Paediatrics/Infant Feeding Flashcards
When should breast-feeding begin?
Ideally, right after birth
What are the intrinsic benefits of breast milk compared to infant formula? What additional benefits may be conferred to a breast-fed
- Composed of macro- and micronutrients specific and ideal for human babies
- breast milk provides maternal antibodies (decreasing infections)
- is less expensive, and more environment friendly
Other benefits
- Decreased incidence of SIDS, lymphoma and other malignancies, obesity, diabetes, and allergies/eczema
- increased IQ scores
What additional benefits of breast-feeding may be conferred to mothers?
- Contracts uterus
- helps in returning to prepregnancy weight
- delay of menses
- “Feel-good” hormone release (oxytocin)
- decreased incidence of breast cancer, ovarian cancer, and osteoporosis later in life
How often should a breast-fed infant feed?
8-12 times every 24 hours until 4 months of age
How long should each feeding last?
10-15 minutes on each breast
What is the current recommendation regarding breast-feeding in the developed world if the mother is HIV+?
Baby should be formula-fed because of risk for infection via breast milk.
How can we promote breast-feeding?
Education pre- and postdelivery about the benefits of breast-feeding, reinforcement, and early lactation training (proper latch-on techniques)
The American Academy of Pediatrics recommends breast-feeding for how long?
Exclusive breastfeeding for 6 months; then breastfeeding with appropriate complementary foods from 6 months to at least 12 months
What can be used as a supplement or alternative to breast milk?
Formula (cow-milk or soy-milk based)
The standard formula for a term infant has how many kilocalories per ounce?
20 kcal/oz
How many ounces should a formula-fed baby feed in the first few months of life?
On average , 2-3 oz every 3-4 hours by 2 weeks of age, progressively increasing to 5-6 oz every 3-4 hours at 6 months of age
How do you know if a baby is eating enough?
Plotting weight, length, and head circumference on a development curve
According to the American Academy of Pediatrics (AAP), what is the recommended daily intake of vitamin D for all infants, children, and adolescents?
400 International Units (IU) per day
What is the AAP’s recommendation regarding vitamin D supplementation for breastfed and partially breastfed term infants?
The AAP recommends supplementing with 400 IU of vitamin D beginning in the first few days of life and continuing until the infant consumes at least 1 L per day (or 1 quart per day) of vitamin D-fortified formula or whole milk (though whole milk should not be used until after 12 months of age).
According to the AAP, what is the lower limit of normal for 25-hydroxyvitamin D concentrations in infants and children?
20 ng/mL
What is the USPSTF recommendation regarding screening for iron deficiency anemia?
There is insufficient evidence to recommend for/against routine screening for iron deficiency anemia in asymptomatic children aged 6-12 months (I recommendation). However, the USPSTF recommends routine iron supplementation (ironfortified formula or iron supplements) for asymptomatic children aged 6-12 months who are at increased risk for iron deficiency anemia (B recommendation).
What are the sequelae of iron deficiency anemia in children?
Psychomotor and cognitive abnormalities, poor school performance
What are risk factors for iron deficiency anemia?
Prematurity, low birth weight infants
How early can you introduce solid foods to babies?
4 months
For how long may a baby’s nutritional needs be met by formula or breast milk alone?
6 months
What are the signs that a baby is ready to eat solid foods?
Head control, loss of extrusion reflex, hunger that continues after consuming 32 oz of formula or nursing ten times per day
What types of food are appropriate for an infant beginning to eat solids?
How should these foods be introduced?
- Food that is soft and easy to digest (rice cereal with iron).
- Slowly and no more than one new food every 3 days (helps monitor for allergic reactions)
Do all babies spit up? Why?
- Generally, all babies will spit up at some time during feeds.
- Babies have low esophageal sphincter tone, and caretakers frequently overfeed or inadequately burp them.
When is reflux in babies worrisome?
- Spitting up happens all of the time
- weight gain is inadequate
- reflux causes the baby to cry incessantly, cough, or wheeze
What should be the primary source of nutrition for a baby up to 1 year of age?
Breast milk or formula (solids are only a supplement)
What foods should be avoided in babies less than 12 months old?
- Potent allergens such as egg whites
- cow milk
- honey
- nut butters
- citrus fruit
- seafood (especially shellfish)
Which of food can cause infant botulism poisoning?
Honey
What types of food should be avoided in children less than 3 years old?
Anything that may cause the toddler to choke (peanuts, whole grapes, raw vegetables that snap into hard chunks, etc)
What teeth are usually the first to erupt? When (on average)?
Mandibular central incisors
6-8 months
What is the most common chronic childhood disease?
Dental caries
At what age should caregivers begin to clean a child’s teeth?
As soon as the first teeth appear, a child’s teeth can be cleansed with a cloth (later advancing to a soft toothbrush).
What is the USPSTF recommendation for fluoride supplementation?
The USPSTF recommends oral fluoride supplementation at recommended doses to preschool children older than 6 months of age whose primary water source is deficient in fluoride (B recommendation).
Which water sources have inconsistent levels of fluoride?
Well water and bottled water
Beginning at what age should a child’s toothpaste contain fluoride?
2 years
Why is it important for young children to only use a small amount of fluorinated toothpaste and learn to rinse well and spit out as much toothpaste as possible when they are done brushing?
Swallowing large amounts of fluoride can cause a child’s permanent teeth to have white spots.
