Nursing 209

N209: Reproductive Health Study Guide • Receives immunity by two methods: o Active acquired immunity: Development of antibiodies via maternal exposure to illness and immunization o Passive acquired immunity: Antibodies passed through placenta by IgG immunoglobulins  There are three primary immunoglobulins: IgG, IgA, and IgM; only IgG passes through the placenta  Usually during third trimester • Most full-term infants have acquired immunity to tetanus, diphtheria, smallpox, measles, mumps, polio, and various bacterial and viral diseases (disappears by six months) • IgA is present in breastmilk; protective against gastrointestinal and respiratory illness • IgM is produced from blood group antigens, gram negative enteric pathogens, and various maternal viruses • IgMmay be seen if exposed to infections such as syphilis, TORCH infections, or from a placental leak 5.16 Nutritional Needs • Fluid requirements: o 60-80 ml/kg during the first 24-48 hours o Increases to 100-150 ml/kg within a few days • Caloric requirements: o Up to two months: 110-120 kcal/kg (50-55 kcal/lb) o After two months: Declines gradually to 100 kcal/kg (45 kcal/lb) by one year o Depends upon infant’s activity level (frequent crying, squirming, etc.) • Breast milk and formula: o Same number of calories/ounce o 9-12% of calories as protein o 45-55% of calories as lactose o 34-46% fat (with 4% linoleic acid) • Protein: o Increased requirements due to rapid growth  First two months: 2.2g/kg o Histidine: An amino acid that is essential for infant growth; present in formula and breast milk o Lactalbumin: Protein in human milk o Casein: Protein in cow’s milk  Cow’s milk is not recommended for one year due to problems with kidney excretion of urea and electrolytes

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