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Lifecycle Nutrition > Pregnancy, Lactation, Infants > Flashcards

Pregnancy, Lactation, Infants Flashcards

0
Q

Pica

A

Craving/eating something normally not considered food

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1
Q

Problems that can occur in pregnancy

A

1) taste and smell change
2) nausea/vomiting
3) heartburn
4) constipation/hemorrhoids
5) taking herbs
6) vegetarian/vegan
7) food safety

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2
Q

Pagophagia

A

Craving ice, used to be freezer ice

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3
Q

Geophagia

A

Eating dirt, almost always clay

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4
Q

Amylophagia

A

Eating laundry starch

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5
Q

Tricophagia

A

Eating string and hair

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6
Q

Two deficiencies common in people with pica

A

Iron and zinc

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7
Q

Ways to help with nausea and vomiting

A

1) separate solids and liquids
2) have dry foods near bed and eat before getting up
3) small frequent meals
4) separate odors from food - leave during cooking, chill meals
5) if from supplements try a different brand

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8
Q

Drugs that can help with nausea

A

1) Vitamin B6 - 10-25 mg every 8 hrs
2) Ginger - 1 g/day for 4 days
3) multivitamin mineral tablets if were taking prior to pregnancy
4) diclectin - prescription drug

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9
Q

Ways to help with heartburn

A 
Less caffeine
Don't lay down after eating
Sleep at an angle
Avoid spicy foods
Don't eat too much at one time
Wear loose clothing
Don't go to bed on a full stomach
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10
Q

Why heartburn during pregnancy

A

GI tract relaxes to absorb more nutrients and sphincters also relax allowing reflux

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11
Q

What meds can dietitians recommend for heartburn

A

Only TUMS - patient needs to see MD for anything else

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12
Q

Why constipation during pregnancy

A

Because GI tract relaxes

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13
Q

Things to help with constipation

A

Fiber
Fluids
Exercise

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14
Q

What is ok for dietitian to recommend for constipation

A

Only Metamucil - no drugs - need to talk to MD for drugs

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15
Q

How to avoid hemhorroids

A

Avoid constipation

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16
Q

When is an herb considered a drug

A

If it has an effect - must talk to an MD

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17
Q

Problems vegetarians/vegans can have during pregnancy

A

Low iron

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18
Q

Why is food safety important during pregnancy

A

Because immune system is decreased

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19
Q

Two bacteria of concern during pregnancy

A

1) Listeria monocytopenes - will cross placenta and cause birth defects - 25% of people have the antibody - comes from delis (slicer) and recommendation is to cook deli meat
2) toxoplasma gondii - from cat box, undercooked meat, unwashed fruits/veggies - causes blindness, seizures and termination

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20
Q

Listeria Monocytogenes

A

Bacteria of concern during pregnancy - 25% of people have the antibodies (ie, have been exposed)

Effects: crosses placenta and can cause birth defects and can cause termination

Causes: deli meats (contaminated slicer) , raw/undercooked eggs, raw meat, unpasteurized milk, soft cheeses (Brie, quest fresco) unless made with pasteurized milk

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21
Q

Toxoplasma gondii

A

Bacteria of concern during pregnancy

Effects: mental retardation, blindness, seizures, termination of pregnancy

Causes: cat litter box, undercooked meats, unwashed fruits/vegetables

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22
Q

Shoulder dystocia

A

Medical emergency that is often a complication of LGA babies

Head comes out but shoulder gets stuck, umbilical cord can get cut off

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23
Q

Placenta abruption (abruptivo placentae)

A

Placenta tears away from the uterus and causes mom to hemhorrage - can see bleeding or not - blood can pool behind the uterus

If placenta tears away prematurely and greatly mom can die and nutrients, oxygen can be restricted to the baby

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24
Q

Exercise during pregnancy recommendation

A

30 min/day

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25
Q

Benefits of exercise during pregnancy

A
  • reduce constipation
  • reduce backaches
  • reduce bloating
  • sleep better
  • decrease risk of gestational diabetes
  • better mood/positive outlook
  • better able to cope with labor
  • get back in shape easier
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26
Q

Conditions effecting pregnancy

A

Obesity
Bariatric surgery
Hypertensive disorders
Diabetes

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27
Q

Obesity during pregnancy

A
  • weight loss not recommended during pregnancy because it disproportionately affects baby
  • higher risk of gestational diabetes, hypertensive disorders, LGA babies, baby growing to be obese
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28
Q

Bariatric surgery and pregnancy

A
  • common to get pregnant after because physical and mental barriers removed
  • causes enormous malabsorption of nutrients - need a good nutrition assessment and biomarkers
  • advised to wait 1-2 yrs before getting pregnant after bariatric surgery
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29
Q

Hypertensive disorders of pregnancy

A
  • is a major killer of women worldwide

1) chronic hypertension
2) gestational hypertension
3) preeclampsia
4) eclampsia

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30
Q

Chronic hypertension

A

When you come into pregnancy with HBP

  • Definition - greater than or equal to 140 diastolic or 90 systolic
  • Treatment - same as before pregnancy - would have sodium restriction
  • would me more likely to have preeclampsia and eclampsia, also placenta abruptiva
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31
Q

Gestational hypertension

A
  • definition - when you develop HBP in the second half of pregnancy (after 20 weeks)
  • similar to preeclampsia/eclampsia but without protein in the urine
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32
Q

Preeclampsia 4 warning signs

A

Hypertension
Edema
Protein in urine
Insulin resistance

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33
Q

Effects of preeclampsia

A
  • Coagulation problems - blood clotting everywhere (liver, brain)
  • mom is more likely to have hypertension and diabetes later in life
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34
Q

Preeclampsia treatment

A
  • No one knows cause - thought maybe placenta not embedded in uterine wall and body rejects
  • only cure is to get rid of the placenta - deliver baby
  • disease usually goes away as soon as baby is delivered
  • restricting sodium does not work
  • antioxidants, fish oils, folic acid have no effect
  • calcium and vitamin D supplements help IF the mom is low helps
  • using multivitamin before pregnancy helps
  • evidence that diet high in plant food helps
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35
Q

Eclampsia

A

Development of preeclampsia into seizure and imminent death

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36
Q

Consequences of uncontrolled diabetes on pregnancy

A

Preeclampsia, stillbirth, baby grows up to have hypertension and diabetes

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37
Q

When pregnant women tested for diabetes

A

Beginning of pregnancy - checking for undiagnosed DM

At 24-28 weeks - checking for gestational diabetes with oral glucose tolerance test

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38
Q

How pregnant women can manage diabetes with diet

A
  • low simple sugars
  • low glycemic index foods
  • carb counting (10-20% breakfast; 20-30% lunch; 30-40% dinner; 30% snack)
  • calories for normal weight gain
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39
Q

Two types of twins

A

1) identical (monozygotic) - after fertilized the egg splits

2) fraternal (dizygotic) - two eggs released and both fertilized

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40
Q

Weight gain for twins

A

Normal weight - 37-54 lbs
Overweight - 31-50 lbs
Obese - 25-42 lbs

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41
Q

Research shows for multiples

A
  • folic acid is important
  • morning sickness increases
  • time in OB’s office increases
  • placenta previa, preeclampsia and gestational diabetes increases
  • C-sections increase
  • low birth weight increases
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42
Q

Most common cause of children with HIV/AIDS

A

Vertical transmission from mom to fetus during pregnancy or from mom to infant during breastfeeding

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43
Q

Chance baby gets HIV/AIDS from mom with no med care

A

25-35%

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44
Q

Chance in US that baby gets HIV/AIDS from mom with med care

A

Less than 1%

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45
Q

Breast feeding recommendation if mom has HIV/AIDS

A

Don’t breast feed

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46
Q

Two types of laws about testing for HIV when pregnant

A

1) opt in - doc must tell you you should get tested but you have to sign a paper to have the testing
2) opt out - you get tested unless you sign a paper saying no

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47
Q

Colorado’s law on HIV testing for pregnant women

A

Opt out

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48
Q

Treatment during pregnancy and after baby is born if mom has HIV

A
  • mom on combo of HIV drugs for entire pregnancy
  • mom gets IV with anti-viral drug called AZT when goes into labor
  • baby gets AZT orally for 6 weeks after birth
  • baby gets tested 14-21 days; 1-2 m; 4-6 m
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49
Q

HIV drugs teratogenic

A

Certain are teratogenic for first trimester but not after - so have to see doc right away if might be pregnant

Protease inhibitors increase chances of hypoglycemia and diabetes

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50
Q

When c-section recommended for mom with HIV?

A

Only if mom not treated and has a high viral load

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51
Q

US policy on breastfeeding

A

All babies should be breastfed from birth to 1 year, and breastfed exclusively for the first 6 months. Breastfeeding can continue as long as mutually beneficial from mom and baby.

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52
Q

When does breast milk become nutritionally inadequate?

A

1 yr

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53
Q

Breast feeding and obesity

A

Breastfed babies are less likely to become obese

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54
Q

IBCLC

A

International Board Certified Lactation Consultant

  • must be reimbursed for services under ACA
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55
Q

Lobules

A

Milk producing glands made of alveoli and eventually empty in multiple openings at nipple

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56
Q

Areola

A

Dark circle around nipple

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57
Q

Ducts are lined with

A

Myoepithelial cells

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58
Q

2 stages of breastfeeding

A

1) milk production

2) milk letdown (ejection)

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59
Q

Letdown

A

Myoepithelial cells contract and send milk towards the nipple

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60
Q

2 hormones involved in milk production

A

Prolactin and oxytocin

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61
Q

Prolactin function and location

A

Causes alveoli to make breastmilk.

Prolactin produced in hypothalamus and stored in anterior pituitary

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62
Q

Oxytocin function and location.

A

Responsible for letdown; causes uterus to contract, controls bleeding, helps uterus to return to normal size; “love” (bonding) hormone.

Produced in hypothalamus and stored in posterior pituitary

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63
Q

When has breast anatomy matured enough that breast feeding possible

A

16 weeks pregnant

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64
Q

When in pregnancy can breast feeding start and why

A

After placenta is gone because placenta puts out a hormone (maybe estrogen) that suppresses milk production

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65
Q

Lactogenesis means

A

Process of producing milk

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66
Q

3 stages of Lactogenesis

A

1) birth to 2-3 days: colostrum
2) 2-5 days: milk comes in
3) 10 days - mature milk

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67
Q

Colostrum is

A

First milk, yellow and thick due to beta-carotene. Filled with antibodies and growth maturation factors. Most important milk for the baby.

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68
Q

Watery and bluish milk

A

Mature milk

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69
Q

Foremilk and fat content

A

First milk that comes out. Will be lower in fat.

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70
Q

Hindmilk and fat content

A

Milk that comes out after foremilk. Has higher fat content.

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71
Q

Engorgement and how to treat

A

When milk comes in and overshoots. Best think to do is feed the baby so the milk amount can stabilize.

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72
Q

Amount of additional kcal required for breastfeeding

A

623 kcal. But mom should pull some of that from fat laid down when pregnant. Recommendation is to eat an extra 500 kcal/day for the first 6 m and an extra 400 kcal/day for 2nd 6 m.

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73
Q

Nipple care

A

Do not toughen
Clean with water - no soap or alcohol
Let air dry

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74
Q

Only things that should be put on nipples

A

Breastmilk and lanolin

75
Q

How milk production is regulated

A

Supply and demand

76
Q

Why babies should not have cow’s milk or goat’s milk before 1 year

A

Forms hard curd in stomach and can cause GI bleeding and cause baby to lose iron through stools.

Also breastmilk is much higher in fat and cholesterol - breastfed babies modulate their cholesterol better possibly because breastmilk had cholesterol.

No vit C in cow’s goat’s milk because they have the enzyme to make their own.

Cow and goat milk too high in sodium and calcium - kidneys cannot handle the solute load

Goat’s milk low in folate and babies develop folate deficiency

Also human milk has more lactose than any other animal on the planet, which is good because IQ data and creation of acidic environment that gives immunity protection.

Iron is low in all 3 milks but the form in human milk is highly bio available (lactoferrin - very available to humans but not to bacteria)

77
Q

Correlation between lactose and IQ

A

Direct correlation between amount of lactose in milk and your IQ.

78
Q

Likelihood that babies have lactose intolerance

A

Extremely rare - only in profoundly retarded - intolerance is usually temporary and will pass.

79
Q

Why breastfed instead of formula

A

1) balance of nutrients is perfect for humans
2) breastmilk is dynamic - composition of milk changes with time
3) isosmotic - exact same as human blood - water in formula is hypotonic and causes hyponaturemia (kidneys cannot hold Na so it gets eliminated with urine)
4) low curd tension
5) increased EPA and DHA
6) minerals are in special forms

80
Q

Benefits of breast feeding for baby

A

1) growth factors
2) decreased mortality (necrotizing enterocolitis)
3) decreased SIDS
4) decreased acute infections (ear infections)
5) decreased chronic diseases (IBS, celiac, leukemia, asthma, atopic dermatitis, eczema
6) decreased obesity - 4% reduction per month breastfed
7) cognitive benefits
8) analgesic effects - circumcision
9) economic benefits
10) less work missed due to baby being sick

81
Q

Breastfeeding benefits for mom

A

1) oxytocin - decrease in bleeding and size of uterus
2) delayed fertility - but not reliable form of bc
3) self-confidence and bonding for new mom
4) decreased risk of ovarian and breast cancer (if young and breastfeed for a year)
5) decreased rheumatoid arthritis

82
Q

Colostrum nutrition compared to mature milk

A

More protein, sodium, potassium and chloride

Less cholesterol and fat (because putting out immunoglobulin)

83
Q

Kcal in mature milk

A

20 kcal/ml

84
Q

Thrush

A

Infection in nipple - intensely painful

niastatin in baby’s mouth and on nipple will make it go away

85
Q

How to tell if baby is getting enough milk

A

1) 6 wet diapers per day and 3-4 mushy poopy diapers
- no brick dust (means dehydrated)

2) weigh baby before and after eating
3) weigh baby and see if growing ok

86
Q

Signs baby wants to eat

A

Rooting, figiting, mouth. Crying is too late.

87
Q

How often should new baby eat

A

8-12 times/day, about every 3 hours

Should be baby led unless baby is too sleepy

88
Q

Baby weight loss after birth

A

No more than 7% and should be back up to birth weight by 1 week

89
Q

What supplements are needed if breastfed

A

Vit K shot at birth for all babies to stop bleeding

Vit D if Mom is African American or Muslim wearing traditional garb - 500 IU given starting with 2nd month for rickets

Iron and zinc after 6 months

90
Q

Mom’s diet affect on breastmilk

A

Affects quantity not quality unless a really poor diet

91
Q

What components of breastmilk fluctuation with mom’s diet

A

Fat and water soluble vitamins.

92
Q

Does breastfeeding help mom with weight loss

A

Found not to be true

93
Q

How much weight recommended for mom to lose when breast feeding

A

Up to 1 lb/week - any more might affect quantity of breastmilk

94
Q

Exercise recommendation while breastfeeding

A

Exercise ok but lactic acid may make milk taser sour to baby

95
Q

Water recommendation for breastfeeding moms

A

2.7 L/day - some can be from fruit and veg

96
Q

Definition infant colic

A

Baby cries 3 or more hours per day without a medical reason

97
Q

Folk reason for colic

A

Thought to be something in mom’s diet that affects gas and cramping in baby - and it is treated that way. Eliminate cow’s milk, onion/cabbage/broccoli, and chocolate

98
Q

What influences breast feeding in the US

A

Healthcare system and formula companies

99
Q

What is the baby friendly hospital initiative

A

Global initiative by WHO and UNICEF (both part of UN) that is aimed at stopping hospitals from being obstacles to breastfeeding by certifying hospitals as baby friendly if they meet 10 rules

1) written policy where breastfeeding is the norm
2) train staff with skills to promote breastfeeding
3) inform all pregnant women of benefits of breastfeeding
4) help initiate breastfeeding within an hour after birth
5) show how to breastfeed and how to maintain breastfeeding when mom and baby are separated
6) no other food or drink for baby unless medically necessary
7) rooming in available
8) encourage breastfeeding on demand
9) no pacifiers or artificial nipples
10) foster breastfeeding support groups after mom gone from hospital

100
Q

Underlying hold up for there not being more baby friendly hospitals

A

No free formula - hospital has to pay for it

101
Q

Number of baby friendly hospitals in US and Colorado

A

243 in US and 3 in Colorado

102
Q

Where women can get help with breastfeeding

A

1) La Leche League - totally volunteer organization where moms who have breastfed will help new moms
2) IBCLC - have to be in healthcare profession, have 90 hrs of accredited education, a certain number of practice hours, and take an exam

103
Q

Potential breastfeeding problems

A

1) flat or inverted nipples
2) let down failure
3) hyperactive let down
4) engorgement
5) plugged ducts
6) mastitis
7) maternal meds
8) herbs
9) alcohol
10) smoking
11) marijuana
12) caffeine
13) jaundice

104
Q

Plugged ducts

A

Milk forms clog in one of the tubes, breast gets red, hot and painful. Treatment is massage, warm compress, position baby different, pump to empty breast

105
Q

Mastitis

A

Same symptoms as plugged duct but plus fever and flu symptoms. Is med emergency (can result in abscess/surgery) and can come from untreated plugged ducts. Doc may give an antibiotic, but you have to feed/pump, continually empty the breast

106
Q

Alcohol when breastfeeding

A

Is not a contraindication but goes through to milk in same concentration as in your blood.

Will be in your milk until completely sober. Can pump and dump.

107
Q

Smoking and breastfeeding

A

Not a contraindication - smoking and breastfeeding is better than not breastfeeding

108
Q

Marijuana and breastfeeding

A

Is a contraindication

109
Q

Caffeine and breastfeeding

A

Goes through to milk but equivalent of 3 cups is considered ok.

Baby doesn’t process caffeine well and could make the baby crabby

110
Q

How breastmilk changes for preterm infants

A

More carbohydrates and less fat

111
Q

Breastmilk benefits for preterm babies

A

Decreased infections
Less necrotizing enterocolitis
Less nosocomial infections
Much better vision

112
Q

What to do if breastmilk not enough to support fast growth of preterm baby

A

Human milk fortifier for increased calories and nutrients

113
Q

Contraindications to breastfeeding

A

1) mom has HIV - 20% transmission rate - not recommended in US, Canada and Western World
2) galactesemia - baby cannot metabolize lactose
3) active TB
4) T-lymphocyte virus I and II
5) illicit drugs (including marijuana)
6) chemotherapy
7) radiotherapies

114
Q

Rules for storing breastmilk

A
  • 6-8 hours at room temp
  • in fridge up to 5 days
  • in freezer inside fridge - 2 weeks
  • in separate freezer - 3-6 months
  • in deep freeze - 6-12 months
115
Q

How to thaw frozen breastmilk

A

In fridge or under cold running water

116
Q

Feeding infant rules

A
  • breastmilk or formula only until 4-6 m
  • need iron and zinc at 6 m
  • fortified infant cereal (rice) by tradition at 4-6 m, then other cereals, veg, fruit, meats
  • one new thing for 3-5 days with spoon
  • by 1 yr eating same as family in a high chair
117
Q

Developmentally baby needs to be able to do this to eat

A

Hold up head and move tongue

118
Q

Only things that go in bottle

A

Breastmilk, formula or water

119
Q

Why babies should not have juice

A

Don’t need it, setting up for obesity and tooth decay

120
Q

What foods baby can’t have for first year

A

Honey - botulism

Corn syrup - maybe botulism

Cow’s milk - but foods with cow’s milk ok

121
Q

When should baby stop bottle

A

1 year

122
Q

Mom’s saliva ok in baby’s mouth?

A

No. Causes tooth decay.

123
Q

When switch from measuring length to measuring height

A

2 years

124
Q

Which growth charts used for 0-2 yrs

A

WHO

125
Q

Which growth charts used for 2-20 yrs

A

CDC

126
Q

What weight and length are considered normal for 0-2 years?

A

Between 5th and 95th percentile

127
Q

Kids should stay on same growth chart line except

A

Mom’s size trumps genetics - baby with small mom might jump in size after born

128
Q

Why do babies sometimes have a weight jump at 1 yr

A

Parents have not gotten rid of the bottle and are giving 8 bottles/day of formula

129
Q

Only way you can tell if child 0-2 is over or underweight

A

Weight-for-length growth chart

Overweight if over 95th%

underweight if below 5th%

130
Q

Sign of acute malnutrition

A

Weight

131
Q

Sign of chronic malnutrition

A

Length

132
Q

On back of growth charts for kids 2-20 yrs is

A

BMI for height -NO RELATION to adult BMIs

133
Q

Categories for BMI for height for kids 2-20 yrs

A

Below 5% - underweight
Between 5-85% - normal weight
85-95th - overweight
Over 95th - obese

134
Q

Adiposity rebound

A

Point on BMI for age growth chart where line stops sloping down and starts to slope up (BMI increasing with age). The earlier it occurs, the more likely you are to be obese

135
Q

Types of infant formulas

A

Standard:

(1) milk-based
(2) soy-based
(3) hydrolyzed

Specialized

136
Q

Why soy formulas not recommended for almost all infants

A

Have phytoestrogens (hormones), phytates and oxalates that cause calcium to be poorly absorbed which affects bone production

137
Q

Why soy formulas should never be used with a preemie baby

A

Has negative growth affects and preemie babies need to have huge growth

138
Q

Possible situations when soy formula would be appropriate

A

Baby with galactosemia (cannot digest lactose) - very rare - or a vegan mom that wants baby to eat vegan

139
Q

Hydrolyzed formulas are

A

Cow milk based but protein is broken down into chunks or individual AAs. Some have MCTs instead of regular fats

140
Q

Uses for hydrolyzed formulas

A

Babies with true food allergies.

3D shape of the proteins is what causes the allergy, and the proteins are broken down.

141
Q

Specialized formulas used for

A

Babies with a particular medical condition (eg, PKU) and sometimes preemie babies. Need a prescription.

142
Q

Need for special shelf formulas

A

No. These are designed for parents and do not help babies.

143
Q

Why lactose is good for babies

A

Helps develop gut bacteria

True lactose intolerance is rare. Parents mistake transitional intolerance for a true problem but should ride it out.

144
Q

Forms of formula

A

Ready to feed
Concentrate - mix 1:1 with water
Powdered - 2 oz water + 1 scoop formula

145
Q

How to prepare powdered formula

A

2 oz water per scoop of formula

Water in bottle first, then add level scoops. Can heat (no microwave) or not.

146
Q

Calories in formulas

A

Standard 20 kcal per ounce

Preterm 24 kcal per oz (used sometimes in hospital) and 22 kcal per oz (sometimes for when leave hospital)

147
Q

What kind of water to use with formula

A

Debate, but tap water usually fine if municipal supply

Problem if too many nitrates/nitrites in water (if under 6m can bind irreversibly to hG and turn baby blue)

Problem if you boil water may concentrate heavy metals or get heavy metals from the pan

148
Q

Problem with concentrating formula

A

Can cause dehydration and death

149
Q

Problem with wanting baby to finish whole bottle

A

Same as force feeding as is giving overheating cues. Should always have some formula left over and routinely throw away - don’t save because of saliva bacteria

150
Q

Why not put baby to bed with bottle

A
  • Last mouthful of food backs up into ears and causes ear infections
  • causes tooth rot - “nursing mouth”
  • causes habit hard to break
  • should hold baby when feeding to bond
151
Q

Why not prechew baby’s food or let your saliva in baby’s mouth

A

Inoculates baby’s mouth with bacteria and increases tooth decay

152
Q

Infant calorie needs

A

First 6 m -108 kcal/kg

2nd 6 m - 98 kcal/kg

153
Q

Infant protein needs

A

1st 6 m - 2.2 g/kg
2nd 6 m - 1.6 g/kg

Protein isn’t a problem if baby is getting enough kcal to grow from breastmilk or formula

154
Q

Infant fat needs

A

Do not restrict fat until 2 yrs - brain needs fat

155
Q

Infant cholesterol needs

A

Do not restrict cholesterol. Evidence that babies that have more cholesterol do better with regulating it later in life.

156
Q

Important fats added to formulas

A

EPA
DHA
linoleic acid
Alpha- linolenic acid

157
Q

Where do babies digest fat and why?

A

In their stomach (not small intestine like adults). Use special lipase for breastmilk.

158
Q

Difference between triglycerides in human milk and triglycerides in other milk

A

Palmitic acid is always in position #2 in breastmilk but in position #1 or #3 in other milk. Stomach enzyme needs palmitic acid in position #2.

159
Q

Infant fluoride requirements

A

1st 6 m - 0.1 mg/day
2nd 6 m - 0.5 mg/day

Don’t supplement fluoride - can be toxic and cause brown teeth. Most get from water supply.

160
Q

Infant vitamin D needs

A

Seeing rickets in black women and Muslim women with traditional dress - due to sun exposure.

Formula fed - don’t supplement
Breast fed - 400 IU/day

161
Q

Infant sodium issues

A

Hyponaturemia - Immature kidneys cannot hold sodium so they pee it out if too much water, or if vomiting/diarrhea

No water - only breastmilk for formula for first 6 m. Feed through sickness or if you can’t feed give pedialyte, not water.

Beware of giving water-like liquids - manzanilla tea and coca cola

162
Q

Infant iron requirements

A

Fe drops off around 4 m and need baby cereal

Term babies are ok with iron for first 4 months - preemies are not because missed iron loading.

Fe deficiency affects IQ

163
Q

Infant lead warnings

A

Babies like lead around 1 year because it tastes sweet. Be ware of old paint, pipes, toys and religious objects from Mexico.

164
Q

Food texture by when

A

By 8 m baby should be having lumps and texture so can learn to chew

165
Q

Foods that infants can choke on

A

White bread, peanut butter, hard foods, round foods

  • should mash or cut in thin strips
166
Q

Only foods babies can’t have for first year

A

Honey and cow’s milk

167
Q

Colic def

A

Crying 3 hrs/day for 3 days/week for 3 weeks - 1954 definition

Usually early in first 6 m

168
Q

Colic helps

A

Swaddle
Simethicone drops
Probiotics - lactobacillus reuteri
Fennel seed extract

Gripe water - no evidence that it works
Dicyclomine - works but causes death

169
Q

Helps for infant diarrhea/constipation

A

No karo syrup - causes osmotic diarrhea
No prune juice

Exercise baby or give 1-2 spoons of prune baby food

Apple juice might cause diarrhea because high in sorbitol - sugar alcohol

170
Q

Failure to thrive

A

Most common cause is abuse/neglect

Have to do calorie counts

171
Q

Allergies in infants

A

Common and usually grow out

Thought is to feed the allergy foods early if family allergy, not avoid.

172
Q

Kids with special needs called

A

“children with special healthcare needs”

173
Q

Colorado program for children with special needs

A

HCP - health care program for people with special needs

174
Q

Definition premature

A

Born earlier than 37 weeks

175
Q

At what age do premature babies do fine and not need special help

A

After 34 weeks

176
Q

Survival chance of 2 lb baby

A

88%

177
Q

What gestational age are docs usually unable to help a preemie baby

A

24 weeks

178
Q

What do preemie babies usually die from

A

Lung problems - lack of surfactant

179
Q

What can be done for a preemie baby’s lungs

A

Inject mom with steroid before giving birth that forces the baby’s surfactant to mature

Give artificial surfactant to a baby on a respirator

180
Q

Problem with ventricles (holes in brain) and preemie baby

A

Ventricles have not yet attached to walls of brain and hardened. The blood vessels in the ventricles will start breaking and bleed into the brain.

181
Q

Problems with babies born earlier than 34 weeks

A

(1) lung injuries
(2) cerebral palsy
(3) mental retardation
(4) injury to intestines - necrotizing enterocolitis

182
Q

Two types of jaundice in newborns

A

Pathologic - caused by disease in baby - usually happens right after birth

Physiologic - normal - 24 hrs to 5 days - due to HG needing to turn into bilirubin and be cleared

183
Q

Kernicturus

A

Bilirubin over a certain level - damaging to brain

184
Q

Two types of physiologic jaundice

A

Breastmilk jaundice - if bilirubin over a certain level need to stop breastfeeding

Breastfeeding jaundice (non) - caused by failure of breastfeeding. Baby needs to clear bilirubin and meconium. Needs to feed more and poop more.

Lifecycle Nutrition (4 decks)

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