Exam 3 lecture 1

Question 1

define typical infant growth

Answer 1

infant weight doubles by 4-6 months
triples by 12 months
infant length increases by 50% by 12 months

Question 2

define malnutrition and failure to thrive

Answer 2

malnutrition- deficiencies or excess in nutrient intake, imbalance of essential nutrients or impaired nutrient intake utilization.

Failure to thrive (growth faltering)- weight crosses two major percentile lines. weight < 3-5th percentile

Question 3

Recommendations on breast feeding if no contraindications? Advantages of breast feeding?

Answer 3

If no contraindication, AAP recommends exclusive breast feeding for 1st 6 months, WHO suggests up to 2 years

Optimal nutrients, decreased risk of infection, decreased risk of immune mediated diseases, psychological and cognitive advantages, bonding, increased child spacing.

Question 4

caloric density of breast milk

Answer 4

20 Kcal

Question 5

breastfeeding contraindications

Answer 5

HIV positive
Ebola
Use of illicit drugs
untreated brucellosis
TB

Question 6

Drugs to avoid in breast feeding fall into two categories, WHat are they?

Answer 6

1. drugs that can harm the infant directly
   ex- Immunosuppressants, chemo, radioactive agents
2. Drugs that reduce milk production
   ex- Ergots, decongestants

People who are in recovery for illicit drugs, methadone is appropriate to continue breast feeding

Question 7

What is an important thing to remember about drugs that have high oral bioavailability in breast feeding

Answer 7

They are more likely to be absorbed by infant

Question 8

Drug characteristics for distribution into breast milk

Answer 8

-Drugs that are no ionized are more likely to go into breast milk
-Small molecular weight
-low protein binding
- high lipid solubility
-long t 1/2
- low Vd

Question 9

How often do term healthy infants feed

Answer 9

6-9 times

Question 10

What should all breast fed infants be supplemented by

Answer 10

cholecalciferol (vitamin D)

Question 11

dosing of cholecalciferol for pre term and term neonates

Answer 11

Premature
a) <1.5 kg: 200 IU daily
b) >1.5 kg : 200-400 IU daily

term infants
a) Partially or fully breastfed- 400 IU
b) Formula fed: 200-400 IU

Question 12

When is iron supplementation indicated

Answer 12

premature neonates and term infants with deficiency

Question 13

What are the cautions we need to use when selecting products

Answer 13

1. there are a lot of many different concentraton/ formulations

errors could occur

Question 14

what is a common ferrous sulfate concentration

Answer 14

75 mg.ml (15 mg elemental iron/ml)

Question 15

when do we give zinc supplements

Answer 15

Only in deficiency

Question 16

What are some dos and donts of initiation of complementary foods

Answer 16

Typically begins at 6 months
Introduce single ingredient food first

Dos- Introduce 1 new food every 4-5 days
Increase Serving size gradually
Emphasize all food groups

Donts- Never put anything but breast milk or formula in bottle
Never give the following to children <1 year
- Honey
- Cow’s milk
- choking hazard
Potential allergens

Question 17

How to calculate fluid requirements for babies of different weights

Answer 17

1. Up to 10 kg- 100 ml/kg
2. 10-20 kg- 1000 ml + 50 ml/kg for every kg greater that 10
3. > 20 kg- 1500 ml + 20 mL/kg for every kg greater than 20

Question 18

how many ml in an Oz

Answer 18

30 ml

Question 19

What weight to use when calculating caloric need for baby

Answer 19

50th percentile weight

Question 20

What are some alternative routes of administration for patients that are non oral

Answer 20

Short term- Nasogastric(NG) (most common, into nose and into stomach), NJ (nasojejunal)

long term- G- tube (PEG, PEJ)