Childhood Growth Flashcards
Breastfeeding (even just for a few days) will reduce risk of (3) because of ?
- overweight/obesity
- T1 diabetes
- asthma
- immune properties of milk
Complementary foods and beverages (CFBs) should NOT be introduced before __ months –> between __-__ months is accepted but no benefits/dangers shown from __-__ months compared to __ months.
- before 4 months
- betwee 4-5 months accepted vs 6 months
CFBs should be rich in (3). why?
iron, vit C and zinc
- iron and zinc stores depleted after 6 months –> no iron in breast milk
- vit C helps with iron absorption
Preventing allergies:
before: ?
now: ?
before: wait around 1 year for GI to be mature enough
VS now: introduce peanut and egg after 6 months may reduce risk of allergy
food allergies affect __-__% of < 4 y-o
6-8%
How to food protein elicit immunological response?
antigen = lock = protein from food –> recognized as harmful substance by immune system
- antibody = key
studies show that increasing peanut dose of peanut to child who is allergic will ?
build up tolerance and make response less threatening
anaphylactic shock? how to treat?
- decrease blood pressure + vasodilatation + trouble breathing
- administer epinephrine to increase blood pressure + medical help
Most serious allergies
soybeans, milk, eggs, wheat, fish
Food intolerances –> Produces ___________ but no ____________ –> not an ________________
common symptoms?
produces symptoms (can be anaphylaxis) but no antibodies –> not an immune reaction
- stomachaches, headaches, rapid HR, nausea, wheezing, coughing, hives
Public health strategy for allergies/food intolerances?
food labeling!
Signs of readiness for infant’s first food (3)
- able to site with support
- can control head/neck movement –> prevents chocking
- infant is 4-6 months old
At 6 months, 3 things that allows infant to start eating food
- better swallowing mechanism and gag reflex
- kidney more mature to process waste
- iron stores depleted = need to start eating food
Infant’s first solid foods –> start with ______ rich foods, then give _________
Tips (2)
iron rich foods
- fruits and veggies (pureed)
1. introduce one food at a time to check allergy
2. no sugar/salt added: natural taste of food
when to begin giving textured f and v vs bread/cereals to infants?
f and v –> 6-8 months
- bread/cereal: 8-10 months
Infant feeding:
- avoid (4)
- encourage (4)
avoid:
- sweets, bottle at bedtime, force feeding, chocking hazards
encourage
- self-feed (baby led weaning), cut food in thin strips (not circles), try new foods, stress-free environment
What shape should food be for infants? why?
long and rectangular, easier to grasp
VS circular and hard –> can get stuck in esophagus
Why avoid honey until _ year old?
risk of botulism –> below 1 y-o can’t metabolize toxins from spores –> causes paralysis and death
Why should we limit sugar and sugary bev in kids foods? (3)
- leaves less room for E from nutrition foods
- related to risk of overweight/obesity
- may set stage for greater intake of sugar later in life
Baby-led weaning (around - months) promotes (3)
- hand-eye coordination
- self regulation (eat what they want, how much they want)
- independance
which milks should be avoided before 2 year old? why?
- if child is allergic to milk, what to do?
skim, partially skimmed (1-2%) or fortified soy beverage
- less fat, less calcium
- if child allergic to cow milk, stay on formula
Better to switch to lower fat once child is 2 years old?
- higher fat milk for longer = decrease risk obesity
- but might be that skinny children are fed whole milk to fatten them up
age 1 or age 2 deposits more fat than lean tissue? what about the other one?
age 1: more fat than lean
age 2 (toddler); more lean than fat
Energy:
- newborn baby
- infant
- adult
- 1 year old
- 6 y-o
- 10 y-o
- newborn baby: 450 kcal/day
- infant: 110 kcal/kg bc growing fast
- adult: 30-40 kcal/kg (2000 kcal for 150lbs)
- 1: 800 kcal
- 6: 1600 kcal
- 10: 2000 kcal
Carb and fibers needs in infants/kids? + benefits
fiber recs for men and women adults?
- 130g CHO/day –> do not restrict! important for brain dev
- Fiber: 19g (1-3 years) and 25g (4-8 y-o) –> promotes bowel mvt
- women: 25g vs men: 38g
Fat recs for kids: AMDR
- 1-3 y-o:
- 4-18 y-o:
- adults:
- higher fat = ?
- 1-3 y-o: 30-40%
- 4-18 y-o: 25-35%
- adults: 20-35%
- better brain development
Length vs height
length: <2y-o
height: 2-18 y-o
child aged 2-5: percentile
- risk of underweight
- healthy weight
- risk of overweight
- overweight
- obese
- <3rd
- 3-85th percentile
- 85-97
- 97-99
- > 99
What to do if aged 2-5 is obese? (3)
- prevent further weight gain
- don’t want to restrict cals bc of loss of nutrients
- let them grow taller + exercise
child aged 5-19: percentile
- risk of underweight
- healthy weight
- overweight
- obese
- severely obese
- <3rd
- 3-85th percentile
- 85-97
- 97-99
- > 99
Difference between 2-5 and 5-19 BMI percentile cut-offs?
2-5: may grow taller all of a sudden, hard to classify strict cut off
- older: more clear cut-offs
What deficiency in children can cause misbehavior and impair thinking? why?
Iron deficiency
- lack of iron reduces energy + affects behaviour, mood, attention span and learning ability
Most widespread nutrition problem in children? high income vs low income?
Iron deficiency
- high income: picky eaters
- low income: lack of access
Give iron supplements to children?
be very careful! prescription only
- iron toxicity = leading cause each year in toddlers/children who accidently ingest iron pills
How to prevent iron deficiency in kids?
7-10mg iron per day
- get from food! pasta, fortified cereals/grains, mushroom, plums, dried peaches
Consequences of increased screen time for children? (5) –> cycle ish
increase screen time = reduces metabolic rate –> become more sedentary –> uses up time that could be spent being active + increase btw-meal snacking –> least likely to eat f & v –> likely to become obese
General dietary/setting recs for children (5)
+ focus on
- variety of foods
- limit sat. fat, sugar, juice
- drink water
- family meals
- encourage fun moments
focus on - moderation!
- balanced meals and snacks
- healthy eating environment
Guidelines for how children should spend their times:
sleep, step, sweat, sit
- Sleep: 9-11 hours (5-13) vs 8-10h (14-17) + consistent bed and wake-up times
- Step: light physical activity –> several hours of structure and unstructured
- sweat: moderate to vig PA –> at least 60min/day + muscle and bone strenghtening >3 days per week
- sit: no more than 2 hours per day
One of leading causes of child mortality? mainly where? (4)
undernutrition
- Africa, India, south America, Asia
WHO definition of malnutrition: wasting vs overweight
- < -2 SD from median of child growth standard under 5 = wasting
- > +2 SD from median = overweight
Severe acute malnutrition cut off/severe wasting –> how many SD from median? Why did WHO make this cut-off?
(-3)
- because less than 1% of children below -3SD in well-nourished populations
Causes of death associated with severe wasting
- common theme?
neonatal, pneumonia, diarrhea, malaria, measles, HIV/AIDS, injuries, others
- infections!
Wasting definition?
causing someone to become weaker and emaciated
Acute vs long term Protein Energy undernutrition (2 each)
Acute:
- wasting
- low weight for height
Chronic:
- stunting –> compromised growth and height
- low weight for age and low height for age
Classifying PEU:
- primary: what? caused by (6)
vs - secondary: what? consequences (4)
Primary:
- malnutrition due to inadequate intake –> undernutrition
- poverty + low food supply + poor quality of food + armed conflicts + political turbulence + natural disasters
Secondary:
- malnutrition due to diseased state
- affects appetite/metabolism + decreased intake/absorption + increased losses + increased requirement
Marasmus:
- what? –> they can grow, but (3)
- how old?
- Deficiency of ?
- develops fast or slow?
- < ____% of typical weight for age
- weight loss? + wasting?
- appearance?
- appetite?
- mental/behaviour symptom
- “successful” adaption to PEM –> they can grow but compromised growth, health impact and can die
- infants < 2y-o
- deficiency of macros and energy –> leads to micronutrient deficiency
- slow
- 60%
- severe weight loss and muscle wasting, including heart
- skin and bones appearance
- good appetite is possible, when food is available
- anxiety and apathy, nervous and agitated
Kwashiorkor:
- what?
- presents with ____________ beyond physical impact
- how old?
- causes (1 OR 1)
- develops slow or fast?
- ___-___% of average weight for age
- appetite? why?
- appearance?
- 2 physiological consequences + explanation
- “unsuccessful” adaptation to PEU
- with additional health issues beyond physical impact
- 1-3 y-o, when child is weaning from breast feeding
- protein deficiency OR infection
- rapid onset
- 60-80%
- loss of appetite bc fluid retention
- not skin and bones –> some muscle wasting + fat retention
- edema (fluid retention which makes them look not wasted) + fatty liver (high levels of glycaemia in blood leads to fat accumulation + low level of prots = impacts ability to transport lipids to other parts of system (lipoproteins)
Edema
- process?
- usually where?
- when pressure is applied… ?
- plasma proteins leave leaky blood vessels and move into tissues –> protein attracts water, causes swelling
- lower part of body
- leaves an indentation –> not elastic, doesn’t bounce back
Compromised growth from PEU will lead to decrease of (4)
- development (physical, social, cognitive)
- adult productivity
- reproduction
- potential of society as a whole
Long term consequences from PEU = infections ish –> 4 + common infections
- fever (lack of antibodies)
- anemia (hemoglobin no longer synthesized in same extent)
- dysentery (infection of GI tract –> diarrhea –> decrease electrolytes and hydration)
- fluid imbalances
- common infections: pneumonia, urinary tract infections, measles, tuberculosis, parasitic infections
Rehab for SAM/PEU/undernutrition (4)
- primary approach = restore fluid and electrolyte imbalances
- nutrition intervention –> cautious to ensure good metabolic adaptation
- treat infections
- programs have to involve local people
Downward spiral of malnutrition (6)
malnutrition and stress (infection, disease, other illness) –> altered metabolism + loss of appetite –> impaired nutrition status –> weakened immunity –> worsened disease –> further deterioration of nutrition status
Double burden of malnutrition in countries that are __________ like _________ –> what happens there?
socioeconomically transitioning like Indonesia
- decrease undernutrition BUT increase overnutrition
Undernutrition –> increase risk of (2)
Overnutrition –> increase risk of ?
- child mortality and poor development
- chronic disease
Food security definition
exists when all people at all times have access to sufficient, safe and nutritious food to maintain healthy and active life
Poverty and obesity paradox:
poverty –> leads to 2 things –> schéma
poverty can lead to hunger –> inadequate intake of E, prots, vit, minerals –> malnutrition
- poverty can lead to food insecurity –> inadequate intake of E, prots, vit, minerals –> malnutrition
OR insecurity –> excessive intake of E, fat and sugar –> obesity
