nutrition case study need in 7 hours.

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Chapters
8 & 9
Infant Nutrition

Very specialized nutritional considerations
High growth rate
Highest requirements for all nutrients
Infant has innate ability to self-regulate
Progression in feeding skills R/T developmental milestones
Inadequate nutrition may lead to consequences that may be lifelong

Key Terms
Liveborn Infant
Natality statistics
Infant mortality
Death that occurs in first year of life
Infant morbidity
Illnesses that occur in first year of life

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The Status of Pregnancy Outcomes
Infant mortality:
reflects general health status of a population
decreases in mortality related to improvements in social circumstances, safe & nutritious food supply, & infectious disease control

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Low Birthweight, Preterm Delivery, & Infant Mortality
Low birthweight (LBW) or preterm infants at high risk of dying in 1st year of life


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Reducing Infant Mortality & Morbidity
Improve birthweight of newborns
Desirable birthweight = 3500-4500 g (7 lb. 11oz. to 9 lb. 14)
Infants born with desirable wt less likely to develop:
Heart and Lung diseases
Diabetes
Hypertension

*

APGAR score
Evaluation of of newborn physical status
Heart rate
respiration
muscle tone
response to stimulation
skin color
8-10 best score

A-ppearance
P-ulse
G-rimace
A-ctivity
R-espiration

Measuring growth for infants
Lose weight first few days
regained by 7-10th day
Double birth weight
4-6 months
Triple @ 1 year
Increase length by 50% @1 year – double by 4 years

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CDC infant growth charts
Overall patternTrend
Appendix A
0-36 mo, male/female
Use months, not yrs
Variety of charts

The 50th percentile -median height or weight for each age group,
50% of children will be above & 50% will be below
change percentiles between 0-18 mos
Then follow channel fairly closely

Nutrient Needs
Kcals
108 kcals/kg 0-6 months
98 kcals/kg 6-12 months
Protein
2.2 g/kg 0-6 months
1.6 g/kg 6-12 months
Fluid
1.5 mL/kcal NO EXTRA FLUIDS/NEEDS MET IN BREASTMILK!

Feeding in Early Infancy
Breast milk and formula
Cow’s milk during infancy

Breast Milk vs Formula

MACRO-NUTRIENT Breast Milk Cow’s Milk Based Formula Soy Based Formula
PRO 7% of kcals 9-12% 11-13%
CHO 38% of kcals 41-43% 39-45%
FAT 55% of kcals 48-50% 45-49%

Infant formula/Human milk substitutes
Regulated by FDA – Infant Formula Act
Nonfat milk with added vegetable fats, V & M
Soy based formulas
Specialized formulas(protein hydrolysate); malabsorption, metabolic disorders

Powdered formula
Concentrated liquid formula
Ready-to-use formula

Feeding
Hold baby– head should be higher than rest of body
Never prop bottle
Proper mixing, storage, dilution

   

   

Developmental characteristics
Sucks well on nipple
Extrusion reflex causes tongue to protrude when solid food or spoon is put mouth
Feeds Q 2-4 hrs during day by 2 mos.
Finishes each feeding w/n 45 min. by 4 mos.

Infant-controlled Feeding:
Attentive to infant behavior – allows quantity to vary
Holds bottle still at an appropriate angle
Poises nipple over lips and allows baby to open up

Infant-controlled Feeding:

Allows pauses – gives time to finish feeding
Soothes fussiness – finds reasons for discomfort

Infant-controlled Feeding:

Ellyn Satter:
Parent-what
Child-when, if, how much

Parent- controlled Feeding
Ignores infant behavior – enforces externally determined quantity
Rotates, tilts, jiggles bottles
Imposes feeding routine-SCHEDULE

Parent- controlled Feeding

Terminates feeding abruptly at pauses
Interprets infant fussiness as a sign of satiety

Development of Infant Feeding Skills
Developmental milestones & readiness for feeding skills
Introduction of solid foods
Preparing for drinking from a cup
Food texture & development
First food: baby rice cereal

Water
How much food is enough for infants?
How infants learn food preferences
Inappropriate and unsafe food choices

Chokables
Whole grapes
Peanut butter
Nuts
Popcorn
Hotdogs
Coin-sized
Stringy or tough meat
Gum
Raisins
Candy
Sticky foods like granola
Teething biscuits
French fries

Nutrition Guidance
Supplements for infants ?
fluoride
iron
vitamin B12
vitamin D

Common Nutritional Problems and Concerns
Failure to thrive (FTT)
organic
nonorganic
Nutrition intervention for FTT
Colic
Iron-deficiency anemia
Constipation and diarrhea

Additional Infant Feeding Concerns
Prevention of baby bottle caries & ear infections
Food allergies & intolerances
Wheat
Eggs
Soy
Nuts
Cow’s Milk
Lactose intolerance
Food Safety!

Infants at High Risk
LBW
born before 34 weeks of gestation
born with consequences of abnormal development
chronic health problems
special health care needs

Growth of Pre-Term Infants
Growth in preterm infants
correction for gestational age
Does intrauterine growth predict outside growth?
Interpretation of growth

Severe Preterm Birth & Nutrition
How sick babies are fed
What to feed preterm infants
Preterm infants and feeding
fatigue
low tolerance of volume
Defensive to feeding
Unpleasant=feeding

Table 9-3, p.232

Congenital Abnormalities and Chronic Illness
GI tract disorders
diaphragmatic hernia
tracheoesophageal atresia

Congenital Abnormalities and Chronic Illness
Cleft lip and palate

Feeding Problems in Infants