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NuFS 106A > Infancy Ch 8 > Flashcards

Infancy Ch 8 Flashcards

1
Q

Define: infant mortality

A

Infant mortality - defined as death that occurs within the first year
-Major cause is low birthweight (< 2500 g)
Other leading causes:
-congenital malformations
-preterm births
-SIDS: Sudden Infant Death Syndrome

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2
Q

Define: SGA, AGA, LGA

A

SGA - small for gestational age: newborn was 90th percen1le of wt/age

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3
Q

Define: failure to thrive

Common Nutrition Problem & Concern

A

FTT

  • Inadequate weight or height gain
  • Energy deficit is suspected

(may involve social worker)
(when you don’t see adequate medical issues & symptoms)

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4
Q

Infant dev: newborn development

A

Newborns:

  • Hear and move in response to familiar voice
  • CNS is immature resulting in inconsistent cues for hunger and sa1ety
  • Strong reflexes that are protective for newborns
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5
Q

what are factors associated w/ infant mortality

A 
Social and economic status
Access to health care
Medical interven1ons
Teenage pregnancy
Availability of abor1on services
Failure to prevent preterm & LBW births
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6
Q

Infant reflexes:

A

Reflex—automatic response triggered by specific stimulus
Rooting reflex—infant turns head toward the cheek that is touched
Suckle—reflex causing tongue to move forward and backward

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7
Q

Infant dev: Infant development & feeding skills development progresses?

A

Digestive System Development:
-During the 3rd trimester: Fetus swallows amniotic fluid
which stimulates intestinal maturation and growth
-At birth: the healthy newborn can digest fats, protein, & simple sugars.
-Common problems include gastroesophageal reflux (GER), diarrhea, and constipation

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8
Q

infant dev: factors that impact food

A

Factors that impact rate of food passage in colon and gastrointestinal discomfort in infants:

  • Osmolarity of foods or liquids
  • Colon bacterial flora
  • Water and fluid balance in the body
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9
Q

infant dev: parenting for feeding practices

A

new parents learn:

  • Infant’s cues of hunger and safety
  • Temperament of infant
  • How to respond to infant cues
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10
Q

What are the energy and protein needs for infants according to body weight (birth to 6 months and 6 to 12 months)? What factors are associated with protein and calorie needs?

A

Energy (Calories):

  • 108 kcal/kg/day from birth to 6 months (range from 80 to 120)
  • 98 kcal/kg/day from 6 to 12 months
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11
Q

Recommendations for infants for food:

A

The recommenda1ons for infants are from the Dietary Reference Intakes (DRI) - Na1onal Academy of Medicine, American Academy of Pediatrics, and the Academy of Nutri1on and Dietetics

  • Energy needs
  • Protein needs § Fats
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12
Q

Protein needs: What are the protein needs for infants according to body weight (birth to 6 months and 6 to 12 months)?

Protein needs are similar to that of energy but are also influenced by body composition

A

Protein Needs
2.2 g/kg/day from birth to 6 months
1.6 g/kg/day from 6 to 12 months
===
Newborn weighing 4 kg (8.8 lbs) needs 2.2 X 4 = 8.8 g
protein
6-month-old weighing 8 kg (17.6 lbs) needs 1.6 X 8 = 12.8 g protein

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13
Q

Energy needs: What factors are associated with calorie needs?

A

Factors that influence calorie needs:

  • Wt & growth rate
  • Sleep/wake cycle
  • Temp & climate
  • Physical activity
  • Metabolic response to food
  • Health status/recovery from illness
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14
Q

Metabolic Rate, Calories, Fats & Protein: How do you assess growth?

A

-Metabolic rate of infants is highest of any time after birth
-The higher rate is related to rapid growth and high
proportion of muscle
-Low carbohydrate and/or energy intake results in protein catabolism impacting growth

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15
Q

Physical growth assessment: What are the indicators of growth problems?

A

Newborns grow faster than any other time of life
Growth reflects:
-Nutritional adequacy
-Health status
-Economic & environmental adequacy
-There is a wide range of growth = typical
-Calibrated scales & recumbent length measurement board required for accurate measures

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16
Q

Compare growth charts: CDC vs. WHO. How do you use and interpret each growth chart?

A

WHO ‘TIL 2:
data & pop. is different
CDC bbs born in US

CDC 2000:

  1. US selected sites w/ 5k measurements
  2. descriptive reference reflecting past: how infants have grown
  3. 66% formula fed & 33% BF for 3mos
  4. birth - 36 mo (3 yrs)
  5. high prevalence

WHO 2011:

  1. WW: 6 selected sites w/ 19K measurements
  2. Prescriptive optimal standard: how infants should grow
  3. All BF @ for 4mo
  4. Birth-24 mos
  5. Low prevalence
17
Q

CDC recommendations

A

CDC recommends that health care providers:

  • Use the WHO growth charts to monitor growth for infants & children ages 0-2 yrs
  • Use the CDC growth charts to monitor growth for children age 2 yrs and older
18
Q

WHO charts (4)

A

Head circumference
weight-for-length (recombinant)
weight-for-age
length-forage

19
Q

CDC Charts (3)

A

BMI-for-age
Weight-for-age
length-for-age (stature)

20
Q

Feeding in Early Infancy: What are the recommended feeding practices during early infancy?

A

Breast Milk and Formula
-Recommend exclusive breast feeding for 1st 6 months &
continuation to 1 yr
-Initiate breast feeding right amer birth
-Growth rate and health status indicate if milk volume intake is adequate
-Standard infant formula provides 20 cal/fl oz
-Preterm formula provides 22-24 cal/fl oz

21
Q

Compare breast milk and formula (cow’s and soy based)

A

COW: Whole, reduced-fat or skim cow’s milk should not be used in infancy
-Iron-deficiency anemia linked to early introduc1on of
cow’s milk
Anemia linked to:
-GI blood loss
-Low absorp1on of calcium & phosphorus
-Displacement of iron-rich foods

SOY Protein-Based Formula During Infancy:

  • Soy protein in place of milk protein should be limited in its use
  • The use of soy formula is not recommended for managing infan1le colic
  • Lactose free and hydrolyzed formulas are beker for infants unable to breasoeed or be fed cow’s milk formulas
22
Q

What are the consequences of using cow’s milk in infancy?

A
  • lots of energy

- not enough iron*

23
Q

Intro to solid foods: What are the recommendations for solid foods introduction?

A
  • At 6 months, offer small portions of semisom food on a spoon once or twice each day
  • Food offered from spoon s1mulates mouth muscle development
  • –
  • Infant should not be overly tired or hungry
  • Use small spoon with shallow bowl
  • Allow infant to open mouth & extend tongue
  • Place spoon on front of tongue with gentle pressure
  • Avoid scraping spoon on infant’s gums
  • Pace feeding to allow infant to swallow
  • First meals may be 5-6 spoons over 10 minutes
24
Q

Which foods should be first offered?

A 
1st foods: 
-iron-rich foods
6 months—iron-fortified baby cereal 
     -Rice cereal is hypoallergenic
-6 months—fruits and vegetables
-Only one new food over 2-3 days
-Commercial baby foods are not necessary but do provide sanitary and convenient choices
-9-12 months som table foods
25
Q

Which foods are considered unsafe?

A

Foods that choke infants

  • Hot dogs
  • Popcorn, potato chips
  • Peanuts, chunks of peanut butter
  • Raisins, whole grapes
  • Stringy meats
  • Gum & gummy-textured candy, hard candy or jelly beans
  • Hard fruits or vegetables
26
Q

Discuss difficulties related to the weaning process

A

Offer water or juice from cup amer 6 months

  • Wean to a cup at 12 to 24 months
  • First portion from cup is 1-2 oz
  • Early weaning may result in plateau in weight (due to reduced calories) and/or cons1pa1on (from low fluid intake)
  • Changing from a bokle to a covered “sippy” cup with a small spout is not the same developmental step as weaning to an open cup
  • Open cup drinking skills also encourage speech development
27
Q

What are the recommendations regarding water, juice and supplements during infancy

A

-Breast milk or formula provide adequate water for healthy infants up to 6 months
-Dehydration is common response to illness in infants (vomit and diarrhea)
-Pedialyte or sports drinks provide electrolytes but lower in calories than formula or breast milk
-Limit juice
-AAP recommends juice is not needed to meet the fluid
needs before the age of 6 months
Avoid colas and tea

Supplements for infants

  • Fluoride—for breasoed infants amer 6 months or if in any area with no fluoridated water
  • Vitamin B12—for vegans
  • Vitamin D—needed if exclusively BF
28
Q

Discuss common nutritional problems and management strategies in infancy: colic

A

Colic - the sudden onset of irritability, fussiness or crying

  • Episodes may appear at the same 1me each day
  • Disappear at 3rd or 4th month
  • Cause unknown but associated with GI upset, infant feeding practices
29
Q

Discuss common nutritional problems and management strategies in infancy: iron deficiency

A
  • Less common in infants than in toddlers
  • Iron stores in the infant reflect the iron stores of the mother
  • More common in low-income families
  • BF infants may be given iron supplements and iron- for1fied cereals at 4-6 months
30
Q

Discuss common nutritional problems and management strategies in infancy: diarrhea/constipation

A 
Diarrhea and Cons1pa1on
-Infants typically have 2-6 stools per day
Causes of diarrhea & cons1pa1on:
-Viral and bacterial infections
-Food intolerance
-Changes in fluid intake

To avoid cons1pa1on assure adequate fluids
Con1nue to feed the usual diet during diarrhea

31
Q

Discuss common nutritional problems and management strategies in infancy: cavities & ear infections

A

Prevention of Baby Bottle Cavities and Ear Infections

  • Are linked to feeding practices
  • Feeding techniques to reduce cavities and ear infections -Limit use of bed1me bottle
  • Offer juice in cup
  • Only give water bottles at bed1me
  • Examine and clean emerging teeth
32
Q

Discuss common nutritional problems and management strategies in infancy: food allergies

A

Food Allergies and Intolerances

  • About 6-8% of children < 4 yrs have allergies
  • Absorption of intact proteins causes allergic reactions
  • Common symptoms are wheezing or skin rashes
  • Treatment may consist of formula with hydrolyzed proteins
33
Q

Discuss common nutritional problems and management strategies in infancy: food intolerances

A

Lactose Intolerance

  • Inability to digest the disaccharide lactose
  • Characterized by cramps, nausea and pain and alterna1ng diarrhea and cons1pa1on
  • Lactose intolerance in uncommon and tends to be overestimated

NuFS 106A (15 decks)

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