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Paediatrics > Infant feeding > Flashcards

Infant feeding Flashcards

1
Q

why is nutrition important?

A
  • prevents disease

- Growth not just about increasing size but change in brain and body structure, composition and function

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2
Q

Phases of growth

Infant, Child and Pubertal

A

nutrition led

growth hormone led

sex steroid led

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3
Q

Birth size and weight?

A 
Maternal size  (diabetic mother - larger baby)
Placental function
Gestation
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4
Q

95% of weight comes from what weeks?

A

20-40 weeks

10-16% body weight is fat

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5
Q

average term infant weight?

A

3.3kg

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6
Q

why do babies need nutrients?

A

Physical activity
Thermogenesis
Tissue maintenance
Growth

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7
Q

how much calories does an infant require per day?

A
  • 100kcal and 2g protein/kg/day
    babies have low fat stores and protein
  • can he halted with frequent illness
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8
Q

average weight gain from 0-3 months?

A

200g per week

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9
Q

average weight gain from 3-6 months

A

150g per week

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10
Q

average weight gain from 6-9 months

A

100g PW

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11
Q

average weight gain from 9-12 months

A

50-75g pw

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12
Q

babies should double and triple weight by what age?

A

6 months and 1 year

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13
Q

after a year old, the average weight a baby should increase each year?

A

2kg

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14
Q

after a year old, the average height a baby should increase each year?

A

5cm

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15
Q

why is Breast fed the best?

calcium and phosphate fats?

A
  • Well tolerated
  • Less allergenic
  • Low renal solute load
  • Ca:PO4, Iron, LCP FAs
  • improves cognitive development
  • boosts active immunity
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16
Q

Breastfeeding a baby reduces the risk of infection - give some examples?

A
  • Macrophages and lymphocytes
  • Interferon, lactoferrin, lysozyme
  • Bifidus factor
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17
Q

breast feeding helps to reduce the risk of?

A

breast cancer and endometriosis, and greater postpartum weight loss and lower body mass index (BMI) in the longer term

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18
Q

Risks of using formula?

A 
No anti-infection properties
Risk of contamination
No transmition of BBVs/drugs
High antigen load
Expensive
Doesn’t need mum
Accurate feed volumes
Provides Vit K
Less jaundice
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19
Q

what is the recommended breast feeding time ?

A

6 months of age

From 6 months, complementary breast feeding alongside solids is supported

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20
Q

standard formulas are typically based with

A

cows milk

  • there are specialised options for:
    1. cows milk protein allergy
    2. nutrient dense
    3. disease specific (PKU)
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21
Q

Nutrient dense formulas include?

A

Infatrini / Smiliac High Energy / SMA High Energy 100kcal/100ml
- those with cardiac issues/ oncology

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22
Q

First line feed choice for cows milk allergy

A

Nutramigen - hydrolysed protein

Aptamil

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23
Q

Second line feeds for those who are more unwell/allergic to cow milk

A

Amino acid based feeds - alfamino
Babies with severe colitis/enteropathy/ symptoms on breast milk
Are over prescribed (and expensive!)

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24
Q

16-40% of babies with reflux may have?

A

cows milk allergy

25
Q

those with a cows milk allergy should have a trial of what ? NICE guidelines

A

6-8 week trial of an extensively hydrolysed or amino acid formula to bottle fed infants<6 months with moderate to severe eczema that has not been controlled by optimal topical treatment particularly if associated with GI symptoms and FTT.

26
Q

Children on a milk free diet for 8 weeks should..?

A

be referred to a dietician

27
Q

Lactose intolerance features

A

Reduced levels of the enzyme (lactase)
Seen to minor degree in some breast fed babies
Post gastro enteritis (Transient and self resolving)

28
Q

Lactose free milk for secondary lactose intolerance is seen in?
- what can it be confused with?

A

Short lived condition eg post gastro-enteritis
Confused with cow’s milk protein intolerance
Lactose free/ “Comfort” milks are not CMP free

29
Q

Soya Milks contain lots of?

A

Phytoestrogens

30
Q

soya milk indications?

A
  • Milk allergy when hydrolysed formulae refused
  • Vegan families, if not breast fed
  • Consider for children>1 year still on milk free diet
31
Q

over what age can you introduce non- formula milk?

A

1 year

32
Q

rice milk is not advised for children,,?
goat’s and sheep milk?
oat and nut milk?

A

under 5

under 1

33
Q

how much calcium calcium fortified “milk” do you need to meet calcium requirements

A

400-500ml

- calcium softies

34
Q

Breast feeding mothers on dairy free diet need to take?

A

Accrete or Cacit D3

35
Q

when do solids begin to be Introduced?

A

6 months

36
Q

early solid use can be associated with?

A

Higher risk of Fe deficiency and coeliac disease.

37
Q

What is neophobia

A
  • fear of trying new foods

- Associated with maternal neophobia

38
Q

Vitamin D deficiency can cause?

can affect who?

A

rickets and poor muscle strength

  • Dark skinned children not on vitamin drops at risk
  • Prolonged breast feeding and mum not on Vit D
39
Q

Supplements for vitamin D - how much do babies need if they are not taking 500mls of formula?

A

8.5-10 ug Vitamin D

40
Q

Everyone over one year of age vit D supplement?

A

10 ug Vitamin D

41
Q

what is GOR?

A

effortless passage of gastric contents into oesophagus with or without regurgitation and vomiting.

42
Q

What is GORD?

A

when the reflux of gastric contents causes troublesome symptoms and/or complications

43
Q

When is the peak age that babies will regurgitate 1-4 times daily or more?

A

3-4 months

44
Q

typical thickeners?

A

Infant Gaviscon sachets (NOT an antacid)

Carobel - 5kcal/100ml - most common

45
Q

Red flag signs with reflux symptoms (6)

A 
Weight loss or poor weight gain
Recurrent or bilious vomiting
GI bleeding
Persisting diarrhoea
Dysphagia
Stridor / cough / hoarseness
46
Q

High risk groups for reflux??

A

Preterm babies, neurological impairment, chronic respiratory illness, anatomical, some genetic disorders e.g. Down’s syndrome

47
Q

GORD treatments?

A 
Medical referral
Trial of milk free diet
Continuous NG/jejunal feeds
Consideration of anti reflux surgery
Drug therapy
48
Q

With GORD, babies require what suppression?

- what does this reduce?

A

acid supression

Reduced gastric acid may increase risk of pneumonia, gastroenteritis and candidiasis

49
Q

Drug therapy for GORD - first line treatment

A

Gaviscon Liquid

can also use low dose erythromycin

50
Q

H2 blockers block?

example?

A

block histamine

Ranitidine

51
Q

Alimemazine - how does it work?

A

(anti histamine)

- relives symptoms

52
Q

PPIs decrease the acidity of stomach - give an example?

A

Omeprazole / Lansoprazole

Esomeprazole for tubes

53
Q

Pro-kinetics like Domperidone promote what ?

A

gastric emptying

54
Q

Colic - inconsolable crying is?

how long?

A

<3 months of age, >3hours/day, >3 days/week

at least a week

no red flag symtoms

55
Q

what can be used for Colic

A

Probiotics
Trial of cows milk protein avoidance
Lactase drops
Anti spasmodics

56
Q

Factors associated with lower iron status at birth include ?

A

include low infant birthweight, and maternal iron deficiency anaemia, obesity, smoking status and gestational hypertension.

57
Q

periods of peak brain development?

A

Neonatal period & 6 months to 3 years

May need to ask GP to check FBC/ferritin

58
Q

laxatives for infants

A

Lactulose

59
Q

laxatives for older children

A

Movicol / Laxido

Paediatrics (49 decks)

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