Infant Flashcards
(27 cards)
Standard Newborn Growth Assessment
Appropriate for gestational age (AGA)
- typically 10-90% on growth charts
Small for gestational age (SGA)
- born <10th% for gestational age
Large for gestational age (LGA)
- newborn was >90th % for gestational age
Extrusion reflex
when something goes into infants mouth push out with tongue
indication that baby is not ready for solids
diminish around 4 months
Motor development in infants
ability to control voluntary muscles
Top down development
Central to peripheral
Influences ability to feed self and the amount of energy expenditure
Critical periods in infant development
Definition: a fixed period of time in which certain behaviours or developments emerge
Necessary for sequential behaviours or developments
If missed, may be difficulty later on
Oral feeding: if disrupted, may have difficulty and be reluctant feeder
Factors that impact cognition development
Sensorimotor development
interactions with the environment
adequate energy and protein and vitamins
stimulation of social and emotional growth
genetics
Development in the digestive system for infants
Fetus swallows amniotic fluid which stimulate intestinal maturation and growth
At birth, the healthy newborn can digest fats, protein and simple sugars
Don’t have many digestive enzymes
Rate of stomach emptying is slower during infancy
Takes 6 months for infant gastrointestinal tract to mature
Stomach shaped differently
Lower concentration of HCl and pepsin
Coordination of peristalsis improves
Renal system is immature
Interpretation for WHO growth charts (Birth to 24 months)
Head circumference for age:
- < 3rd percentile or >97th percentile => potential nutrition or developmental problems
Weight-for-length
- <3rd percentile => can indicate child is underweight due to recent malnutrition, dehydration or genetic disorder
- >97th percentile => may indicate the child is obese
Describe the stages of malnutrition
Acute: decrease in weight
Chronic: height will be decreased
Chronic and more severe: head circumference will be decreasing below percentiles
Factors that influence calories needs
Weight and growth rate
- Birth weight doubles by 5-6 months
- Birth weight triples by 1 year
- Length increases by ~50% by 1 year
- Growth of internal organs
Sleep/wake cycle
Temperature and climate
Physical activity
Metabolic response to food
health status/recovery from illness
Protein needs during infancy
1.52 g/kg/day from birth to 6 months
1.20 g/kg/day from 6 to 12 months
CHO needs during infancy
0-6 months: 60 g/day
6-12 months: 95 g/day
Fat needs during infancy
0-6 months: 31 g/day
6-12 months: 30 g/day
Infants need cholesterol for hormone and brain development
Supply energy to liver, brain, muscles and heart
Essential fatty acids
Low carbohydrate and or energy intake results in protein catabolism impacting growth
Why is breast milk food for babies in regards to fats?
Contains 55% calories from fat
contains more short chain and medium chain fatty acids which is easier to digest and utilize
Nutrient needs for Vitamin D, iron and calcium
Vit d: 400 IU/day - supplementation required for all breastfed infants
Iron:
0-6 mos: 0.27 mg/day
7-12 mos: 11 mg/day
Significant increased risk of deficiency 6+ mos of age
Calcium:
0-6 mos: 200 mg/day
6-12 mos: 260 mg/day
Cues infants may give for feeding readiness
Sits upright in a high chair
Able to hold head up
Watching the food being opened in anticipation of eating
Tight fists or reaching for spoon
Playing with food or spoon
Keeps food in mouth and swallows it, doesn’t push it out
Turns head away if he/she doesn’t want the food item
Infant nutrition: 0-4 months
Poor muscle control to swallow solids
poor capacity to digest, metabolize and excrete solid foods
Infant nutrition: 4-6 months
decrease in extrusion reflex
start to indicate interest and desire for food
sit with support and control head
still not ready for solids
Infant nutrition: 6+ months
First meals are to stimulate mouth muscle development and less for nutritional needs
will try to suck food like it’s a liquid
Traditional feeding vs. baby led
Traditional feeding: start with pureed foods and gradually increase towards more solid textures
Baby-led: baby eats same foods as the rest of the family (with some modifications)
What solid foods should be introduced first?
Iron rich foods
Offer 2-4 tbsp at each meal, but not uncommon to eat lots at one meal and very little at the next
What foods to introduce after iron-rich foods
No set order
Offer foods higher in fat such as avocado, nut butters in foods like oatmeal
Can start to open up ~6 months of age for water, baby don’t have much control until 12+ months
When can we introduce cow’s milk
9-12 months (best to wait until 12)
Only pasteurized
No 2%, 1%, or skim milk until 2nd year of life
has low iron content with poor absorption
Slowly work up to 500mL/day as breast bilk is decreased
What could happen if cow’s milk introduced too early?
GI blood loss
Low absorption of calcium and phosphorus
Displacement of iron-rich foods
Puts more strain on the kidneys
To prevent choking do not offer:
peanut butter or other nut butters spread thickly or served on a spoon.
sticky foods (ex marshmallows or gum)
hard raw fruits or vegetables unless cut into small pieces or grated
stringy our rounded meats (ex sausage, hot dogs)
Popcorn, nuts, seeds
Gummy or hard candy
Fish with bones
Ice cubes
