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Paeds > Feeding Babies > Flashcards

Feeding Babies Flashcards

1
Q

What is the phase of growth in an infant led by?

A

Nutrition

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2
Q

What is the phase of growth in a child led by?

A

Growth hormone

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3
Q

What is the phase of growth of a pubertal patient led by?

A

Sex steriods

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4
Q

What is nutrition the primary treatment for?

A

Metabolic disease

Exclusion diets in food allergies

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5
Q

What does a good functioning placenta mean for the size of the baby?

A

A good sized baby

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6
Q

What do tall ladies have in terms of the size of their babies?

A

Bigger babies

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7
Q

What is energy needed for?

A

Physical activity
Thermogenesis
Tissue maintenance
Growth (not adults)

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8
Q

Energy requirement equation

A

Energy requirement = energy expanded + energy deposited in new tissue

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9
Q

Babies calorie intake vs adult

A

infants 100kcal and 2g protein / kg / day
adults 35 kcal and 1g protein / kg / day
So babies need much more calories

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10
Q

Babies stores for nutrition

A

LOW STORES

Dont have a nutritional reserve like adults

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11
Q

What does frequent illness / infections in children lead to?

A

Stopping them eating properly leading to weight loss

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12
Q

Features of breast milk

A

Well tolerated
Less allergenic
Low renal solute load
Ca:PO4, LCP FAs
Improves cognitive development
Reduces infection due to tailor made passive immunity
- macrophages and lymphocytes
- interferon, lactoferring, lysozyme
- bifidus factor
Perfect nutrition for 6 months for most infants
Suckling / bonding
Increased development of infants active immunity
Increased development of infants gut mucosa
Reduced infection
Decreased breast cancer
Conditions passed down from mother to infant through breast milk

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13
Q

Features of formula milk

A 
No anti infection properties 
Risk of contamination if not made up properly
No transition of BBVs / drugs 
High antigen load
Expensive
Doesn't need mum 
Accurate feed volumes 
Provides Vit K
Less jaundice
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14
Q

UNICEF baby friendly “ten steps”

A

Breast feeding policy
Train all health care staff
Inform all pregnancy women about benefits and management of breast feeding
Help mother initiate breastfeeding within a half hour of birth
Show mothers how to breastfeed and how to maintain lactation even if they should be separated from their infants
Give newborn infants no food or drink other than breast milk, unless medically indicated
Allow mother and infants to remain together 24 hours / day
Encourage breast feeding on demand
Give no treats or dummies to breast feeding infants
Breast feeding support groups

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15
Q

What is the basis of formula feeding?

A

Cow milk

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16
Q

How long are first milks used for?

A

0 - 6 months

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17
Q

How long is milk the exclusive feed for?

A

4 - 6 months

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18
Q

Types of milk for infants

A 
Breast milk 
Standard formula (cow milk based)
Specialised milk 
Pre term formulae 
Nutrient dense formulae
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19
Q

What is specialised formula milk used for?

A

For cow milk protein allergy

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20
Q

Until what age is cow milk not suitable for the MAIN drink and why?

A

until 1 y / o

contains almost no iron

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21
Q

What is the first foreign pathogen you come across when you are a baby?

A

Cows milk protein

22
Q

What does CMPA stand for?

A

Cows milk protein allergy

23
Q

Presentation of CMPA

A 
Delayed, non IgE reactions / IgE reactions 
Vomiting
Diarrhoea
Abdo discomfort / distension 
Eczema 
Possible FH of allergy symptoms
24
Q

Who is CMPA commoner in?

A

Families with an allergic background

25
Q

What is the only test of CMPA?

A

Trial of CMP exclusion

- 4 week trial of milk avoidance

26
Q

Treatment of CMPA

A 
Bottle fed infants 
- Extensive Hydrolysed formula
- Amino acid based formula 
Breast fed 
- Milk free diet for breast feeding mums
- Ca supplements  
Reintro at 4 weeks unless clear benefit 
Re challenge after 6 months improvement 
Milk ladder Approach 
Extensively hydrolysed protein feeds (first line)
Amino acid based feeds (second line)
27
Q

What are the principles of the milk ladder approach?

A

Not all forms of milk are equally allergenic

Heating the milk denatures the antigen

28
Q

What happens using the milk ladder approach?

A

Go up the ladder to tolerate the different foodstuffs with small amounts of milk in them - over 2-3 weeks every foodstuff so no rush
Cookie - > muffin - > pancake -> cheese - > yogurt - > milk

29
Q

What does the milk ladder approach help achieve?

A

Earlier tolerance

- 60-70% on normal diet by one year

30
Q

What babies tend to have amino acid based feeds?

A

Severe colitis / enteropathy / symptoms on breast milk

31
Q

Babies with what drink lactose free milk?

A

Lactose intolerance

For secondary lactose intolerance

32
Q

Pathology of lactose intolerance

A

Reduced levels of the enzyme (lactase)

33
Q

When is lactose intolerance seen?

A

To minor degree in breast fed babies
Post gastro enteritis
Certain ethnic groups post weaning

34
Q

Are lactose free milks CMP free?

A

NO

35
Q

Indications for soya milk

A

Milk allergy when hydrolysed formulae refused
Vegan families, if not breast fed
Consider for children > 1 year still on milk free diet

36
Q

After what age can non formula milks be introduced?

A

> 1 year

37
Q

Different types of other milks

A

Rice milk
Goat and sheep milk
Oat and nut milks

38
Q

Who is rice milk not advised for under?

A

< 5s

39
Q

How much calcium fortified “milk” do babies need to meet calcium requirements?

A

400 - 500ml

40
Q

When are supplements needed for calcium and what is used?

A 
if < 500ml calcium fortified substance
Alliance calcium liquid
> 3 y/o calcium softies 
For breast feeding mums
- accrete
- cacit D3
41
Q

What is weaning?

A

Transition from a milk to a mixed diet

42
Q

When does weaning start?

A

Around 6 months

43
Q

Features of the start of weaning

A

Smooth purees cereal, fruit, veg and meat

Lumps / finger foods

44
Q

Why wean?

A

Milk alone is inadequate

45
Q

What does weaning encourage?

A

Tongue and jaw movements in preparation for speech and social interaction

46
Q

Who needs vitamin D supplements?

A 
Dark skin children 
Scots
All breast fed babies from 1 month 
Bottle fed babies taking <500ml formula 
All children from 1-4 years
47
Q

Vit D supplements for children

A

Healthy start vitamins

OTC childrens vitamins

48
Q

Nutritional issues in toddlers and pre school

A

Learning to feed self and find food
Picky eaters / excess milk
Dependent on carers
Frequent illness

49
Q

Nutritional issues in school age children

A

Learning to be independent
Chronic disease
Obesity

50
Q

Nutritional issues in adolescence

A

Independent
Puberty
Eating disorders

Paeds (28 decks)

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