Infant feeding Flashcards by Sophie C

why is nutrition important?

prevents disease

- Growth not just about increasing size but change in brain and body structure, composition and function

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Phases of growth

Infant, Child and Pubertal

nutrition led

growth hormone led

sex steroid led

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Birth size and weight?

Maternal size  (diabetic mother - larger baby)
Placental function
Gestation

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95% of weight comes from what weeks?

20-40 weeks

10-16% body weight is fat

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average term infant weight?

3.3kg

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why do babies need nutrients?

Physical activity
Thermogenesis
Tissue maintenance
Growth

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how much calories does an infant require per day?

100kcal and 2g protein/kg/day
babies have low fat stores and protein
can he halted with frequent illness

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average weight gain from 0-3 months?

200g per week

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average weight gain from 3-6 months

150g per week

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average weight gain from 6-9 months

100g PW

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average weight gain from 9-12 months

50-75g pw

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babies should double and triple weight by what age?

6 months and 1 year

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after a year old, the average weight a baby should increase each year?

2kg

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after a year old, the average height a baby should increase each year?

5cm

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why is Breast fed the best?

calcium and phosphate fats?

Well tolerated
Less allergenic
Low renal solute load
Ca:PO4, Iron, LCP FAs
improves cognitive development
boosts active immunity

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Breastfeeding a baby reduces the risk of infection - give some examples?

Macrophages and lymphocytes
Interferon, lactoferrin, lysozyme
Bifidus factor

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breast feeding helps to reduce the risk of?

breast cancer and endometriosis, and greater postpartum weight loss and lower body mass index (BMI) in the longer term

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Risks of using formula?

No anti-infection properties
Risk of contamination
No transmition of BBVs/drugs
High antigen load
Expensive
Doesn’t need mum
Accurate feed volumes
Provides Vit K
Less jaundice

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what is the recommended breast feeding time ?

6 months of age

From 6 months, complementary breast feeding alongside solids is supported

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standard formulas are typically based with

cows milk

there are specialised options for:
1. cows milk protein allergy
2. nutrient dense
3. disease specific (PKU)

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Nutrient dense formulas include?

Infatrini / Smiliac High Energy / SMA High Energy 100kcal/100ml
- those with cardiac issues/ oncology

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First line feed choice for cows milk allergy

Nutramigen - hydrolysed protein

Aptamil

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Second line feeds for those who are more unwell/allergic to cow milk

Amino acid based feeds - alfamino
Babies with severe colitis/enteropathy/ symptoms on breast milk
Are over prescribed (and expensive!)

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16-40% of babies with reflux may have?

Study These Flashcards

cows milk allergy

those with a cows milk allergy should have a trial of what ? NICE guidelines

6-8 week trial of an extensively hydrolysed or amino acid formula to bottle fed infants<6 months with moderate to severe eczema that has not been controlled by optimal topical treatment particularly if associated with GI symptoms and FTT.

Children on a milk free diet for 8 weeks should..?

be referred to a dietician

Lactose intolerance features

Reduced levels of the enzyme (lactase) Seen to minor degree in some breast fed babies Post gastro enteritis (Transient and self resolving)

Lactose free milk for secondary lactose intolerance is seen in? - what can it be confused with?

Short lived condition eg post gastro-enteritis Confused with cow’s milk protein intolerance Lactose free/ “Comfort” milks are not CMP free

Soya Milks contain lots of?

Phytoestrogens

soya milk indications?

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

over what age can you introduce non- formula milk?

1 year

rice milk is not advised for children,,? goat's and sheep milk? oat and nut milk?

under 5 | under 1

how much calcium calcium fortified “milk” do you need to meet calcium requirements

400-500ml | - calcium softies

Breast feeding mothers on dairy free diet need to take?

Accrete or Cacit D3

when do solids begin to be Introduced?

6 months

early solid use can be associated with?

Higher risk of Fe deficiency and coeliac disease.

What is neophobia

- fear of trying new foods | - Associated with maternal neophobia

Vitamin D deficiency can cause? | can affect who?

rickets and poor muscle strength - Dark skinned children not on vitamin drops at risk - Prolonged breast feeding and mum not on Vit D

Supplements for vitamin D - how much do babies need if they are not taking 500mls of formula?

8.5-10 ug Vitamin D

Everyone over one year of age vit D supplement?

10 ug Vitamin D

what is GOR?

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

What is GORD?

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

When is the peak age that babies will regurgitate 1-4 times daily or more?

3-4 months

typical thickeners?

Infant Gaviscon sachets (NOT an antacid) Carobel - 5kcal/100ml - most common

Red flag signs with reflux symptoms (6)

``` Weight loss or poor weight gain Recurrent or bilious vomiting GI bleeding Persisting diarrhoea Dysphagia Stridor / cough / hoarseness ```

High risk groups for reflux??

Preterm babies, neurological impairment, chronic respiratory illness, anatomical, some genetic disorders e.g. Down’s syndrome

GORD treatments?

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

With GORD, babies require what suppression? | - what does this reduce?

acid supression | Reduced gastric acid may increase risk of pneumonia, gastroenteritis and candidiasis

Drug therapy for GORD - first line treatment

Gaviscon Liquid can also use low dose erythromycin

H2 blockers block? | example?

block histamine | Ranitidine

Alimemazine - how does it work?

(anti histamine) | - relives symptoms

PPIs decrease the acidity of stomach - give an example?

Omeprazole / Lansoprazole | Esomeprazole for tubes

Pro-kinetics like Domperidone promote what ?

gastric emptying

Colic - inconsolable crying is? | how long?

<3 months of age, >3hours/day, >3 days/week at least a week no red flag symtoms

what can be used for Colic

Probiotics Trial of cows milk protein avoidance Lactase drops Anti spasmodics

Factors associated with lower iron status at birth include ?

include low infant birthweight, and maternal iron deficiency anaemia, obesity, smoking status and gestational hypertension.

periods of peak brain development?

Neonatal period & 6 months to 3 years | May need to ask GP to check FBC/ferritin

laxatives for infants

Lactulose

laxatives for older children

Movicol / Laxido

Infant feeding Flashcards

(59 cards)