Lecture 5 II Flashcards
What is a reflex?
Automatic réponse triggered by specific stimulus
What is a rooting reflex?
Infant automatically turns head toward the cheek that is touched (assets in the act of breastfeeding)
What is a suckle?
reflex causing tongue to move forward and backward
- present at birth
- causes the child to suck anything that touches the roof of its mouth
What Is motor development t?
Ability to control voluntary muscles
What is top to bottom in motor development?
Controls head first and lower legs last
-start tummy time from first days
What does motor development influence?
Ability to feed self
Amount of energy expended
What are the cues infants may give for feeding readiness?
Watching food being opened
Tight fists or reaching for spoon
Irritation if feeding too slow or stops immediately
Playing with food or spoon (sign of being full)
Slow intake or turning away when full
Stop eating or spit out food when full
What re the impacts that affect cognition?
Sensorimotor development
- discovering relationship between bodies and environment
- Adequate nutrient intake
- social and emotional interaction
- genetics
How does the digestive system start to develop?
Fetus swallows amniotic fluid during the 3rT which stimulates intestinal maturation and growth
What are the common problems that arise due to digestive system development ?
Gastroesophageal reflux
Diarrhea
Constipation
At birth what are infants able to digest?
Fat
Protein
Simple Sugar
What are the characteristics of small infants?
Smaller than fully developed gut More horizontal shape Function is immature cause muscles are weaker [Low] of hydrochloric acid and pepsin Increase emptying time
IS the pancreases fully developed when born?
No its not, there is low secretion as a result of pancreatic enzymes
-results in inefficient digestion of solids
Is the Renal system fully developed when born?
System is immature
Limitide capacity to filter waste and excrete Na
We delay intro to solid until 6 months of age
Food with high solute load causes water lass and dehydration
-when solids introduced offer water regularly
What is the base of infant formula?
Non fat cow milk with and without added whey protein
-20-22kcal/oz (same as breast)
What are the typical daily volumes of formula?
birth to one month: 16-20fl oz
1-2: 18-26
2-3: 22-30
3-4: 24-32
What % make sup the composition of breast vs cow milk?
Breast:
7% Cals from protein
38% Cals from carb
55% Cals from fat
Cow
9-12% cals from protein
41-43% carb
48-50% cals from fat
In order for formulas to have ~50% of their cals from fat what kind of fat do they contain?
Vegetable oils replace animals based fats and include essential fatty acids
IN infant formulas, what is the carb makeup?
lactose
Glucose
Sucrose
Whats the whey:casein protein ratio in breast vs formula vs cow?
Breast: 70:30
Formula: 60:40
Cow: 20:80
What amino acid is added to formulas?
Taurineis added for the integrity of retina
If an infant is high risk what are special formulas for?
Milk intolerance
Prematurity
Inborn errors of metabolism
What happens an infant has a lactose deficiency?
Can be temporary or congenital genetic disorder
Use lactose free formulas that still contain
- casein as a source of protein
- Corn syrup and sucrose as the lactose free carb source
What do preterm infants need more of?
Formula with more cysteine added
-these formulas are more cal dense compared to other formulas
What formula is not recommended?
Soy protein instead of milk based
What is important for infants 0-4months for intro to solid foods?
Rooting reflex important to initiate breasfeeeidng
Baby must learn to coordinate sucking swallowing and breathing at the same time
Extrusion reflex: baby will push tongue out to protect from consuming solid foods
What do infants not have at 0-4months interns of muscles??
No muscle control to swallow solids
Capacity to digest food, metabolize and excrete nutrients not sully developed
What is important for infants 4-6months for intro to solid foods?
Decrease extrusion reflex
Start to indicate interest and desire for food
Sit with support and control head
What can you start th intro to soldi foods?
6months
-gradually
What does the intro to solid food coincide with?
Increase energy and nutrient need of infants ~6 months that surpasses what can be provided in breast milk and formula
What percent of children <4yrs have allergies?
6-8%
-and its the absorption of intake protein that cause allergic rxns
What solid foods should you introduce first to infants?
Purified meats and Fe fortified infant cereals
Mashed Avocado
How do you identify allergies?
Single ingredient foods should be tried one at a time
And in small portions
3-5 days apart
What signs and symptoms should parents look out for regarding food allergies?
Nausea vomitting
Abdominal discomfort
Respiratory disturbances
In infants 6-9, what are signs that they are ready to eat?
Can sit independently
Self feed with finger
Pincer grasp
Drink from sappy cup
What are 6-9month meal time tips?
Offer milk first then food
Small amounts of a few familiar food plus newer food
Overtime food can be offered first or at separate occasions
Use milk/formula for any additional liquid needed in food prep or sofening
IS water needed for 6-9?
Allowed but not usually necessary unless hot day
IN infants 9-12 what are signs of readiness?
baby can hold a bottle Grab food and spoon Sit unsupported Continue nrutin/formula on demand \+Fe fortified cereals
for ages 9-12 months what re the beverage recommendations?
Whole cow milk
-skim, 2%, 1% and soy to be avoided
For infants 12months plus what are signs of readiness?
Sit at table and eat foods
Begin to master spoon feeding and drinking from cup
Progression of independence
What are the nutrition goals of 12moth+ ?
Progression of all flavours and textures
Contribute to aloud added sugar and salt
Transition to cow milk
For infants 12+ months what foods should you feed them?
A small variety of everything
When is the right time to introduce cow mil?
9-12 months atleast because:
- Associated with intestinal bleeding and Fe deficiency
- Poor source of Fe
What is a lactose intolerance?
Inability to digest the disaccharide lactose
- lactose intolerance is actually uncommon and tends to be overestimated
- dairy products are such a key source of Ca, introducing foods with low lactose is recommended for older infants who appeared lactose intolerant when younger
What are the signs and symptoms of lactose intolerance?
Diarrhea
Stomach bloating
Gas
Abdominal pain cramps and colic
what are the signs and symptoms of milk/food allergies/
Coughing and wheezing Blood in stool Constipation diarrhea Abdominal pain Anaphylaxis Failure to thrive Eczema/skin rash
What are the most common allergies in infants?
Cow milk Citrus Soy protein Egg white Wheat Fish Nuts
What happens if a family with a known allergy and then they chose to breastfeed?
A fam with a known allergy or intolerance may decrease the risk of the allergy occurring by breastfeeding and postponing allergy causing foods until the second or third year life
If a kids is vegetarian or vegan what are the concerns?
PEM Fe B12 Vitamin D Ca -supplementation may be necessary
What are the foods to avoid for kids?
baby desserts
Canned veggies
Honey
Addes salt sugar andfådd additives
What are the common nutrition related problems and concerns?
Failure to thrive
Colic
Constipation
Dental caries and each infections
What is FTT?
Inadequate wt gain or height gain thought, resulti from a caloric deficit
-can be organic or non organic
What is organic and non organic FFT?
Organic: Results from a diagnosed medical illness
Non-organic: not based on a medical diagnosis and an environmental cause is suspected
What is colic?
Sudden onset of irritability and fussiness or crying
Episodes may appear at the same time each day and duration
Symptoms occur 3-4 months
Causes unknown but associated with upset GI
Infants typically have how many stools/day?
2-6
-stools of breastfed babies tend to be softer than formula babies
What are the causes of diarrhea and constipation?
Viral and bacterial infections
food intolerances
Changes in fluid intake
Diet
How do you reduce infant carries ?
Limit use bedtime bottles
Offer juices in cup not bottle
Only give water bottles at bedtime
Dont pop bottle during feeding
How do you get dental carries?
Caries and ear infections are linked to infant feeding practices
