chapter 11 - infants

Question 1

infants react to parents emotions feeding

Answer 1

if food forced on child, withheld until uncomfortable, or presented in tense manner child reacts w tension and unhappiness

if parent relaxed an infant mealtime can be pleasurable for both parent and child

Question 2

feeding on demand

Answer 2

prevent hungers frustration can bring and help bay realize their needs are being met

newborn have more frequent feeings but normal is approx every 4 fours when baby 2-3 mo old

Question 3

baby body weight in first month

Answer 3

6 months - body weight double
year - triple

Question 4

how many cal per kg during firsy year

Answer 4

98-108 cal per kg (2-3x adult requirement)

Question 5

protein for infants

Answer 5

6 months - 2.2g per kg

6-12 months - 1.6g per kg

Question 6

water for infant

Answer 6

1.5mL of water per cal

Question 7

what supplement should nebworbsm be given

Answer 7

vitamin K

Question 8

what can excess vitamin A cause

Answer 8

damage to liver and bone abnormlaities

Question 9

what can excess vitamin D cause

Answer 9

damange to cv system and kidneys

Question 10

benefits of breast milk

Answer 10

temporary immunity
economial
nutritionally perfect
sanitary
sterile
easy to digest
doesnt cause gi disturances or allergic reactions
reduced load on kidneys (breast milk contains less protein and minerals than infant formula)

Question 11

how long shouold infants nurse

Answer 11

at each breast for approx 5-10 min each session

Question 12

when do growth spurts occur for infants

Answer 12

10 days, 2 weeks, 6 weeks, and 3 months

Question 13

how o know if infant is etting suffucient nutrients and caloreis

Answer 13

6 or more wet diapers daily
normal growht
one or two mustard colored bowel movements a day
breast beocmes less full during nrusing

Question 14

benefits of breasfeeding for mothers

Answer 14

uterus retur to nomral size
controls postpartum bleeding
helps mother more quickly return to prepregnancy weight
decreased risk of breast cancner and osteoporosis

Question 15

breastfeeding percents in 2011

Answer 15

newborn - 79%
6 months - 49%
12 months - 27%

Question 16

healthy people 2020 goals for breastfeeding rates

Answer 16

newborn - 81.9%
6 months - 60m6%
1 year - 34.1%

Question 17

how to hold baby during feeding

Answer 17

semi upright (less inclined to develop middle ear infection bc prevent fluid pool at back of throat and entering tubes from iddle ear)

burp babies during feeding to release gas and prevent regurgitation

Question 18

what is synthetic milk made from and who are they for

Answer 18

for infants extremely sensitive or allegic o infant formulas

made from soybeans

hypoallergenic formulas w predigested proteins are used for infants unable to tolerate all other tpyes of formulas

Question 19

how long does ready to feed/ mixed formula stay good

Answer 19

remain in bottle for an hour
fresh formula is good for 24 hours
ready-to-feed or from concentate is good for 48 hours

Question 20

why is it imortant to measure water when preparing formula

Answer 20

too little and there is too much protein and mineal for kidneys

too much water will dilute nutrient and calorie vlaue so infant will not thrive + brain edema or seizures

Question 21

why shouldnt children under 1 be given regular cows milk

Answer 21

protein is more difficult and slower to digest = gi blood loss

kidneys are challenged by its high protein and mineral content and dehydration and even damange to cns

fati s less bioavailable meaning its not absorbed as effcienly as in human milk

Question 22

what temp should formula be

Answer 22

cold, room temp, or warmed (lukewarm)

consistent temp

warm formula for feeding by placing bottlie in saucepan of warm water or a bottle warmer, shaking the bottle occassionally

Question 23

why shouldnt infants be put to bed w a bottle

Answer 23

saliva dimisniehs as infant falls asleep meaning milk bathes upper front teeth = tooth decay

baby bottle mouth or nursing bottle syndrome - upper jaw to protrude and lower to recede

feed infant bedtime bottle, cleanse teeth and gums, then put to slee

Question 24

how long should infant diet be limited to breast milk or formula

Answer 24

unitl 4-6 mo and then as primary food source until 1 yo

6 months if appropriate supplements of iron and vitmain d and possble vitamin c and fluoride

Question 25

why no early intro of solid food

Answer 25

gi tract and kidneys arent developed to handle solid food early introduction of sold foods many icnrease likelihood of overfeeding and development of food allegies

Question 26

how to know when god is reeady for solid food

Answer 26

physical ability to pull food into mouth rather than push tongue and food out of mouth (extrusion reflex) willingnessto particpate in rocess ability to sit up w support head nac neck control need for additioanl nutrients (over 32 oz of formula or nurse 8-10 x in 24 hours an is at least 4 months)

Question 27

how to introduce solid food

Answer 27

1 food is introduced every 4-5 days no allergi reaction = next food start w single grain cereal (iron-fortified oat, wheat, barley, or rice cereals, then introduction of mixed cereals) cooked and purred veg, then cooked and pureed fruits, egg yok, finely ground meat 2-4 tbsp of each variety of food per mezl btwn 6-12 mo toast, zwieback, teething biscuits, cherios in small amounts NO HONEY bc botulism after 6 months sip of water and less tan 4 oz 100% juice

Question 28

signs of hunger

Answer 28

fussy cry types of crying sucing on her hands moving head toward spoon reaching food sounds or words indiciating hunger cooking during feedings

Question 29

sign of fullness

Answer 29

play w nipple on bottle or breast look around and no long open their mouth to solid food push food away or clenching mouth playing w food and shaking head to signal no

Question 30

foods to avoid bc choking hazard

Answer 30

hot dogs, nuts, whole peas, grapes, popcorn, smal lcandies, small pieces of tough meat, raw veg

Question 31

what is weaning

Answer 31

first given food from a spoon then progresses as child shows interest in and abiltiy to drink from a cup child will ulitamtely discard bottle or refuse breast

Question 32

what charter to use for growth standard charts

Answer 32

WHO for younger than 2 CDC for 2-20

Question 33

premature infants

Answer 33

before 37 weeks sucking reflex not develpoed until 34 weeks so infants born earlier need parenteral nutrtion, tube feeds, or bolus feeding mothers breast milk for preemie bb has more protein, sodium , immunologic properites

Question 34

conersn with preemies

Answer 34

low birth wt, underdeveloped lungs, immature GI tact, inadequate bone mineralization, lack of fat reserves

Question 35

what is cystic fibrosis

Answer 35

inherited idesase body produces abn thick sticky secretions within cels lining organs uch as lungs and pancrease obstructs pancrease, preventing enzymes from reachign intestines to helpbreak down and digest food

Question 36

what percent of chidlren with CF have exocrine pancreatic insuffiency

Answer 36

85

Question 37

what is the recomended total caloric itnake of fat percentage?

Answer 37

35-40%

Question 38

infant w CF

Answer 38

digstive enzyme takein in capsule form during meals supplementation of fat-soluble vitamins during meal times water-miscible form of fat-soluble vitamins if normal levels cant be maintained w use of only fat-soluble vitamins malnourishment is common one oslution is nightime tube feedings

Question 39

infants with failure to thrive

Answer 39

determiend by plotting growth on standardized growth chart w considerations for genetic and ethnic variations

Question 40

what are the parameters affected when an infant fails to thrive

Answer 40

weight for hieght heigh and head circumernece slow development lack f physica lskills like rolling over, sitting, stnading and walking mental and social skilsl are also delayed babies grow most in first 6 nonths and this is when their brain udnergoes crucical development so could affect their livesc

Question 41

causes for failure to thirve

Answer 41

watered-down formula congential abnormalities AIDS lack of bonding child abuse neglect

Question 42

what is cleft lip and palate

Answer 42

baby lip or roof of palate doesnt develop properly maeks it difficult to feed or speak surgery to fix before 12 months

Question 43

cleft lip and feeding

Answer 43

cant cerate suction to pull milk from bottle or breast imperative to find correct feeding modality for cleft lip so nutrirtion eeds are met use special cleft nursrers or a Pigeon or Haberman special needs bottle

Question 44

what are inborn errors of metabolism

Answer 44

inabiltiy to metabolize specific nutrients due to mutations in the genes face common danger of damage to CNS bc abnormal body chemistry = mental retardation and retarded growth early diagnoss + diet therapy increases chance of preventign retardation can be discovered thorugh amniocentesis

Question 45

what is galactosemia

Answer 45

affect 1 in 30000 live births and caused by lack of liver enzyme transferase (convert galactose to glucose) lacks transferase = excessive amt of galactose when ignesting anything containing galactose = toxic levels = diarrhea, vomiting, edema, and abn liver fucntion, cataracts, galactosuria, mental retardation

Question 46

diet therapy for galactosemia

Answer 46

exclusion of anythign contianing milk during infancy parent feed bb lactose-free comemerically prepared formula and as they get old must avoid food, beverage, or med containing lactose take calcium, vitmain D, ribofavlin supplements if liberal diet then baked or process food sw small amoutns f milk

Question 47

what is phenylketonuria

Answer 47

lack liver enymzes phenyl aline hydroxylase which is necessary to metabolize phenylalanine infants become hyperactive, suffer seizures b tw 6-18 mo, mentally retarded public law requires new bon testing for phenylketouria 1 in 10,000-15000 births

Question 48

diet for PKU babies

Answer 48

Lofenalac infant formula (95% phenylalanine removd so only enoug for basic needs) monitor diets for cal and nutrient content + adjut as needs change bc most foods contain protein and phenylalaninew

Question 49

what are synthetic milk for older kids

Answer 49

Phenyl-free and PKU-1,2, or 3 used as beverages, in puddings, and baked goods special formula,p low=rpotein food lieflong adherence to diet si low monitor to avoid metnal retardation and to control hyperactivity and aggressive haviro

Question 50

what is maple syrup urine diseas

Answer 50

congential defect resulting in inabiltiy to metablize three amino acids: leucine, isoleucine, valine odor of uring 1 in 100,000-300,000 when infant ingest food protein, increased blood levels of these amino acds = ketosis hypoglycemia, apathy, and convulsions occur very early child can die from acidosis and could develop mental retardation

Question 51

diet therapy for maple syrup urine dsease

Answer 51

sufficient cal and nutrent w extremely restirced amt of leucine, isoleucine, and valine special formula and low-protein food dietar therapy thorughout life