Feeding

Question 1

What leads infant, school age and adolescent growth

Answer 1

Infant = nutrition / insulin 
School = GH
Adolescent = sex steroid

Question 2

What is nutrition important in

Answer 2

Growth
Disease prevention in breast milk
Rx metabolic disease
Exclusion diet in allergy

Question 3

What is energy in nutrition used for

Answer 3

Physical activity
Thermogenesis
Tissue maintenance
GROWTH (35%)

Question 4

Why is nutrition so important in child

Answer 4

Infants become rapidly malnourished
High demands for growth and maintenance
Low stores
Frequent illness

Question 5

What do children need nutritionally compared to adult

Answer 5

150ml /kg of feed
400-500ml calcium fortified milk
Supplement if less

Question 6

What does birth size and weight depend on

Answer 6

Maternal size
Placental function
Gestation as 95% of weight is between 20-40 weeks

Question 7

What is average weight of new born

Answer 7

3.3kg

Question 8

Why is breast best

Answer 8

Recommended 1st line in 1st 6 months 
Nutritional 
Cognition
Reduce infection as maternal Ab
Passive immunity 
Development of gut mucosa
Low antigen load 
Decreased breast / ovarian Ca
Suckling / bonding 
Reduced risk of SIDS
Pre-term may need supplements
May have poor milk supply, difficulty latching or pain which leads to undernutrition

Question 9

Formula feed

Answer 9

No anti-infection 
Contamination if not made up properly 
High antigen load
No transition of BBV or drugs
Doesn't require mum 
Expensive 
Accurate feed volume
Provide vit K 
Less jaundice

Question 10

What is the Unicef Baby Friendly 10 steps

Answer 10

Policy and train all staff in skills to implement
Initiate as quickly as possible
Show how to breast feed
Inform about benefits / management
Only give new borns breast milk unless medically indicated
Allow mothers and infants to remain together
Encourage breast feeding on demand
Give no teats or dummies to breastfeeding infant
Establish breast feeding support groups

Question 11

What are the options if you can’t breast feed

Answer 11

Formula feed - Cows milk based
Powder or ready to feed
Variation on age

Question 12

What are special formulas

Answer 12

Cows milk allergy
Nutrient dense - high energy
Disease specific
Pre-term formula - high protein and calorie

Question 13

Why is cows milk not main drink for <1

Answer 13

No iron so iron anaemia

Lack of vitamins that breast and formula provide

Question 14

When is soya milk indicated

Answer 14

Milk allergy if hydrolysed formula refused
Vegan family
>1 milk free diet
Likely to react

Question 15

How much fortified milk do you need to meet calcium requirements

Answer 15

400-500ml

Question 16

What is weaning and when does it begin

Answer 16

Transition from milk to mixed diet

6 months

Question 17

What are the benefits of weaning

Answer 17

Encourage tongue and jaw movements for speech and social interaction
Provide nutrients and vitamin

Question 18

Who is at risk of vitamin D deficiency

Answer 18

Dark skin
Long breast feeding if mother not on Vit D
Winter months

Question 19

Who gets vitamin supplements

Answer 19

All breast fed babies from 1 month
Bottle fed <500ml formula as not enough calcium
All children up to school
At risk of vitae’s D deficiency

Question 20

What is normal after birth in regards to weight

Answer 20

Physiological weight loss <10%
Should return to birth weight by day 10
If don’t return by 2 weeks need admission to hospital for investigation of causes

Question 21

How much do babies growth in 1st 3 month

Answer 21

200g / week

Question 22

> 1 how much do they grow

Answer 22

2kg / year

5cm / year

Question 23

What does poor feeding suggest

Answer 23

Sepsis
CMPI
Reflux
Surgical
Syndromes
Tongue tie
Hypoglycaemia

Question 24

How much feed

Answer 24

150ml / kg formula