Infant Nutrition

  1. death that occurs within the first year of life
    infant mortality
  2. death that occurs within the first month of life
    neonatal mortality
  3. major cause of infant mortality (IM)
    low birthweight (<2500g)
  4. Other causes of IM
    • congenital malformations
    • complications related to preterm births
    • sudden infant death syndrome (SIDS)
  5. What are the factors associated with mortality? (4)
    • social and economic status
    • access to health care
    • teenage pregnancy
    • failture to prevent preterm and LBW births
  6. provides healthier care for children in PA that don't qualify for medicaid
    Child health initiatives program (CHIP)
  7. education for healthcare workers to provide proper care for infants
    bright futures
  8. Indicators of newborn health status (3)
    • birthweight
    • length
    • head circumference (indicates brain growth)
  9. Appropriate for gestational age for weight...what percentile?
  10. small for gestational age or intrauterine growth retardation for weight...what percentile?
    less than the 10th percentile
  11. Large for gestational age for weight...what percentile?
    >90th percentile
  12. True/False: Newborn's CNS is immature and so they with have inconsistent cues for hunger
  13. infant turns head toward the cheek that is touched and open mouth
    rooting reflex
  14. reflex causing tongue to move forward and backward
  15. infants ability to control voluntary muscle movement
    motor development
  16. True/False: motor development is bottom up--starts with the legs and then head

    top down--head first then lower legs last
  17. True/False: muscle development is from central to peripheral

    shoulders before hands
  18. a fixed period of time in which certain behaviors or developments emerge
    critical periods
  19. True/False: certain skills must be developed during critical periods in order for subsequent learning to occur
  20. True/False: if the critical period is missed, there may be a difficulty later on
  21. factors (4) that impact cognition
    • sensorimotor development
    • adequate energy and protein intake
    • positive social and emotional interactions
    • genetics
  22. What does the fetus swallow that stimulates the intestinal lining to grow and mature?
    amniotic fluid
  23. how long does it take for the GI tract to mature
    6 months
  24. can occur due to immaturity if the gut (3)
    GERD, diarrhea, constipation
  25. factors that impact the rate of food passage through the colon (3)
    • osmolarity of foods or liquids
    • colon bacterial flora
    • water and fluid balance in the body
  26. Cals needed from birth to 6 months (DRI)
    108 kcal/kg/day
  27. Cals needed from 6 moths to 12 months (DRI)
    98 kcal/kg/day
  28. Protein needed from birth to 6 months
    1.52 g/kg/day (more specific)

    9.1 g/day (general)
  29. Protein needed from 7 months to 12 months
    1.2 g/kg/day (specific)

    11 g/day (general)
  30. True/False: protein needs are influence more directly by body composition than every needs are
  31. What is the recommendation for fat for infants
    no specific recommended intake
  32. Where do infants get their fat?
    breast milk
  33. True/False: Breast milk contains SCFA and MCFA (in addition to LCFA)
  34. True/False: LCFA are easier to utilize and digest than MCFA and SCFA
  35. True/False: metabolic rate of infants is the lowest of any time after birth

    highest! and is related to rapid growth and so they need more calories
  36. Why is it important for growing children to get CHO?
    when CHO intake is limited, amino acids will be converted to glucose for energy and will be less available for growth
  37. Flouride requirements for infants 0-6 months and 6-12 months
    0-6: 0.1 mg/day

    6-12: 0.5 mg/day
  38. Vitamin D requirement for infants
    400 IU/day
  39. Sodium requirements for infants
    120-200 mg/day
  40. True/False: if your child doesn't follow the normal growth pattern they are not normal
    False: there is a wide range of growth patterns considered normal
  41. Newborns ____ their birthweight by 4-6 months and ___ by a year
    • double
    • triple
  42. Typical weight gain for birth to age 6 months
    ~30 g/day 

    1.5-2.5 cm/month
  43. Typical weight gain for 6 months to 12 months
    ~85-140 g/day

    1 cm/month
  44. when do practitioners stop measuring head circumference?
    ~ 2 years old
  45. Types of WHO growth charts (4)
    • weight for age
    • weight for length
    • length for age
    • head circumference
  46. True/False: since you measure growth rate over time if you find one off measurement that means ur child has a problem

    look at trends not individual measurements
  47. Warning signs for growth problems (3)
    • lack of weight or length gain
    • plateau in weight, length, or HC for >1 month
    • drop in weight without regain in a few weeks
  48. AAP and AND recommend ____ ___ for the 1st ___ of life and continuation to ___
    • exclusive breastfeeing
    • 6 months
    • 1 year
  49. kcals in standard formula
    20 kcals/oz
  50. kcals in preterm formula
    22-24 kcal/oz
  51. kcals in breastmilk
    ~20-22 kcal/oz
  52. What is breastmilk higher in when compared to formula?

    55% from BM vs 48-50% in F
  53. What is breastmilk lower in when compared to formula?
    protein but it is adequate
  54. What type of milk should NOT be used during infancy (1st year of life)
    whole, reduce-fat or skim cow's milk (doesn't include cow's milk based formula)
  55. what is linked to the early introduction of cow's milk?
    iron-deficiency anemia 

    • linked to:
    • decreased iron abs due to competition with calcium and phosphorus
    • displacement of iron-rich foods
    • GI blood loss
  56. Why is the high protein in cow's milk a problem?
    too much and too harsh on the GI tract and the kidneys
  57. True/False: there should be limited use of soy protein-based formula during infancy due to the little evidence for benefit of increase soy over milk-based
  58. Why should one use a hydrolyzed formula for milk protein allergy as opposed to soy protein formula?
    one can become allergic to soy
  59. What to use for lactose-intolerant babies
    reduced lactose cow's milk based formula
  60. when do reflexes fade and infants begin to purposely signal wants and needs?
    4-6 weeks
  61. Hunger cues of infants (5)
    • sucking on fists
    • reaching for spoon
    • watching the food being opened in anticipation of eating
    • pointing at food
    • irritation if feeding pace is too slow
  62. Satiety cues (6)
    • seals lips together
    • turns head away
    • playing with food or spoon
    • eating rate slow down
    • pushed food away
    • spits out food
  63. at what age do you start introducing pureed foods on a spoon? how much?
    at 6 months offer 1-2 TBSP for 1-2 meals per day

    *bulk of nutrition is breast milk or formula
  64. What must happen before the introduction of pureed food?
    must be able to sit up and keep head up in high chair
  65. Recommendations for introduction of solid foods (7)
    • shouldn't be overly tired or hungry
    • use small spoon with shallow bowl
    • allow infant to open mouth and extend tongue
    • place spoon on front of tongue with gentle pressure 
    • avoid scraping spoon on gums
    • pace feeding to allow infant to swallow
    • first meals may be small= 5-6 spoons over 10 mins
  66. position for young bottle fed infants
    position in semi-upright position
  67. position for spoon feeding
    infant seated with back and feet supported
  68. adults feeding infants should be:
    in front of infant and making eye contact
  69. offer water (1-2 oz) from a cup at what age?
    6 months
  70. wean infant from bottle drinking at what age?
    12-18 months
  71. true/false: changing from bottle to covered "sippy" cup with a small spout is the same as weaning to an opening cup
    FALSE not the same
  72. When to introduce soft, lumpy foods
    6-8 months
  73. when can infants chew and swallow soft mashed foods?
    8-10 months 

    can't require much chewing (use like a mashed banana) because they aren't developed yet
  74. Examples of first foods at 6 months (2)
    • iron-fortified baby cereal mixed with breast milk or water
    • pureed fruits and vegetables
  75. why is rice cereal normally used for infants?
    easily digest and hypoallergenic
  76. Example of first foods at 9-12 months
    soft table foods such as mashed potatoes, hot cereal, banana
  77. add only ___ new food at a time and offer over a ____ day period

  78. Foods to AVOID (8)
    • popcorn
    • peanuts and nuts
    • rasins, whole grapes
    • stringy meats
    • marshmallows, gum and gummy candy
    • hard candy and jelly beans
    • hot dog pieces 
    • hard raw fruits or vegetables
  79. True/False: Honey should not be fed to infants less than 1 year old

    • honey is potential source of clostridium botulism and infants have immature gut so they can't pass the spore successfully  
    • -spores produce a toxin which causes muscle weakness and can lead to paralysis and respiratory failure
  80. True/False: breast milk or formula prodvide adequate water for health infants up to 6 months

    * additional water needed in hot, humid climates after 6 months
  81. true/false: dehydration due to illness is not common in infants
    false it is common bc of diarrhea 

    use pedialyte
  82. true/false: juices are not recommended before one year of age

    due to hyperosmolality and dental carries

    **avoid colas, clear/colored sodas and tea
  83. Crying or fussiness may be interpreted as ____ resulting in overfeeding
  84. Are babies most likely to be overfed with bottle or breast feeding?

    With breastfeeding baby stops on their own and only a specific amount of milk is produced
  85. babies have an inherent predisposition to what taste?
  86. ____ infants may be exposed to a wider variety of flavors than ____ infants
    breast fed

    formula fed
  87. Recommend a Fluride supplement at 6 months if
    the family lives in an area where there is not Fl in the water
  88. may be prescribed if the mother (who is breast feeding) is the a vegan
    Vitamin B12
  89. Is breast milk is the only form of nutrition, supplementation 400 IU per day recommended  (especially if mom is not in a sunny are). Don't need for formula fed infants
    Vitamin D
  90. if exclusively breastfed it is recommended to have ____ of supplemental ___ starting at 4 months until begins on iron-fortified baby cereal
    1 mg/kg/d

  91. if exclusively breastfed preterm infant, ____ is recommended starting at age 1 month until 12 months to prevent deficiency
    2 mg/kg/d iron supplement
  92. why are preterm infants iron deficient?
    don't have time to build up stores
  93. condition of irritability and excessive, inconsolable in a healthy, well-fed infant

    can occur from early infancy up to 4 or 5 months and episodes may appear at the same time each day
  94. Cause of colic
    unknown but may be due associated with GI upset and may be related to mother's diet when breastfeeding (cow's milk, onions)
  95. Recommendations to relieve colic (3)
    • rocking and swaddling to calm infant
    • proper positioning during feeding
    • burping the infant more frequently
  96. True/False: iron stores in the infant reflect the iron stores of the mother
  97. Long term severe iron deficiency anemia may result in
    long-term learning delays
  98. Why is constipation common in infants?
    the peristalsis in the GI tract isn't that great yet
  99. Why are high fiber foods generally not recommended for constipation?
    mant sources are a choking hazard

    stick with baby food of fruits and vegetables
  100. Why can diarrhea be a serious problem?
    at a risk for dehydration
  101. Why are infants at a  high risk for dehydration with diarrhea? (3)
    • higher metabolic rate
    • smaller fluid reserves
    • dependence on other to provide fluids
  102. What is a common cause of diarrhea for older infants
    excessive fruit just intake
  103. What causes allergic reactions?
    absorption of intact proteins
  104. What should you use if an infant is allergic to cow's milk protein (based formulas)?
    hydrolyzed protein formulas
  105. True/False: GI infections can cause a temporary lactose intolerances that resolves

    **lactose intolerance in infancy tends to be overestimated
  106. Nutrients of concern with vegetarian and vegan diets (6)
    • DHA
    • vitamin D
    • vitamin B
    • calcium
    • iron
    • zinc
  107. A federally funded community based program that provides child development and family support services to low-income families with children from birth to age 3 and includes nutrition education services and helping with alcohol and drug abuse, and helping family sign up for WIC, SNAP, medicaid
    Early head start program
Card Set
Infant Nutrition
LC Exam 2 Matieral