Infant Feeding Flashcards
What are the advantages of breast feeding?
Suckling/bonding
Perfect nutrition for full term neonates –> 6m
Increased development of infant’s active immunity
Less allergenic - antigen load minimal
Increased development of infant’s gut mucosa
Reduced infection (macrophages/lymphocytes/inferferon/lyzosymes etc.)
Decreased risk of breast cancer
Cheap
No need to sterilise bottle
What are the disadvantages of breast feeding?
Transmission of drugs
Transmission of BBVs, e.g. HIV
Nutritional deficiencies - Vit K and D
Breast milk jaundice
What are the advantages of bottle feeding?
No transmission of BBvs/drugs Don't need mum Less jaundice Accurate feed volumes Vit K May be better for prems
What are the disadvantages of bottle feeding?
No anti-infection properties
Risk of contamination
High antigen load
Expensive
What are the unicef baby friendly 10 steps?
- written breast feeding policy
- train all staff to implement policy
- inform all preg woman about benefits of BF
- help mothers initiate BF within 30m birth
- show mothers how to BF and maintain lactation
- give newborns no other food/drink
- room-in (24h contact between mother & child)
- encourage breast feeding on demand
- no teats/dummies
- support groups
What do babies req. up until 1y?
Breast milk/formula milk as cow’s milk alone contains almost no iron
What kinds of formula feed are there?
Standard (most kids)
Specialised - disease specific, nutrient dense, CMPA
Give an example of a pre-term formulae
SMA gold prem 1
Give an example of a nutrient dense formulae
SMA high energy
100kcal/100ml
What sort of hypersensitivity reaction is CMPA?
Delayed, non-IgE - gives symptoms like eczema, diarrhoea, vomiting, abdominal pain/distension
How do you investigate CMPA?
4wk inclusion trial and reintroduce at 6m after improvement unless clear benefit
Reintroduce with milk ladder (biscuit –> muffin –> pancake –> cheese –> yoghurt –> milk)
What are the replacement feeds for CMPA?
1st line: extensively hydrolysed protein feeds
2nd line: amino acid feeds (severe colitis/enteropathy, symptoms on breast milk)
What is lactose intolerance?
Low levels of lactulose
can be present in some breast fed babies
May be secondary and short lived post-gastro-enteritis
When is soya milk recommended?
Not <6m due to phytoestrogens
In non-breast feeding vegan families, milk allergy when formula refused, >1y on milk free diet)
When is rice milk recommended?
Not for under 5
When is goat/sheep milk recommended?
Not for under 1
What is the problem with organic milk?
It is not fortified with calcium
What is the calorific and Ca content of cows milk?
65Kcal and 120mg of Ca per 100ml
Need 400-500ml to meet Ca requirement
Supplement if <500ml
What Ca supplements are there?
Alliance calcium liquid
Softies if >3
Accrete or Cacit D3 for breast feeding mums
When should you wean?
17wks-6m
How should you wean?
Purees –> fruit, veg, meat –> lumps/finger foot
Cup from 7m
Why is it important to wean?
So infant can get vitamins/trace elements
Develop tongue/jaw for speech and social interactions
When should you supplement with vit D?
Supplement breast fed babies from 1m, bottle fed <500ml, all kids 104y
What factors affect birth weight and size?
Maternal height, placenta function, gestation (pre-term –> less fat stores)
What is an average birth weight?
3.3kg
What is the expected weekly weight gain through infancy?
0-3m - 200g 3-6m - 150g 6-9m - 100g 9-12m - 75-50g 1y+ to puberty expect 5cm/yr & 2kg/yr
Wt doubles by 6m, triples by 12m
What does an infant’s energy requirement go towards?
Physical activity Thermogenesis Tissue maintenance Growth (35%) If feed compromised can quickly become malnourished as fat/protein stores so low and calorific requirements so high
