Lecture 1: Nutrition During Infancy Flashcards
Infancy age is (less than/greater) than _______ year
less than 1 year
Newborn/Neonate age
greater than 1 month
Premature infant: born before?
37 weeks of pregnancy
Postmature infant: born after?
42 weeks of pregnancy
Full term infant is _______ to __________ weeks of pregnancy
37-42 weeks of pregnancy
Infant Body weight (kg)
2.5-3.8kg
Infant Body weight (lb)
5.5-8.5lb
Infant Length (cm)
47-54cm
Infant Length (in)
18.5-21.5in
What % of US infants are born in full term?
90%
How do you assess the nutritional status of an infant?
ABCD
Describe Anthropometrics for infant nutrition assessment
weight height head circumference, WHO chart
Describe Biometrics for infant nutrition assessment
glucose, lipids, protein, electrolyte
Describe Clinical Manifestations for infant nutrition assessment
Jaundice- Bilrubin
dehydration
Untreated jaundice may cause brain damage and neurological damage
Describe Dietary for infant nutrition assessment
Check how much babies are consuming breast milk and/or infant formula, wet diapers, stool frequency
Warning signs in growth assesment
– Lack of body wt and ht gain
– Plateau: wt, ht and head circumference >1 month
– Drop: wt
What is the standard newborn growth assessment? (3)
Height, Weight, head circumference
WHO growth chart age range?
infants 0-2 years old
CDC growth chart age range?
2-18 years old
During what age range do infants have the biggest growth spurt?
0-3 months
Infants ________ weight at first then _______ it by the ______ to ________ day
lose, regain, 7th, 10th
infants double their weight by what months?
4th to 6th months
infants triple their weight by ________ year?
1 year
What are the 4 developmental milestones during infancy? individual variation
1 month: lifts head
3 month: holds head up & starts to roll over
6 months: sitting, starts crawling, teething
12 months: starts to walk
1 month developmental milestone?
lifts head
3 month developmental milestone?
holds head up & starts to roll over
6 month developmental milestone?
sitting, starts crawling, teething
12 month developmental milestone?
starts to walk
Stomach capacity at birth (ml)
10-20ml
Stomach capacity at 1 year (ml)
200ml
Infancy total kcal: 0 to 6 months
90kcal/kg/day
CHO ratio needs for infant < 1 yr
39-53
Protein needs for infant < 1 yr
7-11
Fat needs for infant < 1 yr
40-50
Infancy total kcal: 7 to 12 months
80kcal/kg/day
Infancy Protein kcal: 0 to 6 months
1.5kcal/kg/day or 9.1g
Infancy Protein kcal: 7 to 12 months
1.2-1.5kcal/kg/day or 11g
What are the 3 types of infant feeding?
Colostrum, Breast milk, Infant formula
What is colostrum?
milk produced during the first several days following delivery (rich in antibodies)
Breast milk: Gold standard- Calories
5 Kcal/100 ml (20 Kcal/oz)
Breast milk: Gold standard- CHO content
lactose 7.3%
Breast milk: Gold standard- Protein content
protein 0.9%
Breast milk: Gold standard- Fat content(% plus fatty acids)
fat 3-5%, SCFA, MCFA, ARA, EPA, DHA
Benefits of breast feeding for baby? 8
- Help immune system maturation
- Anti-inflammatory factors
- Hypoallergic (reduce incidence of atopic dermiatitis, eczema and
asthma) - Acts as laxative
- Decrease incidence of sudden infant death syndrome (SIDS)
- May reduce the risk of obesity, diabetes, leukemia, IBD
- Help Fe absorption
- Psychological effect (baby and mom)
Benefits of breast feeding for mom? 7
- Psychological effect (baby and mom)
- Decrease in postpartum depression
10.Increase oxytocin secretion stimulate post partum uterine
contractions, minimized blood loss - Increase wt loss
12.Contraceptive role (delay ovulation) - No cost
- Handy, no bottle to warm up and wash
What are the 2 infancy milestones?
self feeding and positive relationship with food/eating
what is Sudden Infant Death Syndrome (SIDS)
Sudden and unexplained death of an infant
under 1 year of age.
* crib death
* 2500 babies/yr in US
How to prevent SIDS? 5
1) Put your baby on his/her back for sleep,
2) A firm mattress or other firm surface.
3) Prenatal care
4) Smoke-free environment
5) Home baby monitor
What are the common nutrition problems in infants? 9
- Milk allergy
- Constipation
- Acute diarrhea
- Cholic
- Gastroesophageal reflux (GER)
- Fe-deficiency anemia
- Vegetarian infants
- BBTD
- SIDS
Milk allergy cause
Cause: milk antigen: b-lactoglobulin and a-lactoalbumin
Milk allergy symptom
Symptom: diarrhea, vomit, rash, anaphylactic shock (rare)
Milk allergy treatment?
- Treatment: hydrolysate formulas
- May related to other food allergy (egg, nuts, fish etc
Stool characteristics
pasty, yellow, soft
Stool frequency for 1 week old infant
4/d
Stool frequency for 1 year old infant
1-2/d
Constipation cuase (3)
inappropriate fluid intake, excessive fluid losses or
medications
constipation is more common in ?
bottle-fed infant
Constipation treatment (3)
1) Accurate preparation of formula
2) 2 additional oz of water after feeding
3) 2 oz of pear or apple juice per day
Acute Diarrhea cause (3)
infection (bacterial, viral or, parasitic),
antibiotics or food intolerance
Acute Diarrhea symptom (1)
diarrhea
Acute Diarrhea treatment (2)
1) middle diarrhea: oral rehydration drink (juice,
pedialyte, Gatorade)
2) > 4d diarrhea causes 10% dehydration need IV
What is colic?
The sudden onset of irritability, fussiness or crying
* Episodes may appear at the same time each day
* Disappear at 3rd or 4th months
Colic causes?
upset GI and feeding practices
what are the 4 Colic Interventions
– rocking, swaddling, bathing
– change feeding position
– relieve gas
– check mom’s diet
Gastroesophageal reflux treatment 6
1) avoid slumping
2) upright position during feeding
3) thickening formula with cereal (?)
4) try hydrolysate or AA based formula
5) eliminate dairy from mom’s diet (breast feeding)
6) if severe, may require pharmaceutical
or medical intervention
Give 3 examples of standard infant formula
Enfamil, Similac, Good Start
Iron-deficiency anemia treatment
iron supplements and iron-fortified
cereals at 4-6 months
what supplement do vegan infants need?
- vitamin D
– vitamin B12
– iron
– possibly zinc
When do you feed infant Portagen Specialized formula?
for patients with defective fat absorption and/or
defective lymphatic transport of fat (chylothorax)
What is baby bottle tooth decay (BBTD)
An oral health disorder characterized by rampant dental caries associated with inappropriate infant
feeing practice
baby bottle tooth decay (BBTD) prevention (7)
- Rub teeth and gums with cloth
- No milk or juice bottle in bed
- Clean teeth daily
- Use a sip cup at a year old
- Give the child water for thirst
- Fluoride to prevent decay
- Regular dental visi
Role of prebiotics and probiotics in breast milk
prebiotics role: increase loctobacillus, bifido bacteria
prevent the adhesion of pathgens to the GI
immune function increase, allergies decrease
Standard Infant formula ingredient and kcal/oz?
– cow’s milk w/o butterfat + vegetable oils, decreasing protein
– 20kcal/oz
Enfamil, Similac, Good Start
Soy formula best for who?
– infants with Galactosemia or vegetarian family
Soy Formula cons?
–Soy phytate can interfere with Ca, P, Zn and Fe absorption
– Adequate for promoting normal growth
– not recommended for premature infant
When do you feed an infant protein hydrolysates?
CM allergy, soy allergy or significant malabsorption
protein hydrolysates ingredient?
small peptide and free amino acid formula
Give 3 examples of protein hydrolysates brands?
Nutramigen Lipil, Pregestimil, Alimentum Advance
Amino acid formulas ingredient?
AA content
When do you feed an infant Amino acid formulas?
- for infant with protein hypersensitivity
Give 3 examples of Amino acid formula brands?
Nutramigen AA lipil, EleCare, Neocate
what are the 4 Specialized formulas?
– Portagen: for patients with defective fat absorption and/or
defective lymphatic transport of fat (chylothorax)
– Similac PM60/40: for infant who would benefit from lowered
mineral intake (impaired renal function)
– Organic
– Formula with probiotics
When do you feed Similac Specialized formula to an infant?
– Similac PM60/40: for infant who would benefit from lowered
mineral intake (impaired renal function)
Why is goat milk not recommended?
Goat’s milk
– high protein, low Vit C, folic acid and Fe
Why evaporated milk formula is not recommended?
– poorly digested fat
– low EFA, , Fe, Zn, Vit E, Vit C
– excess protein, Na, K, Cl and P
Why whole cow milk is not recommended?
- high protein, low Vit C and iron
Why skim/low fat milk is not recommended?
– high protein, low fat, Vit C and Fe
4 proper feeding techniques and schedules
- 15-20 min/bottle
- 10-15 min/each breast
- No air
- Make them burp
What 4 supplements are given to infants?
Vitamin k
Vitamin D
iron
Fluoride
Vitamin K supplement dose and when?
single dose at birth, IM 0.5-1.0 mg
Vitamin D supplement dose and who is at risk?
400 IU, D-Vi-Sol
breast-fed infants, especially at-risk infants
– northern urban area (winter)
– dark skined
– kept covered
– little exposure to sunlight
– mother with inadequate intake of vit D
Iron supplement dose and when?
1 mg/kg/d by 4-6 month breast-fed infant
Fluoride supplement dose and when?
if local water has no F from 6 M
0.25 mg/d depending on age
Breast milk/formula should be exclusively given for the 1st_________ and continued to _____________ or longer
6 months, 2 year
At what month introduce infant cereal/grind food
after 6 month
ratio of solid food to breast milk
20% to 80%
At what month feed 50% to 50%
10 month
When to feed diet similar to rest of family?
1 year
