Question 1

Soy protein-based formulas are considered superior to cow's milk protein-based formulas for managing infantile colic, fussiness, and prevention of atopic disease. Comparisons of various commercial formulas with human breast milk consistently indicate that breastfed infants had a slight advantage offer all other types of artificial formulas.

Accepted Answer

The effects of cow's milk and soy-based formulas on infantile colic, fussiness, or prevention of atopic disease are similar. Comparisons of various formula types with breast milk indicated that breastfed infants had a slight advantage over all other types of artificial infant formulas.

Question 2

Human breast milk contains omega-3 and omega-6 fatty acids. Compared with cow's milk, human milk is low in lactose and relatively high in protein.

Accepted Answer

Docosahexaenoic acid and arachidonic acid are omega-3 and omega-6 fatty acids, respectively. Compared with cow's milk, human milk is high in lactose and relatively low in protein. Note that lipase, an enzyme present in breast milk, breaks down the disaccharide sugar, lactose.

Question 3

Each of the following is true except one. Which one is the exception?

Accepted Answer

After discontinuing breast feeding or infant formulas, vitamin D-fortified whole milk should be provided until age 2. The remaining selections are true. Note also that lactose-free and reduced lactose-containing cow's milk formulas are available and could be used for circumstances in which elimination or a reduction in lactose is required.

Question 4

Each of the following is true of human breast milk except one. Which one is the exception?

Accepted Answer

Human breast milk, normally thin and slightly bluish, contains significant long-chain fatty acids and is relatively high in cholesterol. The enzyme lipase within breast milk aids in digestion of fat from birth. Note that the low mineral content of human milk is ideal for the infant's immature kidneys. An example is iron; the content is low, but it is utilized efficiently.

Question 5

Soy protein-based formulas are appropriate for each of the following except one. Which one is the exception?

Accepted Answer

For infants with cow's milk protein allergy, hydrolyzed protein formula should be considered. Note that these more expensive formulations have not shown any benefits over intact cow protein formulas for healthy, term infants. The remaining selections represent conditions or situations appropriate selection of soy protein-based formula.

Question 6

Fluoride supplementation is recommended for all infants older than 6 months and children because this mineral increases the strength and acid resistance of developing tooth enamel.

Accepted Answer

Before fluoride supplementation is prescribed, the American Association of Pediatric Dentistry (AAPD) recommends a caries risk assessment and an evaluation of dietary sources of fluoride, including fluoridated water. Vitamin supplements containing fluoride can be prescribed by a healthcare provider or dentist. The reason correctly states that fluoride increases strength and acid resistance of developing enamel.

Question 7

An appropriate caloric concentration of infant formula that provides adequate nutrients for full-term infants is approximately _____ kcal/oz.

Accepted Answer

For full-term infants, an appropriate caloric concentration to provide an adequate supply of nutrients is 20 kcal per ounce of body weight. The American Academy of Pediatrics has established guidelines for formulas with respect to electrolyte, mineral, and vitamin content. Adequate amounts of electrolyte, mineral, and vitamin (except for fluoride and iron) are furnished if the infant receives 150 to 180 mL/kg per day of a commercial formula with iron.

Question 8

The most powerful predictor for how much children eat is how much food is put on their plate. The MyPlate sections for kids are different from those of adults.

Accepted Answer

The MyPlate sections for kids are the same as for adults, but serving sizes differ, so smaller sized plates are encouraged. Large portion sizes of snacks and fast foods parallel dramatic increases in childhood obesity.

Question 9

Each of the following is true of iron requirements except one. Which one is the exception?

Accepted Answer

Preterm infants should receive iron supplementation after 2 months. The basis for these recommendations is that during the first 6 months of a full-term infant's life, only minimal amounts of iron are required. This guideline varies depending on the health of the infant and the type of feeding. Note that a premature infant needs iron supplementation before breastfed or formula-fed healthy infants do.

Question 10

Infants both with cleft palates are high risk of developmental delays. While holding the infant in the sitting position during feeding may be easier, it results in nasal regurgitation.

Accepted Answer

Holding the infant in the sitting position is often recommended to minimize feeding difficulties such as nasal regurgitation, excessive air intake, and frequent burping. The main priority is to ensure adequate nutrition. Breastfeeding can sometimes be successful.

Question 11

Maxillary molars are affected first by early childhood caries. Artificial infant milk is more cariogenic than human breast milk.

Accepted Answer

Because the disease state follows the eruption pattern, maxillary incisors are affected first, followed by the molars and then the canines. Breast milk and artificial infant milk are equally cariogenic.

Question 12

The birth weight of an infant doubles in 3 months, and it has quadrupled by 1 year of age. Length or height increases by 50% by year of age.

Accepted Answer

The birth weight doubles in 4 months, and by 1 year of age it has usually tripled. Length or height increases 50% by 1 year of age. This means that a 5-pound newborn will weigh 10 pounds at 4 months and 15 pounds at 1 year. This information is vital because growth is the definitive test of health and is used as the most sensitive and specific indicator nutritional status.

Question 13

What percentage of infants and young children are affected by cow's milk allergy?

Accepted Answer

Cow's milk allergy, the most common allergy, affects 2% to 3% of infants and young children. Many different formulas are available as substitutes when an infant does not tolerate a cow's milk protein-based formula. The American Academy of Allergy, Asthma and Immunology (AAAAI) recommends hydrolyzed protein (protein broken down into amino acids) formula for infants at increased risk of allergic disease (family history). Soy protein-based formulas are the most commonly used substitute, accounting for nearly 25% of the formula market.

Question 14

Well-conducted trials support probiotics in infant formulas for their role in preventing:

Accepted Answer

Well-conducted clinical trials document that probiotics show promise at preventing necrotizing enterocolitis. This condition occurs in neonates with the development of cellular dead patches in the intestines. Digestion and absorption are disrupted. Although much research has been performed, there is insufficient evidence to recommend the addition of probiotics for prevention of allergic diseases, food reactions, or anemia.

Question 15

To help prevent early childhood caries (ECC), the dental hygienist should recommend he infant:

Accepted Answer

All expectant parents should be educated about techniques for avoiding early childhood caries, including avoidance of using a bottle or sippy cup as a pacifier at bedtime, naptime, or throughout the day. Fruit juice provides no nutritional benefit for infants younger than 6 months and is highly cariogenic. To decrease the risk of dental caries, fruit juice should not be given in bottles or sippy cups. After weaning from breast or bottle feeding, babies should be given whole vitamin D-fortified milk. All children require iron, with the need increasing after 6 months.

Question 16

A mother's food choices during pregnancy will affect her child's health, but have little bearing on later preferences because flavors from the mother's diet rarely transmit through amniotic fluid.

Accepted Answer

Flavors from the mother's diet are transmitted through amniotic fluid and mother's milk. A mother's food choices, particularly for fruits and vegetables, influence later preferences and food behaviors.

Question 17

Iron-rich food or a daily low-dose oral iron supplement should be initiated at what age?

Accepted Answer

Because of the high bioavailability of iron, additional sources of iron are unnecessary during the first 4 to 6 months for breastfed infants. Supplemental foods during that time can reduce iron absorption. Note that although the iron content of breast milk is low, inherent compounds in human milk promote efficient iron utilization.

Question 18

Human breast milk provides distinct advantages over commercially produced formulas because the infant's system is not fully developed.

Accepted Answer

The American Academy of Allergy, Asthma and Immunology (AAAAI) strongly recommends exclusive breastfeeding for at least 4 months to reduce potential for long-term health consequences. Specific protein fractions synthesized in breast tissue promote colonies of healthy bacteria in the gastrointestinal tract that aid nutrient absorption and help to protect infants from infections and illness.

Question 19

Infants who are given artificial infant milk tend to weigh less than breastfed infants. No artificial infant milk can match the benefits of breast milk.

Accepted Answer

Infants who are fed artificial infant milk tend to weight more than breastfed infants. It is thought this puts them at risk for obesity later in life, but more research is needed to confirm this association. Although artificial formulas are constantly being modified to duplicate components of human milk more closely, no formula can match the benefits of breast milk.

Question 20

Because of increasing cases of fluorosis, low levels of fluoride are added to commercial infant formula. Breast milk provides low levels of fluoride.

Accepted Answer

Because of increasing cases of fluorosis, no fluoride is added to infant formulas. However, they contain a small amount of inherent fluoride as a result of some of the ingredients and processing. Breast milk provides approximately 0.01 mg/day of fluoride, regardless of drinking water and maternal plasma levels. Despite this low level, dental caries does not seem to increase. The American Dental Association and American Academy of Pediatric Dentistry recommend delaying fluoride supplements for all infants until 6 months of age.

Quiz 14: Nutritional Requirements During Growth and Development and Eating Habits Affecting Oral Health