Nutrition Flashcards
Breastmilk at the START of feeding
watery
HIGH lactose and protein
FOREMILK
Breastmilk as feeding progresses until towards the end of feeding
creamy
HIGH fat
HINDMILK
Stages of Lactation
Colostrum (first 0-7 days)
- PROTEIN rich
- rich in IgA
- high in IgG/protective factors - lactoferrin, lysozyme
Transitional milk
- b/w colostrum and mature milk
- rising levels of macronutrients
Mature milk
- D10-14 of life
- colostrum content + high fat and lactose
Involutionary milk
*produced when breastfeeding frequency decreases
Whey to casein ratio in mature human milk
3:2
Breastmilk has MORE compared to formula milk EXCEPTIONS
Iron
Vitamin D
Vitamin K
Infants condition PEAK at 4 mos and resolve mostly at 12 mos and nearly all at 24 mos
(+) postprandial regurgitation, signs of esophagitis (irritability, arching, choking, gagging, feeding aversion), failure to thrive
GERD
Definitive test for GERD
Esophageal pH probe
Diagnosis for GERD
Barium study of esophagus and upper GIT (poor sensitivity and specificity)
Contraindications to Breastfeeding
Galactosemia Septicemia Active TB Breast cancer Malaria Substance abuse Severe neurosis or psychosis HIV
Vesiculobulbous, ECZEMATOUS, dry scaly or PSORIAFORM lesions, symmetric PERIORAL, SACRAL and PERIANAL areas
Zinc Deficiency
Chronic diarrhea, Stomatitis Glossitis Irritability superinfection
Generalized scaly
dermatitis
Alopecia
Thrombocytopenia,
Failure to thrive
Essential Fatty Acids
Edema, erythema and
burning of sun exposed skin on the face neck hands on butterfly distribution dermatitis around the neck
Niacin (Pellagra)/Vitamin B3
Diarrhea
Dementia
Niacin
Alopecia w/ neurological symptoms
Biotin/Vitamin B7
Follicular hyperkeratosis
Xerosis, Night blindness
Vitamin A
Follicular hyperkeratosis
Perifollicular erythema and hemorrhage
Bleeding swollen gums
Vitamin C
Retinal pigments
Bone
Tooth and Epithelium development
90% BA in breast milk
prematures more vulnerable
Vitamin A
Bone formation
Rickets and Osteomalacia
Content in breastmilk DEPENDS on maternal status
Vitamin D
RBC hemolysis in premature infants
Anti-oxidant
Vitamin E
VKDB
Prevented by prophylaxis
Vitamin K
Affects bones and joints
Perifollicular hemorrhages
Gum swelling
Scurvy
Vitamin C
Stores are adequate for 6 mos
Content in breastmilk NOT affected by maternal status
Iron
Zinc
Content in breastmilk DEPENDS on maternal status
Iodine
Beri beri
B1 (Thiamine)
Nonspecific (cheilosis, glossitis)
B2 (Riboflavin)
Pellagra
B3 (Niacin)
Microcytic anemia + estrogen pills
B6 (Pyridoxine)
Alopecia + neurologic changes
B7 (Biotin)
Megaloblastic anemia
B9 (Folic acid)
Megaloblastic anemia + Neurologic deficit
B12 (Cobalamin)
Bowlegs or knock knees Caput quadratum, Periosteal osteoid Craniotabes Ping pong ball sensation Rachitic rosary, pigeon chest Harrison groove
Vitamin D – RICKETS
White line on end of shafts
Scorbutic rosary beads
Vitamin C
Pellagra
Casal necklace
Pellagrous glove and boots
Glove and boots lesion
Vitamin B3 (Niacin)
Perleche
Vitamin B2 (Riboflavin)
Bitot spots
Xerosis conjunctivae
Xerosis cornea
Vitamin A deficiency
Hyperostosis
Absence of metaphyseal changes
Vitamin A intoxication
