Child Nutrition

Question 1

what are the 3 phases of child growth?

Answer 1

infant (nutrient led)
child (growth hormone led)
pubertal (sex steroid led)
these phases gradually merge

Question 2

what is LRNI?

Answer 2

dietary reference value

lower reference nutrient intake = sufficient for 3% of the population with the lowest needs

Question 3

what is EAR?

Answer 3

dietary reference value
estimated average requirement = used for energy requirements of a population
- about 1/2 will need more than the EAR and 1/2 will need less

Question 4

what is RNI?

Answer 4

reference nutrient intake = sufficient for 97% of the population

Question 5

what is the RNI for protein at each age range?

Answer 5

4-6 months = 12.7g
7-9 months = 13.7g
10-11 months = 14.9g
12-18 months = 14.5

Question 6

how are RNI values for protein met?

Answer 6

generally above the RNI value

Question 7

what is energy reference values for 0-12 months based on?

Answer 7

energy deposited in new tissues + TEE

- TEE = total energy expenditure (including metabolism, growth etc)

Question 8

what is energy reference value for 1-18 years based on?

Answer 8

TEE + deposited energy costs using model BMR X PAL

• BMR = basal metabolic rate
• PAL = physical activity level

Question 9

what does energy deposit equate to?

Answer 9

1% increase in PAL

Question 10

what is the vitamin A RNI and what are some dietary sources?

Answer 10

RNI = 350-400 micrograms
sources
- cheese
- eggs
- yoghurt

Question 11

is it a worry that over half of children exceed the EAR for energy requirement?

Answer 11

not really

by definition of EAR, half of the population will need more than the EAR for energy

Question 12

what is the RNI for vitamin C and what are some sources?

Answer 12

RNI = 25-30 mg
sources
- oranges
- blackcurrants
- potatoes

Question 13

what is the RNI for vitamin D and what are some sources?

Answer 13

7-8.5 micrograms
sources
- sunlight
- small amounts in oily fish, eggs

Question 14

are vitamin D RNI met?

Answer 14

usually not due to lack of sunlight in scotland

Question 15

should children from 6 months old be taking vitamin supplements?

Answer 15

yes

all children consuming <500ml per day of infant formula should take vitamins A, C and D supplements

Question 16

should 2 week old babies be taking vitamin supplements?

Answer 16

breastfed babies should be given a supplement of 8.5-10mg of vitamin D per day

Question 17

why is vitamin D supplementation not required in infants taking more than 500ml of infant formula?

Answer 17

infant formula has added vitamin D

Question 18

what vitamin supplement should breastfeeding mothers take?

Answer 18

vit D (10 micrograms per day)

Question 19

what are the department of health RNI for sodium?

Answer 19

<400 micrograms (1g salt) per day in 0-12 months

<800 (2g salt) in 1-3 years

Question 20

are salt RNIs met?

Answer 20

exceeded

Question 21

how are calcium and iron RNIs met?

Answer 21

iron = usually slightly below
calcium = usually slightly (or hugely in 12-18 months) above

Question 22

is breastfeeding recommended?

Answer 22

yes

exclusive breastfeeding recommended first line for first 6 months

Question 23

what is infant formula?

Answer 23

modified cows milk
whey or casein based formulae
no antimicrobial or bioactive substances from breastmilk

Question 24

guidelines in infant formula?

Answer 24

whey based formula recommended for first year

change of brand or from whey to casein not recommended

Question 25

guidelines in follow on formula?

Answer 25

no advantage over standard infant formula and therefore not recommended

Question 26

when does transition from exclusive breast milk feeding to family foods occur?

Answer 26

when breast milk no longer enough to meet nutritional needs

usually around 6 months but never before 4 months

Question 27

how should infants be fed when weaning off breastmilk?

Answer 27

breast milk still main type of milk consumed
introduce different foods
- energy density of at least 1kcal/g unless meals offered more often

Question 28

how is cows milk used in infants?

Answer 28

can be used in cooking from 6 months
introduced as drink from 12 months
don’t use semi skimmed before 2 years
don’t used skimed before 5 years

Question 29

when should complementary foods be introduced?

Answer 29

around 6 months

Question 30

which types of food should be first introduced?

Answer 30

gluten free if <6 months
don’t add sugar or salt
introduce potential allergy foods one at a time
give foods rich in absorbable iron
low sugar breakfast cereal fortified with iron
avoid whole nuts and seeds until 5 years
clean teeth gently twice a day as soon as they appear using 1000ppm fluoride toothpaste
2-3 times per day from 6-8 months
3-4 times per day from 9-11 months and 12-14 months + nutritional snacks

Question 31

give 3 benefits of exclusive breastfeeding for first 6 months

Answer 31

greater likelihood of higher IQ at 7.5 years
lower obesity risk for baby in later life
lower maternal breast cancer risk

Question 32

what are the recommendations for dental health in infants

Answer 32

introduce drinking from a cup or beaker from 6 months old

tooth brushing should begin as soon as teeth appear

Question 33

how can time of weaning affect risk of obesity?

Answer 33

early weaning = greater risk of obesity in childhood