Test 3 Flashcards
Define infant mortality rate, what does it mean to our health care system?
Infant Mortality Rate (IMR) –number of liveborn infants
who die within first year of life per 1000 births
• Used as indicator of health status and quality of life of populations
• More than twice as high in American blacks as in whites
Where is the United States based on their IMR?
U.S. IMR is higher than many other industrialized countries
What two major indicators predict an infant’s future health status?
Birth weight and length of gestation
Ways of reducing LBW
Poverty • Minority status • Lack of access to health care • Inability to pay for health care • Poor nutrition • Low education level • Unsanitary living conditions • Drug use, smoking, alcohol
National goals for the health of both mom & baby (where are we doing well and where are we
not doing so well?
Objectives focusing on mortality
• Objectives addressing risk factors
• Objectives on incidence of developmental disabilities and
folate intake
Small decline in infant mortality rates for Hispanics, whites,
blacks
• Incidence of neural tube defects has decreased
• Increase in breastfeeding by women in all racial and ethnic
groups
• Continued decline in smoking during pregnancy
No progress or reverse direction:
• Maternal death for African-American women
• Iron deficiency
• Low birth weight
• Proportion of women receiving prenatal care
Recommended weight gains during pregnancy
underweight - 28-40
normal -25-35
overweight 15-25
obese 11-20
Risk of adolescent pregnancy
• Pregnant adolescents are nutritionally at risk and require
intervention
• Risks include hypertension, iron-deficiency anemia,
premature birth, stillbirth, LBW infants, prolonged labor`
Nutrition assessment in pregnancy (three categories)
Preconception Care dietary measures Clinical measures • Anthropometric measures • Laboratory values
Growth of the infant and ways of measuring and interpreting growth
Relative to body weight, infants need more than twice as
much of many nutrients
Breastfeeding recommendations & promotion (also know the barriers)
Helps protect against infection
• Protects against allergy development
• Favors normal tooth and jaw alignment
• Breastfed babies are less likely to be obese
• Convenience and lower cost
Barriers:
• Lack of knowledge or experience among mothers and
family members
• Lack of instruction from health care professionals
• Non-supportive hospital practices
• Lack of work place accommodation
Information provided by hospitals and health care
professionals – Baby Friendly Hospitals
• WIC campaign - Peer counseling among low-income
women
• Best Start project – focus groups
Infant feeding do’s and don’ts
Whole cow’s milk not recommended during first year of life
• Breast milk or iron-fortified formula during first six months
• Begin adding solid foods at six months
Top nutrition related problems in infants
Iron Deficiency
• From continuing breast feeding after six months without
iron supplementation
• Use of cow’s milk earlier than recommended can lead to
deficiency
• Food Allergies
• Less prevalent in breastfed infants
• Introduce foods singly to detect any allergies
Programs for moms and infants
Title V Maternal and Child Health Program
• Medicaid and EPSDT
• Health Center Program
• Healthy Start Program
Ways to improving the health of mothers and infants
Insure quality nutrition counseling is available and accessible
• Use MCH money
• Ask voluntary health organizations to help
• Worksite health promotion programs
• Adolescent pregnancy counseling in the classroom and individually
Insure quality nutrition counseling is available and accessible
• Use MCH money
• Ask voluntary health organizations to help
• Worksite health promotion programs
• Adolescent pregnancy counseling in the classroom and individually
How are children & adolescents doing on the Healthy people 2010 objectives?
Weight status of children reflects a trend for the worse Prevalence of overweight among children and adolescents of all ethnic groups has increased substantially Prevalence of growth retardation among low-income children decreased Percentage of elementary and secondary schools offering low-fat choices for breakfast and lunch increased substantially Proportion of students in grades 9-12 participating in daily physical education has increased slightly Incidence and prevalence of diabetes have increased
What are children and adolescents eating, how do their diets rate? How do they change with
age
Dietary quality of most children aged 2-17 is less
than optimal
Children in poor families are more likely to have
diet rated as poor or needs improvement
Quality continues to decline into adolescence
with decreased vegetables, and increased solid
fats and soft drinks
Children aged 6-11 have lower-quality diet than
younger children
Reduced fruit, milk and sodium HEI scores – more
fast food and salty snacks
Dietary quality of most children aged 2-17 is less
than optimal
Children in poor families are more likely to have
diet rated as poor or needs improvement
Quality continues to decline into adolescence
with decreased vegetables, and increased solid
fats and soft drinks
Children aged 6-11 have lower-quality diet than
younger children
Reduced fruit, milk and sodium HEI scores – more
fast food and salty snacks
What influences this age group’s eating habits?
Fewer families eat meals together Dining out – schools, fast foods, convenience stores, vending machines, worksites Adolescents – convenience and peer pressure are main influence on choices Media influence on food choices and body image
Childhood obesity, what is happening? How do we define/diagnosis it?
Percentage of overweight children has nearly doubled Percentage of overweight adolescents has nearly tripled Obesity – BMI at or above 95th percentile on CDC growth chart Overweight – BMI at or above 85th percentile on CDC growth chart
Other nutrition-related problems of children and adolescents.
associated with hyperinsulinemia, hypertriglyceridemia, reduced HDL cholesterol increased risk of cardiovascular disease, type 2 diabetes, sleep apnea, gallbladder disease, psychosocial dysfunction, orthopedic problems Undernutrition Iron deficiency and iron-deficiency anemia Blood lead level Dental caries High blood cholesterol Eating disorders
What are the nutritional risks of children with special needs? What can we do to help
Are at increased nutritional risk because of feeding problems, metabolic problems, drug-nutrient interactions, decreased mobility, altered growth patterns Need interdisciplinary approach to feeding strategies Legislation and community-based programs have helped
Know the food assistant programs for this age group. Which are run by the USDA & DHHS
School Breakfast Program
• After School Snack Program
• Special Milk Program for Children
• Summer Foodservice Program
What things can discourage nutrition program participation at school? What are some of the
trends of today’s children/adolescents?
Sugar-sweetened beverages Low-nutrient, energy-dense foods Absence of fruits and vegetables Snack bars School stores Vending machines A la carte foods Shortened lunch times
How can we make the schools and healthful environment?
Limitations on competitive foods, vending Nutrition and health education Limit fried and high-fat foods in cafeterias Wellness policy in school districts
Know some of the nutrition education programs and private sector programs offered for this
age group.
Fresh Fruit and Vegetable Program • Expanded Food And Nutrition Education Program • Team Nutrition • Coordinated School Health Program • EAT SMART. PLAY HARD. • Farm to School Programs • Fruits & Veggies – More Matters • Best Bones Forever • Fuel Up to Play 60 • Kids Caf
What are the demographic treads of this age group? What do we see happening? How does it
affect health care?
Americans are living longer than ever before • Good nutrition can retard and ease the aging process in many significant ways • Proportion of elderly is increasing dramatically • Health care demands will increase
