NEWBORN AND INFANT FEEDING

Question 1

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

Answer 1

Convention on the Rights of the Child

Question 2

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

Answer 2

43

Question 3

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

Answer 3

birth to 2 years

Question 4

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.

Answer 4

six months

24 months

Question 5

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.

Answer 5

one hour; six months

24 months

Question 6

LACTATION

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

Answer 6

prolactin and oxytocin.

Question 7

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 —————-.

Answer 7

anterior pituitary

produce milk

minutes; ovulation

Question 8

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.

Answer 8

hypothalamus; posterior pituitary

Contraction; myoepithelial cells

alveoli; ducts

Question 9

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

Answer 9

presence ; crying

stress; pain

Opiates ; B endorphins

Question 10

Lactation

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

Answer 10

Sheehan’s; hypopituitarism

hormonal contraceptives

Question 11

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.

Answer 11

Stress and pain

Infrequent; other feeds

still born; bromocriptine; dopamine

Question 12

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

Answer 12

Frequent; 1st; hour

a lot of fluids ; engorgement

metoclopramide

Question 13

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.

Answer 13

breast milk ; water; breast milk substitutes

Question 14

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.

Answer 14

6 months

express; preserve

Question 15

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).

Answer 15

breast milk

water and water-based

Question 16

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

T/F

Answer 16

F

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

Question 17

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

Answer 17

golden yellow; 2-3days

immunization

Question 18

The initial breast milk is called??

Answer 18

Colostrum

Question 19

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

Answer 19

ten

Question 20

COMPOSITION OF BREAST MILK

List 4

________
________
_________
___________

Answer 20

Energy
Lipids
Protein

Cabohydrate

Question 21

Cholesterol is contained in breast milk

T/F

Answer 21

T

Question 22

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

T/F

Answer 22

F

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

Question 23

List 2 proteins in mature breast milk

Answer 23

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

Question 24

___________ is the major carbohydrate in breast milk.

Answer 24

Lactose

Question 25

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

Answer 25

Fats and lipids

Question 26

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.

Answer 26

intravenous

Question 27

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

Answer 27

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

Question 28

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.

Answer 28

an acute ; short; self-limiting prolonged acute; metabolically unstable chronic; metabolically stable

Question 29

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.

Answer 29

any other food; 6 months vitamins ; trace elements

Question 30

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.

Answer 30

under-nutrition; 2yrs

Question 31

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.

Answer 31

12 weeks; 26 weeks obesity; type 1 and 2 DM

Question 32

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.

Answer 32

breastmilk 200; 550 iron; iron deficiency anaemia

Question 33

COMPLIMENTARY FEEDING To meet the nutritional needs of the infant complementary foods should be: F A D U S

Answer 33

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

Question 34

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

Answer 34

1-2 ; 3-4 ; quantity

Question 35

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.

Answer 35

responsive; forcing

Question 36

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.”

Answer 36

on ART ARV prophylaxis

Question 37

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.

Answer 37

preterm; very low 1 month; 6 months