Postnatal Nutrition Flashcards
Nutrition after pregnancy
important to help mother recover and to provide enough nutrients and energy for breastfeeding -> healthy diet is recommended and foods that provide enough protein, iron and calcium -> increase of 300-400 calories/day, drink plenty of water, avoid excess caffeine/alcohol and nicotine (can pass through breast milk) -> iron supplements may be needed to prevent iron deficiency anemia if serum ferritin is <= 70 micrograms/L
Failure to thrive
slow weight gain -> downward crossing of two or more major percentile lines using the standard growth charts -> management may require a coordinated multidisciplinary approach
Failure to grow
may be due to malnutrition, infections, digestive problems, hormonal problems, chronic heart, kidney or lung diseases
Malnutrition
11-12 million children die each year before the age of 5, this is a contributory factor in 60% -> even milder forms have effects on cognitive function -> 183 million weigh less than they should for age
Nutritional vulnerability in infancy
caused by rapid rate of growth, small body stores, functional immaturity impedes adaptation to both over and undernutrition
Kwashiorkor
edema in face, hands and feet, poor wound healing (insect bites) -> initially grows well and develops many diseases due to low immune system
Starchy diets
needs to significantly increase the energy intake to satisfy the child’s energy needs -> infections also have a huge effect
infant can only take a relatively small amount of fluid so it must contain the maximal amount of nutrients per milliliter -> this nutrient is very important -> the content of this in milk is affected by diet
Fats
important factor in ensuring proper growth and development of the infant -> the content of this in milk is not affected by diet -> casein (indigestible), alpha-lactalbumin (highly digestible -> half of enzyme that makes lactose) and gamma globulins
Protein
40% of intake in the form of lactose
Carbohydrates
fat soluble in milk not affected by diet of the mother, water soluble is affected by the diet
Vitamins
provides the baby with all that it needs for the first 6 months of life -> preferred nutrition for this period
Breast feeding
similar across all cultures -> on average it is 750g -> this suggests that it is not significantly affected by diet
Breast milk production
infant formula has high protein nitrogen, no non-protein nitrogen sources, lower carbohydrates (lactose), slightly lower fat content, same calories as other options of infant feeding
Infant formula
has high non-protein nitrogen sources (25% of nitrogen -> urea, free AA and small peptides), high carbohydrates (lactose) and fats (fatty acid types depends on mother’s diet), contains trophic factors (increases cell replication for normal gut function)
Breast milk
reduced vulnerability to gastro-intestinal and respiratory infections, less likelihood that the baby suffers constipation, diarrhea and wind, suppression of ovulation in mother, better cognitive development due to higher omega 3 FA, decreased mother’s risk of early breast CA
Advantages of breast feeding
introduction of solid foods into infants diet becomes increasingly important at this age (growth curve will begin to taper down in breast feeding alone)
6 months of age
timing of introduction should reflect the pace of development, usually no need to introduce early ( it should be a gradual process (allow gut growth and secretions to develop)
Complementary feeding
6x the risk of dying from diarrhea at 0-5 months, 2x from pneumonia at 0-5 months, 2x from both diarrhea and pneumonia at 6-11 months
Bottle fed
potential downside of breastfeeding in areas of the world where these infections are common -> can be transmitted transplacentally and through breast milk
HIV infection
increase chance of infection with HIV than if never breast fed or exclusively breast fed (protective effects in breast milk)
Mixed feeding (loses advantage of protective effects of breast milk)
varies to meet demands of infant -> first diluted satisfies thirst and then the milk becomes more rich
Composition of breast milk
10% of breast milk protein which is not absorbed (keeps on the surface to repel bacteria)
IgA
iron binding protein that has a direct antibiotic effect on bacteria
Lactoferrin
has strong influence on the type of bacteria that inhabit the intestinal tract
Lysozyme
encourages the growth of lactobacilli which are helpful bacterial that can inhibit many of the disease causing gram negative bacteria and parasites
Growth factors
based on modified cow’s milk or soya protein -> enriched with vitamins and minerals -> can provide nutritional requirements for up to 6 months
Infant formula
used to prevent hemorrhagic disease of the newborn -> may cause major internal bleeding
Vitamin K
should be started at 6 months for breastfed infants and 1 year for babies fed on infant formula
Vitamin drops (A, C and D)
should receive multivitamins and iron earlier
Preterm and low birth weight infants
a child will be on 3 meals, snacks and breast feeds by the end of the first year -> chronic nutritional deficiency leads to failure to thrive -> causes of nutritional deficiency in industrialized countries -> refusal of solids/high intake of liquids, intake of low-density foods (healthy diet), behavioral eating problems, physical illness -> high mortality rates in this age group (nutritional demands are highest in this age group)
Preschool children (1-5 years)
effects of eating habits (low intake of micronutrients due to eating habits: fast food, less fruits and vegetables) -> overweight and obesity -> eating disorders (anorexia nervosa, bulimia)
School children and adolescents
