Lecture 7: Newborn Nutrition Flashcards
What is Colostrum?
- Pre-milk secretion
- Yellowish alkaline secretion present first 2-3 days after delivery
- Very high vitamin content.
- Ideal starter food
How long should you be breastfeeding ideally?
6 months as the exclusive form of nutriton
1 year if you supplement
How quickly do you want to place a baby on the breast at birth?
- Within 10 minutes.
- Begins milk production
- Start uterine contractions, which will inhibit bleeding.
- Their sucking reflex is at its most intense right at birth.
Golden hour!
How often does a baby need to be fed?
- 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
What is normal poop and consistency for a breast-fed infant?
- Yellow mustard colored
- clay/semi-runny consistency
- Usually should not smell if breastfed
Usually poops every feeding
How do formula-fed babies tend to present?
- Overweight
- Smellier poops
Overfeeding them!
When should a baby double their weight? Triple?
- Doubled by 5months
- Tripled by 1 year
What is unique about breast milk?
- Does not need to be warmed past room temp
- Does not require clean water
- Generally free of microorganisms
It is practically 20kcal globally.
What vitamins/minerals are within breastmilk?
- Calcium
- Iron
- Zinc
- ESSENTIAL FAs
but no Vit D
What is essential that breast milk is missing?
Vitamin D
Babies will require supplementation.
Does not matter if mother consumes vitamin D or not.
What is a common difference between breast-fed infant infections vs formula-fed?
Breast-fed typically exhibit milder symptoms of any infection compared to formula-fed
Also less likely to be sick
What are the benefits for a mother to breastfeed?
- Contraceptive effect
- Decreased risk of breast cx, ovarian cx, and T2DM
If a mother has smaller breasts, what is the main concern?
They may have to feed more because their breasts hold less volume.
When is breastfeeding contraindicated?
- Mom has TB
- Mom has HIV+
- Mom on chemo
- Infant with galactosemia
Can a mother positive for HBsAG breastfeed?
Yes, but baby needs Ig and the vaccine.
What is breastfeeding jaundice associated with?
- 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!
What do you need to mix formula with?
Sterile water for the 1st 4 months
Feed LESS! Only 6-8 times a day
What is hydrolyzed formula?
Proteins are predigested
Indicated for MPA and colic
Essentially hypoallergenic formula
MPA = milk protein allergy
What are the advantages to formula?
- Catering to specific needs, like galactosemia
- No vitamin or mineral supplementation needed (Vit D)
- More comfortable feeding in public
- Measurable volume (Helps nervous moms)
How do you feed a baby that has a milk protein allergy?
- Mom decreases dairy intake
- Switch to hydrolyzed if slow weight gain/symptomatic
When should solid food introduction begin?
6 months
When can you start adding chewable foods to a baby’s diet?
7-9 months, like puffs or cheerios.
When is a baby ready for complementary feeding?
- Able to hold head up
- Sit unassisted
- Showing interest in foods
- Ability to track spoon and open mouth
What kind of foods should you AVOID in babies when introducing solid foods?
- Grapes
- Hot dogs
- easily chokable foods that could occlude esophagus
What is the leading cause of injury in young children/infants?
Choking
What are the MC food allergies for babies?
- Cow milk
- Eggs (need red lion stamp)
- gluten
- Nuts/peanuts
- Seeds
- Soy
- Shellfish
- Fish
Is delaying introduction of peanut and hen eggs good?
No! More likely to increase their risk of developing an allergy.
Egg/milk allergies tend to get outgrown, but not peanuts.
When does weaning typically begin?
Age 1
Lasts 1-4 weeks
Why should a baby not get whole cow’s milk prior to age 1?
It can cause anemia (esp iron def)
It has literally 0 iron and inhibits iron absorption
Casein in milk inhibits iron absorption
How long should a baby stay on whole milk?
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.
When is a normal diet introduced to a baby?
Age 2
Aim for high fiber
How many kcals/kg should an infant get? By 1 year? 1 yr+?
- Infant: 120 kcal/kg
- By year 1: 90 kcal/kg
- 1year+: 100 kcal/kg
By adolescence, only 40 kcal/kg
What is colic?
A constantly screaming baby but otherwise healthy!
3+ hrs/day, 3 days a week for 3+ weeks
Colic symptoms image
- Normal PE
- Normal labs
Tx for colic
- Reassurance
- Try to swaddle and move baby gently
- Usually ends by month 3-4
- NOT THE PARENTS’ FAULT
- Take a break
