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## Mometrix ### Fat - One gram of fat provides 9 calories. - Lipids should supply approximately 40-52% of total daily calories. - Common sources of lipids include palm, soybean, coconut, and safflower oils. - Premature infant formulas have a higher percentage of fat supplied as medium-chain trigl...

## Mometrix ### Fat - One gram of fat provides 9 calories. - Lipids should supply approximately 40-52% of total daily calories. - Common sources of lipids include palm, soybean, coconut, and safflower oils. - Premature infant formulas have a higher percentage of fat supplied as medium-chain triglycerides (MCT). - MCTs can be absorbed without pancreatic lipase or bile salts that are deficient in premature infants. ### Proteins - One gram of protein provides 4 calories. - Proteins should provide less than 5% of total daily calories. - Proteins provide amino acids that are used as building blocks for muscle and other tissues. - Preterm formulas have higher protein content than term formula to help meet the increased growth requirements of preterm infants: - Full term: 2 to 2.5 g/kg/day. - Preterm: 3.5 to 4 g/kg/day. ### Circumcision - Circumcision is surgical removal of the foreskin of the penis. - Circumcision has decreased in popularity in the United States over the past 20 years, with current rates at approximately 50%. - Controversies exist concerning the need for circumcision: - Minimal advantages - Decreased incidence of phimosis and urinary tract infections. - Decreased risk for penile cancer and the contraction of sexually transmitted diseases in the adult. - Risks - Bleeding. - Infection. - Pain unrelieved by anesthetic. - Decreased sexual sensitivity in the adult. - Permanent damage to the urinary tract and sex organs necessitating reconstructive surgery. - Local anesthesia or nerve block should be used to prevent pain during the procedure. - If the Plastibell is used, the plastic rim stays in place 3-4 days until healing. - The rim usually falls off but may be removed if still in place in 8 days. - For other procedures, the glans is usually covered with petrolatum gauze for the first few days to promote healing and prevent irritation. ### Respiratory Problems #### Birth Asphyxia - Overview, Mild - Birth asphyxia is the cause of many problems after birth. - Birth asphyxia is defined as an event that alters the exchange of gas (oxygen and carbon dioxide). - This interference with gas exchange leads to a decrease in the amount of oxygen delivered to the fetus along with an increase in the level of carbon dioxide the fetus is exposed to. - This gas imbalance causes the fetus to switch from normal aerobic metabolism to anaerobic metabolism. - Fetal distress results and this distress then leads to increased fetal heart rate, release of meconium into the amniotic fluid, and lowered pH. - Infants experiencing birth asphyxia will often present at birth with Apgar scores that are less than 5. - The following are symptoms of birth asphyxia: - Overly alert for the first 45 minutes to one hour following birth (infants are normally sleepy after about 15 minutes following birth). - The pupils are dilated.