NEWBORN AND INFANT FEEDING Flashcards

1
Q

Every infant and child has the right to good nutrition
according to the “______________________________________”.

A

Convention on the Rights of the Child

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2
Q

About ———% of infants 0–6 months old are exclusively breastfed.

A

43

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3
Q

The period of ____________________ of age is a critical period during which adequate nutrition is
important for the child to achieve optimum growth and development

A

birth to 2 years

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4
Q

OBJECTIVES OF INFANT NUTRITION
 To promote, protect and support exclusive breastfeeding in the first _____________ of life.
 To promote the timely introduction of appropriate and adequate complementary foods while continuing breastfeeding up to ______________ and beyond.

A

six months

24 months

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5
Q

INFANT FEEDING
 Breastfeeding provides the required nutrition for the newborn.

 It is recommended that newborns be put to breast within __________ of birth. (Early initiation).
 WHO recommends that infants be exclusively breastfed for the 1st ___________ of life.
 And then continued till ___________ or more with addition to appropriate, adequate and safe complementary foods.

A

one hour; six months

24 months

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6
Q

LACTATION

 In order to produce milk, hormones are needed.
The two main hormones are __________ and ___________

A

prolactin and oxytocin.

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7
Q

Prolactin (produced by the ________________) acts on the human breast to ______________.

It takes several _________ of the infant sucking at the breast to cause prolactin secretion.

Prolactin is also important in inhibiting —————-.

A

anterior pituitary

produce milk

minutes; ovulation

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8
Q

LACTATION
 During suckling an impulse is sent via a reflex arc to the ___________ → release of oxytocin from the _________________ → __________ of the __________ of the _________ and the __________ → releases breast milk into the ampulla of lactiferous
ducts “milk ejection” or “milk let down” reflex

it can then be expressed by the mother or sucked by the baby.

A

hypothalamus; posterior pituitary

Contraction; myoepithelial cells

alveoli; ducts

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9
Q

LACTATION

This milk ejection reflex can also be stimulated by the _________ or _________ of the baby.
 It can be inhibited by _______,_________,__________, and __________ released during stress can block the
release of oxytocin

A

presence ; crying

stress; pain

Opiates ; B endorphins

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10
Q

Lactation

Lactation can be suppressed by conditions like __________ syndrome postpartum ____________
 Oestrogen containing ________________

A

Sheehan’s; hypopituitarism

hormonal contraceptives

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11
Q

SUPPRESSION OF LACTATION
 _______ and ______
 ________ suckling
 Giving baby _________
 Suppression may be indicated if baby is —————, dies in the neonatal period or there is a contraindication to breast feeding.
 Drugs like ____________ (a ________ agonist that inhibits prolactin) can be used. Side effects are hypotension, rebound breast engorgement, myocardial infarction and puerperal stroke.

A

Stress and pain

Infrequent; other feeds

still born; bromocriptine; dopamine

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12
Q

STIMULATION OF LACTATION

•________ suckling at the breast or expressing starting from the _______ day of life (especially within the 1st ______
of life).
• Proper attachment.
• Encourage mother to drink ________~.. L/day
• Prevent stressful/painful conditions such as breast ______.
• Drugs - ___________ stimulates milk production while intranasal oxytocin cause milk let down

A

Frequent; 1st; hour

a lot of fluids ; engorgement

metoclopramide

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13
Q

EXCLUSIVE BREASTFEEDING

 This is giving an infant __________ only (including expressed breastmilk) with no _______ or other liquids or __________________ .

However, infants can receive ORS, vitamins, minerals and prescribed medicines.

A

breast milk ; water; breast milk substitutes

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14
Q

All mothers should be encouraged to exclusively breastfeed their infants for the 1st _____________ of life.

All mothers should be taught to __________ and _________ breast milk for feeding their infants (with cup) during periods of unavoidable separation.

A

6 months

express; preserve

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15
Q

PREDOMINANT BREASTFEEDING

Here, the predominant source of nourishment is _________ (including expressed breastmilk milk or milk from a wet nurse).

The infant may also have received liquids (__________ and ____________ drinks, fruit juice).

A

breast milk

water and water-based

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16
Q

health care facilities canbe used for the
purpose of promoting breast milk substitutes, feeding bottles or teats.

T/F

A

F

health care facilities should not be used for the
purpose of promoting breast milk substitutes,
feeding bottles or teats.

17
Q

COMPOSITION OF BREAST MILK

 Colostrum – the initial milk ( __________ in colour) that is produced in the 1st _________ after birth
 It is rich in protein, immunoglobulins, leucocytes, lactoferrin, lysozymes and complement – baby’s first _____________
 Protects baby’s digestive system

A

golden yellow; 2-3days

immunization

18
Q

The initial breast milk is called??

A

Colostrum

19
Q

COMPOSITION OF BREAST MILK
 Mature milk is produced from approximately _______ days after delivery upwards. It contains:

A

ten

20
Q

COMPOSITION OF BREAST MILK

List 4

________
________
_________
___________

A

Energy
Lipids
Protein

Cabohydrate

21
Q

Cholesterol is contained in breast milk

T/F

A

T

22
Q

Maternal diet affects the amount of fat in milk and the types of fat.

T/F

A

F

Maternal
diet does not affect the amount of fat in milk but
does affect the types of fat.

23
Q

List 2 proteins in mature breast milk

A

Casein (2.5 g / liter)
-Whey (6.4 g / liter)

24
Q

___________ is the major carbohydrate in breast milk.

A

Lactose

25
Q

_______ and ________ are particularly high at the end of the feeding (hind milk)

A

Fats and lipids

26
Q

PARENTERAL NUTRITION

Parenteral nutrition(PN) is the provision of nutrients by the _________ route.

It is used when the ______ cannot be used to supply nutrition for various reasons including intestinal failure.

A

intravenous

27
Q

INTESTINAL FAILURE

Intestinal failure occurs when ______________________________________________________ , such that intravenous supplementation (IVS) is required to maintain health and/or
growth”.

A

the gut function is reduced below the minimum necessary for the absorption of macronutrients and/or water and
electrolytes

28
Q

CLASSIFICATION OF INTESTINAL FAILURE

 Type I- _______, _______-term and usually ____________ condition e.g. post-operative ileus

 Type II- a ____________ condition, often in
________________ patients, requiring complex multi-disciplinary care and PN for weeks or months.

 Type III- a _________ condition, in ___________ patients, who require PN over months or years. It may be
reversible or irreversible.

A

an acute ; short; self-limiting

prolonged acute; metabolically unstable

chronic; metabolically stable

29
Q

COMPLEMENTARY FEEDING

 This is addition of __________ apart from breast milk from __________.
 Infants are particularly vulnerable during this transition period as new foods are being introduced.
 Complementary foods should contain ____________ and ____________ essential for growth.

A

any other food; 6 months

vitamins ; trace elements

30
Q

COMPLEMENTARY FEEDING
 Complementary feeding period is a critical window of opportunity to prevent ____________ and its long-term consequences.

After age ________ it is difficult to reverse the adverse effects of malnutrition.

A

under-nutrition; 2yrs

31
Q

Introducing complementary foods before ________ or after __________ has negative consequences.

Too early- ______ later in life, atopy, eczema,
gastrointestinal and respiratory infections.
 Too late- nutritional deficiencies, __________ later in life and immune deficiencies.

A

12 weeks; 26 weeks

obesity; type 1 and 2 DM

32
Q

COMPLEMENTARY FEEDING
 From 6 months, ________ is unable to meet all the energy and nutrient needs of the infant.

 Energy gap increases from _______kcal/day from 6-8months to ______kcal/day from 12-23months.

 In addition, other nutrient gaps such as protein, iron, vitamins also need to be filled by complementary feeding.

 The ______ gap is largest making them prone to developing _______________________ during this period if
this gap is not filled.

A

breastmilk

200; 550

iron; iron deficiency anaemia

33
Q

COMPLIMENTARY FEEDING
To meet the nutritional needs of the infant
complementary foods should be:

F
A
D
U
S

A

COMPLIMENTARY FEEDING
To meet the nutritional needs of the infant
complementary foods should be
• Frequent: offered frequently as required.
• Adequate: provide sufficient energy, protein, fat and micronutrients from a variety of foods.
• Dense : gradually increase in consistency.
• Utilized : provided in a form that can be easily digested and absorbed e.g. vitamin A rich-foods are
given with fat and iron-rich foods with Vitamin C to
increase absorption.
• Safe : hygienically stored, prepared and fed

34
Q

COMPLEMENTARY FEEDING

 Complementary foods should be introduced gradually _____ times daily and increased to _______ times daily also
gradually increasing the __________.

A

1-2 ; 3-4 ; quantity

35
Q

COMPLEMENTARY FEEDING

Caregivers should practice __________ feeding i.e., feed children directly, slowly and patiently, encouraging them to eat and not _________ them.

Those that can feed themselves should be assisted and different combinations and variety of foods should be offered to those that refuse to eat.

A

responsive; forcing

36
Q

In 2016, WHO recommended that all infants should be breastfeed irrespective of the HIV status of the mothers, provided mother was _______ and baby also
got ____________.
 Mothers however have the opportunity to “opt-out.”

A

on ART

ARV prophylaxis

37
Q

LOW BIRTH WEIGHT INFANTS
 Breast milk is particularly important for ________ infants and the small proportion of term infants with _________ birth weight.

For this reason, mothers are encouraged to:
 Exclusively breastfeed frequently.
 Babies who are too small or weak to suck should be tube-fed.
 Commence iron supplementation from age __________.
 Introduce complementary foods at _________.
 Calcium and vitamin supplements.

A

preterm; very low

1 month; 6 months