Lifespan Considerations in Therapeutics: Infancy, Childhood, and Adolescence Flashcards
1
Q
Nutrient needs during infancy
A
- Growth directly reflects nutritional well-being and is an important parameter in assessing their nutritional status for a lifetime
- Early nutrition affects later development, and early feeding sets the stage for eating habits that will influence nutrition status for a lifetime
- an infant grows faster during the first year than ever again
2
Q
Nutrient Needs to support Growth
A
- Birthweight doubles by 5-6 months, triples by 1 year (typically reaching 20 to 25 lbs)
- length increases about 10 inches from birth to a year
- high basal metabolic rate; high energy requirements
- as a percentage of body weight, infants need more than twice as much as most nutrients as an adult (100kcal/kg)
- vitamins and minerals critical to growth (vitamins A, D, calcium)
3
Q
Nutrition of the Infant: Water
A
- one of the most important nutrients for infants
- the younger a child, the more of the child’s body weight is water
- breast milk or infant formula normally provides enough water
- if the environmental temp is extremely high, infants need supplemental water
- more water inbetween cells and in vascular space. easy to lose.
- sick babies in the event of vomiting or diarrhea water loss electrolyte solution should be given
4
Q
Weight Gain of Human Infants in Their First Five Years of Life
A
- Taking in a ton of calories
- Muscles are developing
- Brain growth and development
5
Q
Infant Heart rate, Resp rate, energy needs
A
- 120-140
- 20-40
- 45kcal/lb (100/kg)
6
Q
Breast Milk: Energy Nutrients
A
- complete nutrient source for the first 6 months; approximately 8-12 feedings per day
- more easily digested than forumla
- carbohydrate is lactose, which enhances calcium absorption
- lipids are the main source of energy (more dense calorically - need it for brain development)
7
Q
Breast Milk - Vitamins and minerals
A
- with the exception of vitamin D, the vitamin content of the breast milk of a well-nourished mother is relatively high.
- Vitamin C is supplied generously
- Ideal calcium content for infant bone growth and it is well absorbed
- appropriately low sodium
- limited iron is highly absorbable
- zinc is well absorbed
8
Q
Vitamin D deficiency
A
- breast milk has low concentration of vitamin D
- vit. D deficiency impairs bone mineralization
- most likely in infants who are not exposed to sunlight daily, have dark skin, receive breast milk without vit. D supplementation
- rickets
- AAP recommends vit D supplement for all infants who are breastfed exclusively
- may prescribe supplements for vit D, iron, and fluoride
9
Q
Breast Milk - immunological protection
A
- Colostrum and breast milk provide maternal antibodies and other agents
- breast milk is sterile but it also actively fights disease and protects illness
- anti-viral, anti-inflammatory, antibacterial agents and infection inhibitors
- middle-ear infection, respiratory illness, fewer allergic reactions such as asthma, wheezing, and skin rash. Reduced risk of SIDS,
10
Q
Iron supplement for full term breastfed infant
A
- at four months, 1 mg/kg/day of supplemental iron for infants who are exclusively breastfed and for all infants who are receiving more than one-half of their body daily feedings as breast milk
11
Q
Colostrum
A
a milk-like secretion from the breasts, present during the first few days after delivery before milk appears; rich in protective factors
12
Q
Infant Formula
A
- iron-fortified formula recommended by AAP (manufacturers can prepare formulas from cow’s milk in such a way that they do not differ significantly from human milk in nutrient content. meet all energy and nutrient requirements for healthy, full-term infants during first 4-6 months of life)
- FDA mandates quality control procedures (standards have been set for nutrient contents of infant formula, require testing for contamination of Salmonella)
- Special formulas including soy protein and hydrolyzed protein are available (meet dietary needs of infants, specific prematurity or inherited diseases. lactose intolerance, allergies - resent as rash, irritability)
13
Q
Risks of formula feeding
A
- constipation from iron fortification
- no protective antibodies
- lead-contaminated water (requires clean water)
- requires clean bottles and nipples and refrigeration
- careful attention to concentrations
- risk of over-dilution or inconsistency in concentration (can cause malnutrition, growth failure)
- contaminated formula (infections leading to diarrhea, dehydration, and malabsorption)
14
Q
Nursing Bottle Tooth Decay
A
- extensive tooth decay due to prolonged tooth contact with formula, milk, fruit juice, or other carbohydrate-rich liquid offered to an infant in a bottle
15
Q
Transition to Cows Milk
A
- not appropriate during the first year
- can cause intestinal bleeding
- iron deficiency
- bioavailabiilty of iron in cereals decreased
- once infant has reached a year of age and is getting 2/3 of food energy from mixture of cereals, vegetables, fruit and other foods cows milk is acceptable
16
Q
When to introduce solid food
A
- Purpose: to provide nutrients no longer supplied adequately by breastmilk/ formula. by 2-3 months the healthy GI tract is able to efficiently digest and absorb virtually all nutrients
- exclusive breast feeding until 6 months. Ready for complementary foods between 4 and 6 months of age
- choose foods the baby can handle physically and metabolically
17
Q
Factors Governing addition of foods
A
- infant’s nutrient needs
- infant’s physical readiness
- need to detect and control allergic reactions
18
Q
Introducing First Foods: foods that provide iron, zinc and Vitamin C
A
- rapid growth demands iron
- at 4-6 months baby needs more iron than body stores and breastmilk can supply/
- concentration of zinc in breastmilk is initially high but decreases sharply over the first few months of lactation
- proteins: meat, fish, eggs, legumes
- fruit and vegetables for vitamin C
