CH 8 Infant Nutrition
what is first portion from a cup supposed to be?
1-2oz
what are protein needs for infants 6-12 months?
1.6
what is typical length of full term baby?
18.5-21.5 inches
how much % of calories does breast milk get from fat?
55%
when can an infant eat soft mashed foods?
8-10 months
when can an infant start eating soft table foods?
9-12 months
cows milk based formila have what percent of calories from protein?
9-12%
what is energy requirement for babies from 6-12 months?
98 cal/day
what is mean newborn weight for SGA and IUGR?
<10th % wt/age
what results in inconsistent cues for hunger and satiety?
CNS is immature
motor development
ability to control voluntary muscles
when should iron be supplemented?
after 4 months if breastfed
when should you offer water from a cup to an infant?
after 6 months
AGA
appropriate for gestational age
what do infants with vegan diets need to supplment
b12, vitamin d, possibly iron and zinc
who has the highest metabolic rate?
babies
how do we asses newborn health?
birth weight
where should the adult be when feeding an infant?
directly in front of infant making eye contact
what are ear infections linked to?
feeding practices
common problems with digestive system development
gastroesophagual reflux, diarrhea, and constipation
Failure to thrive (FTT)
inadequate weight or heigth gain
what are warning signs of baby growth while looking at growth data?
lack of weight or length gain, plateau in weight length of head circumference for >1month, and drop in weight without regain in a few weeks
LGA
large gestational age >90th wt/age
what results in protein catabolsm impacting growth?
low carbohydrate and/or energy intake
what is highest of anytime after birth?
metabolic rate
what is flavor of breast milk influenced by?
mother's diet
what does food offered from spoon stimulate?
mouth muscle development
what should you allow infant to do when beginning to feed?
open mouth and extend tongue
early cup weaning may result in:
plateau in weight due to reduced calories and constipation due to low fluid intake
what are foods that choke infants?
popcorn, potato chips, peanuts, chunks of peanut butter, stringy meats, gum and gummy textured candy, hard candy or jelly beans, hard fruits or vegetables, hot dogs, raisins, whole grapes
what is the golden standard of breast feeding?
recommended exclusive breast feeding for 1st 6months and & continuation to 1 year
suckle relfex
reflex causing tongie to move forward and backward
what are infants born with?
reflexes and food intake regulatory mechanism
what are critical periods necessary for?
sequential behaviors or developments
what fat chains does breast milk contain?
short and medium chain fatty acids
what happens to infant's reflexes at 4-6 weeks?
they fade
when can an infant swallow very soft lumpy foods?
6-8 months
breast milk has what percent of calories from protein?
7%
what does muscle development influence?
ability to feed self and the amount of energy expended
long chain fatty acids are digested/absorbed how?
absorbed and packaged as a mycon then sent out to lymphatic system
what are required for accurate measures of babies?
calibrated scales and recumbent length measurement
muscle development from _____ to ______
central; peripheral
what can early introduction to lumpy foods cause?
choking
what can improper positioning cause?
choking, discomfort, ear infections
what drinks should you avoid with infants?
colas and teas
what are the leading causes of infant mortality?
congential malformations, preterm births, SIDS
what is lactose intolerance characterized by?
cramps, nausea and pain, alternating diarrhea and constipation
how do babies learn food preferences?
based on experiences with foods
how are short and medium chain fatty acids digested differently than long chain?
be digested and absorbed into your portal vein into your blood then to liver and packaged as VLDL
infant mortatlity
defined as death that occurs with the first year
what is linked to iron deficiency anemia in babies?
early introduction of cow's milk
what does the AAP recommend regarding juice?
juice is not needed to meet the fluid needs before the age of 6 months
what stimulates intestinal maturation and growth?
fetus swallows amniotic fluid
what babies need vitamin d supplementation?
for infants fed exclusively breast milk but not those fed exclusively formula
when should B12 be supplemented?
for vegans
what do babies need cholesterol for?
gonad and brain development
what indicates adequacy of milk volume?
growth rate and health status
IUGR
intrauterine growth retardation
what do food preferences from infancy set the stage for?
lifelong food habits
what are feeding techniques to reduce caries and ear infections?
limit use of bedtime bottle, offer juice in a cup, examine and clean emerging teeth, only give water bottles at bedtime
what is major cause of infant mortality?
low birthweight (<2500g)
Intervention for FTT
may be a complex and involve a team approach including the registered dietician, social worker
recommended amount of fiber for a baby
no recommendations
what are fat needs for babies?
no specific recommended intake level for infants
recommended amount of lead fora a baby
none, toxic
what do newborn growth reflect
nutritional adequacy, healthy status, and economic/environmental adequacy
what should you do regarding food at age 6 months?
offer small portions of semisoft food on a spoon once or twice a day
how many new foods can be introduced at a time?
one new food over 2-3 days
what provide electrolytes but are lower in calories than formula or breast milk?
pedialyte or sports drink
what foods can be introduced at 6 months?
rice cereal and fruits/vegetables
what should you avoid when feeding an infant?
scriping spoong on infants gums
what position do you put young bottle fed infants in when feeding?
semi-upright position with infant seated with back and feet supported
factors that impact cognitition:
sensorimotor development, interactions with the enviornment, adequate energy and protein, stimulation of social and emotional growth, genetics
SGA
small for gestational age
what kind of spoon should be used to introduce food to infants?
small spoon with shallow bowl
factors associated with mortality
social and economic status, access to health care, medical interventions, teenage pregnancy, avaliability of abortion services, failure to prevent preterm & lbw births
open cup drinking skills also encourage what?
speech development
what do infants have an inherent preference for?
sweet taste
what is there genetic predisposition to?
sweet taste
what must new parents learn?
temperament of infant, how to respond to infant cues, infants cues of hunger and satiety
what do iron stores in infants reflect?
the iron stores of the mother
what kind of movement is more development?
top down
causes of diarrhea and constiapation?
viral and bacterail infections, food intolerance, changes in fluid intake
what are cues that infants may give for feeding readiness
watching the food being opened in anticipation of eating, tight fists or reaching for spoon, irritation if feeding too slow or stops temporarily, playing with food or spoon, slowing intake or turning away when full, stop eating or spit out food when full
what are factors that influence calorie needs:
weight and growth rate, sleep wake cycle, temperature and climate, physical activity, metabolic response to food, health status/recovery from illness
what should not be used during infancy?
whole, reduced fat, or skim cow's milk
is dehydration common in infants?
yes
soybean based formula has what percent of calories from fats?
45-49%
cows milk based formila have what percent of calories from fat?
48-50%
preterm infants
infantst born before 37 weeks gestation
recommended amount of fluoride for a baby
0.1-0.5 mg/day
how many stools do infants typical have in a day?
2-6
what is energy requirement for for babies from birth to 6months?
108 cal/day
recommended amount of iron for a baby
11 mg for infants 7-12 months
soybean based formula has what percent of calories from proteins?
11-12%
when should you wean to a cup for an infant?
12 to 24 months
recommended amount of sodium for a baby
120-200 mg/day
what are protein needs for infants birth to 6 months?
2.2 cal/day
what calories do standard infant forumla provide?
20 cal/fl oz
what calories do preterm formula provide?
22-24 cal/fl oz
what is typical weight of full term baby?
2500-3800g or 5.5 to 8.5lbs
breast milk has what percent of calories from carbs?
35%
what is full term for an infant?
37 to 42 weeks
soybean based formula has what percent of calories from carbs?
39-45%
recommended amount of vitamin d for a baby
400 IU/day
cows milk based formila have what percent of calories from carbs?
41-43%
what is baby anemia linked to?
GI blood loss, low absorption of calcium and phosphorus, displacement of iron rich foods
critical periods
a fixed period of time in which certain behaviors or developments emerge
how can you avoid consipation?
assure adequate fluids
reflex
automatic response triggered by specific stimulus
what provides the adequate water for healthy infants up to 6 months?
breast milk or formula
when should fluoride be supplmented?
breastfed infants after 6 months
what are other ways infant formulas are modified?
energy level, form of protein, type of sugar and fat, allergy intolerance, thickness, and micronutrient
what can a healthy newborn digest at birth?
fats, protein, and simple sugar
when is additional plain water needed?
hot humid climates
rooting reflex
infant turns head toward the cheek that is touched
is iron deficiency less common in infants or toddlers?
infants
factors that impact rate of food passage in colon
osmolarity of food or liquids, colon bacterial flora, water and fluid balance in the body
what do growth chart data measure?
over time change in growth rate and need for intervention
what is true regarding hunger and satiety cues between parents and babies?
parenting skills to read them develop more slowly than infants skills to give them
what foods can infants swallow at 6 months?
pureed
what is the higher rate of metabolic rate related to?
rapid growth and high proportion of muscle