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PH3611- Clinical module > Child and infant nutrition > Flashcards

Child and infant nutrition Flashcards

1
Q

Nutrition in infancy

A
  • Infancy= 1st year
  • High nutritional requirements
    • Birth weight doubled at 6 months & tripled at 1yr
    • Length increases by 50% in 1st year
  • Optimal nutrition is important due to
    • Low nutritional stores
    • Rapid growth & development
    • Immature body systems
    • Effect on long term health
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2
Q

Infant nutritional requirements

A
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3
Q

Average feeding patterns

A
  • Demand feeding is recommended
  • Infants over 2.5kg- 8 feeds 3 hourly
  • Infants over 3.5kg - 6 feeds 4 hourly
  • Infants over 4k- 5 feeds 4 hourly (night feed dropped)
  • Once solids established usually have 3-4 larger feeds per day
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4
Q

Average weight gain

A
  • Weight loss in 1st 5-7 days of life
  • If >10% needs further assessment
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5
Q

Growth charts

A
  • Allow comparison between a child’s measurements and normal range of measurements
  • Weighted at birth, 2 weeks, 6-8 week check, at immunisation and if there are weight concerns
  • Would need further assessment if
    • Weight crossed 2 centile spaces
    • Weight was below 0.4th centile or above 99.6th centile
    • If there was more than 2 centiles difference between weight and length centiles
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6
Q

Choices: infant nutrition

Breast v formula

A
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7
Q

Breastfeeding

Advantages of breast feeding to infants

A
  • Ideal nutritional composition, high bioavailability
  • Protective- reduced infection, allergic disease
  • Psychological/bounding benefits
  • Long term health benefits
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8
Q

Breast feeding

Advantages of breast feeding to mother

A
  • Inexpensive & convenient
  • Psychological/bonding benefits
  • Faster uterine contraction & loss of pregnancy wgt
  • Long term health benefits
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9
Q

Initiating and supporting breastfeeding

A
  • First feed soon after birth/skin to skin contact
  • Good positioning and attachment
  • Baby-led/ demand feeding, no treats, dummies or othe oral diet
  • Support- health visitor, national childbirth trust, midwives
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10
Q

Infant feeding survey

A
  • 1 in 3 mothers still breastfeeding at 6 months in 2010 compared with 1 in 4 mothers in 2005
  • Initial breastfeeding rate increased from 76% in 2005 to 81% in 2010
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11
Q

Infant formula

A
  • Most infants have formula at some point
  • Must comply with detailed UK regulations
  • Compositions vary little between brands
  • Manufactures may add non-nutritient factors e.g. Long-chain polyunsaturated fatty acids, nucleotides and probiotics
  • Preparing formula
    • All formula- 1 level sccop add 30 ml of boild and cooled water
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12
Q

Standard infant formula

A
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13
Q

Alternative formula

A
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14
Q

Specialist formula

A
  • Preterm formula should usually be stopped at 6 months corrected age
  • The growth of an infant on a high energy formula should be monitored by a health care professional and stopped when appropriate growth achieved
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15
Q

Complementary feeding

A
  • Breastfeeding is the best form of nutrition for infants. Exclusive breastfeeding is recommended for the 6 months of an infant life
  • The introduction of solid food should commence no later than 6 months of age but not before four months
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16
Q

Inappropriate complementary feeding

Early

A
  • Immature gut
  • Poor head control/immature swallow
  • Increased food allergies in atopic families
  • Increased renal solute load
  • Increased risk of infections
  • Potential for faltering growth
17
Q

Inappropriate complementary feeding

A
  • Difficulty starting after 9 months
  • Food refusal and feeding difficulties
  • Nutritional deficiencies e.g. Fe, Vit D and faltering growth
  • Difficulties associated with progressing from puree to lumps
18
Q

Complementary feeding

A
  • Exclusive breastfeeding until solid foods are introduced is optimal
  • Infants develop at different rate so should be managed individually
  • Parental feeding decisions need to be supported
  • Children up to 5 yrs should be given a vit A,C and D supplement
19
Q

Complementary feeding

Signs an infant may be ready

A
  • They can sit up and hold their head steady
  • Chewing fists
  • Showing interest in others eating
  • Hungry between mild feeds
  • Stopped sleeping through the night
20
Q

Foods and drinks to be avoided

A
  • Sugar
  • Salt
  • Honey
  • Cows milk
  • Eggs
  • Nuts
  • Gluten
  • Adult drinks
21
Q

Formula and milkInf that are not recommended

A
  • Infants formula
    • Soya formula before 6 months
    • The only non-cows milk b ased formula approved in Nannycare
  • As a main drink
    • Any milk except formula
    • Oat milk in 3yr old
    • Rice milk 5 yr old
22
Q

Pre school nutrition 1-4 yr

A
  • Over 1 yr should be eating family foods
  • High energy requirements but small stomach
  • High fibre, low fat ‘ healthy eating is inappropriate
  • Often regular meals and snacks
  • Toddlers eat to appetite- develop understanding of feeling hunger and satisfaction
  • Don’t encourage to finish plate
23
Q

Healthy start

A
  • Vouchers- to help buy some basic foods
    • Cows milk, plain fresh or frozen fruit and veg
    • Infant formula (not follow-on formula)
  • Healthy start vitamins
    • Coupons to swap for free healthy start vitamins
    • Pregnant / breastfeeding
    • Children up to 5
24
Q

Vitamin supplementation

A
  • All children up to age 5 should have a vitamin supplement of A&D
    • E.g. healthy start vitamins, Abidec drops
  • Breastfed babies should start at 1 month
  • Formula fed babies should start at 6 months
25
Q

School age children 5-11

A
  • Parents have control over food choices
  • Appropriate to introduce lower fat, higher fibre diet
  • Preference for sweet, salty and energy-dense foods
  • Need to motivate to try new foods
  • Increasing obesity rates due to ease of energy dense food and sedentary lifestyle
26
Q

Adolescence 12+

A
  • Low fat, high fibre diet recommended
  • They take control over food choices
  • Peer pressure can influence food choice
  • Higher protein and calorie requirements due to growth
  • High calcium and iron requirements- would recommend increase dietary intake not a vitamin/minearal supplement
  • Sedentary lifestyle and easy access to food increasing obesity rates
  • More focus on body image
27
Q

Fe deficiency anaemia

A
  • Common in early childhood
  • Consequences: frequent infections, poor weight gain, developmental delay and behaviour disorders
  • Caused by: early introduction cows milk (As main drink), over dependence on milk (replaces Fe rich food), Focus on sweet not savoury weaning foods, fussy eating
  • Prevention: Encourage Fe rich foods, reduced dependence on milk, can use toddler formula
  • Treatment: Often prescribed Fe supplementation
28
Q

Vit D deficiency

A
  • Vit D deficiency is an increasing issue in all age ranges
  • Vit D controls the absorption of calcium
  • Deficiency: <25nmol/L of 25-hydroxyvitD
  • Deficiency can cause: rickets, hypocalcemia
  • Main source: sunlight
  • Food: oily fish, fortified foods e.g. margarine, infant formula, some cereals and yoghurts
29
Q

Obesity

A
  • In 2012/12: 33% of 10-11 yr olds and 22% of 4-5 yr olds were overweight or obese
  • Excessive weight gain is due to imbalance of energy in v energy out
  • Consequences
    • Increased severity of asthmaRespiratory conditions
    • Social discrimination can lead to
      • Low self-esteem< lower quality of life and lower academic acheivement
    • Increased risk of type II diabetes- atherosclerossi& CVD
30
Q

Obesity

A
  • No easy solution, need family centred approach
    • Encourage physical activity
    • Limit sedentary behaviour
    • Encourage family wide healthy eating and activity

PH3611- Clinical module (28 decks)

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