infant feeding Flashcards
Aap recommends exclusive breast feeding for how long
6 months
If breastfeeding is not possible, what should be used
iron fortified formula
When should solids be introduced
4-6 months
Mother’s conditions:
HIV-1, HIV-2
HTLV-1, HTLV-2
Herpes simplex virus Contraindicated only if active breast lesions are present
Tuberculosis infection
Infant Conditions *
Classic galactosemia (galactose 1-phosphate uridyltransferase deficiency)
Maple syrup urine disease
Phenylketonuria (partial breastfeeding is possible with careful monitoring)
contraindications to breast feeding
Antineoplastic agents Fetal death, congenital anomalies, organ system toxicity
Immunosuppressants Potential suppression of the immune system
Lithium High potential for toxicity
Chloramphenicol Blood dyscrasias, aplastic anemia
Ergot alkaloids Ergotism poisoning
Radiopharmaceuticals Potential toxicity; brief to full interruption of breastfeeding recommended
Bromocriptine Suppresses prolactin secretion; hyperprolactinemic mothers taking drug can breastfeed successfully
Iodides Thyroid suppression
Medications that are contraindicated to breast feeding
Initially, babies will nurse for how long?
8-12 times a day (or every 2-3 hours)
Should babies be put on a schedule or expected to go long periods without eating
No
Breastfed and formula fed babies will frequently do what particularly during known growth spurts. Ie: 2 weeks, 6 weeks and 4 months.
cluster feed
what is the best way to ensure breast milk supply is well established and how long does it take?
Feeding on demand and as frequently as possible. takes 2-3 months to establish a solid supply
Formula fed babies will eat every
2-3 hours and typically take 1-2 ounces for the first few days/weeks of life
What will happen as the baby grows and puts on weight
the baby will demand more with each feed
Easy way of determining the average amount a baby will take with each feed
divide their weight by 2 and that is the amount of ounces they will typically demand
what happens to the weight of formula fed babies
Formula fed babies lose less weight initially and are quicker to regain birth weight
breast milk/formula is the main source of nutrition for
the first 6 months
When can solids be introduced?
4-6 months and when the baby is showing signs of readiness
sits up in high chair, interested in family eating, mimicking eating, tongue thrust diminishing are all signs of
Readiness for solid foods
Do First foods need to introduce one food over a 7 day period
no
How often can breast fed babies try new foods
every day
How often can formula fed babies try new foods
every couple of days
what should be considered before introducing peanut butter if there is Severe eczema, egg allergy or both
strongly consider measuring IgE
Earliest age of peanut introduction
4-6 months
what should be considered before introducing peanut butter if there is Moderate-to-severe eczema
introduce peanut-containing food
what should be considered before introducing peanut butter if there is No eczema or any food allergy
introduce peanut-containing food
How much should babies drink?
Initially and until 6 months: 28 – 32 ounces
6 – 12 months: 24 – 28 ounces
How many meals should a 4 month old?
0-1 meal
How many meals should a 6 month old?
1-2 meals
How many meals should a 9 month old?
3 meals
How many meals should a 12 month old?
3 meals and a snack
Breast fed baby – continue breast feeding for the first year of life with the introduction and incorporation of solids – three meals a day, snack and breast milk – typically 24 ounces of EBM or 4-5 nursing sessions during the day time hours
Goals of feeding
Formula fed baby – by 12 month birthday, taking around 24 ounces of formula with three meals and snack
Goals of feeding
At 1 year of age, transition to whole milk – no more than 24 ounces a day and in a sippy cup – at 2 years, transition to a low fat milk
Goals of feeding
second year of life is less about milk and more about the fat, calcium and vit d – keep in mind as some breast fed babies who wean do no take to whole milk
Goals of feeding
What is important to assess on a newborn
feeding, weight gain, elimination
How much weight does a newborn lose initially
10%
What is the caloric range of human milk from feeding to feeding
19-21 calories per ounce
What has more protein formula or breast milk
formula has slightly higher levels of protein
What is the breastfed stool variant and why does it happen
One soft, voluminous stool occurs usually every 3 to 4 days,
Due to almost complete absorption
indications for use of different formulas
allergies
indication for partially hydrolyzed formula
eczema, contact dermatitis
contains higher concentration of protein. Lactose free. Not for preterm infants. They have not been shown to be of benefit
in the management of infantile colic or cow milk intolerance, and there is no indication for their use in the
prevention of atopic diseases
Soy formulas
not indicated in the management of nonIgE allergies to cow milk protein. However,
only 8% to 14% of infants who have IgE-mediated allergic reactions to cow milk proteins are sensitized to soy
Soy formula
indicated
when strict lactose avoidance is required, as in the rare
case of congenital lactase deficiency or in the management of galactosemia. It is recommended to limit use to infants 6 months and older
Soy formula
formulas
supplemented with probiotics reduce
the incidence
of clinical eczema in high-risk infants
used in infants with conditions characterized by malabsorption
of nutrients
extensively hydrolyzed formula
when are Hydrolyzed formulas used
for the prevention of atopy, particularly eczema, asthma, and food allergies.
may delay or prevent atopic dermatitis compared to cow milk based formula
Extensively hydrolyzed formula or partially hydrolyzed formula
Partially hydrolyzed formula is not indicated in which population
in Cow milk protein allergy so they should be fed Extensively hydrolyzed formulas
Amino acid formulas should be reserved
For those that do not respond to Extensive hydrolyzed formulas
