Infant Feeding Flashcards
What are the nutritonal requirements?
Energy needed for physical activity, thermogenesis, tissue maintenance and growth
Growth demands and energy requirement
What are the risks of infant nutrition?
Infants can become rapidly malnourished
High demands for growth and maintenance
Low stores in fats and proteins
Depends on carers and frequent illnesses
What is the average weight gain?
Double weight by 6 months and triple by a year
Look at growth charts
Static weight is a risk
What are human milk fortifiers?
Commonly used as dietary supplement when babies are born prematurely, particularly those born at <33 weeks
Describe the normal or expected feeding patterns
Up to 2 weeks - 60-70ml 7-8 times a day
As gets older number of feeds declines
What are the types of milk for infants?
Standard instant formula
Hypoallergenic
Lactose free
Anti-reflux and comfort milks
What are some other formulae and supplements which can be used?
Pre-term
Pre-term post discharge
Protein supplement powder
Nutrient dense
Describe comfort infant formulae
Dietary management of colic and constipation - not recommended but are available
Partially hydrolysed whey protein
What are the thickened infant formulae?
Contain protein starch, carob and locust bean gum - not in line with current recommendations
Carobel
Use large hole or variable flow teat
What is cow’s milk protein allergies (CMPA)?
Allergy to milk proteins
Most symptoms occur before 6 months
Most outgrow during childhood
Not a lactose intolerance
Less prevalence in exclusively breast fed babies
What are the symptoms of lactose intolerance?
Loose, watery and frequent stool
Abdominal pain
Excess flatulence and infantile colic
Nappy rash
Describe lactose intolerance
Not allergy, reduced levels of the enzyme and seen to minor degrees in some breast fed
Secondary lactose intolerance - short lived condition and lactose free milks are not CMP free
What is the first and second line feed choices for CMPA?
First - extensively hydrolysed protein feeds and 90% response
Second - amino acid based feeds
Feeds with added probiotics
If breast feeding - mother avoids milk
Describe soya infant formulas
Carbohydrate source is maltodextrin
Phytoestrogens posed a potential risk in under 6 months and risk to reproductive health
Suitable for vegetarians
Cross-reactivity with cows milk
What is the milk ladder?
After 6 months - milk is reintroduced
Starts with baked milk then cheese, yogurt and milk
6 step process
When is the move from formula to normal milk?
Around 1 year of age
What is complementary feeding?
Starts at 6 months of age
Transition from milk to mixed diet
Milk alone inadequate - encourage tongue and jaw movements
Describe neophobia
To reject novel or unknown food in childhood - peaks at 18 months
Normal part of child development
Consider constipation, anaemia and reflux being a factor
Increase acceptance by repeatedly offering food
What can cause a higher risk of vitamin D deficiency?
Pregnant or breastfeeding
Infants and children under 5
Low or no exposure to the sun
Minority ethnic groups who require more sun exposure
What are the risks of low vitamin D?
Poor musculoskeletal health like rickets and poor muscle strength
When are vitamin D supplements given?
All babies from one year of age - 10ug and not required if infant formula
Everyone over 1 year needs 10ug
Abidec/ Dalivit for babies
