Ch. 8 and Ch.9 Lifespan Review Exam 2

Describe how providers and families access nutrition guidance for infants **

* The WIC Program has published Infant Nutrition and Feeding, a comprehensive and very practical guide for health professionals who provide nutrition services to infants, children, and children with special health care needs. *Bright Futures Nutrition provides nutrition and feeding recommendations for parents and caregivers of infants, children, adolescents and children with special health care needs. *Zero to Three is a national nonprofit organization that provides parents, professionals, and policy makers with resources, tools, and publications to nurture development in infancy and childhood.

Special health care needs Infants:

** Energy -The revised Daily Reference Intake (DRI) for energy—the Estimated Energy Requirements (EER)—maybe more accurate in predicting the energy needs of infants and children with special health care needs. - There are three EER age group categories in infancy: 0-3 months; 4-6 months; and 7-12 months. 2.2.1.3. For infants with cleft lip and/or cleft palate, or phenylketonuria (PKU), use of the DRI for energy will be appropriate. 2.2.1.4. Infants with bronchopulmonary dysplasia often need energy intakes above the EER for age. 2.2.1.5. Infants with reduced activity and energy expenditure, lower basal energy needs, or slower rates of growth generally need fewer calories than their peers. These infants include those with Down syndrome and spina bifida. **Nutrition -Protein: 2.2.2.1.1. Protein requirements of infants with special health care needs may be the same as, less than, or greater than those of other infants. In the first 6 months of life, the DRI for protein is 1.52 grams per kg body weight. It declines to 1.2 g/kg from 7 to 12 months of age. Protein recommendations are sufficient if total calories are high enough to meet energy needs. 2.2.2.1.2. Some inborn errors of metabolism such as phenylketonuria (PKU) can affect protein metabolism; treatment may require a restriction or reduction in dietary protein or in certain amino acids, such as phenylalanine. 2.2.2.1.3. Many illnesses interfere with the functioning of the gastrointestinal tract and digestion, even for term infants born with intact enzymes for protein digestion. Protein and fat digestion depend on liver and pancreatic enzymes for intestinal absorption. 2.2.2.1.4. Sick infants may require partially or extensively hydrolyzed protein or amino acid-based formulas. -Protein recommendations lower than the DRI are unusual in infancy. - Fats: . Compared to children and adults, infants need a higher percentage of their daily calories from fat. Fat provides 45-55 percent of the energy content in human milk. Low-fat diets or restriction of fat are not recommended for infants. -Vitamins and Minerals: DRIs of vitamins and minerals for infants were established to meet the nutrient requirements of nearly all healthy and well infants. These recommendations are also generally applicable for most infants with special health care needs. But, vitamin and mineral requirements may be affected by various health conditions, particularly those involving the gastrointestinal tract. ** Certain medications may decrease or impair nutrient absorption or increase excretion, therefore the treatment for some inborn errors of metabolism requires micronutrient supplementation well above the DRI for age. 2.2.2.3.3. Some infants with special health care needs have fluid restrictions that result in a lower feeding volume and reduction in micronutrient intakes. 2.2.2.3.4. Infants with cystic fibrosis (CF) may continue to have problems with fat malabsorption. Fat-soluble vitamin supplementation at levels above the DRI for age are recommended.

Preterm Infants energy and nutrition needs

*** Energy needs -Intakes for recovering premature infants may be higher, and the range of energy needs can be wide. - Infants who are born before 34 weeks of gestation have higher energy needs than late preterm and term infants. - The American Academy of Pediatrics advises that premature infants need 105-130 cal/kg, -. The European Society for Gastroenterology and Nutrition recommends an energy intake range of 110-135 cal/kg. **Nutrition Protein: - Higher protein intakes are recommended for preterm infants; for micro preterm infants born before 30 weeks gestation, this recommendation may be as high as 4.5 grams per kilogram body weight. - Protein requirements are also higher in infants needing to achieve catch-up growth. Catch-up growth is the accelerated growth of a premature or small infant, or malnourished infant or child that occurs during the first two years of life (slides state "occurs during the 1-3 years). Fats: -Fats are more difficult for preterm infants to digest and absorb related to a reduced secretion of pancreatic and liver enzymes. Medium-chain triglycerides do not require bile for absorption and are a routine source of fat in preterm infant formula. *Need EFA + DHA + AA from breast milk, formula or Human Milk fortifier. Vitamins and Minerals: *The American Academy of Pediatrics has addressed the higher iron needs of *preterm infants and recommends iron supplementation for *preterm infants on breast milk feedings. *Preterm infants who are formula fed may need earlier initiation of iron supplementation, and at a higher dose than full-term infants. * Human milk fortifiers are used in neonatal care units to increase the content of specific nutrients and energy content of breast milk, and to meet the high nutritional needs of preterm infants. The key nutrient in human milk fortifiers is protein (an inadequate protein intake in preterm infants will adversely affect their growth and neurocognitive development). ** In addition to protein, other key nutrients in human milk fortifiers include calcium, phosphorus, magnesium, sodium, potassium, chloride, zinc, and copper. Iron is contained in some human milk fortifiers. Premature infant formulas provide very similar amounts of macronutrients and micronutrients as fortified breast milk.

Infant Mile stone 4-6 months related to feeding

**Approximate Mouth Patterns - draw in lower lip as soon as is removed from mouth -up and down movement -imeedialty transfer food from front to back of tongue to swallow **Developmental Skills Hand and Body control * begins to sit with support - Good head control -Use whole hand to grasp objects (palmer) **Baby Care -Takes in a spoonful ot pureed or strainged food and swallows it without choking -Control the position of food in the mouth

Infant Milestone 8-11 months

**Approximate Mouth Patters ( rotary chewing (grinding) **Developmental Skills Hand and Body Control -Begin to put spoon in mouth -Begin to hold cup **Baby Care - Eat chopped foods, small pieces of soft, cooked foods

Infant Milestone 10-11 months

**Approximate Mouth Patters **Developmental Skills Hand and Body Control **Baby Care

Infant Mile stone Birth-5 months related to feeding

**Approximate Mouth Patters - Sucking/swalllowing reflex -tongue thrust reflex -poor lip closure **Developmental Skills Poor control of head, neck, and trunk. **Baby Care - Swallow liquids but pushes most solid object from the mouth

Infant Mile Stone 5-9 months

**Approximate Mouth Patters -up and down munching movement -position food between jaws for chewing **Developmental Skills Hand and Body Control - Begins to sit alone -Begin to use thumb and index finger to pick up objects **Baby Care - begins to eat mashed foods -eats from a spoon easily

Nutrition problems in Infants with Health care needs infants: GROWTH

**Growth - Slow rate of weight gain -fast rate of weight gain - disproportionate rate of weight to heigh gain -unsuaul growth pattern in weight or length gain - altered body composition that decreases or increases muscle or activity - altered size of the organs or skeleton such as an enlarged liver or shornted leg lwngth

How to Asses Adequate Growth in Infants

*Indicators include gestational age, birthweight, length, and head circumference. *SGA, AGA, and LGA are indicators of the infant's size at birth: *(SGA) indicates that the newborn's weight, length, or head circumference plots below the 10th percentile on the growth chart. When all three measurements fall below the 10th percentile, the infant is symmetrically small for gestational age. *Measurements above the 90th percentile are considered large for gestational age (LGA) and more often are noted in infants of diabetic mothers. *Appropriate for gestational age (AGA) infants have birth measurements that plot between the 10th and the 89th percentile. Another indicator, intrauterine growth restriction (IUGR), is a medical diagnosis identified antenatally. IUGR is a significant factor in perinatal morbidity and mortality. Frequent measurements of weight, length, and head circumference during infancy will facilitate early identification of potential problems such as slow or excessive weight gain or slow linear growth.

factors that put infants at nutritional risk and how nutritional assessment and interventions address these risks.

*Infants who have special health care needs or developmental delay. *. Infants affected by abnormal development in utero. E.g. infants with cardiac malformations, exposure to drugs or alcohol, or genetic conditions such as Down syndrome. * Congenital anomalies or chronic illness (clefpt lip palate, heart malformations) Infants at risk for chronic health problems may come from the treatment needed to save their lives, or from the home environment. Some examples of conditions that increase nutritional risk are seizures, cystic fibrosis, & fetal alcohol syndrome. Long-term consequences, such as learning, attention, & behavioral problems, may not be known for yrs. * ELBW- extremely low birth weight: less than 1000g (2.2 pounsd) * small for gestational age: intrauterine growth retardation *large for gestational age- greater than 4000 g (8.8 pounds) *Very low birth weight (VLBW): less than 1500g (3.3 pounds) * low birth weight: less than 5.5 pounds

Nutrition problems in Preterm Infants

*Preterm infants have high metabolic rates, and they will use fat stores and protein in tissues and muscles to meet glucose needs if provision of energy is not adequate. Mother's own breast milk (and donor breast milk) will need to be fortified to meet the nutritional needs of very preterm and extremely preterm infants. Higher volumes of mother's own breast milk were associated with lower incidence and severity of necrotizing enterocolitis (NEC) and late-onset sepsis, and decreased length of stay. 4.2.3. There are gastrointestinal conditions that could interfere with feeding preterm infants and sick neonates such as decreased gut motility, impaired absorption, and gastroesophageal reflux. Gavage feedings are often needed by preterm infants because coordination of their suck swallow-breathe pattern does not generally occur until 32-34 weeks postmenstrual age. 4.2.5. Preterm babies have immature immunological systems and are more susceptible to infection. Every effort should be made to ensure their feedings meet food safety requirements. The rate of administering feeds to preterm infants is often much slower than that for full-term infants, and formula or breast milk is at room temperature for a longer period of time. Contamination of feeding equipment increases with time. 4.2.6. May need enternal feeding which stimulates secretions of gastrointestinal hormones, gut motility, and maturation. 4.2.7. Nutrition problems including impaired growth may be seen in infants with congenital heart disease. The incidence of IUGR is approximately 6 percent among infants with symptomatic heart disease. 4.2.8. When the infant has galactosemia, an inborn error of metabolism. 4.2.9. Lower protein content in pasteurized donor breast milk if mother's milk (preterm mother's milk is higher in protein) is not available or contraindicated. 4.2.10.Disadvantage of these formulas is that their use is associated with higher rates of necrotizing enterocolitis (NEC) in preterm infants. Necrotizing enterocolitis is a very serious condition that affects the intestinal tract of preterm infants. Bacterial infection and inflammation can cause bowel wall destruction and intestinal perforation and surgical intervention

Discuss how feeding and food choices that are not make for their infants can affect later health status

*Recommend that optimal nutrition for infants be provided by exclusive breastfeeding for the first 6 months of life and continuation of breastfeeding for the second 6 months *Breastfeeding is a key public health strategy for improving infant health and reducing morbidity and mortality in the first 12 months *The American Academy of Pediatrics and the Academy of Nutrition and Dietetics Pediatric Practice Group recommend that whole cow milk, skim milk, and reduced-fat milk not be used in infancy. *Food preferences of infants are largely learned, but genetic predisposition toward sweet tastes and against bitter foods may modify food preferences. *Twin studies are showing that food preferences, appetite, and feeding skills are more complicated and genetically influenced behaviors than previously understood.

factors that are associated with increased risk for health and developmental problems in infants.

*The birth weight of a newborn is one of the indicators of the infant's health status. *Premature or preterm infants are born before 37 weeks gestation and are classified by their gestational age and birth weight *Low-birthweight (LBW) infants weigh less than 2500 grams; *very low-birthweight (VLBW) infants weigh less than 1500 grams. *Extremely low-birthweight (ELBW) infants weigh less than 1000 grams. Birthweight and the length of gestation are two of the most important predictors of an infant's survival and later health.

how do feeding and food choices that parents make for their infants can affect later health status.

-Recommend that optimal nutrition for infants be provided by exclusive breastfeeding for the first 6 months of life and continuation of breastfeeding for the second 6 months -Breastfeeding is a key public health strategy for improving infant health and reducing morbidity and mortality in the first 12 months -The American Academy of Pediatrics and the Academy of Nutrition and Dietetics Pediatric Practice Group recommend that whole cow milk, skim milk, and reduced-fat milk not be used in infancy. -Food preferences of infants are largely learned, but genetic predisposition toward sweet tastes and against bitter foods may modify food preferences. -Twin studies are showing that food preferences, appetite, and feeding skills are more complicated and genetically influenced behaviors than previously understood.

Examine factors that are associated with increased risk for health and developmental problems in infants.

-The birth weight of a newborn is one of the indicators of the infant's health status. -Premature or preterm infants are born before 37 weeks gestation and are classified by their gestational age and birth weight -Low-birthweight (LBW) infants weigh less than 2500 grams; very low-birthweight (VLBW) infants weigh less than 1500 grams. Extremely low--birthweight (ELBW) infants weigh less than 1000 grams. Birthweight and the length of gestation are two of the most important predictors of an infant's survival and later health.

Children and youth with special health care needs (CYSHCN)

. Infants, children and adolescents who have or are at increased risk for chronic physical, developmental, behavioral, or emotional condition and who also require health and related services of a type or amount beyond that required by children generally

appropriate nutrition intervention strategies for infants who are experiencing problems with linear growth or weight gain.

.7.1. Monitor weight, length, and head circumference more frequently. 7.2. Monitor the infant's fluid and food intakes and assess adequacy of energy and nutrients, while acknowledging that the infant's intake may be variable due to illness, congestion, or medication use. 7.3. Change the frequency, volume, or concentration of feedings as needed to meet energy and nutrient needs. 7.4. Modify the timing of breastfeeding or bottle feedings, meals, and snacks to fit medication or sleep schedules. 7.5. Assess the infant's position during feeding. This may be important if the infant is not able to sit without support. 7.6. Increase the nutrient density of foods or fluids, so that the infant has to expend less energy during feedings. 7.7. Provide parent education and/or support services as needed, so that the feeding environment is positive and low in stress. 7.8. Observe the infant-caregiver interaction during feedings, at home or in a developmental program, to make sure that signs of hunger, satiety, and comfort result in positive feeding experiences. 7.9.Adjust nutrition goals to the developmental abilities of the infant.

Corrected Age

11.1. A term also known as adjusted age; it's used with preterm infants. It is calculated by subtracting the number of weeks born before40 weeks of gestation from the infant or child's chronological(actual) age.

Parenteral feeding

15.1. Delivery of nutrients directly into the bloodstream.

low-birthweight infant (LBW)

3.1. An infant weighing<2500 g at birth.

Colic

A condition marked by a sudden onset of irritability, fussiness, or crying in a young infant between 2 weeks and 3 months of age who is otherwise growing and healthy.

oral-gastric (OG) feeding

A form of enteral nutrition support for delivering nutrition by tube placement from the mouth to the stomach.

Lactose

A form of sugar or carbohydrate composed of galactose and glucose

Developmental disabilities

A group of conditions related to impairment in physical, learning, language, or behavioral areas. These conditions have onset in the developmental period, may impact daily functioning, and usually last throughout a person's lifetime.

Gastrostomy Feeding

A procedure where a tube is passed through the nose or mouth into the stomach. This is used to feed preterm or newborn infants who are not yet able or have weak or uncoordinated ability to suck and swallow.

Gavage Feeding

A procedure where a tube is passed through the nose or mouth into the stomach. This is used to feed preterm or newborn infants who are not yet able or have weak or uncoordinated ability to suck and swallow.

Galactosemia

A rare genetic condition of carbohydrate metabolism. It can cause serious illness if not identified and treated shortly after birth.

Suckle

A reflexive movement of the tongue moving forward and backward; earliest feeding skill.

MAcrocephaly

Abnormally large head size for age and gender.

Microcephaly

Abnormally small head size for age and gender.

root reflex

Action that occurs if one cheek is touched, resulting in the infant's head turning toward that cheek and the infant opening his mouth.

Nutritional Interventions for High risk infants

Advances in perinatal and neonatal intensive care 1.2.2. More attention is being given to the medical needs and developmental issues of this population of infants. 1.2.3. In-depth nutrition assessments are completed to determine adequacy of energy and nutrient intakes in supporting optimal growth and development. 1.2.4. Regardless of what condition is involved, addressing these nutrition questions. 1.2.4.1. How often does your baby feed? How long does a feeding generally take? 1.2.4.2. How does your baby behave during a feeding? Pulls away, arches back, looks irritable or calm? 1.2.4.3. How does your baby behave after feedings? Satisfied, still hungry, anxious? 1.2.4.4. Has your baby had any other fluids from a bottle? 1.2.4.5. How many wet diapers and stools does your baby have every day?

Reflex

An automatic (unlearned) response that is triggered by a specific stimulus.

sensorimotor

An early learning system in which the infant's senses and motor skills provide input to the central nervous system

Developmental Delay

An impairment in the performance of tasks or achieving developmental milestones that an infant or child should achieve by a specific chronological age. The diagnosis is made with testing that assesses cognitive, physical, social and emotional development, communication and adaptive skills.

Extremely low-birthweight infant (ELBW)

An infant weighing <1000 g at birth.

5. very low-birthweight infant (VLBW)

An infant weighing<1500 g at birth.

Phenylketonuria

An inherited error in protein metabolism involving phenylalanine and the enzyme phenylalanine hydroxylase.

Congenital anomaly

Condition evident in a newborn that is diagnosed at or near birth, usually as a genetic or chronic condition, such as spina bifida or cleft lip and palate.

Seizures

Condition in which electrical nerve transmission in the brain is disrupted, resulting in periods of loss of function that vary in severity.

Hypothyroidism

Condition in which thyroid hormone is not produced in sufficient quantities, interfering with growth and mental development if untreated in infants.

Anencephaly

Condition initiated early in gestation of the central nervous system in which the brain is not formed correctly, resulting in neonatal death.

Necrotizing enterocolitis (NEC)

Condition with inflammation or damage to a section of the intestine, with a grading from mild to severe.

Cleft lip palate

Conditioning which the upper lip and/or palate are not completely formed and in need of surgical correction. The cleft may contribute to feeding problems in early infancy.

Down Syndrome

Conditions in which three copies of chromosome 21 occur and can be associated with decreased muscle tone, short stature and increased risk for overweight.

Infant mortality

Death that occurs within the first year of life.

Weaning

Discontinuation of breastfeeding or bottle feeding and substitution of food for breast milk or infant formula

Congenital Diaphragmatic Hernia

Displacement of the intestines up into the lung area due to incomplete formation of the diaphragm in utero.

Nutrition problems in Infants with Health care needs infants: FEEDING

Disruption of the delivery of nutrients as a result of : - structure or functioning of the mouth or oral cavity -structure or functioning of the gastrointestinal tract, including diarrhea, vomitting, and consiptation -appetite suppression by constipation or medication -posture or position during meal times -instructions unclear or too complicated for parent to follow

Early Intervention Program

Educational intervention for the development of children from birth up to 3 years of age.

Nutrition problems in Infants with Health care needs infants: Nutritional Adequacy

Energy needs are higher or lower - nutrient requirements or higher or lower overall -specific nutrients such as protein or sodium, are required in higher or lower amounts -vitamins, minerals or cofactors (such as carnitiner are required or lower amounts

Nutrition Assessment and interventions for infants with special health care needs and chronic illness

Examples of assessments for special health care needs infants identify problems such as inadequate linear growth or weight gain, inadequate energy or nutrient intake, or delayed progression in the infant's diet. 5.1.2. Also, assessment of disorders that involve the gastrointestinal tract. Newborn infants identified with congenital diaphragmatic hernia (CDH) or tracheoesophageal atresia (TEF), both of these conditions affect motility of the gastrointestinal tract. Optimal provision of energy and nutrients are needed to support the infant's growth and transition to oral feeding. 5.1.3. Additionally, congenital anomaly identified/assess in infancy is cleft lip with or without cleft palate, or cleft palate. A cleft of the palate is associated with increased risk for ineffective feeding because of the difficulty in establishing an effective seal, suck, and swallow. 5.1.4. Lastly, prenatal genetic testing/assessment can detect newborn will have a specific condition at birth. Such as genetic conditions phenylketonuria (PKU) and galactosemia requiring specific nutritional support, involving therapeutic formulas and dietary interventions and restriction of specific compounds. 5.2. Intervention: 5.2.1. Urea cycle disorders requiring protein restriction (e.g., citrullinemia) 5.2.2. Fat-related disorders requiring restrictions on specific fatty acids (e.g., LCHAD, long-chain hydroxyacyl-CoA dehydrogenase deficiency) 5.2.3. Carbohydrate-related disorders requiring restrictions of type or timing of carbohydrates (e.g., glycogen-storage disease) 5.2.4. Disorders sensitive to high-dose vitamins (e.g., B12 responsive methylmalonic acidemia; also, may require a protein-modified dietary intake) 5.2.5. Renal genetic disorders managed with a protein restriction to delay end-stage renal disease (e.g., polycystic kidney disease)

intrauterine growth retardation (IUGR)

Fetal undergrowth from any cause, resulting in a disproportionality in weight, length, or weight-for length percentiles for gestational age. Sometimes called intrauterine growth restriction

Hypoallergenic

Foods or products that have a low risk of promoting food or other allergies.

tracheoesophageal atresia

Incomplete connection between the esophagus and the stomach in utero, resulting in a shortened esophagus.

how to assess adequate growth in infants.

Indicators include gestational age, birthweight, length, and head circumference. SGA, AGA, and LGA are indicators of the infant's size at birth: (SGA) indicates that the newborn's weight, length, or head circumference plots below the 10th percentile on the growth chart. When all three measurements fall below the 10th percentile, the infant is symmetrically small for gestational age. Measurements above the 90th percentile are considered large for gestational age (LGA) and more often are noted in infants of diabetic mothers. Appropriate for gestational age (AGA) infants have birth measurements that plot between the 10th and the 89th percentile. Another indicator, intrauterine growth restriction (IUGR), is a medical diagnosis identified antenatally. IUGR is a significant factor in perinatal morbidity and mortality. Frequent measurements of weight, length, and head circumference during infancy will facilitate early identification of potential problems such as slow or excessive weight gain or slow linear growth.

Full term infants

Infants born at or after 37 weeks gestation.

Preterm infants

Infants born before 37 weeks of gestation.

Nutritional Assesment and Interventions for high risk infants

Infants who have special health care needs or developmental delay. 1.1.1.1. Infants affected by abnormal development in utero. E.g. infants with cardiac malformations, exposure to drugs or alcohol, or genetic conditions such as Down syndrome.

Infants with feeding problems and appropriate nutrition services **

Infants with feeding problems * Infants who were born preterm or have chronic health problems may be more irritable and less able to signal their wants and needs compared to healthy infants. * VLBW infants. 40-45% of family with VLBW infants reported feeding difficulties * Children with developmental disabilities. 70% of children with developmental disabilities have more frequent feeding problems. * Due to feeding problems, increases the risk for failure to thrive (FTT), (child) abused, and neglected. Appropriate Nutrition services: No specific appropriate nutrition services listed in chapter/section.

Nutrition SUpport

Intravenous nutrition or orally modified formulas needed because of inability to consume a regular diet.

Osmolarity

Measure of the number of particles in a solution, which predicts the tendency of the particles to move from high to low concentration. Osmolarity is a factor in many systems, such as in fluid and electrolyte balance

Enteral Feeding

Method of delivering nutrients directly to the digestive system, in contrast to methods that bypass the digestive system.

how growth is tracked and interpreted in infants at risk or with special health care needs.

Modifications in the usual methods and interpretation of growth are needed in conditions known to influence growth and development of at risk or w/special health care needs: *Use of specialty growth charts for specific diagnoses such as Down syndrome. A list of specialty growth charts is included in Chapter 13. Looking at biochemical indicators of tissue stores of nutrients such as iron and protein, and electrolytes such as potassium and sodium. 3.1.3. Obtaining additional anthropometric measurements to facilitate assessment of body composition, such as mid-arm circumference and triceps skinfold. 3.1.4. Close monitoring of head circumference in the first year when the brain is rapidly growing. There is a high risk of growth failure in children with developmental disabilities; this can be seen with slower gains in weight, length, or head circumference. 3.1.5. Using available evidence-based practice treatment guidelines or published protocols for conditions such as cystic fibrosis and inborn errors of metabolism. Assessing medications that may affect weight gain, appetite, or body composition. Side effects of medications can explain rapid changes in weight.

gastroesophageal reflux disease (GERD)

Movement of the stomach contents backward into the esophagus due to stomach muscle contractions. The condition may require treatment depending on its duration and degree.

Cite examples of nutritional interventions that can reduce risk for nutrition and health problems in infancy.

No feeding at night with carbohydrate rich liquid Increased risk of Caries and Ear infections

hyperbilirubinemia

Presence of an excess of bilirubin in the blood.

What are some guidelines and tools that can be used to identify appropriate energy and nutrient needs of infants.

The DRIs have identified age-specific recommendations for energy and for macro and micronutrients for healthy infants from 0 to 6 months and from 7 to 12 months of age The American Academy of Pediatrics (AAP) and the Academy of Nutrition and Dietetics provide guidelines and position papers related to infant health, nutrition and feeding. The 2014 Dietary Guidelines for Americans provide recommendations for healthful eating and physical activity for individuals starting at 2 years of age.

guidelines and tools that can be used to identify appropriate energy and nutrient needs of infants.

The DRIs have identified age-specific recommendations for energy and for macro and micronutrients for healthy infants from 0 to 6 months and from 7 to 12 months of age The American Academy of Pediatrics (AAP) and the Academy of Nutrition and Dietetics provide guidelines and position papers related to infant health, nutrition and feeding. The 2014 Dietary Guidelines for Americans provide recommendations for healthful eating and physical activity for individuals starting at 2 years of age.

EPSDT

The Early Periodic Screening, Detection, and Treatment Program is a part of Medicaid and provides routine checkups for low-income families

Catch-up growth

The accelerated growth of a premature or small infant, or malnourished infant or child that occurs during the first two years of life.

Describe how families of high-risk infants and infants with special health care needs access nutrition resources and services in their communities.

The following are some examples of how nutrition services may be accessed: 8.1.1. Specialty clinics, such as cardiac, neurology, pulmonology, metabolic, and high-risk infant follow-up clinics frequently have registered dietitian-nutritionists on the specialty team. 8.1.2. Specialty formulas, medical foods, or medical nutrition therapy may be provided through contractual agreements, health plan coverage, and enacted state laws. 8.1.3. Every state also has a program funded by the Maternal Child Health Bureau of the U.S. Department of Health and Human Services to identify and advocate for children with special needs, such as the Developmental Disabilities Council. 8.2. Infants who were born preterm or with special health care needs may qualify for nutrition-related services and programs. Some of these include: 8.2.1. Early Intervention Programs funded through the Individuals with Disabilities Education Act (IDEA), Part C 8.2.2. Early Head Start 8.2.3. WIC 8.2.4. State Children with Special Health Care Needs programs 8.3. Infants with disabling conditions are eligible for Supplemental Social Insurance (SSI), a federal program within the Social Security Administration. SSI provides the family with financial support and access to health insurance if the family meets income eligibility guidelines.

Non-nutritive sucking

The sucking by newborns and young infants on items that do not provide fluid or nutrition.

hydrolyzed protein formula

a Formula that contains enzymatically digested protein, or single amino acids, rather than protein as it naturally occurs in foods.

Identify how nutrition problems and concerns impact overall infant he

infants have lower long-term risks if they are breastfed and not exposed to smoking at home. The AAP recommends that infants not be exposed to screen time from televisions, DVD players, computers, and similar devices at home or in cars. The AAP Committee on Sports Medicine policy statement recommends that structured infant exercise programs should not be promoted as therapeutically beneficial for healthy infants. Failure to thrive * colic * iron deficiency * diarheea and constipation * baby-bottle caries and ear infections * Food allergies and intolerances

infant mortality rate-

number of infants deaths for every 1000 live births