13: Childhood and Infancy

Question 0

What are the three eating developmental periods in the first year of life?

Answer 0

Nursing (4-6 mths), transitional (6-10 mths), and modified adult (>10 mths)

Question 1

What is the purpose of growth charts?

Answer 1

Used with other info to assess general health. Will need to he concerned if traverse 2 growth channels quickly.

Question 2

What is a risky feeding period in the first year of life?

Answer 2

Transition. First non sterile foods taken in, also crawling around being exposed to contaminants. Need to have laid down fat to survive potential infections.

Question 3

When is partly skimmed milk not recommended until?

Answer 3

Not recommended for first two years of life.

Question 4

Why is it important that breast milk is high in fat?

Answer 4

High caloric density and easy to convert into body fat.

Question 5

What macronutrient is significantly different between milk and infant formula?

Answer 5

Protein is significantly higher in infant formula.

Question 6

What is a risk of improper dilution of infant formula?

Answer 6

Over diluted: low kcal, failure to thrive. Under diluted: dehydration, metabolic acidosis, hypernatremia (high solute load).

Question 7

What is nursing bottle syndrome?

Answer 7

Nursing at bedtime and through the night, causes dental caries.

Question 8

Why are soy beverages an inappropriate milk substitute?

Answer 8

Too high in manganese, which has a risk of neurotoxicity and decreased cognitive development. Not as energy dense as formula. Many children with cows milk allergies will be equally allergic to soy because of cross reactivity. Phytic acid decreases mineral availablity.

Question 9

Why is goats milk not an appropriate milk substitute?

Answer 9

Low calcium to phosphorous ratio, low energy, could cause failure to thrive.

Question 10

What is Beikost?

Answer 10

Introduction of solid foods.

Question 11

What are some risks of introducing solid foods too early?

Answer 11

Choking, increased risk for developing allergies, diarrhea, under nutrition from decreased milk supply, and increased risk of T1DM due to leaky gut.

Question 12

What are some indications that an infant is ready for solid foods?

Answer 12

No more extrusion reflex, infants weight has doubled, sits with support, controls head movement, is hungry after feelings.

Question 13

What are some risks of introducing foods too late?

Answer 13

Growth faltering, decreased immune protection, under nutrition, feeding aversions.

Question 14

When does the extrusion reflex typically end?

Answer 14

10 wks.

Question 15

When does oral and muscular development for feeding continue until?

Answer 15

3 yrs

Question 16

When are deficiencies unlikely during transition?

Answer 16

When energy and protein needs are being met.

Question 17

What are good first foods?

Answer 17

Iron fortified rice cereals (low allergen) mixed with breast milk or water.

Question 18

Why should spinach, collards, carrots, turnips, and beets be avoided before 4-5 months?

Answer 18

High in nitrites—>nitric oxide, causes methemoglobinemia which is a lack of oxygen to the tissues because cannot bind oxygen to hemoglobin. Same condition can be caused by a pathogenic infection.

Question 19

What account for 75% of all allergies?

Answer 19

Cows milk, egg whites, peanuts.

Question 20

Why should apple, peach, plum, and pear juices be avoided?

Answer 20

Excess content of sorbitol which infants can’t absorb well. Osmotic effect in colon causes diarrhea. Can also cause colic due to gas.

Question 21

How much breast milk is taken in per day when foods are introduced?

Answer 21

600-800 ml/d

Question 22

What is established in the feeding habits by the second year of life?

Answer 22

Sense of taste and enjoyment, form basis for lifelong eating habits, important that food should be pleasurable and follow satiety signals.

Question 23

What are some benefit to having toddlers eat with the rest of the family?

Answer 23

Decrease risk of choking, decrease risk of overeating, decrease food aversions, better socializing, become accustomed to family diet.

Question 24

When is choking risk the highest?

Answer 24

Anytime under 3 yrs

Question 25

When is the greatest risk for iron deficiency anemia?

Answer 25

<5 yrs

Question 26

What are two things iron deficiency anemia is associated with?

Answer 26

Excessive cows milk intake. Occult blood loss + displace iron rich foods.
Excessive exposure to lead. Crawling and lots of hand to mouth behaviour. Interferes with absorption and displaces.

Question 27

What should the pattern of fat intake by in childhood, early adolescence, and after linear growth had stopped?

Answer 27

Nutritious foods should not be restricted or eliminated due to fat content, emphasize energy intake adequate while gradually lowering fat intake, and fat intake recommended per adults.

Question 28

What risks are associated with low fat diets for children?

Answer 28

Micronutrient deficiencies (Ca, Zn, A, Riboflavin). Growth stunting, may increase risk of eating disorders.

Question 29

What is refusal to eat associated with?

Answer 29

Behavioral problems, failure to thrive, impaired growth, recurrent infections.

Question 30

What is lack of breakfast associated with?

Answer 30

Poor attention span, decreased problem solving abilities, poor nutritional intake in general.

Question 31

What is “failure to thrive”?

Answer 31

Downward growth deviation from age and gender norms. In a shorter term context that means wasting, and in a longer term context that means stunting. Associated with delayed motor skills, language acquisition, and social skills.

Question 32

What are some organic (disease) causes of failure to thrive?

Answer 32

Congenital heart defect, malabsorption syndromes, infections, anemia, heart and renal problems, endocrine problems (ex cystic fibrosis), intellectual development delay.

Question 33

What are some non-organic (external) causes of to thrive? Is this the minority or majority of causes?

Answer 33

Abnormal development/behaviour, distorted relationship between caregiver and child, deprived background or distorted health beliefs.

Question 34

Describe the three general patterns of afaik lure to thrive.

Answer 34

1. Decreased head circumference, weight, and height. Usually intellectually handicapped (ex microcephaly).
2. Normal head circumference, weight impaired, height normal. Food is not utilized or retained well, usually malabsorption.
3. Normal head circumference, lower weight, and greatly lowered height. Malnutrition related to poverty or behavioral problems.