Infant feeding

Question 1

What leads the infant phase of growth?

Answer 1

Nutrition

Question 2

What leads the child phase of growth?

Answer 2

Growth hormone

Question 3

What leads the pubertal phase of growth?

Answer 3

Sex steroid

Question 4

What percentage of energy intake in infants goes towards growth demands?

Answer 4

About 35%

Question 5

What are some factors in the importance of good nutrition to infants

Answer 5

Can rapidly become malnourished
Dependent on carer
High demands for growth and maintenance
Low stores of fats and protein
Frequent illness

Question 6

What is the average weight gain in 0-3 months?

Answer 6

200g

Question 7

What is the average weight gain in 3-6 months?

Answer 7

150g

Question 8

What is the average weight gain in 6-9 months?

Answer 8

100g

Question 9

What is the average weight gain in 9-12 months?

Answer 9

50-75g

Question 10

What are the main nutritional benefits of breast milk?

Answer 10

Well tolerated
Less allergenic
Low renal solute load
Ca:PO4
Iron
LCP FAs

Question 11

How does breast milk reduce risk of infection?

Answer 11

Macrophages and lymphocytes
Interferon, lactoferrin, lysozyme
Bifidus factor

Question 12

What are some benefits of formula milk?

Answer 12

No transmission of BBV's/drugs
Doesn't need mum
Accurate feed volumes
Vit K
Less jaundice

Question 13

What are some drawbacks of formula milk?

Answer 13

No anti-infection
Risk of contamination
High antigen load
Expensive

Question 14

What are the main benefits of breast milk?

Answer 14

Near perfect nutrition
Tailor-made passive immunity
Development of infant gut mucosa and active immunity
Reduced infection
Minimal antigen load
Decreased risk of breast cancer

Question 15

Should you give artificial teats to breastfeeding infants?

Answer 15

Advised against

Question 16

Why should cow’s milk not be main drink until at least 1 year?

Answer 16

Contains no iron

Question 17

What is the first line feed choice in cows milk protein allergy?

Answer 17

Extensively hydrolysed protein feed
Nutramigen LGG Lipil 1 & 2
Aprtamil pepti 1 and 2

Question 18

What are some second line feeds for cows milk protein allergy?

Answer 18

Amino acid based feeds

Alfamino

Question 19

When are amino acid based feeds indicated?

Answer 19

Severe colitis
Enteropathy
Breast milk

Question 20

What are some drawbacks of amino acid based feeds?

Answer 20

Over prescribed

Expensive

Question 21

What is the order of the milk ladder?

Answer 21

Cookie/biscuit
Muffin
Pancake
Cheese
Yoghurt
Pasteurised milk/suitable formula

Question 22

What is a possible milk feeding knock-on effect of gastro-enteritis?

Answer 22

Secondary lactose intolerance

Question 23

Which component of soya milk is a concern for babies <6 months?

Answer 23

Phytoestrogens

Disrupt hormone balance

Question 24

When might soya milk be indicated?

Answer 24

Milk allergy when hydrolysed formulae refused
Vegan families, if not breast fed
Consider for children >1 year still on milk free diet

Question 25

Which milk is not recommended for children under 5 years?

Answer 25

Rice milk

Question 26

Which milks are not recommended for infants <1 year old?

Answer 26

Sheep | Goat

Question 27

What are some drawbacks of organic oat and nut milks?

Answer 27

Not calcium fortified

Question 28

What is the recommended time frame for complementary feeding and weaning of an exclusive breast milk diet?

Answer 28

Not before 17 weeks | Not after 6 months

Question 29

What is neophobia?

Answer 29

Normal part of child development To reject novel or unknown foods in childhood Associated with maternal neophobia Increase acceptance by repeatedly offering a variety of foods

Question 30

What are some benefits of introducing solids?

Answer 30

Variety of solids provide a source of protein, energy, vitamins, minerals and trace elements Encourage tongue and jaw movements in preparation for speech and social interaction

Question 31

What are some consequences of poor vitamin D status among Scots?

Answer 31

Higher risk of poor musculoskeletal health such as rickets and poor muscle strength Cannot synthesise Vit D from September to April Diet is a poor source

Question 32

What is GOR?

Answer 32

Effortless passage of gastric contents into oesophagus with or without regurgitation and vomiting

Question 33

What is GORD?

Answer 33

When the reflux of gastric contents causes troublesome symptoms and/or complications

Question 34

What are some options for thickeners to help with GOR?

Answer 34

``` Infant gaviscon (not antacid Carobel ```

Question 35

How is GORD managed?

Answer 35

``` Medical referral Require acid suppression Trial of milk free diet Continuous NG/jejunal feeds Consideration of anti reflux surgery Drug therapy ```

Question 36

What are some drug therapies for GORD?

Answer 36

``` Gaviscon liquid Ranitidine Omeprazole Domperidone Alimemazine ```

Question 37

What does domperidone do?

Answer 37

Pro-kinetic promotes gastric emptying

Question 38

How is colic diagnosed?

Answer 38

Exclusion | Inconsolable baby for at least 3 days out of the week, for at least a week

Question 39

What are the laxatives mainly used in childhood?

Answer 39

Lactulose for infants | Movicol/laxido for older children