Infancy 2 Flashcards
Why are DRIs for infants expressed as Adequate Intake (AI) rather than Recommended Dietary Allowance (RDA)?
Limited research on exact nutrient needs for infants.
DRIs are based on composition of breastmilk and intake data.
RDA exists only for protein, iron, and zinc, as these have more defined requirements
What are the 3 main factors considered when determining an infant’s Estimated Energy Requirement (EER)?
Basal metabolism (brain, liver, heart, kidneys).
Energy for tissue accretion (growth).
Physical activity (not accounted for in EER equations).
How does energy deposition (growth) change over the first year?
First 3 months: 180-200 kcal/day.
3-6 months: 50-60 kcal/day.
7 months - 3 years: 15-20 kcal/day.
Energy for growth decreases as infancy progresses.
Why is fat essential in an infant’s diet, and how much is required?
Energy dense for rapid growth (up to 55% of energy in breastmilk).
AI for 0-6 months: 31g/day.
AI for 7-12 months: 20g/day.
What are the essential fatty acid requirements for infants?
AI for omega-3 (α-linolenic acid) and omega-6 (linoleic acid) established.
No AI specifically for DHA, but human milk naturally contains it.
How do infant protein needs compare to adults?
0-6 months: AI = 1.5g/kg/day.
7-12 months: RDA = 1.2g/kg/day.
Much higher per kg than adults due to rapid growth.
Why should infants not drink water in the first 6 months?
Breastmilk/formula provides all necessary hydration.
Water can displace nutrient intake and cause water intoxication.
Exceptions: dehydration due to illness or extreme heat, under medical supervision.
How do calcium needs change in the first year?
AI 0-6 months: 200 mg/day (from breastmilk).
AI 7-12 months: 260 mg/day (from breastmilk + food).
Absorption rate in breastmilk: 55-60% (higher than formula).
Why are newborns at risk for vitamin K deficiency?
Low placental transfer of vitamin K.
Low levels in breastmilk.
Immature gut microbiota (cannot synthesize vitamin K).
What is the risk of vitamin K deficiency in infants, and how is it prevented?
Risk: Vitamin K deficiency bleeding (VKDB), which can be fatal.
Prevention: 1.0 mg intramuscular vitamin K injection at birth.
0.5 mg for preterm infants (<1500g).
Oral supplementation available but less effective.
Why is vitamin D supplementation recommended for breastfed infants?
Breastmilk contains low vitamin D.
Limited sun exposure in infants.
Prevents rickets (bone deformities due to poor calcium absorption).
What is the recommended daily vitamin D supplementation for breastfed infants?
400 IU (10 mcg) per day via vitamin D drops.
Formula-fed infants do not need supplements (formula is fortified).
Why do infants need additional iron after 6 months?
Low iron in breastmilk, but highly absorbable.
Fetal iron stores last ~6 months, then need dietary iron.
RDA for 7-12 months: 11 mg/day (requires iron-rich/fortified foods).
Why are infants at higher risk for iron deficiency anemia?
Fast growth rate increases iron demand.
Common at ~9 months if diet lacks iron-rich foods.
Can lead to long-term cognitive impairments.
What causes neonatal jaundice?
Breakdown of fetal hemoglobin → excess bilirubin.
Immature liver cannot efficiently metabolize and excrete bilirubin.
Risk: High bilirubin can cause neurological damage.
How is neonatal jaundice treated?
Physiological jaundice: Frequent breastfeeding to flush bilirubin out.
Pathological jaundice: Phototherapy (blue light) to break down bilirubin.
What are the primary roles of the child and caregiver in infant feeding?
Infant: Controls when and how much to eat.
Caregiver: Recognizes hunger and satiety cues, supports feeding.
Why is exclusive breastfeeding recommended for the first 6 months?
Optimal nutrition: Right quantity and quality of nutrients.
Bioactive factors: Protect against infections and allergies.
Easily digestible: Supports immature gut.
What are 4 contraindications for breastfeeding?
Infant: Galactosemia.
Parent: Chemotherapy, HIV, certain drug use.
What are three alternatives to direct breastfeeding?
Expressed mother’s milk (pumped breastmilk).
Donor milk (pasteurized human milk).
Infant formula (human milk substitute).
What are the three main types of infant formula?
Powdered formula (cheapest, mixed with water).
Liquid concentrate (pre-mixed, diluted with water).
Ready-to-feed formula (most convenient, no mixing)
How is cow’s milk altered to resemble human milk in formula?
Increase carbohydrates (add lactose or corn syrup).
Reduce protein and adjust whey:casein ratio.
Add iron and DHA.
Modify fats to mimic breastmilk composition.
Why is soy-based infant formula NOT recommended for allergies?
Infants allergic to cow’s milk may also react to soy proteins.
Hydrolyzed formula is preferred for allergies.
How can caregivers tell if an infant is hungry?
Early cues: Mouth opening, turning head, rooting.
Mid cues: Stretching, increasing movement, sucking hands.
Late cues: Crying (stress signal, hard to calm).
How much formula/milk should infants consume daily?
~150mL/kg/day for first 3 months.
Feeding should be on demand, based on hunger cues.
