Ost528-G&d-Early/late Infancy,toddlers-Dr. Douma

Front 1

What is uniquely superior for infant feeding, human milk or substitut feeding options?

Back 1

Human milk

Front 2

Exclusive breast feeding is supported for how many months?

Back 2

First 6 mos.

Front 3

How long should breastfeeding continue?

Back 3

For at least 12 months.

Front 4

What are the 3 forms that formulas can come in?

Back 4

1.Ready to feed
2.Liquid concentrate
3.Powdered

Front 5

What is wrong with goat's milk?

Back 5

Has an inadequate amount of folate-->leads to megaloblastic anemia

Front 6

Can all mammalian young process lactose?

Back 6

Yes

Front 7

At what age does one become lactose intolerant?

Back 7

Until the age of weaning (age 2-5)

Front 8

Cow-milk formula with added rice starch is good for babies with what?

Back 8

Acid reflux disorders

Front 9

What do people erroneously believe Low iron cow-milk formula should be used for?

Back 9

Constipation.

Front 10

What do babies with low Iron look like?

Back 10

Pale-physiologic anemia.

Front 11

Is there a reason to feed a baby lactose-free cow milk formula?

Back 11

NO, since babies don't become intolerant until ages 2-5.

Front 12

What type of formula do babies with PKU need?

Back 12

Phenylalanine free formula. PKU babies can be partially breast fed, but monitor their phenylalanine levels.

Front 13

What is galactosemia?

Back 13

Babies cannot break down the simple sugar galactose.

Front 14

Can babies with galactosemia have lactose?

Back 14

No, b/c lactose=galactose + glucose

Front 15

What must babies with galactosemia have?

Back 15

They cannot have lactose and must be given soy formulas.

Front 16

How is Vitamin D made?

Back 16

Vitamin D is made in the body in response to sunlight.

Front 17

What does Vitamin D help us do?

Back 17

Vitamin D helps us absorb and retain calcium.

Front 18

What happens when there is not enough Vitamin D?

Back 18

The body will pull the calcium out of the bones.

Front 19

Where are the natural sources of Vitamin D found?

Back 19

Fatty fish, fish oils, and supplemented cow's milk

Front 20

Is whole milk or skim milk a better source of Vitamin D?

Back 20

Whole milk--b/c vitamin D is fat soluble.

Front 21

What are soft, weak, bones called?

Back 21

RICKETS

Front 22

How much more sun exposure does dark skin require to make adequate Vitamin D?

Back 22

3-6X more sun exposure

Front 23

How does one take a Vitamin D supplement?

Back 23

Take a 1/2 dropper of the OTC product once a day starting with the first two months of life.

Front 24

What is an alternative way to get Vitamin D besides supplementation?

Back 24

Get a daily dose of summer sunshine. B/w 9-11am and 3-5pm are the best times. Stay out for only 5-10 minutes.

Front 25

Since they are born early, what have premature babies lost out on building up stores of?

Back 25

Iron, Fat, Calcium, Phosphorus, & Protein

Front 26

When babies are born very early (32-34 weeks), how do they feed?

Back 26

Babies require enteral feeding (tube feeding) until they can suck/swallow.

Front 27

Why is it hard to give a baby a parenteral feeding?

Back 27

Hard to keep the veins open.

Front 28

When height, weight, BUN, and phosphorus levels are normal, the baby can return to human milk, but what supplements are still required?

Back 28

Iron and multivitamins.

Front 29

If premature babies are fed formula vs. HM, what are they more like to get?

Back 29

Twice as likely to get sepsis and ten times more likely to get necrotizing enterocolitis.

Front 30

What will happen to birth weight at 4-6 mos?

Back 30

Birth weight will double.

Front 31

What will happen to birth weight at 12 mos?

Back 31

Birth weight will triple.

Front 32

What happens to birth length by 12 months?

Back 32

Birth length will increase by 50%

Front 33

At about 6 mos. what plays a strong influence in growth?

Back 33

Genetics.

Front 34

When is crossing percentiles in a growth chart a concern?

Back 34

Baby crosses greater than 2 percentiles.

Front 35

Flat line on a growth chart usually indicates what?

Back 35

Baby is not getting enough to eat.

Front 36

From 6-12 mos., why are solid foods added to a babies diet?

Back 36

Baby needs more iron (to make hemoglobin), zinc, and calories.

Front 37

What is the most difficult mineral to add to food?

Back 37

Iron

Front 38

What 2 substances found in meat are potent enhancers of absorption?

Back 38

Vitamin C and an unknown factor.

Front 39

This mineral is necessary for growth, immune function, and healing. Sources include meats, cheese, legumes, and whole grains. This mineral is more tightly bound to casein and phytates.

Back 39

Zinc

Front 40

When should cow milk be introduced?

Back 40

1 year.

Front 41

This feeding substance has too little iron, linoleic acid, vitamin # and has too much sodium, potassium, and protein.

Back 41

CM

Front 42

Toddlers that are picky eaters have what?

Back 42

"Neophobia" or the fear of trying new things.

Front 43

What is a condition where a toddler eats non-nutritional substances like clay, chalk, dirt, paint, ice, etc...for greater than 1 mo.

Back 43

PICA

Front 44

What is PICA associated with?

Back 44

No clear cut cause; possibly iron & zinc deficiency, laed poisoning, or mental/developmental delay

Front 45

An immune response to small amounts of food, about 1-2 hours after exposure, and one that occurs within minutes related to histamine is called what?

Back 45

Immediate response.

Front 46

What percentage of infants and toddlers retain immediate allergies to food?

Back 46

only 2-3%

Front 47

What is the RAST blood test?

Back 47

Diagnoses food allergies.

Front 48

An allergic immune response related to large amounts of food, with non-fatal symptoms of vomiting, diarrhea, and blood in the stool is called what?

Back 48

Delayed response.

Front 49

Why can't the RAST test be done with a delayed allergic response?

Back 49

B/c delayed allergic response is not IgE mediated, therefore one cannot do the RAST blood test.

Front 50

What is a common manifestation with food hypersensitivities?

Back 50

Eczema.

Front 51

Cow Milk

Back 51

Used if baby has a problem with CM, is vegetarian, or has galactosemia. It is NOT recommended for premature babies. It is NOT indicated to prevent allergy/colic and CM enteropathy.

Front 52

**recommended**

Back 52

Soy Milk

Front 53

An option for those with CM protein sensitivity or malabsorption issues like CF, short gut, or biliary atresia. This can be 2 times as expensive as CM as soy.

Back 53

Partially digest protein hydrolysate

Front 54

Casein (protein)

Back 54

Whey (protein)

Front 55

Fats

Back 55

CHOs

Front 56

Ca

Back 56

Fe

Front 57

CM

Back 57

HM

Front 58

CMF

Back 58

SF

Front 59

80%

Back 59

30%

Front 60

20%

Back 60

70%

Front 61

same

Back 61

30% more than CM

Front 62

2X greater Ca than HM

Back 62

More Fe than HM

Front 63

Protein

Back 63

Minerals

Front 64

Other

Back 64

Human Milk

Front 65

Cow Milk Based Formula

Back 65

Soy Based Formula

Front 66

Partially Hydrolysed Formula (Cow's Milk Formula Variation & Soy Based Variation)

Back 66

Partial Hydrolysed Formula

Front 67

Elemental Amino Acid Formula

Back 67

Pre-Term Formulas

Front 68

80%whey

Back 68

60%whey, 40%casein

Front 69

Soy Protein Isolate

Back 69

100%whey, NO casein Cow Milk Formula Variation: whey is partially broken down into what are called "comfort proteins" so that it might be better tolerated by babies. Soy-based variation: soy protein is partially broken down into smaller groups for better digestion.

Front 70

Casein and whey are heat treated and enzymatically hydrolysed into free amino acis and peptides (Not a pure amino acid formula)

Back 70

The proteins in this formula are completely digested

Front 71

30% more protein and more whey than HM

Back 71

human milk fat, natural sorce for arachidonic acid and docosahexaenoic acid,

Front 72

Fat comes from Medium Chain Trigylercide Oil, soy oil, coconut oil, palm oil, high oleic sunflower oil. Arachidonic acid and Docosahexaenoic Acid are added to enhance vision and IQ. They are low chain polyunsaturated fatty acid synthetic sources and generally regarded as safe although some babies experience diarrhea.

Back 72

Fat come from Medium Chain Triglyceride Oil, soy oil, coconut oil, palm oil, and high oleic sunflower oil.

Front 73

Medium Chain Triglyceride Oil and polyunsaturated vegetable oil.

Back 73

More fat than HM

Front 74

Lactose.

Back 74

Lactose

Front 75

Sucrose

Back 75

Lactose-free. CHOs include sucrose, tapioca starch, corn syrup solids, and cornstarch.

Front 76

Glucose polymers are better absorbed than HM

Back 76

HIGHLY absorbable

Front 77

The minerals have to be at high levels to drive absorption b/c phytates are plant things that bind minerals and make it harder for them to be absorbed. Phytoestrogens may affect babies but their effects are unknown.

Back 77

More minerals like Ca, Ph, Fe, Zn, Na, and K than HM

Front 78

Taurine, Nucleotides are added to enhance immune functions

Back 78

Taurine, carnitine, and methionine

Front 79

Used for babies that cannot tolerate the CM or soy formulas. It doesn't cost any more than the CM or soy formulas.

Back 79

$$$EXPENSIVE$$$

Front 80

The use of this formula is indicated in babies with multiple food protein intolerances. The formula is given by prescription only. The advantages are little or no digestion is required, the stool volume is low, there is minimal stimulation of bile & pancreatic secretions. If you infuse it (via GI tube), it may cause cramping & osmotic diarrhea.

Back 80

Contain a lot of calories (22-24 kcal/oz), and have more vitamins like ADEK & B's than HM

Front 81

First 4 weeks

Back 81

1-3 mos.

Front 82

3-6 mos.

Back 82

7-9 mos.

Front 83

10-12 mos.

Back 83

1-2 oz/day (30-60 g/day)

Front 84

20-30 g/day

Back 84

20 g/day

Front 85

15 g/day

Back 85

12 g/day

Front 86

Birth to 6 mos.

Back 86

Milk only

Front 87

6 mos.

Back 87

Toddler-Hood

Front 88

Add other foods & milk. Need more iron, zinc, and calories in diet.

Back 88

At 6 mos the infant is immunologically at a lower risk for food allergies b/c the GI tract is more mature.

Front 89

Tongue extrusion reflex is gone.

Back 89

Give rice cereal b/c it is fortified with iron and zinc.

Front 90

Babies get the most amt of iron from beef.

Back 90

Do NOT give honey until after 1 year.

Front 91

Amt. fluoride given depends on drinking water.

Back 91

Toddler could continue to breast feed

Front 92

Try to wean the child off the bottle and begin using cups

Back 92

After the age of 2, the child can have 2% milk instead of whole milk.

Front 93

Aim for 12-20 oz of cow milk/day. Limit the amt b/c there is not absorbable iron in cow milk and it's constipating.

Back 93

Don't give Toddler Formula if they are receiving the adequate amt. of iron & vitamins in their diet.

Front 94

In a toddler, when you take their milk volume down, they will have an increase in appetite for other foods.

Back 94

Foods in diet

Front 95

Calories

Back 95

Protein

Front 96

Vitamin

Back 96

Minerals

Front 97

Other

Back 97

Vegetarian

Front 98

Celiac

Back 98

poultry, seafood, dairy, eggs, or vegan

Front 99

It's hard for the vegan to get calories

Back 99

Legumes and grains that complement the essential amino acids.

Front 100

It's hard for the vegan to get B12

Back 100

Iron comes from fortified cereals, and Zn is found in a variety of foods.

Front 101

AVOID GLUTEN:wheat, rye, barley, semolina, spelt, malt, and triticale CAN EAT:rice, corn, soy, potato, quinoa, millet, buckwheat, arrowroot,& amaranth. Oats can be eaten if they have not been contaminated with wheat, which is generally the case in this country.

Back 101

Autoimmune gluten enteropathy where the child gets vague abdominal symptoms & maybe even poor growth. 1/133 in the US have the genetic predisposition.