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77 Cards in this Set
- Front
- Back
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How long should you breast feed?
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6 months exclusive breastfeeding
Followed by continued breastfeeding w/ appropriate food until 1 yro |
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What is the breast feeding trend?
What about oklahoma rates (general)? |
The rates are rising
OK is among the lowest |
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What race has the lowest rates?
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Non-hispanic black mothers
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What group of moms has the highest rate of breastfeeding INITIATION?
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>30 yro
> High school education Household > 400% of poverty level |
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What group of moms has the highest rate of exclusive breastfeeding at 6 mos?
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>30yro
Postive emotional and mental health Home free of tobacco smoke |
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What barriers do mothers face?
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Lack of knowledge
Social norms poor family support embarrassment lactation problems Employment and child care Barriers w/ health services |
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What is colostrum?
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Milk produced during pregnancy and early days of breastfeeding
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What is the colostrum made of?
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yellow-orange, thick and VERY easily digestible liquid
(high in beta-carotene) Low fat, high carb and protein (3 x mature milk) Na+,K+,Cl-, cholesterol |
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What is important about colostrum for baby?
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First vaccine = IgA coats mucus membranes in throat, GI, and lungs
Helps pass meconium and bilirubin (decrease jaundice) "liquid gold" |
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What are the benefits for baby?
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Decreased risk/rates of:
- hospitalization for respiratory infections - otitis media (decreased 50% for >3 mos) - GI infection, Celiac disease/Irritable bowel disease - SIDS - asthma, atopic dermatitis and eczema |
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What benefits does breastfeeding have against common diseases or epidemics in the US?
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Decreased rates of:
- Obesity - DM1 and DM2 |
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What cancers does breastfeeding reduce the rates of?
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ALL
AML |
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What does breastfeeding reduce the risk for in Moms?
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Decrease risk/rates of:
- DM1 - RA - CVD - Breast/Ovarian Cancer |
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What are benefits to the mothers body with breastfeeding?
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Decrease postpartum blood loss
More rapid uterine involution Increased child spacing Faster return to pre-pregnancy weight |
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What are contraindication of breastfeeding?
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Galactosemia in infants
Brucellosis Positive for Human T-cell lymphotrophic virus Active TB HIV + Illicit drug use |
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What are the 10 steps to successful breastfeeding?
(Also qualify hospital to be baby-friendly) |
- written breastfeeding policy routinely communicated to all health care staff.
-Train all health care staff to implement this policy. - Inform all pregnant women about the benefits and management of breastfeeding. - Help mothers initiate breastfeeding within one hour of birth. - Show mothers how to breastfeed and how to maintain lactation, even if they are separated from their infants. - Give newborn infants no food or drink other than breast-milk, unless medically indicated. - Practice "rooming in"--allow mothers and infants to remain together 24 hours a day. - Encourage breastfeeding on demand. - Give no pacifiers or artificial nipples to breastfeeding infants. - Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital or clinic. |
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What is in breastmilk that makes baby feel full and sleepy?
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cholecystokinin
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What is in breast milk?
Why is there more of one macromolecule verse another? |
High fat, High carb, to low protein ratio
High carb is thought to increase brain development in humans |
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When should the first feeding occur?
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Within first hour of life for breastfeed baby
Within first three hour of life for formula feed baby |
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How often should healthy infants be allowed to feed?
How long at each feeding? |
2-3 hours
10-15 minutes |
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What are signs of hunger?
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Suckling noise
Hand to mouth Rooting reflex |
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What are common problems with breastfeeding?
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Inadequate milk intake (most common reason for early termination)
Breastfeeding jaundice |
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What are common problems with latch during breastfeeding?
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Nipple tenderness
Mastitis |
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What should be checked for in baby that is not latching well?
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Ankyloglossia
Cleft Palate |
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What should be done to reduce latch problems and nipple tenderness?
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- Ensure good latch
- Neck position - Air dry nipple - Apply breast milk/lanolin cream to nipple - Nipple Shield |
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What are symptoms of mastitis?
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Breast tenderness
Firmness Erythema PT may experience fever and myalgia |
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How do you treat mastitis?
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Warm compress
Antibiotic therapy covering beta-lactamase X 10 days CONTINUE BREASTFEEDING!!! |
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What is in cow milk-based formula?
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Iron-fortified
Docosahexaenoic Acid (DHA) Arachidonic Acid (ARA) |
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Why would soy formula be used?
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Galactosemia
Hereditary lactase deficiency Documented IgE-mediated allergy to Cow's milk |
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What is a hydrolyzed formula?
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Predigested and hypoallergenic formula
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What does Oklahoma WIC provide?
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Gerber Good Start formula
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How much formula do MOST infants consume?
How much does the amount increase by? |
3-4 oz per feeding every 3-4 hours during the first month
~1 oz/month until max 7-8 oz. per feeding by 6 mos |
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When do most formula feed babies NOT need middle of the night feeding?
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2-4 months
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When should baby be burped?
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Every 2-3 oz when bottle feed
When switching breasts |
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When does baby usually start teething?
Which teeth are first to come in? |
6-7 mos
Mandibular primary incisors |
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What are symptoms of teething?
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Fussiness, mouthing behaviors and drooling
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When does primary dentition usually complete?
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30 months of age
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When do kids usually get permanent dentition?
Wisdom teeth? |
13 yro
17-21 |
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How should teething be managed?
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Chewing on chilled teething ring
Benzocaine NOT used if <2 yro |
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What is the most common breastfeeding position?
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Cradle position
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When should baby be introduced to solids?
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Solids should be delayed until at least 4 mos
6 moa preferred When baby can control head and neck with good support |
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How should baby end breastfeeding session?
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On the same breast they started on
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How should solid foods be introduced?
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Introduce solid food 1 at a time at 2-3 day intervals
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What are examples of first solid foods? Why?
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Grain cereals and pureed meats
Because of Iron and Zinc content |
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What should baby receive once per day when eating solid foods?
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Good source of Vitamin C
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What are signs of food allergies?
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Diarrhea
Rash Vomiting |
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What foods should be avoided in breastfeeding babies?
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Hard round food (Carrots, nuts, grapes = choking)
Honey avoided in < 1 yro |
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When does baby have skill to begin eating finger foods?
Food examples? |
8-10 mos
small pieces of: soft fruit, cheese, well-cooked meat |
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When does baby have ability to feed themselves and drink with both hands?
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9-12 mos
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When should cows milk be introduced?
What type of cows milk should be used? What is limit of cows milk? |
> or = to 1 year
Whole cow's milk (don't offer skim until >2 yro) Limit intake to <32 oz |
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What drink is NOT an essential part of healthy diet for infants?
What is limit? |
100% Fruit juice
Limit 4 oz/day |
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When can fruit juice be introduced?
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When infant can drink from cup (~6 moa)
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What is fruit juice linked to?
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Overnutrition/undernutrition
GI disturbance Dental Carries |
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What is encouraged instead of fruit juice?
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Whole fruits
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T/F: Juice is not used to treat diarrhea
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True
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T/F: Fruit juice is the same as fruit drinks
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False
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When should baby see a dentist for the first time?
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Within 6 mos of first tooth
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When should oral hygiene begin? How much?
What is used? |
after 1st tooth
Twice daily brushing with fluoridated toothpaste |
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When should baby be weaned from bottle?
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12-18 mos
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What can benzocaine gels do to babies who are teething?
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Inhibit gag-reflex
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What supplementation is recommended for infants > 4 moa? What are acceptable options?
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Iron supplement (fortified cereal, pureed meat)
Fluoride (In tap water) Vitamin D (400 IU/Day) |
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What should be supplemented in babies with vegetarian mothers?
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B12
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What reasons should vitamins A, D, E, K be supplemented for infants?
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Infants w/ Liver disease or fat malabsorptive state (Ex: CF)
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What should sedentary behaviors be limited to in children?
What should not be in child's bedroom? |
No more than 1-2 hour/day of "screen time"
(internet, TV, ipad, games) NO TV in bedroom |
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What should parents be counseled on in regards to food?
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Parents choose meal times/regular family meals
Pay attention to portion Limit snacking during sedentary behavior Avoid pressuring kids to eat certain foods Avoid restricting access to certain foods |
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What causes increased appetite in adolescence?
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Growth acceleration
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What are obstacles for weight management in teens?
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Skipping meals
Snack (1/3 of calorie intake from snacks) Eating away from home Lure of fad diets Endless hunger pangs |
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What is considered pediatric overweight/obesity?
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BMI 85th - 95th percentile = Overweight
BMI > 95th percentile = Obese |
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What increases the risk of obesity in children?
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Family history
Increased odds if both parents are obese |
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What is used to plot growth charts?
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Height and Weight
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What labs should be checked in overweight children > 2?
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Fasting lipid profile
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What labs should be checked in overweight children >2 with family history of CVD or obesity?
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Fasting lipid profile
Fasting Glucose LFT |
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What should be the treatment of overweight or obese children?
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Behavior change with Family involvement
Establish health eating and activity patterns NOT weight loss (will grow into size) |
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What are other treatment options beside behavior change?
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Pharm:
- Sibutramine - Orlistat Bariatric Surgery (severe cases) |
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What is failure to thrive?
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Children whose:
- Weight curve has fallen by 2 major percentile channels from previously established rate - Weight for length decreases below 5th percentile |
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What are causes of failure to thrive?
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Inadequate dietary intake
Weak or uncoordinated suckle Breathing problems (laryngomalacia) Inappropriate formula mixing |
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What antimicrobial properties does breast milk have?
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Lysozyme, Lactoferrin, Immunoglobulin IgA
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