Development Flashcards
WHO recommendation for infant feeding
Recommend exclusive breastfeeding for first 6 months of life
- free
- contains antibodies which protect neonate against infection
- linked to better cognitive development, lower risk of certain conditions later in life, reduced risk of SIDS, less obesity in later life, reduce breast and ovarian cancer in mother but maybe due to socio-economic factors
Issues with breast feeding
Poor milk supply Difficulty latching Discomfort or pain for mother Inadequate nutrition for baby Overfeeding
Feeding volumes for baby
On formula
- 150 ml/kg/day
Preterm and underweight babies may require more
Split between feeds every 2-3 hrs initially, then 4 hours and longer between feeds until transition to feeding on demand
Acceptable initial weight loss in babies
10% for breast fed
5% for formula fed by day 5
Gain back by day 10
Features of weaning
Gradual transition from milk to normal food
Starts around 6 months of age
- pureed foods that are easy to palate and digest - pureed fruit and baby rice
Phases of growth in children
First 2 years = rapid growth driven by nutritional factors
From 2 years to puberty = steady slow growth
During puberty = rapid growth spurt driven by sex hormones
Definition of overweight in children
Overweight = BMI over 85th percentile Obese = BMI over 95th percentile
Complications of obesity
Bullying Impaired glucose tolerance Type 2 diabetes CVS disease Arthritis Certain types of cancer
Define faltering growth
Fall in weight across
- one or more centiles if birthweight below 9th centile
- two or more centiles if birthweight between 9th and 91st centile
- three or more centiles if birthweight above 91st centile
Ix for faltering growth
Urine dipstick - UTI
Coeliac screen - anti-TTG or anti-EMA antibodies
Specific tests if symptoms point to specific diagnosis
Mx of faltering growth
Regular reviews to monitor weight gain
When difficulty breastfeeding - midwives, health visitors, peer groups and lactation consultants
- feed with breastmilk prior to top up feeds
- express when not breastfeeding to encourage lactation to continue
Encourage regular structured melatiems and snockes
Reduce milk consumption to improve appetite for other foods
Review by dietician
Additional energy dense foods to boost calories
Nutritional supplement drinks
Causes of short stature
Familial short stature Constitutional delay in growth and development Malnutrition Chronic diseases - coeliac disease - IBD - congenital heart disease Endocrine - hypothyroidism Genetic - Down syndrome Skeletal dysplasias - achondroplasia
Define constitutional delay in growth and puberty (CDGP)
Variation on normal development Short stature in childhood Delayed puberty Growth spurt in puberty lasts longer - ultimately reach predicted height Delayed bone age
Define hypogonadism
Lack of sex hormones - oestrogen and testosterone
- normally rise prior to puberty
- lack of these hormones causes delay in puberty
Types of hypogonadism
Hypogonadotropic = deficiency of LH and FSH Hypergonadotrophic = lack of response to LH and FSH by gonads
