N&M 4 Flashcards
What are the guidelines regarding when a child is ready to switch to skim
milk?
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calculate age stuff
Postnatal age Corrected age 1 month 36 weeks gest 2 months term 3 months 1 month 4 months 2 months Calculate the # of wks the infant was premature 40 wks - Number of weeks at birth ex. Baby born 28 wks 40-28 = 12 wks early or 3 months Baby chronological age 4 months Adjusted age: 4-3 = 1 month
introducing foods
s
whey vs bm
The composition of human milk is different from that of cow’s milk; for this reason, unmodified cow’s milk is not recommended for infants until at least 1 year of age. Both provide 20 kcaUoz; however, the nutrient sources of the energy are different. For example, protein provides 6./o to 7% of the energy in human milk and 20o/oof the energy in cow’s milk. Human milk is 600/owhey proteins (mainly lact- albumins) and 40o/” casein; by contrast, cow’s milk is 20% whey and 80o/ocasein.Gaseinforms a tough, hard-to-digest curd in the infant’s stomach,whereaslactalbumin in human milk forms soft, flocculent, easy-to-digest curds. The amino acids taurine and cystine are present in higher concentra- tions in human milk than in cow’s milk.
skim milk in infancy
Low-fat (1o/”to 2”/”) au;’dn,onfat milk are also inappropri- ate for infants during the first 12 months of life. The infants may ingest excessive amounts of protein in large volumes of milk in an effort to meet their energy needs, and the de- crease amount of essential fattyacids^
foods kids cant eat
Foodswith skinsor rinds and foodsthat stick to the roofofthemouth(e.g.,hotdogs,grapesb,readwithpeanut butter) may causechoking and should not be offered to younginfants
table of foods
check picture
What are the guidelines regarding when a child is ready to switch to skim
milk?
after 2
- Know how to convert from ounces to ml and ml to ounces
1 ml = 0.033814 oz
1 0z = 29.5735 ml
Iron
iron store last 4 months. Additional sources may needed between
4-6 month
Flouride
6 months or when baby 1st
tooth erupted (.25 mg of
fluoride/kg/d
Waterlow’s classification of malnutrition
Mild malnutrition: weight at 80 – 89% of expected weight(50th tile) – Moderate malnutrition: weight at 70 – 79% of expected weight – Severe malnutrition: <70% of expected weight
causes of failure to thrive
Inadequate intake – Biological, social, poor appetite Excessive loses – Malabsorption, vomiting, reflux Increased caloric needs – Various disorders Caretaker causes: – Inadequate understanding of infant/child feeding or nutritional needs – Psychosocial stress – Inadequate duration or number of feedings – Inattention to or misinterpretation of hunger Difficult temperament – Slow feeder – Delayed feeding skills – Subtle hunger cues – Apathy due to neglect or inadequate stimulation
Why they add MCT oil to the premature infant formula
When a high-energy formula is needed, MCT oil and Polycose can be added to a base that has a concentration of 24kcaUoz or greater (either full-strength premature formula or a concentrated standardformula), with a maximum of 50% of total calories from fat and a minimum of 9o/oof total calo⁄ries from protein
What are the additional EAA for premature infants?
( Histidine,
Tyrosine, cystine and taurine)
birth weights
Classification definitions: – Preterm - < 37 weeks gestation – Term - 37 – 42 weeks gestation – Postterm - > 42 weeks gestation Birth weight – Full term birth – 2870 – 4000 grams – Low birth weight – <1000 grams
Fat percentage
Up to 54% of total calories or 30
gm/day
cystic fibrosis
Individuals with CF are at high risk for malnutrition. Mal- digestion and malabsorption, as well as the progressive complications of the disease,make it difficult to meet in- creased nutrient needs. Factors interfering with adequate intake and retention ofnutriens include dyspnea,coughing and cough-induced vomiting, gastrointestinal discomfort, anorexia during episodes of infection, possible impaired senseof smell and taste,and glucosuria.
pku
Formuln. For PKU dietary therapy is planned around the use of a formula/medical food with Phe removed from the protein. The formulas or medical foods described in Thble 44-3 provide a major portion of the daily protein and energy needsfor affectedinfants, children, and adults. In general, the protein source in the formula or medical food is r.-amino acids,with the critical amino acid (i.e., Phe) omit- ted. Carbohydrate sources are corn symp solids, modified tapioca starch, sucrose, and hydrolyzed cornstarch. Fat is provided by a variety of oils.
range of 2 to 6 mg/dl
Many adults with PKU have had the benefits of early diag- nosis and treatment and are less likely to be affected by neurologic damage. However, among those who have had some degree of mental retardation, hyperactivity and self- abuseare often major concerns.Not all patients have re- sponded to the late institution of treatment with improved behavioral or intellectual function. For the difficult-to- manage older patient, a trial of a low-Phe food pattern is recommended.If successfulc, ontinued Phe restriction ther- apy may facilitate behavioral management.
maple syrup urine disease
Maplesyrupurinedisease(MSUD),or branched-chaikneto- aciduria,resultsfrom a defectin enzy-rnaticactivity,specifi- cally the branched chain cr-ketoaciddehydrogenasecom- plex. This decarboxylation defect prevenrs metabolism of the branched-chain amino acids (BCAAs) leucine, isoleu- cine, and valine
Nutrition therapy requires very careful monitoring of blood concentrations of leucine, isoleucine, and valine; growth and general nutritional adequary.
galactosemia
a h i g h l e v e l o f p l a s m a g a l a c o s e -I - p h o s p h a t e combined with galactosuria-is found in rwo autosomal- recessivemetabolic disorders: salactokinasedeficiencv and galactose-I -phosphateuridyl trinsferase(CALT) deficiency, which is also called classicgalactosemia.Galactosemiare- sults from a disturbance in the conversion of galactose to glucosebecauseof the absenceor inactivity of one of the enzyrnes
developmental delay
the condition of a child being less developed mentally or physically than is normal for its age.
premature infant vit and min
Therefore prematureinfantsmay be at risk for vitamin E deficiencybecausethey typically have a limited lipid absorptivecapacityfor sometime vit a iron calcium and phosphorus vit d folic acid
tolerance of feeding
All preterm babies receiving enteral nutrition should be monitored for signs of feeding intolerance. Vomiting of feedings usually signals the infant’s inability to retain the provided amount of milk. When not associatedwith other signs of a systemic illness, vomiting may indicate that feed- ing volumes were increased too quickly or are excessivefor the infant’s size and maturity. Simply reducing the feeding volume may resolve the problem. If it does not or if the in- fant has signs of a systemic illness, feedings may need to be interrupted until the infant’s condition has stabilized.Bile- stained emesismay indicate that the infant has an intestinal blockage and needsadditional evaluation or that the feeding tube has slipped into the intestine.
Abdominal distention may be caused by excessivefeed- ing, organic obstruction, excessiveswallowing of air, resus- citation, or sepsis(i.e., systemic infection). Observing in- fants for abdominal distention should be a routine practice for nurses.
Mention 3 ways that will tell you that the breast fed infant is getting enough
calories?
dirty diapers
weight gain
