed per day based on weight)

A

infants need 108cal/kg/day during this period -
there are 20 cals/ounce formula or breast milk

108 cal x infant weight. Then take this value divided by 20 to get ounces.

51
Q

energy needs for infant 12 months old (amount formula or breast milk in ounces)

A

100 kcal/kg/day -
20 cals in one ounce formula

Take 100 cal x infant weight. then take this value divided by 20 to get ounces of formula or breast milk per day.

52
Q

how many calories/kg/day does an infant 0-6 months need? what about 12 months old?

A

0-6: 108 kcal/kg/day

12: 100 kcal/kg/day

53
Q

newborn RR

A

40-60 breaths/min

54
Q

when should newborn pass first meconium? urine?

A

within first 24 hours

urine within first 24-48 hours

N7515 (4 decks)

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