Ch 12 - Nutrition Flashcards
Breastfeeding advantages
no cost
reduced GI infection + NEC
reduced risk of T1DM, HTN, Obesity
enhanced bond with mother
Properties of Breast milk - humoral (3), cellular (2), nutritional (2)
Humoral - secretory IgA, lysozyme, lactoferrin (protects against E. Coli), IFN
Cellular - macrophages & lymphocytes
nutritonal - easily digestible proteins & lipids, high Ca, high Fe absorption
Fomula feeding - why is it modified cow’s milk ? (2)
Unmodified contians too much protein & electrolytes & in adequate iron
When can Cow’s milk be started, & what is good about follow-on formula
12 months - however need to add supplements as it is deficient in vits A, C, D
follow on formula is fortified with iron and vitamins
Specialized formula - uses
for those with Cow milk protein allergy, lactose intolerance, CF, neonatal cholestatic liver disease
Soy formula - when should it not be used?
Do not use in infants
Weaning - when is it recommended
After 6 months - start gradually with pureed foods
if
Failure to thrive (FTT): define, mild, severe
Suboptimal weight gain in infants + toddlers
mild - fall 2 centile lines
severe- fall 3 centile lines
Causes of FTT: non-organic causes(4)
These make up 95% of the causes and include:
feeing issues, insufficient budget, neglect/abuse, poor maternal education
Causes of FTT: organic (6)
Impaired suck/swallow - CP, clet palate
GI - Crohn’s, coeliac, CF, food allergy
Congenital - Down, IUGR, premature, infection
Endocrine - hypo/hyperthyroid, storage disorders,
Mangagement of FTT (4)
MDT - health visitor, paediatric dietician, speech/lang therapist, social services etc.
How is nutrition assessment made ? (4)
Anthropometry - height, weight, mid upper arm circum
lab - low plasma albumin/ vits/minerals
food intake - dietary call
immunodef - lymphocyte count
Marasmus: definition (1), presentation (5)
D - protein energy malnutrition
P - wasted, wizened appearance, apathetic, withdrawn, Height:weight > 3 SDs below median
Kwashiorkor: definition (1) presentation (5)
severe protein energy malnutrition due to late weaning + high starc diet
P - wasted, OEDEMA (unlike in marusmus), flaky-paint skin rash, hyperkeratosis, hepatomegaly, hypoglycaemia, brady cardia, hypotension, angular stomatitis etc.
Management of kwashiorkor & marasmus
correct hypoglycaemia/hypothermia
rehydrate slowly
electrolyte correction
micronutrients
