Infant Nutrition Flashcards
When should folic acid supplementation start and what doses of folic acid should be given to low, moderate and high risk patients?
Supplementation should be initiated 3 months before pregnancy and continued until 4-6 weeks after pregnancy, or so long as mom is breastfeeding.
Low risk: 0.4-1mg dy
Moderate risk: 1mg until 12 weeks gestation, then 0.4-1mg dy
High risk: 1mg + 3x1.0mg or 5mg until 12 weeks, then 0.4-1mg dy
Differentiate between moderate and high risk patients in regards to folic acid deficiency
Moderate: personal or family history, if mother has diabetes, teratogenic medications, or GI malabsorption
High: personal history or previous NTD pregnancy
When is iron supplementation important, and what dose?
Important during later pregnancy and 27mg daily
How much extra should mother ben eating during pregnancy?
2-3 extra servings per day (340-450 calories) in the second and third trimester
What foods should mother be cautious of during pregnancy?
Caffeine: up to 300mg/day
Fish: avoid large fish
Listeriosis: avoid unpasteurized milk, soft cheeses, and raw/undercooked meat
How much extra food should mom have during breastfeeding?
500 extra calories a day
Drink a glass of water each time they breastfeed
Supplement with 1000mg calcium/day
What are benefits of breastfeeding for the mother?
Reduced postpartum bleeding
weight loss
reduced risk of breast and ovarian cancer
improved bone health
What are the 3 types of breastmilk?
Colostrum: the first milk produced when the baby is born. Rich in proteins and other nutrients. Changes to breastmilk within 72 hours
Foremilk: released at the beginning of a feeding, watery and satisfies thirst
Hindmilk: released as feeding continues, rich, fatty and satisfies hunger
How do you know if the baby is getting enough food?
6+ wet diapers daily
Stool is soft, yellow and seedy
What are the 5 main types of infant formula?
Cow milk-based formulas Lactose-free cow milk-based formulas Soy protein isolate-based formulas Hydrolyzed protein formulas Amino-acid based formulas
Describe cows milk-based formulas
May have added arachidonic acid/DHA
Some may have low-iron formulas because it causes constipation, but formulas should have iron!!
When should we consider lactose-free cow milk-based formulas?
Congenital lactase deficiency, or after a bout of diarrhea
Need to consider carefully before switching, as lactose is important in mineral absorption and bacterial colonization
When should we consider soy protein isolate-based formulas
Recommended for galactosemia or congenital lactase deficiency, or if a vegetarian diet is desired
Should not be used if child has a milk protein allergy, as there’s potential cross reactivity
When should we consider hydrolyzed protein formulas?
For infants intolerant to intact cow milk protein and soy proteins, may be useful for infants with malabsorptive disease.
Proteins have been broken into peptide chains and free amino acids
When should we consider amino-acid based formulas?
In infants with severe milk protein hypersensitivities, or malabsorption-associated diseases when hydrolyzed formulas don’t work
Should we supplement infants with iron?
May not be necessary for all infants
Iron stores in breastfed babies are depleted after 4-6 months as breastmilk is low in iron. Important for formulas to be iron-fortified
Deficiency can impact cognitive development
Should we supplement infants with vitamin D?
Breastfed babies require 400 IU vitamin D supplementation daily, and more in northern communities
Formula fed babies only require supplementation if in northern communities
When can infants start having food? What kind of food is good for first foods?
~6 months, when baby seems hungrier, has good control of neck muscles, and can show interest/disinterest
First foods should be a good source of iron, such as single-grain iron-fortified infant cereal.
New foods should be introduced one day at a time, 3-5 days apart to identify allergic reactions– should not delay introduction of allergens!
