Chapter 8 413
Full term infant
(37-42 weeks) -typical weight 5.5 - 8.5 Lbs -typical length 18.5 - 21.5
4. What is the AVERAGE caloric need of infants in the first six months of life and 6-12 months per kg of body weight, based on growth in breast-fed infants?
-108 Kcals/kg body weight birth to 6 months -98 kcal/kg body weight 6 to 12 months -can vary depending on weight, growth rate, sleep habits, climate, physical activity, metabolic response to food, and health
9. Describe the steps in correcting failure to thrive (FTT).
-1st increase caloric and protein intake -assess growth and nutrition adequacy, establish a card plan, and provide and follow up -gaining agreement with caregivers about how and when intake and weight monitoring will be done -enroll infant in early intervention program -solving barriers to follow up care, such as transportation -assessing social supports to assure a constant supply of food and formula -assisting in advocating for infant with in health care delivery system
14. Describe other nutrients that an infant may need and how to supplement with them. What are additional recommendations for vegans?
-Infants receiving well-planned vegetarian diets grow normally -breastfed vegan infants need supplements -vitamin d -Vitamin B12 -Possibly iron and zinc
3. Name conditions that reflect the immaturity of the gastrointestinal tract.
-gut should be functional at birth -GERD, Colic, Unexplained diarrhea, and Constipation -6 months for the tract to mature -these conditions do not interfere with food absorption -Colic -Ger -Diarrhea -Constipation
7. List the unsafe foods to give a one-year old.
-hot dogs -hard candy, jelly beans -peanuts and other nuts, chunks of peanut butter -whole grapes -uncut stringy meats, sausage -sticky gums. Gummy foods -hard fruits or vegetables
12. Plot a newborn's weight at birth. Be able to explain if she is SGA, LGA or AGA.
-infants below 10th percentile for gestational age means that it is SGA -infants above 90th are LGA -AGA: appropriate for gestational age
15. Describe how infants develop food preferences.
-infants learn food preferences -flavor of breast milk influenced by mothers diet -genetic predisposition to sweet taste -food preference from infancy sets stage for lifelong food habits
10. Explain cues for progressing food in infants.
-infants watching food being opened in anticipation of eating Cues indicate readiness to feed: -tight fidsts or reaching for a spoon -irritation if feeding is to slow or stops -playing with food or spoon -slowing intake or turning away when full -stop eating or spit out food when full
11. Explain good feeding practices to limit baby bottle caries and ear infections.
-limit the use of a bottle as part of bedtime ritual -offer juices in a cup, not a bottle -put only water in a bottle if offered for sleep -examine and clean emerging baby teeth to prevent cavities from developing
13. What are typical weight gain patterns for healthy newborns?
0-3 month baby weight gain: 20 -30 grams per day 0-6 month baby weight gain: 15 - 21 grams per day 6-12 baby weight gain: 10 -13 grams per day
6. What foods/liquids should be recommended for a baby suffering constipation?
1. make sure the infant is getting sufficient fluids 2. Avoid medications unless prescribed 3. Prune or other juices that have laxative effects 4. Avoid foods with high dietary fiber
Preterm Infant
32 weeks < 37 weeks
9. Describe the steps in correcting failure to thrive (FTT).
A registered dietician will assess growth and nutritional adequacy, establish a care plan, and provide follow-up as a part of a team approach. She may also work with other specialists concerning medical or psychological aspects. - Gaining agreement from the caregiver about how and when intake and weight visits will be done. - Enrolling the infant in an early intervention program in the local area - Arranging for transportation or solving other barriers to follow-up care - Assessing social supports to assure a constant supply of food and Formula (if used) - assisting the family in advocating for the infant within the health care delivery system, such as finding a local pediatrician and getting prescriptions filled
14. Describe other nutrients that an infant may need and how to supplement with them. What are additional recommendations for vegans?
B12 shots if vegan -Fluoride - 0.1 - 0.5 mg/d depending on age (too much may caue tooth discoloration) -Vitamin D - 400 IU/Day -Iron - 11 mg for infants 7 - 12 months -Fiber - no recommendations -lead - none - may be toxic -Supplements for infants -Flouride - for breastfed infants after 6 months or if in any area with no fluoridated water -iron - after 4 months if breastfed -vitamin B12 - for vegans -Vitamin D - needed if exclusively breastfed
16. Explain how caries and ear infections are related. What are feeding techniques to reduce both?
Caries and ear infections are linked to feeding practices Feeding techniques to reduce caries and ear infections -limit use of bedtime bottle -offer juice in a cup -only give water bottles at bedtime -examine and clean emerging teeth
1. Describe the average gestation for a full-term and preterm infant.
Full term infant (37 to 42 weeks) i. typical weight 2500 - 3800 g (5.5 to 8.5 lbs) ii. typical length 47 - 54 cm (18.5 to 21.5 in) iiii. 88% of U.S. infants are born full term Preterm infant 32 weeks < 37 weeks
8. Explain the recommended age for weaning an infant from the breast or bottle to a cup.
Infants will have enough skills to be weaned to a cup at 12-24 month 1-2 years
5. Describe the types of fats that are required in an infant's diet.
Linoleic acid and alpha - linoleic acid Short and medium chain fats (found in breast milk) are more readily utilized than long chain fats (found in formula)
14. Describe other nutrients that an infant may need and how to supplement with them. What are additional recommendations for vegans?
Only in Canada and the United States are certain supplements are recommended for infants that are breastfeeding under certain circumstances. - Fluoride supplements are recommended if the family lives in a place that does not provide fluoridated water - if breast milk is the only form of nutrition after six months, fluoride is recommended.
2. Explain how motor development typically occurs in infants and how it's related to feeding skills/milestones.
The development of muscle control is TOP DOWN -Head Control 1st -Leg Control last Also from central to peripheral *Shoulders 1st *Then hands Motor development influences the ability to feed an the amount of energy expended
8. Explain the recommended age for weaning an infant from the breast or bottle to a cup.
The recommended age for weaning an infant from the breast or bottle to a cup is from 12-24 months. Breastfed infants may make the transition from being breastfed to drinking from a cup without ever having to use a bottle. If breastfeeding is continues as recommended for the first year of life, introducing a cup of water or juice after six months is recommended, near the time that foods are offered on a spoon. Infants who are not breastfed exclusively, or breastfed for less than 12 months to have additional fluids offered in a bottle because their ability to meet their fluid needs by drinking from a cup are not sufficiently developed. Developmental readiness for a cup begins at 6-8 months. Eight-month-old infants enjoy trying to mimic drinking from open cups. However, their ability to elevate the tongue and control the liquid emerges later, closer to a year. The 10-12-month old infant enjoys drinking from a hand held cup and trying to hold his own cup, even though the main feeding method is the breast or bottle.
Fat Needs
¥ No specific recommended intake level for infants ¥ Breastmilk contains about 55% calories from fat ¥ Infants need cholesterol for gonad and brain development ¥ Breast milk contains short-chain and medium-chain fatty acids (in addition to the long-chain) Ð Easier to digest and utilize than long-chain fatty acids
protein needs infants average
¥ Protein Needs Ð 2.2 g/kg/day from birth to 6 months Ð 1.6 g/kg/day from 6 to 12 months
infant needs
Ð Fluoride—0.1 - 0.5 mg/d depending on age (too much may cause tooth discoloration) Ð Vitamin D—400 IU/day Ð Sodium—120-200 mg/day Ð Iron - 11 mg for infants 7-12 months Ð Fiber—no recommendations Ð Lead—None—may be toxic
how much is that
Ð Newborn weighing 4 kg (8.8 lbs) needs 2.2 X 4 = 8.8 g protein Ð 6-month-old weighing 8 kg (17.6 lbs) needs 1.6 X 8 = 12.8 g protein ¥ Protein needs are similar to that of energy but are also influenced by body composition