Nutrition In Breastfeeding Flashcards Preview

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Flashcards in Nutrition In Breastfeeding Deck (23)
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1
Q

Why are infants restricted primarily to breastfeeding or specific formula?

A

They have low secretion of digestive enzymes and their kidneys have a low renal capacity

  • this means that before 5 months old they cant eat solid food
  • and until 12 months they cant fully digest/process solid foods with ease like adults
2
Q

What are the body measurements used in growth charts for children based on age

A

0-36 month infants

  • weight for age
  • length for age
  • weight for length
  • head circumference for age

2-5 years
- weight for stature

2-20 years

  • weight for age
  • stature for age
  • BMI for age
3
Q

What is the AAP recommendation for breastfeeding

A

Unless medically recommended, the infant should be breastfeed for the first six months and continued ideally for 12 months total
- the baby is not to receive additional foods except for vitamin D supplementation

85% start breastfeeding built by 6 and 12 month milestones are at 58% and 35% respectively (mothers aren’t hitting the recommended goal as often)

If breast feeding is not possible = use iron-fortified infant formula should be used

4
Q

What is the benefit of breast milk over formula

A

Breast milk contains distinct bioactive substances such as macrophages, Ig’s, cytokines, growth factors, anti microbes

Also contain monosaccharides and smaller easier to digest building blocks that an infant can digest

5
Q

The three stages of breast milk and the unique features

A

1) Colostrum
- first breast milk secreted usually at time of bother and for the first few days
- is yellow clear and is super high in fat and low in proteins
- focuses more on immunological properties rather than nutrient (although it stills has nutrition obviously)
- contains high IgA, Lactoferrin and EGF
- contains high sodium, chloride and magnesium
- contains low lactose, potassium and calcium

2) transitional milk
- starts after colostrum and contains higher levels of lactose and potassium but lower sodium
- lasts from roughly 4-5 days -> 2 weeks postpartum

3) mature milk
- continues after 2 weeks until stopping breast feeding
- is more stable, provides more nutritional values vs immunological properties

6
Q

Advantages to fetus and mother for breastfeeding

A

Fetus

  • decreases incidence of respiratory/GI infections and otitis media
  • decrease rates of SIDS
  • decrease rates of atopic dermatitis, eczema and asthma
  • decreases risk of obesity, diabetes celiac diseases, IBD and childhood leukemia and lymphoma

Mother

  • decreased postpartum hemorrhage
  • delayed ovulation
  • more rapid uterine involution
  • decreased postpartum depression
  • decrease risk for chronic Morbidities (HTN, diabetes, etc)
  • decreased risk for some cancers
  • improved bonding
7
Q

Breast milk storage in a bottle

A

Is a common practice and requires pumping

Can be stored in a fridge for 48 hrs or in a freezer for 3 months

baby will get benefits of breast milk as a whole but will not get the benefit of change in milk composition that occurs over the course of feeding in contact with mother skin

8
Q

When is breast feeding contraindicated

A

Infants who are diagnosed with galacotsemia

Mothers who have type 1 or type 2 T-cell lymphotropic virus

Mother who are HIV positive

Mothers who abuse drugs and are not enrolled in any treatment program

9
Q

Milk sharing

A

Using breast milk from another mother or women to use for the infant

This is NOT recommended since this runs the risk of transmitting infections (even if the women is asymptomatic)

10
Q

When is using donor milk okay?

A

Only if its from a regulated agency and only for preterm infants who are very low weight

this is because the donor milk could be at a different stage of lactation which contains variable protein and zinc content of breast milk

Also this milk is pasteurized to guarantee safety, which means it will have less bioactive compounds

11
Q

What nutrients can be altered in mother breast milk based on diet

A

Fatty acid concentration

Vitamin A/D

thiamin

riboflavin

niacin

Vitamin B6 and 12

all others appear to be not affected

12
Q

Which vitamin do infants need to take supplementation for?

A

Vitamin D and K

  • D = breast milk is low for the first 9 months of breastfeeding so often needs 400 IU supplementation for the first few days of birth (could give mother 4000/6400IU supplementation and that has been shown to increase levels in breast milk to optimal levels). These should be continued until 12 months when the baby can start mixing fortified cows milk
  • K = need a single dose at brith and if diet is low for mothers = may need supplementation for the mother
  • the GI tract lacks any sterile GI bacteria and also lacks vitamin K from maternal system = cant make clotting factors well
  • vitamin K fortification increases clotting factors and helps prevent both hemorrhoid anemia of a newborn and GI infections that are chronic
13
Q

Factors to successful breastfeeding

A

Initial breastfeeding should take place within the first hour of birth and direct skin-skin contact is needed

Mother need to be comfortable (sitting up or lying down)

Mother should adjust position with every feeding for the first few weeks

Should nurse 8-12 times a day (feed on demand not a schedule though if possible)
- on schedule = decreased breast milk production

14
Q

How to tell if the baby is getting enough to eat

A

9-12 wet diapers a day (or 4-5 heavy wet diapers)

Babies should have bowel movements with most feedings

Baby should nurse 8-12 times a day and the baby should appear satisfied

Monitor the baby weight (on average babies gain 1 oz per day during the first three months of life)

15
Q

If formula is in powdered form what must be done by strict guidelines

A

Reconstituted via a specific amount fo water

  • too little water = too diluted
  • too much water = too concentrated

3 month babies = sterile water only
- if using tap = boil it for 1 minute and then let it cool before adding

Older than 3 month babies = any water but the amount needs to be regulated

16
Q

Should you microwave baby bottles

A

NO

  • results in uneven patterns of heating with some areas of the bottle becoming too cold and some becoming too hot
  • if its too hot = can cause facial and palatial burns to the baby and destroy antibodies in the milk
17
Q

Introduction of solid foods

A

Are typically introduced at 6 months of age
- usually time with the ability of the infant to sit upright with little-no help, majority of primitive reflexes are gone

Should introduce 1 new food at a time and wait 3-5 days before introducing the next new food

Start with small amounts (1 tsp at most)

Start with dry infant cereal first (avoid infant rice cereal due to risk of arsenic exposure)

Follow with meats -> fruits -> vegetables in this order

Avoid salt and sugar but don’t restrict fat and cholesterol

18
Q

Foods to avoid in infants <12 months

A

Any hard round foods (choking risk)

Honey (botulism risk)

Cows and plant-based milk (too complex to digest fully)

Fruit juice (not nutrient rich enough and doesn’t satisfy satiety enough (increased risk of obesity))

Sugar-sweetened beverages

19
Q

Why must spinach, carrots, broccoli and beets NOT be puréed at home for infants

A

They contain trace amounts of nitrite that is sufficient enough to potentially cause methemoglobinemia in infants

20
Q

Dental caries in newborns

A

Is the most common chronic disease of childhood

Associated with improper feeding practices or giving infants a poor/ unhealthy diet

Practices to help prevent

  • local water fluoridation beginning at 6 months
  • adding fluoride to breast milk or formula starting at 6 months
  • avoid fruit juices and drinks during first 12 months
  • putting only water in a bedtime bottle if the baby needs it
  • clean infant teeth with a damp washcloth
  • visit dentist by age 1 ow within 6 months after first tooth ergots
21
Q

Food allergies in infants

A

Approximately 4% of infants get this and the most common are

  • cows milk (most common)
  • soy
  • egg
  • fish
  • wheat
  • tree-nuts
  • peanuts

introduce these foods starting at 4-6 months and monitor to watch for reaction. DONT delay introduction because this is actually associated with an increased risk of developing an allergy

22
Q

When to give water to an infant

A

Only if you notice a reduction in urine output or dark colored urine or if the baby is using formula

If breast feeding well and the baby is gaining weight adequately = usually normal hydration

also needs to be wetting at least 6 diapers a day = proper hydration

23
Q

Di ions of responsibility feeding protocol

A

Developed by Ellyn Satter and is appropriate from birth to early adolescents

Encourages the caregiver to take leadership of

  • what
  • when
  • where the feeding takes place

Encourages the child to determine

  • how much
  • weather to eat or not eat

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