Obesity in Infants
more than 32 oz of
Obesity in infants is defined as a weight
greater than the 90th
to 95th percentile on a standardized
height/weight chart.
Obesity occurs when there is an increase
in the number of fat
cells because of excessive calorie intake.
Preventing obesity in
infants is important because the extra fat
cells formed at this
time are likely to remain throughout
childhood and even
into adulthood. If a child becomes obese
because of
overingestion of milk, iron-deficiency
anemia may also be
present because of the low iron content
of both breast and
commercial milk. Once infant obesity
begins, it is difficult to
reverse, so prevention is the key (Farrow
& Blissett, 2008).
Overfeeding in infancy often occurs
because parents were
taught to eat everything on their plate,
and they continue to
instill this concept in their children. This
occurs most often
with formula-fed infants whose parents
urge them to empty
their bottle or finish a cereal serving. It
can occur any time
parents automatically feed an infant when
the child cries,
rather than investigating what the cry
might really mean. As
a general rule, an infant should take no
formula daily. When solid food is
introduced, a bottle of
water can be substituted for formula at
one feeding. Nonfat
milk should not be given because it
contains so little fat that
essential fatty acid requirements may not
be sufficient to en-sure cell growth.
Another way to help prevent obesity is to
add a source of
fiber, such as whole-grain cereal and raw
fruit, to an infant’s
diet. These prolong the stomach-
emptying time, so they can
help reduce food intake. Caution parents
about giving obese
infants foods with high amounts of
refined sugars, such as
pudding, cake, cookies, and candy.
Encourage parents to
learn more about balanced nutrition and
to provide this for
their entire family.
Concerns of the Family With a Cognitively
or
Physically Challenged or Chronically Ill
Infant
An infant born with a cognitive or physical
challenge or an ill-ness is usually
hospitalized immediately after birth for
diagno-sis and treatment. This can result
in delayed bonding because
the newborn is separated from the
parents during this time.
Encourage parents to visit an intensive
care nursery regularly to
help form a strong parent–child
attachment. If parents cannot
visit, urge them to call the hospital as
frequently as they can to
inquire about their child. In addition,
nurses can supply digi-tal photographs of
an infant for parents to take home.
Many of the developmental events of the
infant year (so-cial smile, laughing out
loud, reaching for an object, uttering
the first word, sitting, talking) are
activities that encourage
parent–child interaction because they
make an infant fun to
be with and naturally make a parent want
to spend more
time with the child. Children who are
cognitively challenged
may not reach these milestones. Children
who are physically
challenged may be unable to achieve
them as well if they can-not reach up and
pat their mother’s face or hold out arms
to
be picked up by a father. If children
cannot interact with par-ents in these
ways, parents may find themselves
equally un-able to interact with their
children. If infants leave the hos-pital with
a cast or other equipment such as a
ventilator for
care, parents may be so concerned with
these items that they
cannot initiate normal singing and playing
activities with
their children.
To encourage a good parent–child
relationship, point out
the positive things an infant can do.
Perhaps the child’s facial
expression says, “Pick me up,” even
though he does not reach
up with his hands; perhaps his eyes follow
his mother’s ac-tions even though he
cannot yet call to her.
Helping parents to interact more fully
with their infants
helps to build a sense of trust in an infant.
Without a sense
of trust, children have difficulty expressing
themselves to oth-ers; they may not
believe they are lovable or people would
want to interact with them. Physically
challenged individu-als, no matter what
their ages, need people around them to
give them help at whatever point they
cannot meet their own
needs. It is unfortunate when physically
challenged children
cannot reach out for help because they do
not have a sense of
trust.
Infants who are cognitively or physically
challenged or
chronically ill experience the same health
and growth prob-lems as other infants.
Parents may be reluctant to bring up
these concerns at health care visits
because they believe such
problems pale in comparison to the
primary illness or condi-tion. When taking
the health histories of children with
chronic or longstanding medical
problems, ask parents about
secondary concerns. “What about
everyday things? Any
problems there?” Treat these concerns
seriously, so parents

can feel confident about bringing them to

your attention at

future health care visits. Also mention

they are part of nor-mal infant
development so parents can begin to view
their

child apart from the primary illness