Feeding Babies Flashcards
What are the three phases of growth in children?
Mediated by what?
- Infant - nutrition driven
- Children - growth hormone led
- Pubertal - sex steroid led
What is nutrition important?
- Important for not only growth but body structure, composition and function.
- Disease prevention - such as in breastfeeding.
- Primary treatment in metabolic disease, and exclusion diets in food allergy.
What are the factors contributing to babies birth size and weight?
- Maternal size
- PLacental function
- Gestation (95% of weight gain in 20-40 weeks)
What is nutrition needed for in children?
Energy is needed for:
- Physical activity
- Thermogenesis
- Tissue maintenance
- Growth
Energy requirement = energy expended + energy deposited in new tissue
Growth demands - about 35% of energy intake in infants but falls for rest of childhood
What are the risks in infant nutrition?
- Infants can rapidly become malnourished.
- Dependent on carer
- High demands for growth and maintenance
- infants 100kcal and 2g protein/kg/day
- adults 35kcal and 1g protein/kg/day
- Low stores (Fat and protein)
- Frequent illness
Generally outline the weight gain seen in children?
Double weight by 6 months and triple by 1 year.
After 1 year approx 2kg and 5cm/year until puberty
What are the benefits of breast milk?
- Nutritionally best for full-term (might not meet premature baby needs)
- Well tolerated
- less allergenic
- Low renal solute load
- Calcium Phosphate, LCP FAs
- Improves cognitive development
- Reduces infection.
- Macrophages, Lymphocytes, Interferon, Lactoferrin, Lysozyme
Some pros and cons of Formula milk
Pros
- No transition of BBVs/Drugs
- Provides Vitamin K
- Doesn’t need mother there
- Less jaundice
Cons
- no anti-infection properties
- Contaimination risk
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If breastfeeding is not possible what to do?
- Formulas
- All are cows milk based
- Composition are variable for age.
Types of Milk for babies?
- Milk is the exclusive feed for 4-6 months
- Breast is Best- WHO recommendation
- Standard formula (Cows milk based)
- Specialised
- for cows milk protein allergy
- nutrient dense
- disease specific
- Cows milk not suitable as main drink until 1 year
- Contains almost no iron
Preterm and high dense formulas can be given in premature babies, tube fed, cardiac etc… (more caloriess to cath up growth).
What is CMPA?
Cow’s Milk Protien Allergy
- Delayed non IgE reaction
- Characterised by:
- Vomiting, diarrhoea, abdominal discomfort, distension, eczema
- Only test is trial of CMP exclusion
How is CMPA essentially treated?
- 4 week trial of milk avoidance
- Special formula or milk free diet for breast feeding mums.
- Reintroduce at 4 weeks unless clear benefit
- Re challenge after 6 months of improvement.
- Milk Ladder approach - gradual increasing exposure to milk products.
Generally outline lactose intolerance.
- Not allergy
- Reduced levels of lactase enzyme.
- Seen in minor degree in some babies.
- Can occur in post gastro enteritis.
- Secondary - short lived condition
- Often confused with CMPA
Why not give soya milk?
- Phytoestrogens
- Cross reactivity with cows milk
Can give in vegan families.
