26- not gaining weight

Question 1

how much do infants gain in 1st 4 months

Answer 1

gain an average of 20-30 grams per day during the first 4 months of life

total: doubles by 4 mo

Question 2

what form of weight is it in

Answer 2

fat

Question 3

formula or breastfed gain more?

Answer 3

formula- ingest more calories

Question 4

maternal conditions that cause low birth weight

Answer 4

Maternal hypertension
Diabetes (although many infants of diabetic mothers are large for gestational age)
Lupus
Maternal malnutrition.
drugs

Question 5

normal ranges for infant for pulse, BP, RR

Answer 5

pulse-100-160
BP- 90/50 is 50th%
RR- 30-60

Question 6

FTT def.

Answer 6

1 of these:
–Weight falls below the 3rd percentile

–Weight for height/length falls below the 3rd percentile

–The rate of weight gain slows compared with previous growth, crossing two or more major percentiles on the growth chart in a downward direction.

Question 7

causes of FTT

Answer 7

Chronic diarrhea or vomiting
Congestive heart failure (CHF)
Formula allergy
Improperly prepared formula
Inadequate formula volume
Malabsorption
Parental neglect
Severe gastroesophageal reflux

90%- inorganic

Question 8

Pregestimil

Answer 8

formula that is made especially for infants who have protein or fat malabsorption. Pregestimil is typically mixed to contain 20 Cal/ounce. The protein source in the formula is fragmented rather than intact as in regular formulas and milk, and the fat source is primarily medium chain triglycerides (MCT).

easier to digest

Question 9

formula allergy presentation

Answer 9

intestinal blood loss

fussy

Question 10

labs to evaluate FTT

Answer 10

BUN Cr- renal failure?
CBC- anemia?
CXR- infiltrates?
Electrolytes
Fecal fat analysis- malabsorption?
LFTs
Neonatal screen
Occult blood, stool
Ova and parasite
stool culture
sweat chloride- CF?
Thyroid function tests
UA
Urine culture

Question 11

Differential for FTT

Answer 11

CHF
hypothyroid
malabsorption
formula allergy
gastroenteritis