infancy

infant mortality

death that occurs within the first year, congenital malformations, low birthweight, preterm births, maternal complications

factors associated with mortality

socioeconomic status, teenage pregnancy, failure to prevent preterm and low birth weight babies, inadequate weight gain during pregnancy, poor maternal nutritional status

normal growth patterns

first few days- weight loss; by day 10- weight regain; 4-6 months- double weight; first 12 months- triple weight

CDC charts

frequent measurements of weight and length during infancy will facilitate early identification of potential problems

warning signs in growth charts

no increase in weight or length, continued decline in weight or length, small or large for gestational age infants

growth assessment

calibrated scales and recumbent length measurement board required for accurate measures

reflex

automatic response triggered by specific stimulus

rooting reflex

infant turns head towards the cheek that is touched, helps baby find the nipple

suckle

reflex causing tongue to move forward and backward, permits feeding

Infants born with reflexes that will prepare them to feed successfully

Need to coordinate sucking, swallowing, and breathing, prefer sweet taste, at 4-6 weeks, reflexes fade, infant begins to purposely signal want and needs

assessing newborn health

motor development, ability to control voluntary movement

non-organic failure to thrive

delay in growth/development caused by lack of bonding between infant/parent

protein digestion

enzyme level low compared to adult levels but infant can digest enough protein to meet needs, 0-6 months need 1.52 g/kg of body weight, 7-12 months need 1.2 g/kg of body weight

fats

lipases- mouth and stomach, fat digestion begins in the mouth, unique to infants

digestion of carbohydrates

disaccharides- babies have enzymes to break down; polysaccharides- can’t break down until 6 months, baby food

carbohydrate

lactase and sucrase, amylase activity rapidly increases during first 3 months

energy needs

80-120 calories per kg of body weight

infant forumla

single amino acids, sucrose, vegetable oil, increased vitamin and mineral content

why you shouldn't use cow or soy milk during infancy

iron-deficiency anemia, lack of nutrients, increased allergy risk

problems with early introduction

May decrease intake of breast milk/formula and decrease growth, low calories, low in fat, kidneys not mature, swallowing not well coordinated, coughing, respiratory illness

inappropriate choices in infancy

juice intake, sugar-sweetened beverages, honey, chocking hazards, water

fluoride supplements

at 6 months for infants residing in communities with low levels of water fluoridation

iron supplements

recommended for exclusively breastfed infants at 4 months until iron containing foods are introduced

development of food preferences

repeated exposures needed to develop new preferences, 8-12 times

baby-led weaning

baby controls what and how much they eat by feeding themselves, caregivers must provide healthy and safe food options, baby must be able to sit upright and reach for grasp objects and take them to the mouth

failure to thrive

based on growth record, can be diagnosed during infancy or later, caloric deficit is root cause

iron deficiency and iron deficiency anemia

inadequate iron contributes to long-term learning delays

early childhood cavities

avoid high frequency consumption of sugar, limit use of bedtime bottle, see dentist

common allergens

milk, eggs, fish, shellfish, peanuts, tree nuts, wheat, soy and sesame

metabolic disorders

Rare disorders involving urea cycle, amino acids, and organic acid metabolism

galactosemia

breast-feeding absolutely contraindicated, infant cannot convert lactose → galactose → glucose, lack of energy, failure to thrive, specialized formula needed

managing PKU infants

mother with PKU can breast feed if infant is normal, infant with PKU can be breast fed, early treatment important