Nutrition Flashcards
Breast feeding initiated and continued upto
- Initiated ASAP > 1hr of delivery
2. Continued upto 2yrs
Nipple confusion
Milk flows easier from a bottle milk than breast milk without much efforts. In a bottle fed baby, baby starts preferring bottle feeds to breast milk as less effort is needed for getting milk.
Signs of good attachment of baby to breast
- Baby’s mouth wide open
- Most of the areola and nipple are inside the baby’s mouth only upper part is visible
- Baby’s chin touches breast
- Baby’s lower lip is everted
Physiology of breast feeding ( reflexes in mom and baby)
Maternal reflexes 1. Prolactin reflex 2. Oxytocin reflex In baby 1. Rooting reflex 2. Suckling reflex 3. Swallowing reflex
Immunological components of breast milk
PLABB P- PABA (Para amino benzoyl acid) against Malaria L- Lactoferrin - E. Coli A- IgA B- Bile salt Lipase - Guardia B- Bifedus Factor - E. Coli
Bioactive substances in breast milk
Helps in intestinal maturation
- Epidermal Growth Factor
- Transforming Growth Factor- B
Breast milk contents
CH²O - 1. LACTOGEN
2. GALACTOCEREBROSIDE
PROTEIN 1. Whey Protein 2. Casein
FATS 1. PUFA (DHA, Arachidonic acid)
Other benefits of breast milk
Baby - 1. IQ increases 2. NEC risk Decreases 3. SIDS risk Decreases Mother - 1. Lactation amenorrhea- prolactin 2. PPH risk Decreases- oxytocin - helps in involution 3. Breast/ Ovary CA risk Decreases
Increased levels of Casein in breast milk causes
Constipation & Cow Milk Protein Allergy (CMPA)
Brain growth promoting substances in Breast milk
- Galactocerebroside
- Whey Protein
- Taurine, Cysteine
- DHA, Arachidonic acid
Nutrients Deficient in breast milk
Vit k - prophylactic given @ birth
Vit D - 400 IU/day upto 1 yr supplementation
Iron - supplement in preterm babies
Vit B12 - (in strict vegetarian mothers)
Absolute contra indication of breast feeding
- 1° lactose intolerance
- Galactosemia
- Mother on RT/CT
- Mixed Feeding in HIV mothers
Relative contra indications breast feeding
Maternal infections
- HIV
- Herpes
- TB
- Varicella
Milk produced my mother of preterm baby has increased contents of
SIIPS S- Sodium I- Iron I- IgA P- Proteins S- Sugar (calorie)
Protein requirement in
- 0-6months
- 6-12months
- <5yrs
- 5-10yrs
- 10-12 /early adolescent
- Mid & late adolescents
- 1.2 g/kg/day
- 1.7 g/kg/day
- 20g/day
- 30g/day
- 40g/day
- 50g/day
Calorie requirement in
- 1st 10kg
- 10-20kg
- > 20kg
- 100kcal/kg/day
- 1000 + 50kcal/kg/day for each additional kg
- 1500 + 20kcal/kg/day –”–
Breast problems during lactation
Inverted nipple
Sore nipple
Breast engorgement/ mastitis
Breast abscess
Causes of short limb dwarfism
ACR
- Achondroplasia
- Congenital hypothyroidism
- Rickets
Achondroplasia - pathogenesis
Autosomal Dominant
FGFR3 gene defect in chromosome 4p
Achondroplasia - C/F
- Rhizomelia (short proximal limbs)
- Large Head with Prominent forehead
- Hydrocephalus due to small F. Magnum
- Spinal cord stenosis d/t reduced interpeduncular distance
- Trident Hand
- Champagne Glass Pelvis
Causes of small trunk dwarfism
SMall TV
- Spondyloepiphyseal Dysplasia
- Mucopolysacchridosis
- TB spine (Potts spine)
- Vertebral anomalies
US:LS Ratio normal
Birth - 1.7:1
3-5yrs - 1.3:1
5-7 yrs - 1:1
7-10yrs - 0.9:1
Proportionate short stature /dwarfism causes
CAM of GCN ( gaming channel network)
- C - Cushing’s syndrome
- A - Acquired hypothyroidism
- M - Malnutrition
- G - Growth Hormone deficiency
- C - Chromosomal anomalies
- N - Normal Variant
CHARGE Syndrome
A/with choanal atresia C- Coloboma of eye H- Heart defects A- Attesia(choanal) R- retardation (growth) G- genitourinary anomalies E- Ear Anomalies
