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HUNT 243 > Lecture 10 - Complementary Feeding > Flashcards

Lecture 10 - Complementary Feeding Flashcards

1
Q

what is complementary feeding defined as

A

the process starting when breast milk alone is no longer sufficient to meet nutritional requirements, and therefore other foods and liquids are needed along with the breast milk or formula

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2
Q

what is another word for complementary feeding

A

weaning

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3
Q

when is complementary feeding recommended

A

around 6 months of age

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4
Q

what allows newborns to be ready to feed

A

they are born with reflexes that prepare them to feed

such as : rooting, mouthing, head turning, gagging, swallowing and coordinate breath and swallow

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5
Q

baby must show all of these signs to be ready to start solids, what are they

A
  • baby is around 6 months of age
  • baby can hold their head up
  • baby sits when well supported
  • baby opens their mouth as food approaches
  • baby can keep food in their mouth and then swallow it, instead of pushing the food out
  • baby shows signs of biting and chewing
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6
Q

what are the risks of early introduction (<5 months) to complementary feeding

A

increased risk of :

  • eczema and food allergies
  • respiratory disease
  • gut infection
  • diarrhoea and dehydration
  • impaired iron absorption and iron deficiency
  • malnutrition due to decrease in milk energy and inadequate complementary foods
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7
Q

what are the risks of late introduction of complementary feeding

A

increased risk :
- iron deficiency

  • feeding difficulties
  • growth faltering
  • other micronutrient deficiencies
  • development of food allergies
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8
Q

on average the first teeth being to erupt when the baby is :

A

around 6 to 9 months old

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9
Q

the full set of 20 deciduous teeth has usually erupted into the mouth by what age

A

around 3 years of age

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10
Q

do infants need teeth to eat food

A

no they do not

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11
Q

what is the progression of texture of food for infants

A

pureed

mashed

chopped

family foods

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12
Q

what is recommended about moving through the texture of foods with infants

A

move through the stages quickly, if you stay on pureed food to long you could miss critical period

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13
Q

what is the texture and development stage of a head up baby (0-6months)

A

suck, swallow, extrusion reflex

  • move liquid only from front to back of mouth
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14
Q

what is the reflex and texture of food for a supported sitter baby (6-7 months)

A

being able to move the tongue from side to side without moving the head

  • smooth, running puree
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15
Q

what is the texture of food like for an independent sitter (7-8 months)

A

thick puree, small soft lumps or mashed

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16
Q

what is the texture of food like for a crawler (8-12 months)

A

chew and swallow soft mashed, minced, grated, chopped foods

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17
Q

what is the texture of food like for a infant beginning to walk (12-24 months)

A

family foods, maybe different shapes but similar to what the family eats

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18
Q

Prolonged use of purée foods (> 9 months) and introduction of lumpy foods later than 10 months is associated:

A
  • feeding difficulties (commonly refusal) in older children
  • low intake of nutrient rich foods
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19
Q

what is responsive feeding ( how should children be feed and what to do if they refuse)

A
  • sensitive to hunger and satiety cues
  • feed slowly and patiently encourage children to eat but do not force them
  • if child refuses food, experiment with different food combinations, tastes, textures and methods of encouragement
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20
Q

signs a baby is hungry

A
  • opening mouth and turning head from side to side
  • fussing and leaning toward the breast or food
  • increasing physical movements that become agitated / excited
  • crying in a distressed intense way
  • asking for or pointing at foods
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21
Q

signs a baby is full

A
  • pushing or arcing away, pushing food or plate away
  • turning head away or shaking head to communicate ‘no more’
  • spitting out food
  • using words like “all done” or “get down”
  • becoming distracted and more interested in what is going on around them
22
Q

what are the foods first recommendations

A

iron rich and then also vegetables and fruit

23
Q

what are good choices for iron rich first foods

A

cooked pureed meat, chicken and fish

baby rice cereal : iron fortified cereal mixed with water, breast milk or formula

cooked and mashed plant based proteins

24
Q

what are the conflicts on baby rice

A
  • some nutritionists do not recommend baby rice as it is processed
  • unsupported concerns on inadequate salivary amylase
  • unsupported concerns about high arsenic
25
Q

what are the unsupported concerns about inadequate salivary amylase

A

they were worried that the starch would cause GI concerns for the baby, however at 6 months babies have adult level functioning salivary amylase

26
Q

iron deficiency is prevalent in infancy is due to

A

high requirement - high growth rate

iron stores received in utero begin to run low

27
Q

what infants are most at risk of iron deficiency

A
  • low intake of “high iron” foods
  • low birth weight (<2,500g)
  • pre term infants because they do not gain those additional iron stores in the past couples weeks
  • low socioeconomic status / food insecure
28
Q

what are the consequences of iron deficiency for infants

A
  • altered intestinal function
  • impaired cognitive, social and socio-emotional development
29
Q

what are the consequences of iron deficiency anaemia for infants

A
  • fatigue / decreased activity
  • sustained IDA may be associated with irreversible and detrimental effects on intellectual and motor performance
30
Q

prevention of iron deficiency

A
  • food based (foods first) approach
  • unknown risk of iron supplementation for healthy young children
  • however, iron supplementation required for some infants
31
Q

what is the first foods approach (vegetables and fruit)

A
  • provide important nutrients : vitamins, minerals, fibre
  • fresh, washed in clean water, frozen or canned
32
Q

early childhood intakes of vegetables and fruit improves what

A

improves immunity, aids digestion, decreases risk of obesity

33
Q

what is repeated exposure of vegetables important for

A

important for acceptance from the infant as they are used to the sweetness of breastmilk and vegetables are often bitter tasting

34
Q

how many exposures to a food can it take for acceptance

A

8-15 exposures

35
Q

what are ways of exposing children to food

A

see, touch, smell, taste

  • providing the food in different forms may help with exposure
36
Q

what liquids should infants be ok to have

A

only breast milk, formula and water

37
Q

what are the guidelines with preparing foods for infants and why

A

do not add salt, soy sauce, sugar, honey or artificial sweeteners, they have very sensitive taste buds

38
Q

honey should be avoided for what age infants

A

< 12 months

39
Q

why should honey be avoided in infants

A

can cause infant botulism caused by the toxin Clostridium botulinum

40
Q

equipment must be sterilised for infants until what age

A

6 months

41
Q

Home-prepared and commercial infant foods can be kept in a covered container in the fridge for how long

A

up to 48 hours

42
Q

why should a baby never be left alone to eat

A

choking is silent

43
Q

what are the characteristics of gagging

A
  • watering eyes
  • pushing tongue forward out of mouth
  • retching movement to bring food forward
  • may vomit
  • loud / dramatic
44
Q

what are the characteristics of choking

A
  • may cough or gasp as trying to get air
  • may go silent
  • may make a struggling sound or raspy whisper
  • silent
45
Q

what are the foods that you should be aware of that could cause choking

A
  • small hard foods
  • small round foods
  • foods with skins or leaves
  • compressible food
  • thick pastes
  • fibrous or stringy foods
46
Q

what are the main reasons that cows milk should not be given as a drink until infants are older than 12 months

A
  • concentration and bioavailability of iron is low
  • may displace other solid foods, reducing nutrient intake
  • may cause gastrointestinal blood loss
  • high renal solute load
47
Q

what is the issue with cows milk and renal solute load

A

the high mineral concentration compared to human milk is hard on the kidneys and infants have immature kidneys

48
Q

when is cows milk ok for babies

A

when in food,

it just the high concentrations or high doses that cause issues

49
Q

what is the concern with baby food pouches

A

adverse health outcomes (such as decay, obesity, motor development) with pouch “suckling”

50
Q

what are dietitian concerns about baby food pouches

A

the infant cannot see, touch or smell pouch contents (this is important for exposure to foods)

51
Q

what is the nutritional intake of babies who have baby food pouches like

A

nutrient intakes are similar to infants who do not consume baby food pouches, additionally no difference in iron status but slightly higher intakes of total sugars

HUNT 243 (30 decks)

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