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

*

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

*

Low Birthweight, Preterm Delivery, & Infant Mortality

Low birthweight (LBW) or preterm infants at high risk of dying in 1st year of life

*

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

*

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