Infant Feeding Lecture Powerpoint

Question 1

Breast feeding is recommended exclusively for the first __ months of life

Answer 1

6 months

Question 2

Colostrum

Answer 2

Produced within 2 weeks postpartum (transitions out), considered liquid gold in terms of nutritional value for the infant as it has a greater protein content and lower counts of carbs and fat and cannot be reproduced by formula

Question 3

Mature milk

Answer 3

Produced by mother after 2 weeks of age, contains ideal balance of nutrients and energy

Question 4

Breastfeeding recommnedations

Answer 4

exclusively x6 months, complementary foods and breastmillk 6 months, breastfeeding to continue for 1 year or longer

Question 5

Breastfeeding benefits for infant (11)

Answer 5

• decreased risk of hospitalizations from respiratory tract infection 72%
• decrease risk of RSV by 74%
• Decrease in risk of otitis media by 50%
• decrease in risk of GI infection by 64%
• decrease in risk of necrotizing enterocolitis by 58% especially in preterm infants (always recommneded that they receive mother’s milk)
• Protective overlap of breastfeeding and initial gluten ingestion against celiac
• rates of obesity significantly lowered
• decrease in risk of IBS in children
• 36% reduction in risk of SIDS
• decrease in type 1 and 2 diabetes
• reduction in risk of leukemias

Question 6

Maternal benefits of breastfeeding (6)

Answer 6

• lower postpartum blood loss and more rapid involution of uterus
• decrease in post partum depression
• decrease in rates of abuse
• decrease risks of type 2 diabetes in mothers without gestational diabetes
• lower risk of HTN, breast and ovarian cancer
• economic benefits to society

Question 7

Barriers to breastfeeding

Answer 7

-inadequate milk intake or the perception of inadequate milk production (most common)

Question 8

True evidence of insufficient feeding is based on these 3 things

Answer 8

• nursing history (should typically 8-12 times times in 24 hrs, usually space out with time)
• decreased infant urine and stool output (should have 6-8 urinations and 3 or more pale, yellow, seedy stools)
• excess weight loss of infant

Question 9

It is expected for a normal infant to regain birth weight by __ weeks

Answer 9

2 weeks

Question 10

Contraindications to breastfeeding (10)

Answer 10

• HIV positive
• suspected or confirmed ebola
• infant with metabolic disorder of classic galactosemia
• hepatitis C IF there are cracked bleeding nipples
• if mom develops varicella within 5 days prior to delivery thru 2 days after (EBM can be given)
• active herpes lesion on breast (can give EBM)
• active or untreated Tb
• street drugs (not including smoking)
• certain drugs such as amphetamines, chemo agents, statins,
• G6PD deficiency

Question 11

Expressed breast milk (EBM)

Answer 11

Squeezing milk out of breast and storing it to feed to baby later

Question 12

Vitamin and mineral supplements in newborn

Answer 12

• vit K supplement at birth
• vit D supplement (not a lot in milk) in first 6 months
• fluoride supplement if no flluoride in water

Question 13

3 formula options

Answer 13

Ready to feed (RTF)

• Concentrated liquid
• powder

Question 14

Formula feeding

Answer 14

Feed on demand in first days, as time goes on will become more spaced and at 12 months can transition to fortified cows milk

Question 15

3 major classes of infant formulas

Answer 15

• Cows milk based (most common, higher levels of fat, has vit D added in)
• soy based (effective for galactosemia, concern of phytoestrogens
• specialized formula (whey or casein based, hypoalergenic options such as alimentum and nutramigen and nonallergenic such as neocate and elecare - these are expensive!)

Question 16

Formula intolerance

Answer 16

Trouble digesting formula, may be due to sensitivity to ingredient, only small amount of babies actually have a formula intolerance (differs from an allergy)

Question 17

Food protein induced allergic proctocolitis (FPIAP also known as protein intolerance)

Answer 17

Non IgE mediated most common cause of rectal bleeding in otherwise healthy infant typically starting at 1-4 weeks of age, often from dietary triggers in mom (cows milk most often) that can be easily treated by discontinuing parental consumption

Question 18

Signs of a milk allergy in infant (5) and what causes it and what is the prognosis

Answer 18

• rash
• wheezing
• upset stomach
• bloody stools
• severe cases anaphylaxis

IgE associated mechanisms responsible for 60% of cow milk induced adverse reactions

Good, most outgrow the rxn over time

Question 19

Lactose intolerance in the infant

Answer 19

Very rare, typically shows up after age 3,most common symptom is diarrhea

Question 20

Milk allergy vs lactose intolerance

Answer 20

Allergy involves GI, skin, and respiratory and is immune response while lactose intoelrance involves bowel only

Question 21

When to switch formulas for infant? (5)

Answer 21

• Ideal keep infant on same formula for 6-8 weeks even if baby is crying, gassy, or spitting up, give time
• change feeding technique
• limited trials
• trial of infant probiotic
• do NOT go to soy formula

Question 22

What time should solid foods be introduced to the infant? Is there a correct order to introduce?

Answer 22

4-6 months, no as long as its 1 food at a time waiting a few days before introducing new foods

Question 23

Certain foods to be avoided in infants younger than 1 year

Answer 23

• hard round foods (nuts, grapes, raw carrots, round candies)
• honey and karo syrup (risk of botulism)
• cows milk (esp raw/unpasteurized)

Question 24

When can water be introduced to the infant? Juice?

Answer 24

6 months, juice should be limited to no more than 4-6 oz/day

Question 25

Hyper allergenic foods to gradually introduce to infant after less allergenic foods have been tolerated

Answer 25

• cows milk
• eggs
• peanuts
• soy
• wheat
• treenuts
• fish