Infant and Childhood nutrition Flashcards
What measurements are infant growth/maturation determined by?
-length/height
-weight
-head circumference
What is the stomach capacity at birth compared to that of a 1 month old
20-90mL or 0.7-3 ounces at birth
90-150mL or 3-5 ounces at 1 month old
True or False: human milk empties more rapidly than formula from the stomach
True, this means more frequent feedings are required
What part of the GI tract affects the nutrient absorption
The small intestine which is very short in length in an infant
In what year of life do the GFR values reach adult values
the 3rd year of life
*filtration begins in the fetus during week 9 of development
When do all the characteristics of nutritive sucking develop?
swallowing develops by end of first trimester(12-13weeks)
sucking develops at 22-23 weeks gestation
effective sucking(rhythmic alternation between suction and swallowing) develops at 33-34 weeks of gestation
nutritive sucking develops at 33-34 weeks with a full mature pattern occurring at 37 weeks gestation
What is different about premature infants when it comes to nutritive sucking
inefficient pattern for 1month or more of life
How long is gastric motility delayed in an infant
the first few days
What are the birth weight categories of premature infants and their weights?
low birth weight: less than 2500 grams
very-low-birth-weight: less than 1500 grams
extremely-low-birth-weight: less than 1000 grams
micropreemies: less than 750 grams
What is the average birth weight for an infant
3500 grams
How much water weight is lost immediately after birth
6-10% of birth weight
How much should a term infant weigh at 4-6 months? 12 months?
should double birth weight by 4-6 months and triple it by 12 months
What are the basic requirements for a healthy diet
water
carbohydrates
proteins and amino acids
fat and essential fatty acids
micronutrients
How much water does the holliday-seger method estimate is needed for term infants
100mL/kg for the first 10 kg
50mL/kg for the second 10 kg
20mL/kg for every additional kg
How much maintenance water should premature infants be getting
120-170 mL/kg/day
For how long do human milk/formula = adequate daily water intake
the first 6 months of life
What percentage of the daily calorie intake is fulfilled by carbohydrates
40-50%
At what age should the child start consuming dietary fibers
at age 6-12 months, it is encouraged to get dietary fiber needs from whole cereals, green veggies, and legumes
Why does carbohydrate intake need to be balanced with fats
to ensure healthy neurological development
How much does the total body protein intake change in the first year of life for an infant
it increases from 11% to 15%
T or F: preterm infants have higher protein needs
True, their needs are not met by human milk and their diet needs fortification from commercial powders/liquids
Why is human breast milk so important for an infant to consume protein-wise?
the protein content changes with the growing infant to meet their needs. Formulas can not mimic this well
What are the essential amino acids
cysteine
histidine
isoleucine
leucine
lysine
methionine
phenylalanine
threonine
tryptophan
tyrosine
valine
Why is taurine especially important for infants
-cell membrane protector
-conjugates bile acids
*if infant has a deficiency, vision, hearing and fat absorption is affected
What happens to an infant if they have an essential fatty acid deficiency
-increased metabolic rate
-neurocognitive development is delayed
-failure to grow
-hair loss
-dry flaky skin
-thrombocytopenia
-impaired wound healing
What are the 2 essential polyunsaturated fatty acids(PUFA)
linoleic acid(omega-6 fatty acid) -> arachidonic acid
linolenic acid(omega-3 fatty acid) -> docosohexaenoic acid
How long does the WHO and American Academy of Pediatrics recommend exclusive breast feeding
they recommend exclusive feeding for the first 6 months of life
*recommend through 12 months if appropriate for parent/child
What is the healthy people goal 2030 for exclusive breastfeeding
that 42.4% will breast feed exclusively for the first 6 months of the infants life
What are the benefits of breast feeding for the infant
-optimal nutrition source
-improved parent-child binding
-decreased risk of infant infections
-decreased risk of SIDS, diabetes, leukemia, obesity, hyperlipidemia, eczema, celiac disease, IBD
-POSSIBLE enhanced performance on cognitive development
What are the benefits of breast feeding for the parent
-improved bonding
-decreased postpartum bleeding
-decreased menstrual blood loss
-increased spacing between children
-earlier return to pre-pregnancy weight
-decreased risk of breast and ovarian cancer
-decreased risk of RA
-decrease risk of osteoporosis
-no money spent on formula
What are the contraindications to breast feeding
- HIV infection(can be passed thru breast milk)
- infant galactosemia
- parental untreated TB
- parental human T cell lymphotropic virus 1 or 2 infection
- presence of a herpes simplex lesion on the breast
- parental use of contraindicated medications
Why is cow milk not for infants under the age of 1 year?
too much protein and not enough iron
Why should evaporated milk be avoided
Not made for general nutrition
Why might goat milk be better than cow milk for children
the fat is digested more easily than cow milk
however must be fortified with folate, iron and vit D
What are the 4 types of infant formulas
premature
newborn
infant/toddler
specific health conditions
What are the 3 base types of infant formula
milk-based
soy protein
casein hydrolysate
What are the formulations available
concentrated liquid
powder
ready-to-feed
Why is the sterility of the formula important
the infants immune system isn’t fully developed and the stomach acid isn’t as strong so can’t destroy any contaminants
What type of formula should preemies and immunocompromised infants receive
only receive ready to feed or liquid
*mfg to be sterile
Are powdered formulations guaranteed to be sterile
no, they are not guaranteed or required to be sterile and should undergo sterile prep before feeding
How can formulas be made to be more concentrated
-vary the amount of water added
*ONLY CONCENTRATE WITH MEDICAL ADVICE
What are modular macronutrient components
protein, carbohydrates, fat and combinations of the above that can be added to either human milk or infant formula to fortify formula
*only do under medical advice/supervisions
Why is supplementation needed for preterm infants
preterm milk can not supply nutritional needs of premature infants
all supplementation products are liquid and sterile
*supplementation products are mixed into 60-100ml of human milk and varies by product
What infants are therapeutic formulas used for
infants with health conditions requiring dietary adjustments and must be used with medical supervision
What are some indications for therapeutic infant formulas
allergy/sensitivity to cow milk or soy protein
biliary atresia
celiac disease
cystic fibrosis
various causes of diarrhea
gastroesophageal reflux
hepatitis
lactose intolerance
prematurity
refractory seizure disorder
renal insufficiency
What are the number of feedings an infant requires
-birth-2weeks: 6-10 feedings/day (2-3 oz/feed)
-2 weeks-1month: 6-8 feedings/day(3-5 oz/feed)
-1-3 months: 5-6 feedings/day (4-6 oz/feed)
-3-4 months: 4-5 feedings/month (6-7 oz/feed)
-4-12 months: 3-5 feedings/day (7-8 oz/feed)
What are the signs and symptoms of dehydration in infants
rapid breathing
increased heartrate
restlessness and/or irritability
lethargy/weakness
poor skin turgor
sunken fontanelle
sunken eyes
lack of tears when crying
excessive thirst
decreased urine output
How soon can loss of fluid from diarrhea or vomitting cause dehydration
it can produce severe dehydration within 24 hours
this can include fluid and electrolyte imbalances, shock and even death
When should you call a medical provider in regards to diarrhea and vomitting
-potential formula-related cause if incorrect dilution of concentrated product or incorrect addition of modular product
-severe diarrhea or vomiting
-mild symptoms lasting 72 hours
-any signs or symptoms associated with dehydration
-bloody stool
-projectile vomiting
-green, bilious vomiting
What are the steps that should be taken to prepare equipment for feeding
- wash hands before handling feeding materials and preparing formula
- using tongs place all equipment into a deep pan and cover with COLD water
- bring to a rolling boil and continue boiling for 1-2 minutes
- Remove equipment from pan using tongs and place on clean towel
*Can sterilize in dishwater with a heated drying cycle
How do you sterilize tap water
bring to a rolling boil for 1-2 minutes and then allow to cool to room temp for 30 minutes
On what part of the body do you test the temperature of the formula before feeding the baby
test on the inside of your wrist
How long can you store breast milk for in the fridge and the freezer
store for up to 96 hours in the glass or plastic airtight container in the fridge
keep frozen for up to 6 months
How do you thaw breast milk
thaw rapidly by holding container under lukewarm water
place in lukewarm water bath
**use thawed milk within 24 hours or thawing
***NEVER refreeze
What are the beyond use dating for each type of formula
- liquid concentrate can be refrigerated for up to 48 hours
- ready-to-use formula can be refrigerated for up to 48 hours
- Unused, reconstituted liquid can be refrigerated for up to 24 hours
- Unused powder can be stored at room temperature up to 1 month
