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101 Cards in this Set

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What is uniquely superior for infant feeding, human milk or substitut feeding options?
Human milk
Exclusive breast feeding is supported for how many months?
First 6 mos.
How long should breastfeeding continue?
For at least 12 months.
What are the 3 forms that formulas can come in?
1.Ready to feed
2.Liquid concentrate
3.Powdered
What is wrong with goat's milk?
Has an inadequate amount of folate-->leads to megaloblastic anemia
Can all mammalian young process lactose?
Yes
At what age does one become lactose intolerant?
Until the age of weaning (age 2-5)
Cow-milk formula with added rice starch is good for babies with what?
Acid reflux disorders
What do people erroneously believe Low iron cow-milk formula should be used for?
Constipation.
What do babies with low Iron look like?
Pale-physiologic anemia.
Is there a reason to feed a baby lactose-free cow milk formula?
NO, since babies don't become intolerant until ages 2-5.
What type of formula do babies with PKU need?
Phenylalanine free formula. PKU babies can be partially breast fed, but monitor their phenylalanine levels.
What is galactosemia?
Babies cannot break down the simple sugar galactose.
Can babies with galactosemia have lactose?
No, b/c lactose=galactose + glucose
What must babies with galactosemia have?
They cannot have lactose and must be given soy formulas.
How is Vitamin D made?
Vitamin D is made in the body in response to sunlight.
What does Vitamin D help us do?
Vitamin D helps us absorb and retain calcium.
What happens when there is not enough Vitamin D?
The body will pull the calcium out of the bones.
Where are the natural sources of Vitamin D found?
Fatty fish, fish oils, and supplemented cow's milk
Is whole milk or skim milk a better source of Vitamin D?
Whole milk--b/c vitamin D is fat soluble.
What are soft, weak, bones called?
RICKETS
How much more sun exposure does dark skin require to make adequate Vitamin D?
3-6X more sun exposure
How does one take a Vitamin D supplement?
Take a 1/2 dropper of the OTC product once a day starting with the first two months of life.
What is an alternative way to get Vitamin D besides supplementation?
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.
Since they are born early, what have premature babies lost out on building up stores of?
Iron, Fat, Calcium, Phosphorus, & Protein
When babies are born very early (32-34 weeks), how do they feed?
Babies require enteral feeding (tube feeding) until they can suck/swallow.
Why is it hard to give a baby a parenteral feeding?
Hard to keep the veins open.
When height, weight, BUN, and phosphorus levels are normal, the baby can return to human milk, but what supplements are still required?
Iron and multivitamins.
If premature babies are fed formula vs. HM, what are they more like to get?
Twice as likely to get sepsis and ten times more likely to get necrotizing enterocolitis.
What will happen to birth weight at 4-6 mos?
Birth weight will double.
What will happen to birth weight at 12 mos?
Birth weight will triple.
What happens to birth length by 12 months?
Birth length will increase by 50%
At about 6 mos. what plays a strong influence in growth?
Genetics.
When is crossing percentiles in a growth chart a concern?
Baby crosses greater than 2 percentiles.
Flat line on a growth chart usually indicates what?
Baby is not getting enough to eat.
From 6-12 mos., why are solid foods added to a babies diet?
Baby needs more iron (to make hemoglobin), zinc, and calories.
What is the most difficult mineral to add to food?
Iron
What 2 substances found in meat are potent enhancers of absorption?
Vitamin C and an unknown factor.
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.
Zinc
When should cow milk be introduced?
1 year.
This feeding substance has too little iron, linoleic acid, vitamin # and has too much sodium, potassium, and protein.
CM
Toddlers that are picky eaters have what?
"Neophobia" or the fear of trying new things.
What is a condition where a toddler eats non-nutritional substances like clay, chalk, dirt, paint, ice, etc...for greater than 1 mo.
PICA
What is PICA associated with?
No clear cut cause; possibly iron & zinc deficiency, laed poisoning, or mental/developmental delay
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?
Immediate response.
What percentage of infants and toddlers retain immediate allergies to food?
only 2-3%
What is the RAST blood test?
Diagnoses food allergies.
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?
Delayed response.
Why can't the RAST test be done with a delayed allergic response?
B/c delayed allergic response is not IgE mediated, therefore one cannot do the RAST blood test.
What is a common manifestation with food hypersensitivities?
Eczema.
Cow Milk
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.
**recommended**
Soy Milk
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.
Partially digest protein hydrolysate
Casein (protein)
Whey (protein)
Fats
CHOs
Ca
Fe
CM
HM
CMF
SF
80%
30%
20%
70%
same
30% more than CM
2X greater Ca than HM
More Fe than HM
Protein
Minerals
Other
Human Milk
Cow Milk Based Formula
Soy Based Formula
Partially Hydrolysed Formula (Cow's Milk Formula Variation & Soy Based Variation)
Partial Hydrolysed Formula
Elemental Amino Acid Formula
Pre-Term Formulas
80%whey
60%whey, 40%casein
Soy Protein Isolate
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.
Casein and whey are heat treated and enzymatically hydrolysed into free amino acis and peptides (Not a pure amino acid formula)
The proteins in this formula are completely digested
30% more protein and more whey than HM
human milk fat, natural sorce for arachidonic acid and docosahexaenoic acid,
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.
Fat come from Medium Chain Triglyceride Oil, soy oil, coconut oil, palm oil, and high oleic sunflower oil.
Medium Chain Triglyceride Oil and polyunsaturated vegetable oil.
More fat than HM
Lactose.
Lactose
Sucrose
Lactose-free. CHOs include sucrose, tapioca starch, corn syrup solids, and cornstarch.
Glucose polymers are better absorbed than HM
HIGHLY absorbable
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.
More minerals like Ca, Ph, Fe, Zn, Na, and K than HM
Taurine, Nucleotides are added to enhance immune functions
Taurine, carnitine, and methionine
Used for babies that cannot tolerate the CM or soy formulas. It doesn't cost any more than the CM or soy formulas.
$$$EXPENSIVE$$$
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.
Contain a lot of calories (22-24 kcal/oz), and have more vitamins like ADEK & B's than HM
First 4 weeks
1-3 mos.
3-6 mos.
7-9 mos.
10-12 mos.
1-2 oz/day (30-60 g/day)
20-30 g/day
20 g/day
15 g/day
12 g/day
Birth to 6 mos.
Milk only
6 mos.
Toddler-Hood
Add other foods & milk. Need more iron, zinc, and calories in diet.
At 6 mos the infant is immunologically at a lower risk for food allergies b/c the GI tract is more mature.
Tongue extrusion reflex is gone.
Give rice cereal b/c it is fortified with iron and zinc.
Babies get the most amt of iron from beef.
Do NOT give honey until after 1 year.
Amt. fluoride given depends on drinking water.
Toddler could continue to breast feed
Try to wean the child off the bottle and begin using cups
After the age of 2, the child can have 2% milk instead of whole milk.
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.
Don't give Toddler Formula if they are receiving the adequate amt. of iron & vitamins in their diet.
In a toddler, when you take their milk volume down, they will have an increase in appetite for other foods.
Foods in diet
Calories
Protein
Vitamin
Minerals
Other
Vegetarian
Celiac
poultry, seafood, dairy, eggs, or vegan
It's hard for the vegan to get calories
Legumes and grains that complement the essential amino acids.
It's hard for the vegan to get B12
Iron comes from fortified cereals, and Zn is found in a variety of foods.
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.
Autoimmune gluten enteropathy where the child gets vague abdominal symptoms & maybe even poor growth. 1/133 in the US have the genetic predisposition.