Infant Feeding Lecture Powerpoint Flashcards
Breast feeding is recommended exclusively for the first __ months of life
6 months
Colostrum
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
Mature milk
Produced by mother after 2 weeks of age, contains ideal balance of nutrients and energy
Breastfeeding recommnedations
exclusively x6 months, complementary foods and breastmillk 6 months, breastfeeding to continue for 1 year or longer
Breastfeeding benefits for infant (11)
- 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
Maternal benefits of breastfeeding (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
Barriers to breastfeeding
-inadequate milk intake or the perception of inadequate milk production (most common)
True evidence of insufficient feeding is based on these 3 things
- 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
It is expected for a normal infant to regain birth weight by __ weeks
2 weeks
Contraindications to breastfeeding (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
Expressed breast milk (EBM)
Squeezing milk out of breast and storing it to feed to baby later
Vitamin and mineral supplements in newborn
- vit K supplement at birth
- vit D supplement (not a lot in milk) in first 6 months
- fluoride supplement if no flluoride in water
3 formula options
Ready to feed (RTF)
- Concentrated liquid
- powder
Formula feeding
Feed on demand in first days, as time goes on will become more spaced and at 12 months can transition to fortified cows milk
3 major classes of infant formulas
- 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!)
Formula intolerance
Trouble digesting formula, may be due to sensitivity to ingredient, only small amount of babies actually have a formula intolerance (differs from an allergy)
Food protein induced allergic proctocolitis (FPIAP also known as protein intolerance)
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
Signs of a milk allergy in infant (5) and what causes it and what is the prognosis
- 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
Lactose intolerance in the infant
Very rare, typically shows up after age 3,most common symptom is diarrhea
Milk allergy vs lactose intolerance
Allergy involves GI, skin, and respiratory and is immune response while lactose intoelrance involves bowel only
When to switch formulas for infant? (5)
- 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
What time should solid foods be introduced to the infant? Is there a correct order to introduce?
4-6 months, no as long as its 1 food at a time waiting a few days before introducing new foods
Certain foods to be avoided in infants younger than 1 year
- hard round foods (nuts, grapes, raw carrots, round candies)
- honey and karo syrup (risk of botulism)
- cows milk (esp raw/unpasteurized)
When can water be introduced to the infant? Juice?
6 months, juice should be limited to no more than 4-6 oz/day
Hyper allergenic foods to gradually introduce to infant after less allergenic foods have been tolerated
- cows milk
- eggs
- peanuts
- soy
- wheat
- treenuts
- fish
