Nutrition Flashcards
Anthropometric measurements
1) weight , 2)length/height. 3)head circumference 4)body mass index [BMI] mid-arm
circumference. 5)skin folds thickness.
Data 1- BMI 2-energy in breast milk % 3-pr ||| The main proteins in the whey 4# Carbohydrates
Normal 18.5-24.9 Overweight 25 - 29.9 obesity Grade I 30 - 34.9 obesity Grade II 35 - 39.9 obesity Grade III <40
Underweight | 16-18.5
Severely underweight/ 15-16
Very severely underweight less than 15
Breast milk contains approximately 67kcal/100 ml, with approximately
50 %of its energy derived from fat , 40 %from carbohydrate and 10 %from protein .
whey : casein ratio : 60 : 40 more easily digested curd
The main proteins in the whey fraction of breast milk are
α-lactalbumin and lactoferrin which provide a complete source of essential amino acids, including taurine, which is present in high concentrations in human milk, but is absent from cow’s
@@@Carbohydrates
Breast milk contains about 70 g/l of carbohydrate, most of which is lactose & trace amount of oligosacchrides.
Colostrum
Produced in the first 1-4 days of life
So Called transitional milk
Colostrum often has a yellow hue color.
Volumes are low but The content of immunoglobulin (IgA, IgG, IgM) is much higher than the mature milk . Very rich in proteins, vitamin A, and sodium chloride, but contains lower amounts of carbohydrates, lipids, and potassium than normal milk .
Mature milk
• Foremilk : ( first portion drawn during a feeding
-is designed for the infant’s thirst. -usually have more protein with low in fat content.
• Hindmilk (the milk that follows foremilk -contains more fat and a higher caloric content. -provides the energy and nutritional content necessary for
adequate growth. This is the reason it is important to emphasize
adequate emptying of the breast with feedings.
Lipids in breast milk
More than 98 % of the fat in breastmilk is in the form of triglycerides and long-chain polyunsaturated fatty acids LC-PUFA:-
linoleic acid which converted into arachidonic acid ARA (omega-6) and α-linolenic acid converted into decosahexonic acid DHA (omega-3) .These are termed essential fatty acids which play important roles in the brain & eye development .
Humoral in breastfeeding
Cellular
Secretory IgA
Comprises 90 %of Ig in human milk to provides mucosal protection.
Interferon: Antiviral agent Bifidus factor
Promotes growth of Lactobacillus Bifidus hcihw
,
metabolises lactose to lactic and acetic acids. The resulting low pH may inhibit growth of gastrointestinal pathogens
Lactoferrin
Iron binding protein. Inhibits growth of E.coli
Lysozyme: Bacteriolytic enzyme
@@@Cellular
Macrophages:- Phagocytic , synthesise lysozyme , lactoferrin ,
Lymphocytes:-
T cells may transfer delayed hypersensitivity responses to
infant .
B cells synthesise IgA
Exclusive breastfeeding
Exclusive breastfeeding is defined as “ an infant’s consumption of only human milk with no supplementation of any type;
Breastfeeding advantages
Enhance vaccine response
For the mother: 1)- Promotes bonding between mother and baby
2)- Reduce risk of postpartum bleeding 3)- Possible reduction in premenopausal breast, uterine, ovarian cancer 4)- Decrease osteoporosis 5)- Promotes postpartum weight loss & Reduced risk of metabolic syndrome 6)- Breastfeeding diabetic mothers require less insulin. 7)- Contraceptive:-although not a reliable contraceptive-, which is important in reducing birth rate in developing countries.
Mastitis
Mastitis (infection) : It occurs in 2-3 %of lactating women Usually unilateral , Manifesting at 2nd week after delivery with sudden onset of fever, breast pain, with localized warmth, tenderness, edema, and erythema Organisms implicated in mastitis include Staph. aureus ,E. coli ,succocotperts A puorg , H. influenzae ,Klebsiella pneumoniae dna Bacteroides pps , . A breast abscess is a less-common but is a more serious complication of mastitis .
4-Insufficient milk syndrome
4-Insufficient milk syndrome
– It is defined as failure to thrive in infants due to
insufficient breast milk intake.
Insufficient milk syndrome
It is defined as failure to thrive in infants due to
insufficient breast milk intake.
– The infant might cry or be lethargic.
– weight loss
>7 %of birth weight, delayed
stooling . – Dehydration (Hypernatremic) , decreased urine
output. – Jaundice
Breast milk jaundice
Persistently high serum indirect bilirubin in a thriving breastfed healthy baby. It generally declines by the 2nd wk of life .
It may be due to presence of 3-alpha-20-beta
pregnanediol in the breast milk Which inhibit
glucuronyl transferase or due to enhanced
absorption of bilirubin from the gut .
CI of breastfeeding
Infant causes: Absolute: Certain inborn errors of metabolism IEM such as galactosemia. Temporary: a. Craniofacial anomalies e .g.cleft lip/palate, b. Ankyloglossia (tongue tie) may interfere with the infant's ability to effectively breastfeed
Picky eaters
children between one and five years of age who are
brought in by their parents for refusing to eat
are healthy and have an appetite that is appropriate for their age and growth rate.
preschoolers are described by their parents as poor or ‘picky’ eaters.
Where the child’s ‘refusal’ to eat is found to be related to unrealistic expectations.
If the child looks well and is growing normally,→ the refusal to eat is most often physiological.
Etiology #
1- Parental growth expectations are excessive
2-Threats & punishment
3- Distraction and quarrelling
4- Imitation: Most children like to copy others.
5- Attention-seeking:
6-Autonomy: As toddlers struggle to develop a sense of autonomy, they
prefer self-feeding and become selective in their choice of foods. If
pressured or forced to eat, children’s need for autonomy may lead
them to resist eating.
7- Neophobia : Young children tend to be neophobic —they do not like
new foods - and are often perceived as picky eaters by their parents.
8- Beverages -9- Snacks:
Appetite stimulants
Appetite stimulants such as cyproheptadine are generally not indicated for isolated food refusal and should never be considered solely to alleviate parental anxiety. Vitamin or mineral supplements can be used if the quality of the diet is questionable.
