Exam 3: Pediatric Nutrition Flashcards
Describe the typical infant growth patterns
- weight doubles by 4-6 months
- weight triples by 12 months
- length increases by 50% by 12 months
Preschool Growth
- ages 2-6
- growth slows, but is constant
- adipose tissue distribution begins after age 2
Middle Childhood Growth
- ages 7-10
- steady growth
- females > males in height and weight
Adolescence
- ages 11-18
- begins before puberty and continues until growth is complete
- rate of weight gain increases
When do you use the WHO growth chart?
< 2 years old
When do you use the CDC growth chart?
2-20 years old
Pediatric Malnutrition
deficiencies or excesses in nutrient intake, imbalance of essential nutrients or impaired nutrient utilization
What can result from pediatric malnutrition?
- wasting
- stunting
- underweight
- obesity
- micronutrient deficiencies
- refeeding syndrome
What is anthropometry?
- growth charts with z-scores, mid-upper arm circumference (MUAC)
- Z score tells us the distance and direction of an observation from a population mean
What defines failure to thrive?
- Fall of 2 major percentiles
- Weight < 3-5th percentile
What are the 3 causes of malnutrition?
- Inadequate caloric intake
- inadequate absorption
- excessive energy expenditure
AAP recommendations for breast feeding
- exclusive breastfeeding for the first 6 months
- optimally continue for at least a year
- may extend beyond 1 year if desired
Newborn Breastfeeding Advantages
- optimal nutrients
- decrease risk of infections
- decrease risk of immune-mediated diseases
- psychological and cognitive advantages
Mother Breastfeeding Advantages
- decreased post-partum bleeding
- faster time to attainment of pre-pregnancy weight
- decreased risk of breast and ovarian cancer
- mother-infant bond
Caloric density of breast milk
20 kcal/ounce
Breastfeeding Contraindications
- active, untreated maternal TB
- HIV positive
- Human T-cell lymphotrophic virus
- Ebola infection
- untreated brucellosis
- use of illicit drugs
Drugs that can harm the infant directly when breastfeeding
- immune suppressants
- chemotherapy
- radioactive agents
Drugs that reduce milk production
- ergots, decongestants, antihistamines
Drug characteristics to consider while breastfeeding
- high oral bioavailability = more likely to be absorbed by the infant
- PK characteristics
Drugs that increase concentrations in breastmilk
- non-ionized
- small molecular weight
- low protein binding
- high lipid solubility
- long half-life
- low Vd (stays in the blood)
