Infant Nutrition Flashcards
A full term infant is __ to ___ weeks
37-42 weeks
typical birth weight is _____ to _____
2500-3800 g
5.5 - 8.5 lbs
typical birth length is ___ to ____
47-54 cm
18.5 - 21.5 in
what is late preterm
34 to 36 6/7 weeks gestation
what is preterm
28 to 33 6/7 weeks gestation
what is extremely preterm
less than 28 weeks
what is considered low birth weight
<2500 g
what is considered very low birth weight
<1500 g
what is considered extremely low birthweight?
<1000 g
infant mortality is defined as ?
what is the major cause
death within the 1st year of life
low birth weight
what are some resources and prevention programs to combat infant mortality?
Medicaid
Child Health Initiatives Program (CHIP)
Early and Periodic Screening, Diagnostic, and Treatment program (EPSDT)
Bright Futures Nutrition
newborn health status is assessed by what indicators?
birthweight
length
head circumference
small of gestational age (SGA) or _______ mean that the newborn is below the ___ percentile of weight for gestational age
intrauterine growth retardation (IUGR)
<10th percentile
Large for Gestational age (LGA) means the newborn was > the _____ percentile of weight for gestational age
> 90th percentile
why do newborns have inconsistent cues for hunger?
CNS is immature
infant turning head toward the cheek that is touched and open mouths
rooting reflex
reflex causing tongue to move forward and backward
suckle reflex
infants ability to control voluntary muscle movement
motor development
order that the infants get motor development
head first then lower legs last
muscle development for infants from ____ to ____
central to peripheral
Around this time, infants can…
0 months
1 month
2 months
3 months
4 months
5 months
0 months - fetal posture
1 month - chin up on stomach
2 months - chest up on stomach
3 months - reach for toes in back and miss
4 months - sit with support
5 months - sit on lap and grasp object
Around this time, infants can…
6 months
7 months
8 months
9 months
10 months
6 months - grasp dangling object
7 months - sit alone
8 months - stand with help
9 months - stand holding furniture
10 months - creep/crawl
Around this time, infants can…
11 months
12 months
13 months
14 months
15 months
11 months - walk when led (hold hands)
12 months - pull to stand by furniture
13 months - climb stair steps
14 months - stand alone
15 months - walk alone
a fixed period of time in which certain behaviors or developments emerge
critical periods
what happens if skills are not learned in the critical period
may be difficulty later on
what are some factors that impact cognition and cognitive development in infants?
sensorimotor development
adequate energy and protein intake
positive social and emotional interactions
genetics
how does the fetus’ intestinal lining get stimulated to grow and mature
from swallowing amniotic fluid
it takes ____ for the GI tract to mature
6 months
at birth, the healthy newborn can digest ______________.
fats
protein
simple sugars
common problem with infants due to immaturity of the gut?
GERD
diarrhea
constipation
what factors impact the rate of food passage through the colon?
osmolarity of foods or liquids
colon bacterial flora
fluid intake
the guidelines of nutritional needs for infants are from the _____
DRIs
________ and _______ provide guidelines and position papers related to infant nutrition and feeding
american academy of pediatrics (AAP)
academy of nutrition and dietetics
energy needs for infants range from ____ to ____ kcal/kg/day
_____ from 0-6 months
_____ from 6-12 months
80-120 kcal/kg/day
108 kcal/kg/day
98 kcal/kg/day
infants have the highest metabolic rate of any time after birth, which is related to rapid growth and ______
high proportion of muscle
when CHO intake is limited in infants, _____ will be converted to glucose for energy and will be less available for the infant to grow. This is a ______ reaction
amino acids
catabolic
protein needs of infants from
0-6 months is ____
7-12 months _____
RDA: ___
1.52 g/kg
1.0 g/kg
1.2 g/kg
fat need for infants?
no fat recommendations
-only an AI
0-6 months is 31 grams
7-12 months is 30 grams
fat restriction for infants is not recommended because infant need cholesterol for ____ and ____ development
brain and gonad
fat contributes about ___ of the kcal in breastmilk
including _____ FA (multiple answers)
- _____ FA are easier to digest and utilize
half
short, medium, and long chain
short and medium
fluoride requirements for infants
not recommended until 6 months old
recommended for infants ≥6 months with <0.3 ppm fluoride in local water
vitamin D requirement for infants
400 IU/day
Sodium requirements for infants
0-6 months —-> 120 mg/day
7-12 months —-> 370 mg/day
iron requirements for infants breastfeeding
at 4 months old, supplement with 1mg/kg/day until iron containing complementary foods are introduced
iron requirements fro infants consuming formula
iron fortified formula as their main beverage for first year of life
vitamin ___ rich foods enhance iron absorption from nonhdme sources.
C
newborns double weight by _____
triple weight by ____
4-6 months
1 year
what devices are required to assess physical growth of infants?
calibrated scales
recumbent-length measurement board
typical weight and hight gain from 0-6 months is ____ and ____
typical weight and hight gain from 7-12 months is ____ and ____
30 g/day and 1.5-2.5 cm/month
85-140 g/week and 1 cm/month
WHO growth charts include what measurements
weight for age
length for age
weight for length
head circumference for age
AAP and AND recommend exclusive breastfeeding for the first ____ months and continuation to ____ as optimum nutrition in infancy
6 months
1 year
standard infant formula provides _____ kcal/oz
preterm infant formula provides _____ kcal/oz
19-20
22-24
what forms can formula be purchased as?
ready to feed
concentrated liquid
powder
carbohydrate modified formula used for _______.
gastrointestinal disorders
protein modified formulas for _______
inborn errors of metabolism
electrolyte altered formulas for ________
renal disease
calcium/vitamin D modified formulas for ______
hypercalcemia
infant formula differences
casein to whey ratio
degree of hydrolysis of the protein source
fat source (palm oil most similar to breastmilk)
how to prepare ready to feed formula
shake to re-suspend any mineral sediment that may have settled
how is warming bottles viewed
not necessary
promotes bacteria growth
how should you avoid warming formula?
Why?
microwave
uneven heating leading to hot spots and loss of nutrients
Prepared bottles should not be left out of the refrigerator for more than _____
Any formula remaining in the bottle after a feeding should be
discarded within _____
It is best to make powdered infant formula fresh for each feeding. If bottles are made in advance, they can be stored in the refrigerator for up to _____. Powdered formula should be stored in a cool, dry place. Once opened, powdered formula should be covered with the manufacturer’s lid and used within _____
After opening ready-to-feed and concentrated liquid formula, cover the unused portion and store in the refrigerator for up to _____
2 hours
1 hour
24 hours
1 month
48 hours
Typical daily volumes fro young infants not being breast fed…
0-1 month
1-2 months
2-3 months
3-4 months
16-20 oz per day, 8-12 feedings a day, 1-2.5 oz per feeding
18-26 oz per day, 8-10 feedings a day, 2-4 oz per feeding
22-30 oz per day, 6-8 feedings a day, 3-5 oz per feeding
24-32 oz per day, 4-6 feedings a day, 4-8 oz per feeding
Percentage of protein, carbs, and fat in breastmilk
7% protein
38% carbs
55% fat
Percentage of protein, carbs, and fat in cow’s milk based formula
9-12% protein
41-43% carbs
48-50% fat
cow milk recommended in infancy
should not be used in infancy
linked to iron-deficiency anemia
- decreased absorption due to competition with calcium
advice of use of soy protein based formula during infancy
should be limited
no evidence for its benefit
for lactose intolerance give infant ______
reduced lactose cows milk based formula
for lactose intolerance give infant ______
reduced lactose cows milk based formula
for milk protein allergy give infant______
hydrolyzed formulas
infants are born with reflexes and food intake regulatory mechanisms. At ____ weeks, reflexes fade and infant begins to purposely signal wants and needs
4-6 weeks
hunger cues of infants
sucking on fists
reaching for spoon
watching food being opened
pointing at food
irritation if feeding pace too slow or if feeder stops temporarily
satiety cues of infants
seals lips together
turns head away
playing with food or spoon
eating rate flows
pushes food away
spits out food
mouth pattern at…
0-5 months
4-6 months
5-9 months
8-11 months
10-11 months
sucking/swallowing
draw in lip when spoon removed
up and down munching movement with jaw
side to side tongue movement, can curve lips around cup
rotary chewing (grinding)
infants must be able to ______ and ______ before introducing solid foods.
keep heap upright
sit with little support
at 6 months first meals should be offered in _____ portions of ____ food on a spoon at ___ meals a day.
1-2 tbsp
pureed
1-2 meals
why do we introduce food with a spoon?
stimulates muscle development
when starting to introduce food, infants should not be overly ___ or ____.
tired or hungry
to feed infant new foods use a____ spoon and a _____ bowl.
Pace feeding to allow infant to swallow.
First feeding may be small in volume, ____ baby spoons over 10 minutes.
small
shallow
5-6
when starting to feed infant allow then to ________ before you place spoon on front of tongue with gentle pressure.
open mouth and extend tongue
improper positioning when feeding infant, it may cause _____, ______, and ______.
choking
discomfort
ear infections
young bottle fed infants should be positioned _______
in a semi upright position
when spoon feeding infants, infant should be positioned _______
with back and feet supported
directly in front of adult making eye contact
offer water to infants after ______ and from a _____
wean infant from using a bottle to drinking from a cup at _____ months
first portion from a cup is _____
6 months
cup
12-18 months
1-2 oz
changing to a sippy cup is not the same as open cup developmental step.
open cup drinking skills encourage _____ development
speech
early introduction at ____ months should be pureed foods
very soft lumpy foods can be introduced at _____
they can chew and swallow soft mashed food at _____
mature chewing skills develop when they are ______
6 months
6-8 months
8-10 months
toddler
at 6 months you can give the infant _________ and ________ to eat.
add one new food at a time and offer over a _____ period
can add soft table foods at _____
iron-fortified baby cereal mixed with breast milk or water
pureed fruits and veggies
3-5 day
9-12 months
unsafe food choices that are associated with choking
popcorn
peanuts ands nuts
raisins or whole grapes
stringy meats
marshmallows, gum, gummy candy
hard candy and jelly beans
hot dog pieces
hard raw fruits or veggies
sticky foods
honey
honey should not be given to infants until ____
how come?
1 year old
potential source of clostridium botulism
- spored produce toxin which cause muscle weakness and can lead to paralysis and respiratory failure
- infants at risk bc immature gut
breast milk or formula provide enough water for healthy infants up to _____
additional plain water then needed in hot, humid climates
juices not recommended until _____
avoid colas and teas
6 months
1 year
dehydration due to illness is common in infants and ________ can provide electrolytes for rehydration, but they provide _____ than breast milk or formula
oral rehydration products (ex:pedialyte)
less calories
DRI for water or fluids given to Infants 0-6 months is _____ and for infants 7-12 months is ______
0.7 L/day
0.8 L/day
crying or fussiness may be misinterpreted as hunger and result in ________
new parents must learn infant’s ________
overfeeding
cues for hunger and satiety
crying or fussiness may be misinterpreted as hunger and result in ________
new parents must learn infant’s ________
overfeeding
cues for hunger and satiety
_____ infants may be exposed to a wider variety of flavors than _____ infants
infants have a predisposition to ____ taste
food preference from infancy sets stage for ____ food habits
breastfed
formula-fed
sweet
lifelong
fluoride recommended at ___ months if family lives in a place without fluoridated water.
6 months
vitamin B12 may be prescribed for _____ infants if mother is ______
breastfed
vegan
vitamin D supplement of ____ per day if infant is _____
400 IU
purely breast-fed
if exclusively breastfed, it is recommended to have ____ of supplemental iron starting at _____ and ending when infant can eat iron fortified cereals.
for exclusively breastfed preterm infants, iron supplement of ____ starting at _____ until _____
1 mg/kg/day
4 months
2 mg/kg/day
1 month
12 months
for premature infants a _____ with minerals including fluoride is commonly recommended
liquid MVI
educational materials are available from ____,_____, and _____
WIC
Bright Futures program
Academy of Nutrition and Dietetics
condition of irritability and excessive, inconsolable crying in a healthy, well-fed infant
colic
colic can occur from early infancy up to _____
episodes may appear _____
4 to 5 months
at the same time each day
prebiotics and probiotics have been added to infant formulas for ______ but more research is needed
colic
recommendations to receive colic
rocking and swaddling to calm infant
proper positioning during feeding
burping the infant more frequently
iron stores in the infant reflect _______
iron stores of the mother
iron deficiency anemia is more common in ______ families
long term anemia may result in long term _____
low income
learning delays
constipation in infants is _____ and often ____ duration
high fiber foods not recommended bc they are ____
common
short duration
cooling hazards
causes of constipation in infants
not enough fluid intake
excessive fluid loss
allergies
medications
infant formula being mixed improperly
common cause of diarrhea in infants is from _______
- infants are at high risk of dehydration due to higher ______, smaller _____, and dependence on others to provide fluids.
excessive intake of fruit juice
higher metabolic rate
smaller fluid reserves
recommendations fro infant diarrhea
keep feeding normally
avoid simple sugars in foods
oral rehydration solution may be needed
GER and GERD in infants affects ___ of healthy infants
peaks between __ and ____ months and usually resolves by ______.
Caused by _______
2/3
1 and 4 months
12 months
underdevelopment of LES that separates the stomach from esophagus
prevention fo GER and GERD in infants
small frequent meals
burping baby after feeding
keep baby upright 30 minutes after eating
continue breastfeeding
thicken infant formula (consult with pediatrition)
preventative measures of early childhood caries
limit bedtime bottle
avoid sugar containing beverages
wean from bottle between 12-14 months
brush or wipe emerging teeth and gums
The primary recommendation for prevention of allergies
is ___________ for the first ___ of life
Infants’ GI tracts are very sensitive so it is difficult to diagnose
a true allergy vs. intolerance
About ___% of children <__ yrs have food allergies that started
in infancy
exclusive breastfeeding
4 to 6 months
6-8%
4
Absorption of ______ causes allergic reactions
- Can occur after an ________
* Common symptoms are __________
Delaying or avoiding the introduction of ___________ such as wheat, peanuts, fish, or eggs beyond ____ months of age does not reduce allergies, regardless of whether the child is at higher risk for the development of allergies
intact proteins
intestinal illness
wheezing or skin rashes
common food allergens
6 months
Infants allergic to cow’s milk protein will
often have an allergic reaction to ________
Management may involve use of a specialized formula with ___________
* e.g. ________________
soy protein
hydrolyzed proteins
Similac Alimentum, Nutramigen (Enfamil)
lactose intolerance is the inability to digest the disaccharide ______, which is main component of CHO in breastmilk and cow’s milk based formula
It is characterized by cramps, nausea, and alternating diarrhea and constipation.
lactose
lactose intolerance in infancy is often _______
____ infections can cause temporary lactose intolerance that resolves
_______________ can be used
overestimated
GI
lactose reduced formulas
infants receiving well planned vegetarian diets grow normally, but vegan diets increase risk of nutrient deficiencies such as _____________________
B12
D
calcium
iron
zinc
DHA
Early head start program
- a federally funded, community based program that provides early, continuous, intensive, and comprehensive child development and family support services to _____ families with children from ___ to ___ old. the program also includes ______
low income
birth to 3 years
nutrition education
newborn metabolic screening includes _____, ______, _____, and _____.
It varies from state to state. Pennsylvania screens for ____ conditions
PKU
Congenital hypothyroidism
Galactosemia
Sick cell anemia
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