Diet 204 Test 2

Front 1

The healthy people 2010 contains wide ranging national health goals focusing on what two major themes?

Back 1

1. Increasing the quality and years of healthy life
2. Eliminating racial and ethnic disparities in health status

Front 2

A specific objective related to breast feeding is to "_______"

Back 2

increase the proportion of women who breast feed.

Front 3

source of milk for offspring, AKA breast

Back 3

Mammary gland

Front 4

rounded or oblong shaped cavity present in breast

Back 4

Alveoli

Front 5

cells in acinus (milk gland) that are responsible for secreting milk components into ducts

Back 5

Secretory cells

Front 6

____ and ____ increase during puberty ; levels of both hormones increase dramatically to prepare mammary glands for lactation

Back 6

Estrogen and progesterone

Front 7

when milk formation begins

Back 7

lactogenesis I

Front 8

increased blood flow to breast ; milk "comes in"

Back 8

LActogenesis II

Front 9

milk composistion is stable

Back 9

Lactogenesis III

Front 10

stimulates milk production; released in response to suckling, stress, sleep, and sexual intercourse

Back 10

prolactin

Front 11

stimulates letdown; tingling of the breast may occur corresponding to contractions in milk ducts; causes uterus to contract, seal blood vessels and shrink in size

Back 11

Oxytocin

Front 12

Human milk is the only food needed by the majority of healthy infants for~ 6 months ; It nurtures and protects infants from _____

Back 12

infectious disease

Front 13

The _______ changes over a single feeding, over a day, based on age of the infant, presence of infection in the breast, with menses and maternal nutrition status

Back 13

composition of human milk

Front 14

line the alveoli and can contract to cause milk to be secreted into ducts

Back 14

myoepithelial cells

Front 15

hormone produced during letdown that causes milk to eject into ducts

Back 15

oxytocin

Front 16

larger ducts for storage of milk behind the nipple

Back 16

lactiferous sinuses

Front 17

rounded structures of mammary glands

Back 17

lobes

Front 18

term for human milk production

Back 18

lactogenesis

Front 19

___ in mammary glands are the functional units

Back 19

avleoli

Front 20

Each avleoli is composed of _____ with a duct in the center

Back 20

secretory cells

Front 21

_____ that line the alveoli contract during letdown causing milk ejection

Back 21

myoepithelial cells

Front 22

Milk is stored in the ________

Back 22

lactiferous sinuses

Front 23

During puberty the ovaries mature with increases in ____ and ____

Back 23

estrogen and progesterone

Front 24

The first milk secreted during the first few days ; very high in proteins such as secretory IgA and lactoferrin

Back 24

Colostrum

Front 25

major component in human milk , isotonic with maternal plasma

Back 25

water

Front 26

~0.65 kcal/mL; higher fat milk has more calories than lower fat milk; lower in calories than human milk substitute (HMS)

Back 26

energy

Front 27

provide 1/2 the calories in human milk

Back 27

lipids

Front 28

_____ reflects dietary intake of the mother

Back 28

fatty acid profile

Front 29

Lipids in Human milk: Very low fat diet with adequate CHO & protein, milk is high in __________

Back 29

medium chain fatty acids

Front 30

essential for retinal development

Back 30

DHA - docosahexaenoic acid

Front 31

present in human milk from maternal diet

Back 31

trans fatty acids

Front 32

higher in human milk than HMS; early consumption of cholesterol through breast milk appears to be related to lower blood cholesterol levels later in life

Back 32

Cholesterol

Front 33

lower than in whole cow's milk ; have antiviral and antimicrobial effects

Back 33

Total proteins in human milk

Front 34

main protein in mature human milk ; facilitates calcium absorption

Back 34

casein

Front 35

a soluble protein that precipitates by acid or enzyme ; some minerals, hormones and vitamin binding proteins are part of whey

Back 35

Whey

Front 36

~ 20 - 25% nitrogen in human milk ; use to make non-essential amino acids

Back 36

non-protein nitrogen

Front 37

Dominate CHO in human milk; enhances calcium absorption

Back 37

lactose

Front 38

prevent binding of pathogenic microorganisms to gut, which prevents infection and diarrhea

Back 38

Oligosaccharides

Front 39

content in colostrum is ~ double that of mature milke ; yellow color from beta carotene

Back 39

Vitamin A

Front 40

content reflective of mother's exposure to sun

Back 40

Vitamin D

Front 41

Level linked to milk's fat content ; level not adequate to meet needs of preterm infants

Back 41

Vitamin E

Front 42

~5% of breastfed infants at risk for K deficiency based on clotting factors; infants who did not receive K injection at birth may be deficient

Back 42

Vitamin K

Front 43

Water soluble Vitamins in human milk: content reflective of mother's diet ; vitamin most likely to be deficient is ___

Back 43

B6

Front 44

___ and ____ are bound to whey proteins

Back 44

Vitamin B12 and folate

Front 45

____ is seen in women who have hypothyroidism or latent pernicious anemia , are vegans or malnourished, have had gastric bypass

Back 45

Low B12

Front 46

__________ : content related to growth of infant , concentration decreases over 1st 4 months except for magnesium

Back 46

minerals contribute to osmolality

Front 47

Minerals in human milk mostly have high _________ , exclusively breastfed infants have very low risk of ______ despite low iron content of human milk

Back 47

bioavalibility and anemia

Front 48

bound to protein and highly available , rare defect in mammary gland uptake of zinc may cause zinc deficiency that appears as diaper rash

Back 48

zinc

Front 49

_____ is the only mineral not affected by the mother's diet

Back 49

fluoride

Front 50

______ in mother's diet influences taste of breast milk

Back 50

flavor of foods

Front 51

Exposure to a _______ may contribute to infants interest and acceptance of new flavors in solid foods

Back 51

variety of flavors

Front 52

increased _______ stimulates uterus to return to prepregnancy status

Back 52

oxytocin

Front 53

What are the benefits of breastfeeding for women? (3)

Back 53

1. increased oxytocin stimulates uterus to return to prepregnancy status
2. delay in monthly ovulation resulting in longer intervals between pregnancies
3. increased self- confidence and bonding with infants

Front 54

What are the benefits of breast feeding for infants? (7)

Back 54

1. nutritional benefits
2. immunological benefits - lower infant mortality in developing countries
3. reductions in chronic illnesses
4. breastfeeding and childhood overweight
5. cognitive benefits
6. socioeconomic benefits
7. analgesic effects

Front 55

According to the AAP and the U.S. surgeon general optimal duration of breastfeeding is what?

Back 55

exclusively for 6 months and best to breastfeed for 12 months

Front 56

prevents infants from taking things into lungs

Back 56

Gag reflex

Front 57

infant opens mouth wide when close to breast and thrusts tongue forward

Back 57

oral search reflex

Front 58

infant turns to side when stimulated on that side

Back 58

rooting reflex

Front 59

_____ is signaled by infant bringing hands to mouth, sucking on them and moving head from side to side

Back 59

Hunger

Front 60

___ is a late sign of hunger

Back 60

crying

Front 61

allow infant to nurse on one breast as long as they want to ensure they get _____ with its high fat content that provides satiety.

Back 61

hindmilk

Front 62

____ feedings a day are normal for newborns

Back 62

10-12 ; stomach empyting occurs in about 1.5 hours for breastfed infants

Front 63

In infants stomach emptying occurs in ____

Back 63

~1.5 hours

Front 64

What are the vitamin supplements for breastfeeding?

Back 64

vitamin K and sometimes Vitamin D

Front 65

all US infants receive injections at birth

Back 65

Vitamin K

Front 66

exclusively breastfed infants need supplements at 2 months

Back 66

Vitamin D

Front 67

What is the normal weight loos for newborns during the 1st week?

Back 67

~7% of birth weight

Front 68

If there is weight loss of ___ there should be evaluation by the lactation consultant

Back 68

10% or more

Front 69

Malnourished infants become ___, ___, ____ and _____.

Back 69

sleepy, non-responsive, have a weak cry & wet few diapers

Front 70

By day 5 to 7infants should have ___ wet diapers, and ___ soiled diapers

Back 70

6; 3-4

Front 71

Carries can occur in children who are breast fed, risk factor is ____________

Back 71

frequent nursing at night after 1st year

Front 72

All children should be seen ______ months after the 1st tooth erupts or at ____ age

Back 72

6 months, or 1st year of age

Front 73

Based on mypyramid, a breast feeding woman needs ____ calories for her diet.

Back 73

2400

Front 74

the maternal diet should include:
grains = ?
vegetables = ?
fruits = ?
milk = ?
meats and beans = ?
oil = ?

Back 74

8 ounces
3 cups
2 cups
3 cups
6.5 ounces
7 teaspoons

Front 75

What are the energy and nutrient needs for lactation?

Back 75

Energy needs vary by activity levels; DRI : + 500 kcal/day for the 1st 6 months and +400 kcal/day afterwords

Front 76

Components of maternal diet may be linked to ____: Culprit foods are what?

Back 76

colic: cow's milk, eggs, peanuts, tree nuts, wheat, soy and fish

Front 77

protein-calorie malnutrition : results in reduction in milk ____ but not _____

Back 77

volume, not quality

Front 78

Weight loss during breastfeeding: Theoretically, the caloric DRI assume a loss of ____ kg/month

Back 78

0.8kg/month

Front 79

Most women do not reach prepregnancy weight by ____ after birth

Back 79

1 year after birth

Front 80

Modest or short-term energy reductions do not decrease ______

Back 80

milk production

Front 81

Modest energy restriction combined with increased activity may help women _________

Back 81

lose weight and body fat

Front 82

Exercise does not inhibit _____ or ____

Back 82

milk production or infant growth

Front 83

____ enhances fatty acid mobilization

Back 83

aerobic activity

Front 84

Restriction in energy intake enhances _____

Back 84

prolactin

Front 85

_______ is not needed in well-nourished women

Back 85

vitamin and mineral supplements

Front 86

lactating women should drink _____

Back 86

to thirst

Front 87

Depending on the type diet a lactating woman is on determine the _____ that may be needed

Back 87

supplement

Front 88

Women who are Overweight or obesity prior to pregnancy and excess prenatal weight gain breastfeed for a _______ duration

Back 88

shorter

Front 89

Both ________ and _____ mothers need breastfeeding support

Back 89

low-income and more affluent mothers

Front 90

What are the barriers to breastfeeding ? (6)

Back 90

1. embarrassment
2. time and social constraints
3. lack of support from family and friends
4. lack of confidence
5. concerns about diet and health
6. fear of pain

Front 91

What is avalible to breastfeeding women for breastfeeding promotion, facilitation, and support? (6)

Back 91

1. role of the health care system is supporting breast feeding
2. prenatal breastfeeding education and support
3. lactation support in hospitals and birthing centers
4. lactation support after discharge
5. the work place
6. the community

Front 92

A pediatrician, nurse or other knowledgeable health care practitioner should see all breastfed infants at ____ of age

Back 92

2-4 days of age

Front 93

founded in 1956 ; international organiation that provides education, information, support and encouragement to women who want to breast feed

Back 93

Le Leche League

Front 94

for ________ a multidisciplinary breastfeeding task force should be established with representatives from physicians, hospitals and birthing centers, public health, home visitors, la leche league, government/industry/and school boards, and journalists

Back 94

The community

Front 95

What are the public food an d nutrition programs?

Back 95

USDA WIC program
and
Model breastfeeding programs

Front 96

WIC national breastfeeding promotion project - loving support makes breastfeeding work; wellstart international

Back 96

Model breastfeeding programs

Front 97

The vast majority of women do not experience significant problems during breastfeeding

Back 97

true

Front 98

Most porblems could have been prevented with proper prenatal breastfeeding education and a positive breastfeeding initiaiton period

Back 98

true

Front 99

What are the common breastfeeding conditions? (6)

Back 99

1. sore nipples
2. letdown failure
3. hyperactive letdown
4. engorgement
5. plugged duct
6. infection - mastitus

Front 100

When milk doesnt eject from the breast, very uncommon, oxytocin nasal spray may be prescribed, relaxation techniques may help reduce problem

Back 100

Letdown failure

Front 101

may be prevented by proper positioning of the baby on breast, the areola should be in the baby's mouth with tonge and extended against lower lip

Back 101

sore nipples

Front 102

streams of milk come from breast(often time from both breasts) ; if too active may cause infant to choke while nursing ; mother should express milk untill the flow slows then allow infant to nurse ; can cause gas in the infant because the infant tries to drink faster and takes in too much air

Back 102

hyperactive letdown

Front 103

breasts are overfilled with milk; results when supply-and-demand process is not yet established are milk is abdundant
best prevention: nurse frequently- newborns may nurse every 1 to 2 hours
when the baby isnt yet empting the breasts and when the baby starts sleeping more and doesnt feed as much

Back 103

engorgement

Front 104

caused by milk staying in the ducts; painful knot may form in breast; treated by massage and warm compress; prevented by complete emptying of breasts and chaning position of infant while feeding

Back 104

plugged duct

Front 105

mastitis is a bacterial infection of the breast ; incidence is 1 to 5 % of breast feeding women; most common at 2-3 weeks postpartum; gives off a flu like feeling; early treatment: feed the baby as much as possible to empty breasts, and antibiotics

Back 105

infection - mastitus

Front 106

What may mastitus (infection) result from? (3)

Back 106

1. sore and cracked nipples
2. blood borne source of bacterial infection
3. missing a feeding resulting in engorement then plugged duct may precipitate engorement

Front 107

Most medications are excreted through the breast milk ; true or flase?

Back 107

true

Front 108

_____ are not at as high of a risk for drug side effects

Back 108

older infants

Front 109

What are the following examples of? Pharmacokintetic properties of the drug, time average breast milk/plasma drug concentration ratoio drug exposure index, infants ability to absorb detoxify and excrete the drug, infants age feeding pattern total diet and health

Back 109

Variables to consider related to medications during lactation

Front 110

the ratio of the concentration of the drug in the milk to the concentration of the drug in the maternal plasma

Back 110

milk/plasma drug concentration ratio

Front 111

the average infant milk intake per kilogram body weight body weight per day X (the milk plasma ratio divided by the rate of drug clearance) X 100

Back 111

Exposure index

Front 112

Even when a safe drug is chosen keep a look for any _______ in the infant

Back 112

differences (changes)

Front 113

Current evidence suggests combined oral contraceptives (OC) may reduce _____

Back 113

the volume of breast milk

Front 114

The ACOG & WHO recommend against use of combined OC during _______

Back 114

the first 6 weeks postpartum

Front 115

_____ only OC & implants are safe and effective

Back 115

Progestin

Front 116

Herbs during lactation :
1. Echinacea -
2. Ginseng root -
3.St. John's wart-
4.Ephedra (ma huang)
5.Fenugreek-
6.Cabage leaves -

Back 116

1.not recommeded
2. not recommended
3. may suppresses lactation
4. not recommended
5. infants may be allergic
6. safe for topical use to reduce engorgement

Front 117

___ quickly passes to the breast milk

Back 117

alochol

Front 118

Level of alcohol is breast milk iss the same as in _____

Back 118

maternal plasma

Front 119

Peak plasma levels occur at ___ mins after consumption if consumed w/o food and ___ mins after if consumed with food

Back 119

30-60 w/o
60-90 with

Front 120

Alcohol decreases ____ & ___

Back 120

oxytocin and letdown

Front 121

Alcohol does what to the milk?

Back 121

affects the odor - the infant may refuse to drink due to the odor

Front 122

What is the impact of the alochol on breast milk? (4)

Back 122

1. decreases Oxycontin and letdown
2. affects odor of the milk
3. decreases volume consumed by the infant
4. interferes with sleep patterns of the infant

Front 123

Nicotine in the breast milk levels are _____ times higher in breast milke than mother's blood plasma

Back 123

1.5 to 3 times higher

Front 124

the half-life of nicotine is ___ mins so best to delay feeding as long as possible after smoking

Back 124

95 minutes

Front 125

What are the of nicotine while breast feeding ?

Back 125

otitis media, respiratory infections, asthma , colic and reflux

Front 126

____ may change DNA and RNA & the proteins needed for growth

Back 126

Marijuana

Front 127

the level of caffeine in the mothers breast milk is only ___ of that in the mother's plasma

Back 127

1%

Front 128

____ may accumulate in infants younger than 3 to 4 months - it varies from infant to infant

Back 128

caffeine

Front 129

____ may interfere with sleep or cause hyperactivity and fussiness of infant ; but there are no proven long term effects

Back 129

Caffeine

Front 130

What are the drugs or substances that are classified by the AAP as drugs of abuse and are contraindicated ? (4)

Back 130

1. amphetamines
2. cocaine
3. heroin
4. phencyclidine (angel dust, PCP)

Front 131

a yellow color of the skin seen in about 60% of full-term and 80% of preterm infants

Back 131

Jaundice

Front 132

How common is jaundice in full term infants? preterm infants?

Back 132

60% and 80%

Front 133

If jaundice is not resolved the elevated ____ can cause permanent neurological damage

Back 133

bilirubin

Front 134

____ is the most frequent cause for hospital readmission for newborns?

Back 134

jaundice

Front 135

What are 2 major risk factors for severe hyperbilirubinemia?

Back 135

1. jaundice observed in the first 24 hours of life
2. gestational age of 35-36 weeks

exclusive breastfeeding, particulalarly if nursing isnt going well and weight loss is excessive

Front 136

What are 2 minor risk factors of severe hyperbilirubinemia?

Back 136

1. gestational age of 37-38 weeks
2. jaundice observed before dischange

macrosomic infant of a diabetic mother

Front 137

What are 2 decreased risk factors of severe hyperbilirubinemia?

Back 137

1. gestational age of >= 41 weeks
2. exclusive bottle feeding

Discharge from hospital after 72 hours

Front 138

What are 3 environmental polluntants that may be found in breast milk?

Back 138

1. lead - renal, central nervous system impairments
2. mercury - central nervous system impairements
3. brominated flame retardants - thyroid disorders, brain development

Front 139

The WHO and AAP and the USDHHS overwhelmingly support the imporatance of breastfeeding even in a contaminated wold.

Back 139

True

Front 140

a pigment produced as heme from red blood cells break down

Back 140

bilirubin

Front 141

____ is usually processed by the liver and excreted in the baby's stool

Back 141

bilirubin

Front 142

The newborn's liver is not fully mature so _____ is common during the dirst few days of life

Back 142

jaundice

Front 143

Where does the color first appear with jaundice int he body?

Back 143

first in the face and upper body then progresses downward toward the toes

Front 144

In the fetal state _____ were needed to carry oxygen delivered by the placenta

Back 144

high levels of hemoglobin

Front 145

At birth infants have very high levels of hemoglobin and hematocrits at levels of ___ and ___

Back 145

50 and 60%

Front 146

As an infant breathes on his own, high hemoglobin is not needed so RBC begin to break down at ____

Back 146

higher rates

Front 147

Explain the physiological occurance of New born jaundice

Back 147

Beings the 1st day after birth rising steadly with a peak around days 6-7 , Bilirubin level <12 mg/dL , Condition resolves within a few days ; the cause is normal heme breakdown

Front 148

Explain the pathological new born jaundice

Back 148

begins within 1st day after birth rises rapidly and lasts longer ; Bilirubin levels are > 8 mg/dL in the first day; medical intervention with photo-therapy ; cause : various pathological conditions --> immunological disorder galactosemia

Front 149

____ is toxic to cells and may cause brain damage

Back 149

Bilirubin

Front 150

Brain and brain cells destroyed by bilirubin do not ______

Back 150

regenerate

Front 151

What is the mortality rate of bilirubin encepahlopath or kernicterus ?

Back 151

50%

Front 152

What may bilirubin encephalopathy or kernicterus cause?

Back 152

cerebral palsy, hearing loss, paralysis of upward gaze. ; only occurs when not treated properly

Front 153

Onset later than physiological jaundice - typically the 7th to 10th day

Back 153

breast-milk jaundice syndrome

Front 154

____ of breast-fed infants are jaundiced at 3 weeks

Back 154

1/3 of infants

Front 155

Thought that more bilirubin is reabsorbed due to factors in breast milk that promote its absorption ; while the cause is unknown this is a possible reason.

Back 155

Breast-milk jaundice syndrome

Front 156

______ typically resolved it self but in severe cases is treated like regular physiological jaundice

Back 156

breast-milk jaundice syndrome

Front 157

The AAP guideliens recommend ______ for the treatment of jaundice

Back 157

phototherapy using fluorescent lights

Front 158

During the treatment of jaundice the light is absorbed in the bilirubin changing it to a _______ product that can be excreted by the kidneys

Back 158

water-soluble

Front 159

The AAP guidelines encourage the _____ of breast feeding

Back 159

continuation

Front 160

Inform parents that most breastfed infants will become ______

Back 160

jaundice

Front 161

Only _____ of these infants will develop extreme hyperbilirubinemia and kernicterus

Back 161

a small fraction

Front 162

What is the main obstacle when breastfeeding twins, triplets, and quadrulplets ?

Back 162

time and fatigue of the mother

Front 163

____ increases milk supple

Back 163

frequent nursing

Front 164

Parents of multiples need support in ? (4)

Back 164

1. organizaion
2. feeding
3. individualization
4. stress management

Front 165

_______ for greaterthan or equal to 4 months protects against allergies ectopic dermatitis and wheezing.

Back 165

exclusively breast feeking

Front 166

the development of food allergies are influecne by what numerous factors?

Back 166

genetics, duration of breast feeding, time of introductino of other foods , maternal smoking , air pollution , etc.

Front 167

Consumption of ____ by the lactating mother may protect against allergies

Back 167

omega 3 fatty acids

Front 168

no scienctific evidence does ___ foods in a mothers diet produce gas in infant

Back 168

gassy foods

Front 169

Low-allergen maternal diet associated with reduction in _______

Back 169

distressed behavior (colic)

Front 170

What are the allergenic foods eliminated ?

Back 170

cows milk, eggs, peanuts, tree nuts, wheat,soy and fish

Front 171

Infants born ___ weeks may have subtle immaturity making breastfeeding difficult

Back 171

~ 37 weeks

Front 172

What are the complications of near term infants?

Back 172

respiratory instability, poor temperature control, lower glycogen and fat stores , immature immune system, weak suck-swallow coordination

Front 173

___ may be transmitted to infant by breast milk

Back 173

HIV

Front 174

tranmission rates __ to __ depending on duration of breastfeeding with HIV infection.

Back 174

5 to 40%

Front 175

What does the DHHS recommend when it comes to mothers with HIV infection and breast feeding?

Back 175

should not breastfeed or provide their breast milk for the nutrition of their own infant or other infants

Front 176

provide human milk to infants who cannot be breastfed by their mothers

Back 176

human milk banks

Front 177

some neonates ICU's had milk banks until the 1980's when ___ became prevalent

Back 177

HIV infections

Front 178

What are 2 model programs for breast feeding ?

Back 178

1. Breastfeeding promotion in physicians' Office practices (BPPOP)
2. The rush mothers' milk club

Front 179

infant born between 37 and 42 weeks of gestation

Back 179

full term infant

Front 180

infant born at or before 37 weeks gestation

Back 180

preterm infant

Front 181

What is the typical weight of a full term infant ?

Back 181

2500 to 3800 g ( 5.5 to 8.5 lbs)

Front 182

What is the typical length of a full term infant?

Back 182

47-54 cm (18.5 to 21.5 in)

Front 183

___ of U.S. infants are born full term

Back 183

88%

Front 184

death that occurs within the first year of life

Back 184

infant mortality

Front 185

What is a major cause of infant mortality?

Back 185

low birth weight; ( <2500g)

Front 186

What are the other leading causes of infant mortaility?

Back 186

1. congenital malformations
2. preterm births
3. sudden infant death syndrome

Front 187

What are 6 factors associated with infant mortality ?

Back 187

1. social and economic status
2. access to health care
3. medical interventions
4. teenage pregnancy
5. availability of abortion services
6. failure to prevent preterm and LBW birth

Front 188

What are the resources and prevention programs to combat infant mortality? (5)

Back 188

1. medicaid
2. child health initiatives program (CHP)
3. Early periodic screening, detection, and treatment program ( EPSDT)
4. WIC and CDC (nutrition surveillance program)
5. Bright Futures

Front 189

What does IUGR stand for?

Back 189

intrauterine growth retardation. What is the definition?

Front 190

what terms mean the infant was < 10th % wt/age

Back 190

small for gestational age (SGA) and intrauterine growth retardation (IUGR)

Front 191

What term means the new borh was > 90th % wt/age?

Back 191

large for gestational age (LGA)

Front 192

Infants ___ and __ in response to a firmiliar voice

Back 192

hear and move

Front 193

Because the infant CNS system is immature it results in what?

Back 193

inconsistent cues for hunger and satiety

Front 194

Infants have strong reflexes, especially in ____ and ____.

Back 194

suckle and root

Front 195

automatic response triggered by specific stimulus

Back 195

reflex

Front 196

infant turns head toward the cheeck that is touched

Back 196

rooting reflex

Front 197

reflex causing tongue to move forward and backward

Back 197

suckle reflex

Front 198

ability to control voluntary muscles

Back 198

motor development

Front 199

______ is top down - controls head first and lower legs last

Back 199

motor development

Front 200

Muscle development is from ___ to ____

Back 200

central to peripheral

Front 201

What does motor development influence?

Back 201

ability to feed self and the amount of energy expended

Front 202

Gross motor skills rate of development: at what months to the following actions happen?
1. fetal posture -
2. chin up
3. chest up
4. reach and miss
5. sit with support
6. sit on lap and grasp object
7. sit on high chair ; grasp dangling object
8. sit alone
9. stand with help
10. stand holding furniture
11. creep
12. walk when led
13. pull to stand by furniture
14. climb stair steps
15. stand alone
16. walk alone

Back 202

1. 0 months
2. 1 mo
3. 2 mo
4. 3 mo
5. 4 mo
6. 5 mo
7. 6 mo
8. 7 mo
9. 8 mo
10. 9 mo
11. 10 mo
12. 11 mo
13. 12 mo
14. 13 mo
15. 14 mo
16. 15 mo

Front 203

a fixed period of time in which certain behaviors or developments emerge

Back 203

critical periods of infant development

Front 204

____ is necessary for sequential behaviors of development

Back 204

critical periods of infant development

Front 205

What are factors that impact cognition? (5)

Back 205

1. sensorimotor development
2. adequate nutrient intake
3. positive social and emotional interactions
4. genetics
5. combination of senses and motor skills

Front 206

the fetus swallows ______ which stimulates intestinal maturation and growth

Back 206

amniotic fluid

Front 207

What are common problems of the digestive system development of infants ?

Back 207

gastroesophageal reflux (GER), diarrhea , and constipation; often due to increasing in maturity of GI tract (peristalsis ,etc)

Front 208

What are the factors that impact the rate of food passage in the GI tract?

Back 208

1. osmolarity of foods or liquids
2. colon bacterial flora
3. water and fluid balance

Front 209

What is it important for new parents to learn?

Back 209

infant cures of hunger and satiety temperament of infant, how to respond to infant cues

Front 210

the infants emotional reactions to new situations, activity level, and sociability

Back 210

temperment; the temperment of the infant in relation to that of the parent can increase or decrease feeding problems

Front 211

What are the factors that account for the range of caloric needs of infants ?

Back 211

weight, growth rate, sleep/wake cycle, temperature and climate, physical activity, metabolic response to food, health status and recovery from illness

Front 212

What are the energy needs of a full term infant ?

Back 212

108 kcal/kg/day from birth to 6 months
98 kcal /kg/day from 6 to 12 months

Front 213

What are the protein needs for full term infants from birth to 6 months?

Back 213

2.2 g/kg/day

Front 214

What are the protein needs for full term infants from 6 -12 months ?

Back 214

1.6 g/kg/day

Front 215

Breastmilk contains ___ calories from fat.

Back 215

55%

Front 216

Infants need cholesterol for ____ and ___ development

Back 216

growth and brain

Front 217

Why is it important that breast milk contain short-chain and medium-chain fatty acids ?

Back 217

easier for the infant's digestive tract to digest and utilize than long-chain fatty acids

Front 218

The metabolic rate of infants is ____ of any time after birth

Back 218

highest

Front 219

_______ result in protein catabolism impacting growth

Back 219

low carbohydrate and/or energy intake

Front 220

What nutrients/ besides proteins and fats are important in the infants diet?

Back 220

fluoride, vitamin D, sodium

Front 221

Elevated blood levels of ___ can be toxic to the developing brain, interfere with calcium and iron absorption, and bring about slowed growth and shorter statue

Back 221

lead; infants should be screened at 9 to 12 months but if siblings have been found to have it screening can start at 6 months

Front 222

____ is incorportated into the enamel of forming teeth, including those not yet erupted

Back 222

fluoride

Front 223

What is the DRI for fluoride ?

Back 223

0.1 - 0.5 mg/d depending on age; too much can cause discoloration

Front 224

What is the recommendation for Vitamin D because the breast milk has low amount if it?

Back 224

200 IU/ day ; if the infant is not exposed to adequate amounts of sun a supplement is needed

Front 225

____ is required for bone mineralization with calcium.

Back 225

vitamin D

Front 226

What is the recommendation for sodium?

Back 226

120 mg/day ; it is set to match the milk content

Front 227

Are there any recommendations for fiber and lead?

Back 227

no recommendations for either

Front 228

Newborns ___ birthweight by 4-6 months and __ by one year

Back 228

double . triple

Front 229

What does infant growth reflect?

Back 229

nutritional adequacy , health status, economic and environmental adequacy

Front 230

______ and _____ required for accurate measures

Back 230

calibrated scales and recumbent length measurement board

Front 231

What is the typical gains in weight and height (in length) for 0-3 months?

Back 231

weight - 20 to 30 g per day
600 to 900 g per month
length - 1 mm per day
30 mm per month

Front 232

What is the typical gains in weight and heigth (length ) for age of 3-6 months?

Back 232

weight - 15 to 21 g per day
450 to 630 g per month
length - 0.68 mm per day
20 mm per month

Front 233

What is the typical gain in weight and height (length) for age 6 -12 months?

Back 233

weight - 10 to 13 g per day
300 to 390 g per month
length - 0.47 mm per day
14 mm per month

Front 234

Physical growth assessment helps identify _______, preventing or minimizing slowing of the growth rate.

Back 234

health problems early

Front 235

Measures over time identify change in ____ and _____

Back 235

growth rate and need for intervention

Front 236

What are warning signs for infants?

Back 236

1. lack of weight gain
2. plateau in weight, length, or head circumference for greater than 1 month
3. drop in weight without regain in a few weeks

Front 237

AAP & ADA recommend exclusive breastfeeding for _____ and continuation to _____

Back 237

1st 6 months and continuation to the 1st year

Front 238

Breast feeding should be initiated right after birth

Back 238

true

Front 239

___ and ___ indicate adequacy of milk volume

Back 239

growth rate and health status

Front 240

The standard infant formula provides ___; preterm formula provides ___

Back 240

standard = 20 cal/ oz
preterm = 22-24 cal / oz

Front 241

IS any form of Cows milk okay to use during infancy?

Back 241

Whole, reduce-fat or skim cow's milk should not be used in infancy

Front 242

____ is linked to early introduction of cow's milk

Back 242

iron-deficiency anemia

Front 243

What is anemia linked to?

Back 243

GI blood loss, Calcium and phosphorus, displacement of iron-rich foods

Front 244

When is it okay to introduce cows milk?

Back 244

at 1 year

Front 245

Infants are born with ___ and ___ that aid in the development of infant feed skills

Back 245

reflexes and food intake regulatory mechanism

Front 246

Infants have an inherent preference for ____

Back 246

sweet taste

Front 247

At ____ the reflexes fade and infant begins to purposely signal wants and needs

Back 247

4-6 wks

Front 248

At ___ infants move tongue from side to side indicating readiness for solid foods

Back 248

4 - 6 months

Front 249

Food offered from spoon stimulates _____

Back 249

muscle development

Front 250

at 4-6 months offer small portions of _____ food on a spoon once or twice each day

Back 250

semisoft food

Front 251

____ is the least allergenic and is introduced 1st

Back 251

rice cereal

Front 252

What are the 7 recommendations for introduction of solid foods to infants?

Back 252

1. infant should not be overly tired or hungry
2. use small spoon with shallow bowl
3. allow infant to open mouth and extend tongue
4. place spoon on front of tongue with gentle pressure
5. avoid scraping spoon on infant's gums
6. pace feeding to allow infant to swallow
7. first meals may be 5-6 spoons over 10 minutes

Front 253

What is the importance of infant feeding proper positions?

Back 253

improper positioning may cause choking, discomfort, and ear infections

Front 254

position young bottle fed infants in a ______ position

Back 254

semi-upright

Front 255

Spoon-feeding should be with infant __________

Back 255

seated with back and feet supported

Front 256

Adults feeding infants should be directly _____ .

Back 256

infront of the infant making eye contact

Front 257

First meals should be _____ over ____ time period

Back 257

5-6 spoons over a 10 minute period

Front 258

What are the steps for preparing for drinking in a cup? (4)

Back 258

1. offer water or juice from a cup after 6 months
2. wean to cup at 12 to 24 months
3. first portion from a cup is 1-2 oz
4. early weaning may result in plateau in weight and/or constipation

Front 259

Can swallow pureed foods at ___

Back 259

4-6 months

Front 260

early introduction of lumpy foods may cause ___

Back 260

choking

Front 261

Can swallow very soft, lumpy foods at _____

Back 261

6-8 months

Front 262

by ____ infant can eat mashed foods

Back 262

8-10 months

Front 263

at 4-6 months the first foods should be ___

Back 263

iron-fortified baby cereal

Front 264

at 6 months the first foods introduced should be ____

Back 264

fruits and vegetables ; 1 new food every 2 to 3 days . this is done to determine if the infant has a food allergy

Front 265

___ are sanitary and convenient

Back 265

commercial baby foods

Front 266

at 9-12 months the first food introduced should be ____

Back 266

soft table foods

Front 267

What are the foods that are inappropriate and unsafe for infants/children?

(please pray real good sally has hot heat)

Back 267

popcorn, peanuts, raisins, whole grapes, stringy meats, hard candy or jelly beans, hot dogs, hard fruits or vegetables

Front 268

When should water be introduced?

Back 268

after 6 months ; limit the intake of juice and avoid cola and teas

Front 269

All forms of fluid contribute to ___ ; additional plain water needed in hot, humid climates .

Back 269

water intake

Front 270

____ is common in infants; pedialyte or sports drinks provide electrolytes but lower in calories than formula or breast milk

Back 270

dehydration

Front 271

How much food is enough for infants?

Back 271

infants vary in temperament; crying or fussiness may be interpreted as hunger resulting in over feeding

Front 272

first foods may appear to be rejected due to _____

Back 272

immature tongue movement

Front 273

How do infants learn food preferences?

Back 273

the flavor of breast milk is influenced by the mother's diet ; they have a genetic predisposition to sweet taste; food preference from infancy sets the stage for lifelong food habits

Front 274

Providing a ______ is recommended so infants can explore and move as a part of their developmental milestones

Back 274

stimulating environment

Front 275

Do infants require exercise?

Back 275

no. infants do not have the strength or reflexes to protect themselves and their bones are more easily broken than those of older children and adults

Front 276

What supplements are needed for infants?

Back 276

1. fluoride - for breast fed infants
2. iron - if the mother was anemic
3. vitamin B12 - if the mother is a vegan
4. Vitamin D - needed if low sun exposure

Front 277

condition of inadequate weight or height gain thought to result from a calorie deficit, whether or not the cause can be identified as a health problem

Back 277

Failure to thrive (FTT)

Front 278

inadequate wt or length(height) gain resulting from a diagnosed medical illness

Back 278

organic failure to thrive

Front 279

inadequate wt or ht gain without an identifiable biological / medical diagnosis , so than an environmental cause is suspected

Back 279

non organic failure to thrive

Front 280

What is the recommended intervention for FTT?

Back 280

may be complex and involve a team approach including the registered dietitian

Front 281

general term used to group specific diagnoses together that limit daily living and functioning and occur before age 21

Back 281

developmental disabilities

Front 282

the sudden onset of irritability, fussiness or crying ; episodes may appear at the same time of each day ; disappears; cause is unknown but associated with GI upset, infant feeding practices

Back 282

Colic

Front 283

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

Back 283

colic

Front 284

uncommon in infants because of prenatal iron stores of the mother ; more common in low-income families

Back 284

iron-deficiency anemia

Front 285

Breastfed infants may be given iron supplements and iron fortified cereals at ____

Back 285

4-6 months

Front 286

What is the RDA of iron for infants?

Back 286

infants up to 6 months - 6 mg
6 to 12 months - 10 mg

Front 287

Infants typically have ___ stools/day

Back 287

2 to 6 stools/day

Front 288

What are the causes of diarrhea and constipation?

Back 288

1. breastmilk
2. iron-fortified formula
3. soy formula
4. bacteria or virus

Front 289

Prevention of baby bottle carries and ear infections are both linked to ____

Back 289

feeding practices

Front 290

What are the feeding techniques to reduce carries and ear infections ?

Back 290

1. limit use of bedtime bottle
2.offer juice in cup
3. only give water bottles at bedtime
4. examine and clean emerging teeth

Front 291

About ___ of children less than 4 years have allergies

Back 291

6-8 %

Front 292

Absorption of ____ causes allergic reactions

Back 292

intact proteins

Front 293

What are the common symptoms of food allergies and intolerance?

Back 293

wheezing or skin rashes, GI upset

Front 294

What is the treatment for food allergies and intolerances?

Back 294

treatment may consist of formula with hydrolyzed proteins

Front 295

formula that contain ezymatically digested protein, or single amino acids rather than protein as it naturally occurs in food

Back 295

hydrolyzed protein formula

Front 296

inability to digest the disaccharide lactose ; characterized by cramps, nausea and pain and alternating diarrhea and constipation

Back 296

lactose intolerance

Front 297

a form of sugar or carbohydrate composed of galactose and glucose

Back 297

lactose

Front 298

how is lactose intolerance treated?

Back 298

with soybean - based or lactose-free cow's milk formulas ; many infants "outgrow" lactose intolerance

Front 299

___ do not reflect ethnic diversity ; some cultural practices are harmful ; others are harmless or helpful.

Back 299

baby foods

Front 300

_____ may impact willingness to participate in assistance programs

Back 300

cultural considerations

Front 301

Can infants receiving a well-planned vegetarian diets grow normally?

Back 301

yes

Front 302

What do breastfed vegan infants need supplemented?

Back 302

vitamin D, vitamin B12 , iron, possibly iron and zinc

Front 303

What is a nutrition intervention for risk reduction?

Back 303

Early head start program

Front 304

works with families at risk such as drug abuse, infants with disabilities or teenage mothers

Back 304

Early head start program

Front 305

Model program: newborn screening and expanded newborn contains?

Back 305

phenylketonuria, galactosemia, hypothyroidism, or sickle-cell anemia

Front 306

all new borns are screened for rare conditions that may cause disability or death.

Back 306

model program: new born screening and expanded newborns

Front 307

infants , children or adolescents with, or at risk for a physical or developmental disability or with a chronic medical condition

Back 307

children with special health care needs

Front 308

a federal category of services for infants, children and adolescents with or at risk for physical or developmental disability or witha chronic medical condition caused by or associated with genetic /metabolic disorders, birth defects, prematurity, trauma, infection or perinatal exposure to drugs

Back 308

children with special health care needs

Front 309

an infant weighing < 2500 g or < 5 lbs 8 oz at birth

Back 309

Low-birth weight (LBW)

Front 310

an infant weighing < 1500 g or 3 lbs 5 oz at birth

Back 310

very low birth weight (VLBW)

Front 311

an infant weighing < 1000 g or 2 lbs 3 oz at birth

Back 311

extremly low birth weight (ELBW)

Front 312

occuring from birth to 28 days after birth

Back 312

neonatal death

Front 313

occuring after 20 weeks gestation to 28 days after birth

Back 313

perinatal death

Front 314

advances in ____ have reduced infant mortality

Back 314

health care

Front 315

Advances in neonatal health care have increased survival of infants who were ___, ___, and or ____.

Back 315

preterm, low birth weight and or chronic conditions

Front 316

becuase of the advances in neonatal health care and more infants surviving this is an increased need for ______.

Back 316

specialized nutritional services

Front 317

What are the key questions regarding infants?

Back 317

1. how is the baby growing
2. is the diet providing all required nutrients
3. how is the infant being fed

Front 318

Families of infants with special health care needs should be considered ____

Back 318

at risk

Front 319

the emotional impact of having sick newborn maybe overwhelming to parents ; health care providers must be sensitive to parent's emotional needs

Back 319

true for infants at risk

Front 320

______ are required for infections, fever, difficulty breathing, temperature regulation, and recovery from surgery.

Back 320

increased calories

Front 321

preterm energy needs are _____

Back 321

120 kcal/kg

Front 322

decreased calories recommended for _____ or _____

Back 322

spina bifida or down syndrome

Front 323

What are the protein requirements if growth or digestion are not affected?

Back 323

2.2 g/kg

Front 324

What are the protein requirements required for preterm or recovery from illness ?

Back 324

3.0 - 3.5 g/kg

Front 325

What is the possibly needed requirement for ELBW?

Back 325

4 g/kg

Front 326

What form of proteins are available for infants?

Back 326

hydrolyzed protein or single amino acid formulas and specific amino acid formulas such as for PKU

Front 327

___ % of calories from fat should be provided?

Back 327

55% ; a low fat diet is rarely required for VLBW or ELBW infants

Front 328

Medium chain triglycerides (MCT) beneficial to VLBW and ELBW infants because of ______

Back 328

low pancreatic and liver enzymes

Front 329

essential fatty acids and DHA and amino acids are important for infants

Back 329

true

Front 330

a liquid form of dietary fat used to boost calories; composed of medium chain triglycerides

Back 330

MCT oil

Front 331

peroid of time shortly after a slow growth period when the rate of weight and height gains is likely to be faster than expected for life and gender

Back 331

catch-up growth

Front 332

condition in which body pools of calcium are unbalanced and low levels are measured in blood as a part of a generalized reaction to illness

Back 332

hypocalcemia

Front 333

May need additional vitamins and minerals to support _____ or during ______.

Back 333

"catch up" growth or recovering from an illness

Front 334

_____ provide additional calories and nutrients

Back 334

human-milk fortifiers

Front 335

Tracking growth reflects _____ for most infants

Back 335

nutritional status

Front 336

What are additional methods to use if underlining conditions exist are?

Back 336

1. growth charts for specific conditions
2. biochemical indicators
3. body composition
4. head circumference
5. medications that impact growth

Front 337

"Neonatal research network growth observational study research network" tracks infants birth weight between ___ and ___

Back 337

501 and 1501 g

Front 338

How do they compare and chart growth in preterm infants?

Back 338

Infant health and developmental growth charts:
for LBW premature
for VLBW premature

Front 339

How do you calculate correction for gestational age?

Back 339

([40]length of a full term pregnancy - gestational age at birth)/ 4 = months
infants current age - months = correction for gestational age

Front 340

Does intrauterine growth predict outside growth?

Back 340

Yes, no maybe ; it depends on intrauterine environment, fetal origins theory, and other factors like air pollution

Front 341

______ is frequently used to measure improvement in preterm and sick infants

Back 341

rate of growth

Front 342

____ or ____ may affect body composition and growth

Back 342

microencephaly and macroencephaly

Front 343

small head size for age and gender as measured by centimeters (or inches) of head circumference

Back 343

microcephaly

Front 344

large head size for age and gender as measured by centimeters (or inches) of head circumference

Back 344

macrocephaly

Front 345

range of symptoms reflecting slow development such as slow growth and /or feeding problems

Back 345

developmental delays

Front 346

conditions represented by at least a 25% delay by standard evaluation in one or more areas of development such as gross or fine motor; cognitive, communication, social or emotional development

Back 346

developmental delay

Front 347

developmental delays seen in infancy

Back 347

down syndrome

Front 348

What do nutritional concerns include?

Back 348

1. weak facial muscles causing feeding difficulty
2. overweight common- close monitoring of growth
3. low amount of movement resulting in reduced caloric needs

Front 349

the incidence and prognosis of severe preterm birth and nutrition is a survival rate of ~ ___. Nutrition support is generally ______. they have ____ metabolic rates .

Back 349

90%, required and high

Front 350

Preterm infants fed by nutrition support types are ?

Back 350

parenteral and enteral

Front 351

nutrients delivered directly to the blood stream

Back 351

parenteral

Front 352

nutrients delivered directly to GI tract

Back 352

enteral

Front 353

condition of deficts in communication and social interaction with onset generally before age 3 in which mealtime behavior and eating problems occur along with other behavioral and snesory problems

Back 353

autism

Front 354

provision of regular foods or nutrients by methods other than eating regualr foods or drinking regular beverages such as directly accessing the stomach by tube or placing nutrients into the blood stream

Back 354

nutrition support

Front 355

What are conditions requiring parenteral feeding?

Back 355

Gastrointestinal problems may interfere with oral feeding.
Damage or inflammation to GI tract from necrotizing enterocolitis (NEC)

Front 356

What are conditions requiring enteral feedings?

Back 356

Gastrointestinal reflux, constipation, spitting up, vomiting , etc.

Front 357

What are types of enteral tub feedings?

Back 357

Oral-gastric (OG)
transpyloric
gastrostomy
jejunostomy

Front 358

How important is food safety for severe preterm infants?

Back 358

it is vital for preterm infants with immature immune systems because if they get sick they are likely to die form it ( the lose to much weight etc. )

Front 359

What should preterm infants be fed?

Back 359

breast milk, human milk fortifier , and preterm infant formulas

Front 360

varies in caloric content but higher in calories than normal formulas , can add MCT oil and whey protein

Back 360

preterm infant formulas

Front 361

What are the challenges in feeding VLBW or ELBW infants?

Back 361

fatigue, low tolerance of volume , and "disorganized feedings" (due to their increased sleep needs etc.

Front 362

Feeding problems are seen in ____ of VLBW infants ; feeding problems may cause frustration in families . Recommendations for introducing solids and weaning are based on _______.

Back 362

40-45% ; corrected gestational age

Front 363

What are the nutrition interventions for preterm infants ?

Back 363

1. frequent growth assessment
2. monitor intake
3. adjust feeding frequency/volume
4. nutrient density to facilitate eating
5. parent education
6. observe parent-infant interactions
7. consider developmental abilities

Front 364

What are the nutrition services avalible for preterm infants?

Back 364

federal disability programs, IDEA, Early head start, WIC, and MCH block grant

Front 365

condition with inflammation or damage to a section of the intestine with grading from mild to severe

Back 365

necrotizing enterocolitis (NEC)

Front 366

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

Back 366

oral gastric feeding (OG)

Front 367

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

Back 367

transpyloric feeding (TP)

Front 368

form of enteral nutrition support for delivering nutrition by tube placement directly into the stomach , by bypassing the mouth through a surgical procedure that creates an opening through the abdominal wall and stomach

Back 368

Gastrostomy feeding

Front 369

form of enteral nutrition support for delivering nutrition by tube placement directly into the upper part of the small intestine

Back 369

jejunostomy feeding

Front 370

educational intervention for the development of children from birth up to 3 years of life

Back 370

early intervention program

Front 371

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

Back 371

congenital anomaly

Front 372

category used in tracking infant deaths in which specific diagnoses have a high mortality

Back 372

infant mortality attributeable to birth defects (IMBD)

Front 373

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

Back 373

anenchephaly

Front 374

displacement of the intestine up into the lung area due to incomplete formation of the diaphragm in utero

Back 374

disaphragmatic hernia

Front 375

incomplete connection between the esophagus and the stomach in utero resulting in a shortened esophagus

Back 375

tracheoesophageal atresia

Front 376

condition in which the upper lip and roof of the mouth are not formed completely and are surigcally corrected resulting in feeding speaking and hearing difficulties in childhood

Back 376

cleft lip and palate

Front 377

rare genetic condition of protein metabolism in which breakdown by products build up in blood and urine causing coma and death if untreated

Back 377

maple syrup urine disease

Front 378

condition in which chromosome 22 has a small deletion , resulting in a wide range of heart speech and learning difficulties

Back 378

VCFS ( also known as Digeorge syndrome )

Front 379

hormone for ductal growth

Back 379

estrogen

Front 380

hormone for alveolar development

Back 380

progesterone

Front 381

hormone for development of terminal end buds

Back 381

human growth hormone

Front 382

hormone for alveolar development

Back 382

human placental lactogen

Front 383

hormone for alveolar development and milk secretion

Back 383

prolactin

Front 384

hormone for letdow: ejection of milk from myopithelial cells

Back 384

oxytocin