7.1. Gastroenterology - Feeding Babies Flashcards

1
Q

What are the Recognised Phases of Childhood?

A
  1. Neonate - < 4 Weeks Old
  2. Infant - < 1 Year Old
  3. Toddler - 1-2 Year Old
  4. Pre-School - 2-5 Year Old
  5. School Age
  6. Teenager / Adolescent
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2
Q

What leads Growth in:

  1. Infants?
  2. Children?
  3. Pubertal?
A
  1. Infant - Nutrient Led
  2. Child - Growth Hormone Led
  3. Pubertal - Sex Steroid Led
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3
Q

What is Birth Size / Weight Dependent on?

A
  1. Maternal Size
  2. Placental Function
  3. Gestation - 95% of weight gained in 20-40th weeks
  4. Average Term Infant = 3.3Kg
    Note - More than Genetic Make-Up
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4
Q

What is Energy Needed for in Infnats?

A
  1. Physical Activity
  2. Thermogenesis
  3. Tissue Maintenance
  4. Growth (about 35% of intake in Infants)
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5
Q

What are the Infant Nutrition Risks?

A

Undernutrition:

  1. Dependent on Carer
  2. High Demand for Growth / Maintenance
  3. Low Stores (Fat and Protein)
  4. System Immaturity
  5. Rapid Brain Development
  6. Frequent Illness
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6
Q

What is the Energy Requirement of an Infant?

A

95-110Kcal / Kg / Day:

  1. 40-50% Carbohydrates
  2. 35-40% Fat
  3. 10-15% Protein (1.5-2g / Kg / Day)
  4. Macro- / Micro-Nutrients
  5. Major / Trace Elements
  6. Vitamins
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7
Q

What is the Average Weight Gain per Month for:

  1. 0-3 Months?
  2. 3-6 Months?
  3. 6-9 Months?
  4. 9-12 Months?
A
  1. 200g
  2. 150g
  3. 100g
  4. 50-75g
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8
Q

What are the Types of Feeds for Infants?

A

Milk - Exclusive Feed for 4-6 Months:
1. Breast - is Best
2. Formula - Standard (Cows Milkd Based) / Specialised / Hydrolysed Protein or Amino Acid or Nutrient Dense
Note - Cows Milk is not the Main Drink till > 1 as it contains no Iron

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9
Q

Why is Breast the Best form of Milk to Give the Child?

A
  1. Nutritionally:
  2. a) Easier to Digest Protein and Lipid
  3. b) Less Allergenic
  4. c) Low Renal Solute Load
  5. d) Ca:PO4 / Iron / LCP Fa’s
  6. Improves Cognitive Development
  7. Reduces Infection - Macrophages / Lymphocytes / Interferon / Lactoferrin / Lysozyme / Bifidus Factor
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10
Q

What is used when Breast Feeding is not Possible?

A

Cow Milk Based Formula:

  1. Pre-Term Formulae (SMA Gold Prem)
  2. Nutrient Dense Formulae (Infantrini)
  3. Easy Digest (Aptamil) - for “Minor Digestive Problems”
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11
Q

What is the Feed Choice for Cows Milk Protein Allergy?

A
  1. Extensively Hydrolysed Protein Feeds - Nutramigen LGG
  2. Amino Acid Based Feeds - Babies with Severe Colitis / Enteropathy / Symptoms on Breast Milk
    Note - 1. is First Line, 2. is over prescribed and Expensive
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12
Q

When Should Lactose Free Milks be used?

A
  1. Lactose Intolerance - Not Allergy, Reduced Levels of Enzyme
  2. Secondary Lactose Intolerance
  3. Short Loved Condition - Post Gastro-Enteritis
    Note - Confused with Cows Milk Protein Intolerance - Lactose Free Milk are not CMP Free
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13
Q

What are the Indications for using Soya Milk?

A
  1. Milk Allergy when Hydrolysed Formulae Refused
  2. Vegan Families, if not Breast Fed
  3. Consider for Children ? 1 year still on Milk Free Diet
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14
Q

What is Weaning?

A

Transition from Milk to Mixed Diet

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15
Q

When does Weaning occur?

A

Starts at about 5-6 months:

  1. Smooth Purees Cereal / Fruit / Veg / Meat
  2. Lumps from 6-7 Months
  3. Cup from 7 Months
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16
Q

Why does Weaning occur?

A

For Nutritional / Developmental Changes:

  1. Milk needed for Energy Requirement is too Great
  2. Source of Vitamins / Trace Elements
  3. Digestion and Absorption of Nutrients from other Animals / Plants is part of our Make-Up
  4. Encourage Tongue and Jaw Movements in Preparation for Speech and Social Interaction
17
Q

What is a common Vitamin Deficiency in Scotland?

A

Vitamin D - Can lead to Rickets - So babies are Supplementes in Bottles

18
Q

What are Toddler / Pre-School Nutrition Issues?

A
  1. Learning to Feed Self / Find Food
  2. Picky Eaters / Excess Milk
  3. Dependent on Carer
  4. Frequent Illness
19
Q

What are School Ages Nutrition Issues?

A
  1. Learning to be Independent
  2. Chronic Disease
  3. Obesity
20
Q

What are Adolescent Nutritional Issues?

A

Independent, Puberty, Eating Disorder