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Pediatrics > Lecture 7: Newborn Nutrition > Flashcards

Lecture 7: Newborn Nutrition Flashcards

1
Q

What is Colostrum?

A
  • Pre-milk secretion
  • Yellowish alkaline secretion present first 2-3 days after delivery
  • Very high vitamin content.
  • Ideal starter food
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2
Q

How long should you be breastfeeding ideally?

A

6 months as the exclusive form of nutriton

1 year if you supplement

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3
Q

How quickly do you want to place a baby on the breast at birth?

A
  1. Within 10 minutes.
  2. Begins milk production
  3. Start uterine contractions, which will inhibit bleeding.
  4. Their sucking reflex is at its most intense right at birth.

Golden hour!

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4
Q

How often does a baby need to be fed?

A
  • 8-12 times on demand
  • At night, maybe like Q4h.
  • 1st day: 5m/breast
  • 2nd day: 10m/breast
  • 3rd day+:10-15m/breast

Babies lose weight for the first 5-7 days, before returning to original birth weight

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5
Q

What is normal poop and consistency for a breast-fed infant?

A
  • Yellow mustard colored
  • clay/semi-runny consistency
  • Usually should not smell if breastfed

Usually poops every feeding

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6
Q

How do formula-fed babies tend to present?

A
  • Overweight
  • Smellier poops

Overfeeding them!

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7
Q

When should a baby double their weight? Triple?

A
  1. Doubled by 5months
  2. Tripled by 1 year
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8
Q

What is unique about breast milk?

A
  • Does not need to be warmed past room temp
  • Does not require clean water
  • Generally free of microorganisms

It is practically 20kcal globally.

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9
Q

What vitamins/minerals are within breastmilk?

A
  • Calcium
  • Iron
  • Zinc
  • ESSENTIAL FAs

but no Vit D

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10
Q

What is essential that breast milk is missing?

A

Vitamin D

Babies will require supplementation.

Does not matter if mother consumes vitamin D or not.

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11
Q

What is a common difference between breast-fed infant infections vs formula-fed?

A

Breast-fed typically exhibit milder symptoms of any infection compared to formula-fed

Also less likely to be sick

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12
Q

What are the benefits for a mother to breastfeed?

A
  • Contraceptive effect
  • Decreased risk of breast cx, ovarian cx, and T2DM
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13
Q

If a mother has smaller breasts, what is the main concern?

A

They may have to feed more because their breasts hold less volume.

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14
Q

When is breastfeeding contraindicated?

A
  • Mom has TB
  • Mom has HIV+
  • Mom on chemo
  • Infant with galactosemia
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15
Q

Can a mother positive for HBsAG breastfeed?

A

Yes, but baby needs Ig and the vaccine.

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16
Q

What is breastfeeding jaundice associated with?

A
  • Inadequate intake of breast milk
  • Infrequent stooling
  • Unsatisfactory weight gain
  • AKA Bad feeding

Baby is dehydrated, having exaggerated physiologic jaundice

Not the same as breastmilk jaundice!

17
Q

What do you need to mix formula with?

A

Sterile water for the 1st 4 months

Feed LESS! Only 6-8 times a day

18
Q

What is hydrolyzed formula?

A

Proteins are predigested

Indicated for MPA and colic

Essentially hypoallergenic formula
MPA = milk protein allergy

19
Q

What are the advantages to formula?

A
  • Catering to specific needs, like galactosemia
  • No vitamin or mineral supplementation needed (Vit D)
  • More comfortable feeding in public
  • Measurable volume (Helps nervous moms)
20
Q

How do you feed a baby that has a milk protein allergy?

A
  • Mom decreases dairy intake
  • Switch to hydrolyzed if slow weight gain/symptomatic
21
Q

When should solid food introduction begin?

A

6 months

22
Q

When can you start adding chewable foods to a baby’s diet?

A

7-9 months, like puffs or cheerios.

23
Q

When is a baby ready for complementary feeding?

A
  1. Able to hold head up
  2. Sit unassisted
  3. Showing interest in foods
  4. Ability to track spoon and open mouth
24
Q

What kind of foods should you AVOID in babies when introducing solid foods?

A
  • Grapes
  • Hot dogs
  • easily chokable foods that could occlude esophagus
25
Q

What is the leading cause of injury in young children/infants?

A

Choking

26
Q

What are the MC food allergies for babies?

A
  • Cow milk
  • Eggs (need red lion stamp)
  • gluten
  • Nuts/peanuts
  • Seeds
  • Soy
  • Shellfish
  • Fish
27
Q

Is delaying introduction of peanut and hen eggs good?

A

No! More likely to increase their risk of developing an allergy.

Egg/milk allergies tend to get outgrown, but not peanuts.

28
Q

When does weaning typically begin?

A

Age 1

Lasts 1-4 weeks

29
Q

Why should a baby not get whole cow’s milk prior to age 1?

A

It can cause anemia (esp iron def)

It has literally 0 iron and inhibits iron absorption

Casein in milk inhibits iron absorption

30
Q

How long should a baby stay on whole milk?

A

Age 2

High fat content is helpful. You can switch to 2% or lower after age 2.

However, does not have much nutrition beyond that, especially in terms of vitamins/minerals.

31
Q

When is a normal diet introduced to a baby?

A

Age 2

Aim for high fiber

32
Q

How many kcals/kg should an infant get? By 1 year? 1 yr+?

A
  • Infant: 120 kcal/kg
  • By year 1: 90 kcal/kg
  • 1 year+: 1000 kcal + 100 kcal/year

By adolescence, only 40 kcal/kg

33
Q

What is colic?

A

A constantly screaming baby but otherwise healthy!

3+ hrs/day, 3 days a week for 3+ weeks

34
Q

Colic symptoms image

A
  • Normal PE
  • Normal labs
35
Q

Tx for colic

A
  • Reassurance
  • Try to swaddle and move baby gently
  • Usually ends by month 3-4
  • NOT THE PARENTS’ FAULT
  • Take a break

Pediatrics (23 decks)

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