Children’s Nutrition

Question 1

Whan is the development of the human digestive system complete?

Answer 1

The final development of human digestive system is complete by the 10th/12th month - 2nd year of life

Question 2

Sucking reflex:

Answer 2

24th week of pregnancy

Question 3

Swallowing-sucking coordination:

Answer 3

• 4 sucks per 1 swallow

- No coordination in babies with birth weight <1700g

Question 4

Gastro-esophageal sphincter sufficiency development:

Answer 4

• Till 6th week of modified gestational age

- Feeding in semi-sitting position and maintaining upright position after feeding for first 6 weeks of life

Question 5

Emptying of stomach:

Answer 5

• Neonates and young infants
  
  • fast phase (within 20 mins accounting for 75% of stomach capacity)
  • Slow phase (180 mins)

Question 6

Period of intestinal passage:

Answer 6

• Premature babies and neonates: 8 - 96 hours

- Adults: 8-12 hours

Question 7

Physiological insufficiency of the anus:

Answer 7

Decreased tonus of the anal sphincter during the first 10 hours of life

Question 8

Look at the tables

Answer 8

page 4

Question 9

Minimum breastfeeding period

Answer 9

6 months ideally

Question 10

Composition of breastmilk

Answer 10

changes throughout the day

Question 11

How is the breastmilk initially?

Answer 11

sweet and watery

Question 12

How is the breastmilk over time?

Answer 12

more fatty and protein rich

Question 13

Breastmilk - 0-5 days:

Answer 13

• colostrum
• antibodies
• neutrophils
• macrophages
• lymphocytes B and T
• interferon
• lysozyme
• growth factors

Question 14

Breastmilk - 5 -14 days:

Answer 14

intermediate milk which is protein rich

Question 15

Breastmilk - from 2nd week:

Answer 15

mature milk, high fat and lactose content, less protein content

Question 16

Breast milk composition:

Answer 16

• Proteins: mostly whey during first week to equal whey and casein quantity by 8th months
• Carbs: lactose, oligosaccharides
• Low mineral component
• Low ratio calcium:phosphorus (2:1) preventing hypocalcemia and hyperphosphatemia

Question 17

Absolute contraindications to breastfeeding:

In child

Answer 17

• galactosemia

- innate lactose intolerance

Question 18

Relative contraindications to breastfeeding:

In child

Answer 18

• cleft palate
• some heart anomalies
• cachexy

Question 19

What are the contraindications for a mother to breastfeed?

Answer 19

• Active TB (non-treated or <2nd week of treatment)
• Infectious stage of VZV infection
• HIV infection
• HTLV-1 and HTLV-2 infection
• Mother treatment with some drugs

Question 20

What is not a contraindication for breastfeeding for a mother?

Answer 20

Acute infection in mother

• Hep A (mother requires gamma-globulin infusion)
• Hep B (mother requires gamma-globulin infusion and first dose of vaccine)
• Hep C (no additional infections)
• CMV, EBV HSV (unless over the breast)
• Mastitis and irritable breast
• Jaundice
• Delivery by C-section
• Silicone implant
• PKU in infant - requires supplementation with low-phenylalanine modified milk

Question 21

See table

Answer 21

page 5

Question 22

Vitamin D recommendations for mothers:

Answer 22

Mothers in 3rd trimester of pregnancy - 400 IU/day

Question 23

Vitamin D recommendations for full-term breastfed babies:

Answer 23

• 400 IU/day in mothers who were NOT supplemented

- 400 IU/day since the beginning of the 3rd week in mothers who WERE supplemented

Question 24

Vitamin D recommendations for full-term bottle-fed babies

Answer 24

Full-term bottle-fed babies require no supplementation

Question 25

Vitamin K recommendations - Healthy breastfed babies:

Answer 25

25 mcg/day between 2nd week and 3rd month

Question 26

Vitamin K recommendations - Babies with jaundice:

Answer 26

50 mcg/day

Question 27

Vitamin K recommendations - Bottle-fed babies:

Answer 27

no requirement