healthy infants are born with enough iron to last them this long
T/F: an infant who is deficient in iron can receive what they need via the breast milk
false, breast milk contains very little iron and they will need an iron supplement
What is the best way to get iron after being 4-6 months old?
fortified cereals and supplements
What is the most common nutritional deficiency in infants
iron deficiency anemia (hypochromic, microcytic)
What can occur if an infant does not receive enough folate?
How long does a healthy term infant have B12 storage for?
How is B12 deficiency similar and different from folate deficiency?
Both cause a megaloblastic anemia but B12 has neurological sx
Vitamin D is synthesized from this molecule in the skin
Vitamin D deficiency will result in low serum levels of these 2
calcium and phosphorous
How long are children to be kept out of direct sunlight?
Guidelines state that no infant should be in the direct light for first 6 mos of life
What is administered in a 1 mg dose to children at birth IM to prevent hemorrhagic disease of the newborn?
vitamin K (phylloquinone)
What would lead you to think that an infant had a vitamin K deficiency?
bleeding, bruising, and weakening of bones
When does a kid need fluoride? What are the Sx of fluoride excess?
after 6 mos, mottled teeth
What is the role of carnitine?
facilitates fatty acid transport across mitochondrial membrane
What are 3 benefits of taurine in newborns
neurologic and retinal development, aids bile acid conjugation
These 2 amino acids are required in premature babies
cysteine and tyrosine (cysteine may lower requirement for methionine)
How much would expect a 7 pound baby (at birth) to weigh at 6 months?
14 pounds, they double weight by 6 months
What is an acceptable amount of an infants birthweight for them to LOSE in the first few days of life?
What are 4 conditions regarding a newborn's birthweight that require immediate attention?
birthweight < 5th percentile; weight loss > 10%, loss continuing beyond 10 days, weight loss not regained by 3 weeks
This is a sensitive measurement of protein-energy metabolism (PEM)
infant body length
This device measures infant length in the recumbent position
What is suggested by a poor head circumference?
poor nutritional status
If a woman chooses to forego breast-feeding, then milk from what 3 animals should you ensure that the infant is NOT drinking?
cow, goat, sheep
How many times/day should an infant breastfeed/eat
8-12 times per day
When are solid foods appropriate to give to an infant?
after 4-6 months; they can chew and swallow by 1 year
The WHO recommends this pattern of feeding for 1st year of life?
breast feeding for 6 months; then introduction of soft foods with continued breast feeding
Do infant's stomachs empty fast or slow? What is the effect of low levels of zymogenic cells (chief cells)?
slow; low levels of pepsin since zymogenic = pepsinogen
Why shouldn?t an infant drink cow's milk?
Their immature stomach cannot breakdown the complex molecules present; also, it can overload the renal system and cause dehydration
What is the stomach capacity at birth vs. 1 year later?
20 ml; 200 ml
At what age does a child begin to produce lactase? Pancreatic amylase?
birth; 6 months
Fat is very important for the growth of this organ in an infant
BRAIN (myelin), and other organs
These 2 molecules provide energy to the brain
glucose, ketone bodies
How much of the following (in grams) is required per day for an infant: fat, carbs, protein
31, 60, 9.1 (don't forget the 0.1, very important)
What usually has more protein, breast milk or formula?
When do infant nutrition requirements peak?
first 2 months of life
BOTTOM LINE: how much breast milk or formula does an infant need/day to satisfy their requirements?
Breast milk helps to prevent this skin disorder
What is the effect of breastfeeding on post-partum bleeding in the mother?
This infant reflex is required for effective breastfeeding
6 contraindications to breastfeeding
HIV positive, ACTIVE TB, HTLV, herpes of the nipple, active drug or alcohol abuse
What happens at birth that stimulates milk production in the mother?
sudden drop in progesterone with continued prolactin production
What is unique about the colostrum in comparison to later milk secretions?
it contains more immunoglobulins
At the beginning of a feeding the baby receives foremilk, towards the end they receive hindmilk which is particularly high in _______
When should a mother offer breast #2 to a baby who is suckling breast #1?
When breast #1 is emptied
Although the iron content of breastmilk is lower than that of formula, why is the absorption rate higher?
because breastmilk contains lactoferrin
This is a VERY important fat in breast milk
Why might DHA synthesis be deficient in newborns?
because they cannot convert alpha linolenic acid to DHA
What effect does lactoferrin in breast milk have on bacteria?
it steals their iron!
Name 2 growth hormones in milk
epidermal growth factor and IGF-1
Why should a woman who is breast-feeding take in adequate calcium?
to protect her own stores since she is losing it in the milk
Regarding the embryo when, specifically, is the need for folate the greatest?
the first trimester but particularly around the days of neuropore closure (18-28)
Before week 12 the fetus is fed via this______... Bonus super ninja status: what duct connects the infant to this structure?
yolk sac; vitelline duct, that actually wasn't that hard, you're not a ninja.
What "cofactors" are needed for uptake of the following: 1) Vitamins A, D, E, K 2) Vitamin A specifically 3) Vitamin D specifically
1) lipoproteins 2) retinol binding protein 3) vitamin D binding protein
This is the circulating iron transport protein
What is true of the maternal absorption rate of iron during pregnancy compared to the non-pregnant state
it increases in pregnancy (gut takes up more iron)
Give an example of a vitamin that should not be taken in excess for the infant
vitamin A (phocomelia I think)
Which vitamin enhances the uptake of iron?
Name 2 things that decrease iron uptake
black tea and whole grains
What effect does caffeine have on serum calcium?
decreases it by increasing excretion (prob bc diuretic, so maybe all diuretics do this idk)
Why shouldn?t you rely on spinach as a calcium supplement?
it contains oxalic acid (which forms calcium oxalate) and this decreases its uptake
Explain in terms of surface area why infants receive more nutrients (i.e. why do infants receive nutrients from the mother more so than mothers receive nutrients from the baby?)
the surface area on the MATERNAL side is 6x greater than that on the fetal side, therefore more is extracted from mom
Which fat is especially important to be in the diet of a pregant woman?
This fat in the fetus is particularly important for brain development
DHA. You have been conditioned.
What effect may caffiene intake >300 mg/d have on the infant
If a woman is constipated what should you recommend that she eat?
high fiber foods
What is particularly important to avoid in HTN mothers (i.e. pre-eclampsia)?
What are 3 ways to evaluate fetal growth in a mother
maternal weight gain, fundal height, US