A nurse is reviewing the dietary intake of an infant who is receiving complementary foods and drinks along with breast milk.

Which of the following foods should the nurse instruct the mother to limit or avoid to prevent dental caries?

Use an oral syringe to squirt the medication into the side of the mouth.

This is because an oral syringe allows the nurse to measure the exact dose of the medication and deliver it slowly and safely into the infant’s mouth, avoiding choking or aspiration.

The other choices are wrong for the following reasons:

• Choice A) Mixing the medication with formula in a bottle can alter the taste and effectiveness of the medication, and also make it difficult to ensure that the infant receives the full dose.

• Choice C) Placing the medication on a pacifier can cause the infant to spit out the pacifier or the medication, and also increase the risk of infection from contaminated pacifiers.

• Choice D) Dipping a cotton swab in the medication and rubbing it on the gums can irritate the oral mucosa and cause pain or bleeding, and also waste some of the medication on the swab.

Breast milk does not contain enough vitamin D for bone health.Vitamin D is needed to support healthy bone development and to prevent rickets, a condition that causes weak or deformed bones.Breast milk alone does not provide infants with an adequate amount of vitamin D.The Dietary Guidelines for Americans and American Academy of Pediatrics recommend breastfed and partially breastfed infants be supplemented with 400 IU per day of vitamin D beginning in the first few days of life.

Choice B is wrong because breast milk does not interfere with vitamin D absorption from sunlight.However, reducing sun exposure is important for preventing skin cancer, and other factors such as clothing, air pollution, and skin type can also decrease the amount of vitamin D a person can make from sunlight.

Choice C is wrong because breast milk does not increase vitamin D excretion in urine.

Vitamin D is a fat-soluble vitamin that is stored in the body and not easily lost in urine.

Choice D is wrong because breast milk does not inhibit vitamin D synthesis in the liver.Vitamin D is synthesized in the skin from exposure to sunlight, and then activated in the liver and kidneys to its active form.

Breast milk does not affect this process.