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Propeudeutics of pediatrics > Feeding > Flashcards

Feeding Flashcards

(65 cards)

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1
Q

What are the three types of feeding?

A

Artificial
Natural
Mixed

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2
Q

What are the phases of development of milk and mammary glands in a female?

A
  1. Mammogenesis
  2. Lactogenesis
  3. Galactopoiesis
  4. Automatic phase
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3
Q

What happens during the phase of mammogenesis?

A

In mammogenesis, during the first 2-3 months of pregnancy, the following happens:

  • hypertrophy of parenchymal tissue + reduction in interstitial tissue
  • increase in the #alveolar cells
  • lengthening and branching of the milk ducts and milk sinuses
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4
Q

What happens during the stage of lactogenesis?

A
  • milk production, in response to prolactin
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5
Q

When is the greatest amount of prolactin produced?

A

At night

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6
Q

What hormones play a part in lactation?

A
  • insulin
  • cortisol
  • prolactin
  • oxytocin
  • parathyroid and thyroid hormones
  • growth hormone
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7
Q

What characteristics of the female breast indicate good lactation?

A
  • breasts adopt cylindrical shape
  • pigmented areola
  • breast temp > axillary temp by 1 deg C
  • venous system is well developed
  • milk is released from the breasts in a continuous flow
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8
Q

What are important rules during breastfeeding to ensure integrity of the breasts is maintained and to prevent pain during feeding?

A
  • infant should grasp areola and nipple
  • the chin of the infant should touch the breast firmly
  • the mouth should be wide open and the lower lip turned out
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9
Q

There are four classes that can be used to categorise the severity of deficiency of milk in a breastfeeding infant, what are they?

A

I - 25 % deficient
II - 25 -50 % deficient
III - 51-75 % deficient
IV - >75 % deficient

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10
Q

What is galactorrhoea?

A

Galactorrhea is the sporadic evacuation of milk from the mother’s breast in two possible ways:

  • milk leaks from unused breast
  • milk leaks from both breasts between and during feeds
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11
Q

What is agalactia?

A

The absence of breast milk

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12
Q

Breast-milk varies in composition of fats, proteins, carbs and calorie content. What are the three groups of breast milk?

A
  • colostrum (milk post-partum after a few days)
  • transitive milk (for baby)
  • mature milk
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13
Q

How does the composition of breast milk differ between the beginning and end of feeding?

A
  • early milk is richer in proteins, lactose (blue hue)

- late milk is richer in fats (white shade)

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14
Q

What is taurine? What is its significance in breast milk?

A

Taurine is an aminosulfonic acid, heavily rich in breast milk; it’s made up of cysteine and methionine
- Taurine promotes the assimilation of fats for forming brain and retinal tissue in the newborn; only adults synthesise taurine, and hence it can only be acquired from breast milk

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15
Q

What are the fat-soluble vitamins?

A

A, D, E, K

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16
Q

What is the function of B-lactose in breast milk?

A

B-lactose has the following functions in breast milk:

  • intestinal absorption
  • makes an (partially) acidic environment
  • increase ‘bifidum bacteria
  • vitamin B synthesis
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17
Q

What are the water-soluble vitamins?

A 
B1 - thiamine
B2 - riboflavin
B3 - niacin
B5 - pantothenic acid
B6 - pyridoxine
B7- biotin
B9 - folic acid
B12 - cobalamin
C
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18
Q

What is vitamin B1 also known as? What is its function?

A
  • Vitamin B1 = thiamine

- its function is as a coenzyme in decarboxylation reactions (as pyrophosphate)

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19
Q

What is vitamin B2 also known as? What is its function?

A
  • Vitamin B2 = riboflavin

- its function is as a coenzyme (FAD, FAM)

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20
Q

What is vitamin B6 also known as? What is its function?

A
  • Vitamin B6 = pyridoxine

- Its function is to serve as a coenzyme

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21
Q

What is vitamin B12 also known as? What is its function?

A
  • Vitamin B12 = cobalamin/cyanocobalamin

- its function is for normal folate metabolism and DNA synthesis

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22
Q

What is the function of vitamin C?

A

Vitamin C is used in mnay redox reactions and hydroxylation of collagen

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23
Q

What is the function of biotin (vitamin B9)?

A

Biotin serves as a cofactor in carboxylation reactions

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24
Q

What is the function of folate (vitamin B9)?

A
  • transfer of 1-C units in DNA synthesis
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25
What is the function of pantothenic acid?
- Incorporate into CoA
26
How does a child acquire vitamin E?
Breast milk
27
What should be the ideal ratio of Ca:P in a mother's breast milk?
2:1
28
Good quality lactation and breast feeding have a positive effect not only on the child, but also on the mother's health. How so?
- helps reduce uterus, to prevent bleeding and secondary anemia - prevents pregnancy naturally in the short-term - staves off pathological development in breast
29
How many times does a newborn feed daily?
7 times - ca. 3 hour intervals
30
How does the feeding pattern of a newborn change?
- beginning of 2-3 months, the child feeds 7 times a day, ca. every 3 hours - ends of 3 months, child feeds 6 times a day ca. 3.5 hours - 4-5 months, the child feeds 5 times a day ca. every 4 hours
31
What is the function of zinc?
It is a cofactor of many enzymes ie. oxidases
32
What is the function of selenium?
- component of glutathione peroxidase | - antioxidant with vitamin E
33
What is the function of iodine?
needed to make thyroid hormones (T3, T4)
34
What is the function of iron?
prosthetic group for Hb and other enzymes
35
What is the function of copper?
component of the following enzymes: - cytochrome c oxidase - dopamine hydroxylase - tyrosinase - lysyl oxidase - collagen cross-linking enzymes
36
What does deficiency of vitamin B1 (thiamine) cause?
- wet and dry beriberi - korsakoff syndrome - wernicke syndrome
37
What is Wernicke's encephalopathy?
Wernicke's encephalopathy is a triad of: 1. ocular abnormlaities 2. altered gait 3. confusion
38
What is the difference between Wernicke's encephalopathy and Korsakoff's syndrome?
Korsakoff's syndrome is an extension of Wernicke's encephalopathy, with an extension of the patient making up stories
39
There are 8 B vitamins. What are they?
``` B1 - thiamine B2 - riboflavin B3 - niacin B5 - pantothenic acid B6 - pyridoxine B7 - biotin B9 - folic acid B12 - cobalamin ```
40
What is meant by the term weaning?
Gradually tapering the child off of milk and introducing them to food.
41
When is solid food first officially introduced to children?
4-6 months old / when body weight is double that at birth
42
What are the contraindications to breastfeeding for mothers?
- psychiatric diseases - skin diseases - kidney, heart failure
43
What are contraindications to breastfeeding in infants?
- hemolytic anemia - extremely premature child - inherited storage diseases ie. maple syrup disease
44
Almost all mothers encounter reduced breast milk volume during breastfeeding. This is known as a lactational crisis. How can this be overcome?
- feed the baby at night, since most prolactin is released at night - alternate between both breasts
45
What is meant by the hungry crisis?
The hungry crisis is a temporary reduction in milk volume at months 3, 7, 12
46
What is hypogalactation? What causes it?
Hypogalactation is reduced secretion of milk from the breasts. It is caused by: - extensive post-natal bleeding - sick mother - medicines, stress - late delivery
47
During breastfeeding the milk can be divided into 2 categories, what are they?
1. Foremilk | 2. Hindmilk
48
A mother's breast milk can be divided into colostrum, transitive milk and mature milk. How do these differ in composition?
- colostrum contains highest amount of proteins - mature contains lowest amount of proteins - colostrum contains lowest amount of fats - mature milk contains highest amount of fats - colostrum contains lowest amount of carbohydrates - mature milk contains highest amount of carbohydrates
49
Breast milk can be divided into colostrum, transitive milk and mature milk. How do these differ in calorie content?
- colostrum is the most calorific | - transitive and mature milk are ca. half the calorie value of colostrum
50
What is so special about colostrum?
[protein] in colostrum is the highest before applying the baby to the breasts
51
How does the protein composition differ between breast milk and cow's milk?
In terms of protein, cow's milk and breast milk differ in the ratio of albumin-globulin:caseinogen, with the cow's milk having the highest ratio
52
What are the characteristic features of fats in breast milk?
- fats are easily absorbed from breast milk due to presence of lipase (infants do not have a fully developed pancreas - the site of lipase production - and hence outflow of bile does not happen - low [saturated fatty acids] in breast milk vs cow's milk - high [unsaturated fatty acids] like linoleic acid, arachidonic acid
53
What is the composition of vitamins in breast milk?
vitamin A and K are higher in colostrum than mature milk
54
What is the most common food that children first receive when they are weaning?
vegetable puree
55
During the weaning rpocess, solid foods are gradually introduced into the child's system. During the initiation stage of weaning, at which feeding does the child receive food?
2nd feed
56
How long does it take to introduce the first weaning food?
1 month
57
When are vegetable oils and fats introduced into the diets of infants during weaning?
6 months
58
It takes approximately a month for a child to adapt to their first weaning food. If the weaning food is porridge, the composition changes, how so?
- initially porridge will be half milk and half water - then porridge will be full milk - finally porridge will be full milk and have added fats
59
It is possible to introduce food too early into a child's system and this can have profound effects on the child. What do these effects include?
- reduced formation of breast milk, since the baby is sucking less - anemia, secondary to reduced iron absorption - intestinal/digestive problems
60
The first weaning food replaces the 2nd milk feed. what about the second weaning food?
The 2nd weaning food replaces the 4th feed and the 1st weaning food replaces the 2nd feed
61
Artifical feeding is very common in newborns, for several reasons. In this type of feeding the child received special prepared mixes in two possible forms, what are they?
- Adapted (humanised) - non-adapted These groups can be divided further into sweet and sour mixes
62
What are adapted mixes?
Adapted mixes are mik formulas derived form cow's milk - they are nutritionally beneficial because they contain carbohydrates, protein, fats and minerals (in a similar composition to breast milk) necessary for development
63
Why are adapated sour milk mixes favourable over their sweet counterparts?
- protein is curdled - stimulate function of salivary glands - more easily digestible/ increased absorption in intestines - promote secretion of pancreatic trypsin and intestinal enzymes - stimulate bile secretion - normalise metabolism - induce hematopoiesis
64
What are non-adapted (humanised) milk mixes?
Non-adapted dairy mixes are food mixes from infants prepared from fresh/dry animal's milk without processing.
65
What is mixed feeding?
Mixed feeding is a type of feeding where the child receives natural milk and artificial milk for the first 6 months of his life.

Propeudeutics of pediatrics (7 decks)

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