L6 Importance of Infant Feeding and Gestational Age

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Questions and Answers

What can hypernatremic dehydration in breast-fed infants result from?

High consumption of cow's milk

Excessive breastfeeding frequency

Loss of more than 10% of birth weight (correct)

Inadequate intake of fluoride

What is a potential consequence of water intoxication in infants?

Rapid weight gain

Increased calcium absorption

Hyponatremia (correct)

Dehydration

Which mineral intake requirement is specifically noted for infants aged 0 to 6 months?

600-800 IU/day of Vitamin D

200-260 mg/day of Calcium (correct)

100-150 mg/day of Iron

0.5-1 mg/day of Fluoride

How does iron availability in breast milk compare to other sources?

Iron in breast milk is highly bioavailable Signup and view all the answers

Which food source is least recommended for iron intake in infants under 12 months?

Cow's milk Signup and view all the answers

What is the primary source of fluoride for infants?

Commercially prepared infant cereals Signup and view all the answers

Which statement accurately describes the weight difference between breast-fed and formula-fed infants at 12 months?

Formula-fed infants typically weigh 600 to 650 g more than breast-fed infants. Signup and view all the answers

At what age does an infant typically double their birth weight?

4 months Signup and view all the answers

What is a key feature of human milk that aids in an infant's brain development?

High proportion of fatty acids Signup and view all the answers

What percentage of weight gain in the first 4 months is accounted for by fat?

42% Signup and view all the answers

What is the classification for an infant weighing less than 1500 grams at birth?

Very low birth weight Signup and view all the answers

Which of the following most accurately describes 'Intrauterine growth retardation' (IUGR)?

Can be symmetrical or asymmetrical Signup and view all the answers

Which of the following does NOT contribute to infantile colic?

Frequent feeding Signup and view all the answers

Which of the following measurements is NOT used for antenatal estimation of gestational age?

Infant posture Signup and view all the answers

What is a common characteristic of infantile colic?

It lasts for more than 3 weeks. Signup and view all the answers

Which statement is incorrect regarding growth patterns in infants?

Growth charts are representative of differences in racial or ethnic groups. Signup and view all the answers

What does the term 'small for gestational age' (SGA) mean?

Weight below the 90th percentile for gestational age Signup and view all the answers

What percentage of breast-fed infants demonstrated distressed behavior by 6 weeks?

16% Signup and view all the answers

What is a primary benefit of the passage of breast milk hormones to infants?

They offer antimicrobial protection Signup and view all the answers

Which of the following is NOT a sign of colic?

Crying ceases after feeding. Signup and view all the answers

What classification does an infant with a birth weight less than 2500 grams fall under?

Low birth weight Signup and view all the answers

Which of the following is a physiological indicator used postnatally to assess infant development?

Neurologic signs Signup and view all the answers

What length gain is expected by 12 months in infants?

50% Signup and view all the answers

What does the CDC growth chart calculator provide for children and teens?

BMI and BMI-for-age percentiles Signup and view all the answers

What factor is NOT mentioned as influencing the observed energy intake of infants and toddlers?

Nutritional requirements Signup and view all the answers

In the first two years of life, which group of infants has the highest total energy expenditure?

Older infants Signup and view all the answers

What is the adequate intake (AI) of protein for infants from birth to 6 months?

1.5 g/kg/day Signup and view all the answers

How does the protein content in breast milk change by 4 months of age?

Decreases to around 1.15 g/kg/day Signup and view all the answers

Which statement is true regarding the protein intake of breast-fed infants from 1 month to 6 months?

Decreases from 2.0 g/kg/day to 1.0 g/kg/day Signup and view all the answers

What effect does providing excess energy through complementary foods have on breast milk intake?

Reduces milk intake Signup and view all the answers

What is a contributing factor to the difference in protein digestibility between human milk and infant formula?

Source of protein varies Signup and view all the answers

Which of the following is NOT a characteristic of infants fed human milk compared to formula-fed infants?

Higher protein intake Signup and view all the answers

What is a potential consequence of improperly introducing complementary foods?

Negative impact on breast milk intake Signup and view all the answers

At 6 months, what is the typical breast milk intake of a breast-fed infant compared to the calculated AI?

Lower than the AI recommendation Signup and view all the answers

Why may protein requirements be greater for formula-fed infants compared to breast-fed infants?

Less efficient utilization and retention of protein. Signup and view all the answers

Which fatty acids are essential for infant growth and dermal integrity?

Linoleic acid and a-linolenic acid Signup and view all the answers

What is the recommended percentage of energy intake from carbohydrates for infants?

30 - 60% Signup and view all the answers

Which carbohydrate is primarily found in human milk?

Lactose Signup and view all the answers

What should not be given to infants younger than 1 year due to the risk of botulism?

Honey Signup and view all the answers

How does the concentration of DHA in human milk vary?

It depends on the mother's diet. Signup and view all the answers

What is the total recommended water intake for infants?

0.7 - 0.8 L Signup and view all the answers

Why might young infants develop a water imbalance?

Their renal concentrating capacity is less than older children. Signup and view all the answers

What is a significant risk associated with significantly lower fat intakes in infants?

Low energy intake Signup and view all the answers

What type of formula is inappropriate for infants?

Boiled formula Signup and view all the answers

Study Notes

Importance of Infant Feeding

Exclusive breastfeeding provides sufficient nutrition for infants to grow at a healthy rate if the mother is well-nourished.
Human milk offers unique nutritional benefits including a high whey-to-casein ratio, essential fatty acids for brain and retinal development, and immunological/antimicrobial protection.

Gestational Age and Size

Gestational age is assessed antenatally (last menstrual period, uterus size, fetal heart tone) and postnatally (neurologic signs, physical maturity).
Birth weight classification includes:
- Low birth weight (LBW) < 2500 gm
- Very low birth weight (VLBW) < 1500 gm
- Extremely low birth weight (ELBW) < 1000 gm
Gestational age classifications include:
- Premature < 37 weeks
- Full term 37 - 42 weeks
- Postterm > 42 weeks
Small for gestational age (SGA) infants have a birth weight below the 10th percentile.
Intrauterine growth retardation (IUGR) can be symmetrical (length and head growth < 10th percentile) or asymmetrical (poor weight gain but normal length and head growth).

Growth & Body Composition

Infants double their birth weight by 4 months and triple it by 12 months.
Growth velocity is rapid in early infancy, requiring high nutrient demand.
In the first 4 months, 42% of weight gain is fat, decreasing to 19% in the next 18 months.

Early Feeding: Colic

Infantile colic is characterized by excessive crying in a healthy, well-nourished infant.
Symptoms include crying for more than 3 hours a day for at least 3 days a week for more than 3 weeks.
Possible causes include maternal tension, smoking/alcohol consumption, allergens in breast milk or formula, and cow's milk protein.
Colic resolves spontaneously without intervention.
Prevalence is reported in both breastfed and formula-fed infants, and breastfeeding doesn't offer protection.

Estimating Energy Needs

Total energy expenditure is greater in older infants than younger ones, in males than females, and in formula-fed than breastfed infants.
Providing excess energy from complementary foods can reduce breast milk intake.

Protein

Breastfed infants receive adequate protein for the first 6 months.
Adequate intake (AI) for infants 0-6 months is 1.5 g/kg/day, reflecting mean intake of human milk-fed infants.
Protein content in breast milk varies throughout lactation, but no studies show negative effects from the amount provided.
Breastfed infants have improved immune function and fewer illnesses compared to formula-fed infants.
Formula-fed infants may require more protein due to less efficient utilization and retention.

Lipids

Adequate fat intake is essential for infant health, with linoleic acid crucial for growth and dermal integrity.
Human milk contains high levels of essential fatty acids: linoleic acid, alpha-linolenic acid, arachidonic acid (ARA), and docosahexaenoic acid (DHA).
Infant formulas are supplemented with linoleic and alpha-linolenic acid, from which ARA and DHA are derived.
DHA is important for visual and psychomotor development, particularly in premature infants.

Carbohydrates

30-60% of energy intake should come from carbohydrates.
Human milk contains 40-50% of energy as carbohydrates, primarily lactose.
Honey and corn syrup should not be given to infants under 1 year due to the risk of botulism spores.

Water

Infants require water for skin/lung loss and feces/urine output.
Recommended total water intake is 0.7-0.8 L.
Human milk and properly prepared formula provide sufficient water in typical conditions.
Infants may need additional water in hot, humid environments, or in case of diarrhea/vomiting.
Water deficit can lead to hypernatremic dehydration, while excess water can lead to hyponatremia.

Minerals

Calcium: Breastfed infants retain about two-thirds of their calcium intake, with an AI of 200-260 mg/day for 0-6 months.
Fluoride: Essential for preventing dental caries, but excessive intake can cause fluorosis.
- Human milk is low in fluoride, with commercially prepared infant cereals and fluoridated water being significant sources.
Iron: Full-term infants have adequate iron stores for the first 4 months.
- Iron-fortified cereals and infant formula are good sources; cow's milk is not a good source and should be avoided before 12 months.
- Monitoring iron status is important due to the long-term effects of iron deficiency anemia.

Vitamins

Vitamin B12: Milk from mothers who restrict their B12 intake is deficient.
Vitamin D: Breast milk provides most vitamins but is deficient in vitamin D.

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Description

Explore the critical aspects of infant feeding, emphasizing the benefits of exclusive breastfeeding and its nutritional advantages. Additionally, understand the classifications of gestational age and birth weight, including the implications of low birth weight and intrauterine growth retardation.