nutrition Flashcards
what drives nutrition in infants, children + adolescents
infant = nutrition led child = growth-hormone led pubertal = sex steroid led
do neonates require iron supplementation?
no
healthy term dont need exogenous for first 6 months
endogenous sources - haemoglobin, storage iron, functional tissue iron
when should infants start solid food?
should not start solid foods before 6 months
- breastmilk is then no longer enough for nutritional needs
Sold food before 4 months = risk factor for being overweight at 3 yrs
- Breastfeeding >= 4 month is protective
when can unmodified cows milk, semi skimmed, and skimmed milk be introduced to infants?
no unmodified cows milk as main drink in under 12months - can be used to cook 6-9months
semi skimmed - not til 2yrs
skimmed - not til 5yrs
consequences of late weaning
inadequate energy + nutrients from breast milk alone - faltering growth + malnutrition
micronutrient deficiency - iron, zinc
optimal development of chewing, new tastes + textures
identifying faltering growth
fall of 1+ if birthweight <9th centile
fall of 2+ if birthweight 9th-91st centile
fall of 3+ if birthweight >91 centile
weight if below 2nd centile for age no matter birthweight
public health nutrition interventions
- Food environment supports healthier choices
- Access to effective weight management services
- Sector leaders promote healthy diet + weight
- Diet related health inequalities are reduced
benefits of breastfeeding
Reduced –
o Incidence of Otis media
o Dental caries
o Malocclusion
More clarity of speech
Supports mother-baby relationship and mental health bond
benefits of breastmilk
Reduced o Incidence of infection o Gastro, resp, urinary, ear, necrotising enterocolitis o Severity of allergies, asthma, wheeze, heart disease o Juvenile onset diabetes o Sudden infant death syndrome (SIDS) o Obesity in both childhood + adulthood o Childhood leukaemia o High BP + cholesterol levels o IBD
Improves response to immunisations
benefits of breastmilk in preterm babies
- Ideal first food
- Crucial for brain development
- Promotes growth + maturation of systems
- Protects from infection + inflammation – colonisation by healthy bacteria
- Switches on digestive hormones + lipases
- Dose dependent – more receives, more the benefits
- Babies’ formula fed in early days have 5 times the risk of developing necrotising enterocolitis
benefits of breastfeeding for mum
Reduces risk of – o Breast + ovarian cancer o Cardiovascular disease o Osteoporosis o Obesity + type 2 diabetes
Delays return to fertility
Supports the mother-baby relationship + mental health of both
signs of ineffective breastfeeding
baby o Feeding very frequently o Frustration o Poor weigh gain o Jaundice o Hypernatremia Mum o Sore nipples o Engorgement = breasts overly full o Mastitis = inflammation of breast tissue o Low milk production o Loss of confidence
most common reason for women to stop breastfeeding
perceptions of poor milk supply
not true ! might be more hungry during growth spurt etc
breastfeeding frequency
first week - very often, could be every hour
first few weeks - 8-12 times a day
initially after birth, baby receves colostrum from breast, what are effects of colostrum?
High levels of immunoglobulins particularly lactoferrin o Helps with absorption of iron – difficult for iron to be absorbed in formula Strong anti-inflammatory effect Stimulates gut growth Concentrated nutrition Initiates acidic pH environment Laxative effect to clear meconium Small volume but large in value
signs of tongue tie
difficulty attaching to breast/staying attached
feed for long time, short break, feed again
not gaining weight
clicking sound as they feed
difficulty sticking tongue out
heart shaped tongue when stuck out
stages of lactation (lactogenesis)
- breast development + colostrum production from approx 16weeks gestation
- onset of copious milk secretion occuring between 32 + 96hrs after birth
- maintenance of milk production
what hormones are involved in lactation?
prolactin
progesterone
oxytocin
prolactins role in lactation
responsible for milk production
responsive to touch/stimulation
levels high at night
progesterones role in lactation
inhibits milk production by inhibitng prolactin
–> produced during pregnanct + drops when baby born
oxytocins role in lactation
sends messages to cells in breast to let milk down - causes milk delivery
pulsatile on muscle cells
high when baby is near
stress can delay
skin-to-skin post birth promotes
- Regulation of temp, heart rate + breathing in baby
- A reduction in stress hormones in both mum + baby
- Feeding behaviour in baby
- Colonisation of babys microbiome by mum/dads microbes
- Lactation hormones in mum
