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Preventative Med. & Nutrition > Exam #1: Pediatric Nutrition > Flashcards

Exam #1: Pediatric Nutrition Flashcards

1
Q

Why is growth closely monitored in children?

A

Growth is an important indicator of proper nutrition

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2
Q

Is BMI in children used the same as adults?

A

NO

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3
Q

When does the most growth occur in children?

A

Infancy

*****Note that instructor calls infancy 0-2 years

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4
Q

Where does most of the mass come from in the first 4 months of life?

A

Fat

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5
Q

How does weight fluctuate in the first few weeks of life?

A
  • Initial decline in first few days

- Should regain in 7-10 days

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6
Q

Generally, when should an infant double & triple weight?

A 
Double= 6 months
Triple= 1 year
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7
Q

How big is an infants stomach at birth, day 3, and day 10?

A

Newborn= shooter marble

Day 3= ping pong ball

Day 10= egg

*****This is important to remind mothers of to prevent over-feeding.

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8
Q

How do the energy requires of an infant compare to an adult?

A

Much higher as an infant

**Almost twice as much as adult comparatively; make sure parents are paying attention to hunger cues

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9
Q

What are the protein requirements of infants?

A

V. high i.e. 2.2g/kg/d at birth, which declines with age

*****Note that these requirements increase with stress/ trauma/ illness

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10
Q

What is the main dietary energy source in infants?

A

Lipids

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11
Q

What vital functions do lipids play in the developing infant?

A
  • Absorption of fat soluble vitamins
  • CNS develoment
  • Brain development
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12
Q

What proportion of calories should come from fat in an infant?

A

40-50% or higher in the first year

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13
Q

What proportion of calories should come from carbs?

A

30-60%

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14
Q

Where should carbs come from in infants?

A

Cereals
Fruits
Veggies

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15
Q

What vitamin must be supplemented in infants that are exclusively breastfed?

A

Vitamin D

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16
Q

What vitamin is injected at birth to prevent bleeding or hemorrhage?

A

Vitamin K

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17
Q

Does calcium need to be supplemented in infants?

A

No- human milk and formula have adequate sources of Ca++

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18
Q

How can lactose intolerant infants get Ca++?

A

Cooked greens i.e. collard, mustard, kale

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19
Q

What can iron deficiency lead to in infants?

A

Long term developmental & behavioral issues

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20
Q

Should iron be supplemented in infants?

A

Yes, at 4-6 months

*****Note that cow’s milk is a poor source of iron

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21
Q

What is the recommended feeding method for all infants?

A

Breastfeeding

22
Q

What is the major benefit to breastfeeding vs. formula?

A

Immune factors that are not in formula

23
Q

What are the four stages of human milk expression?

A

1) Colostrum
2) Transition milk
3) Mature milk
4) Extended lactation

24
Q

What are the characteristics of colostrum?

A
  • Low fat
  • High protein
  • Rich in immunologic substances
25
Q

What are the characteristics of transition milk?

A
  • Ig & protein decrease

- Fat, calories & lactose increase

26
Q

What are the characteristics of mature milk?

A

Fat, calories, & lactose remain high

27
Q

What happens to the composition of milk during extended lactation?

A

Vitamin and mineral content decrease

28
Q

How is breastfeeding assessed (for adequacy)?

A

1) Weight/ growth
2) Voiding i.e. # of wet diapers
3) Stooling
4) Feed-on-demand
5) Duration (10-20 min/ side)
6) Activity level of infant

29
Q

Is it normal for a breastfed infant to go several days without a bowel movement?

A

Yes, it can be…

30
Q

What is a common cause of constipation in a breastfed infant?

A

Iron supplementation

31
Q

What are the three major forms of formula?

A
  • Ready to feed
  • Concentrate*
  • Powder*

*Need to be mixed with water

32
Q

How does formula differ from breast milk?

A

Micronutrients in higher concentrations i.e. vitamins, minerals, and iron

33
Q

When are soy formulas recommended?

A
  • Galactosemia
  • Lactase deficiency
  • Family values
34
Q

Why are Ca++, phosphorus, zinc & iron increased in soy formula?

A

Soy phytates & fiber interfere with absorption

35
Q

Why would you recommend protein hydrolysate formula?

A

Allergy to intact protein

36
Q

Why would you recommend an amino acid based formula?

A

Severe protein allergy after switch to protein hydrolyaste

37
Q

Why is cow’s milk not recommended until age 1?

A
  • Renal solute to high
  • Can lead to renal failure, dehyration, and GI bleed
  • Whey: Casein ratio off
  • Inadequate vitamins & minerals
  • Not enough fat
  • Low EFAs
38
Q

When can solids be started in an infant?

A

When infant is able to sit w/ head up or propped up

39
Q

How do you correct growth for premature infant?

A

40 weeks - GA= # weeks premature

*****This is the correction factor that will be used until 2 years (24 months)

40
Q

What will a preterm infant be deficient in?

A

Fat

41
Q

How are premature infants initially fed?

A

Enteral (feeding tube) vs. parenteral (IV)

- PN= VLBW or ELBW

42
Q

What is adiposity rebound?

A

Increase in body fat in preparation for pubertal growth spurt

43
Q

How does protein need vary with childhood and adolescence?

A
  • Decreased need as growth slows after infancy

- Increased at puberty

44
Q

Are multivitamins recommended in children?

A

NO

45
Q

What are the definitions of “overweight” and “obese” in childhood/ adolescence?

A

Overweight= 85th-94th percentile

Obese= >95th percentile

46
Q

What are the defining features failure to thrive?

A
  • Infants that fail to grow and develop at normal rate
  • Small head circumference
  • Muscular wasting
  • Weight loss/ poor weight gain
47
Q

What is the difference between primary & secondary FTT?

A

Primary= social/ environmental

Secondary= originates from disease state

48
Q

What is necrotizing enterocolitis?

A

Acute inflammatory bowel disorder characterized by ischemic necrosis of GI

**Mostly seen in premature or LBW

49
Q

What are the major nutritional complications of CF in infants?

A
  • Malabsorption especially of fat soluble vitamins
  • Essential fatty acid def.

****CF prevents release of pancreatic enzymes to small intestine

50
Q

What is the difference between acute and chronic diarrhea?

A 
Acute= 3+ loose stools per day 
Chronic= 3+ for greater than 2 weeks
51
Q

What is the definition of constipation in infants?

A

Delay/ difficulty in passing stools present for 2+ weeks

52
Q

When is reflex a problem in infants?

A

When it interferes with growth

*****Note that this is v. common & typically does NOT require intervention

Preventative Med. & Nutrition (30 decks)

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