Gremlin: Growth, Development and Nutrition Flashcards

1
Q

kcal in breast milk

A

20 kcal/oz

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2
Q

how long should a baby be breast fed

A

through 6 months PNA but there’s support for doing so through the first year

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3
Q

Vitamin D supplement

A

400 IU QD in the following populations
- infants receiving < 1000 mL/day of VitD fortified formula, food, or milk
- super important for breast fed ifnants because breastmilk has 25 IU/L of VitD
- adolescents not obtaining 600 IU through fortified milk

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4
Q

fluoride supplementation

A

0.5mg/day in breastfed infants > 6 months
- do not give kids < 2yr fluoride toothpaste

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5
Q

iron supplementation

A
  • breast fed
    • full term = 1 mg/kg/day from 4-12 months
    • pre-term = 2 mg/kg/day from 1-12 motns
  • formula
    • full term = formula containing 4-12 mg/L of Fe until 12 months
    • pre-term = adtional 1 mg/kg/day for a tdd of 2 mg/kg/day
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6
Q

GER affects about _ of infants

A

2/3, usually resovles by age 12-14 months

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7
Q

methods to help with GER

A
  • parenteral reasssurance
  • position change
    • supine position for sleeping
  • diet changes
    • volume or frequecy of feedig
    • hypoallergenic or anti-reflux formula
    • thickening formula to increase caloric density
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8
Q

complications of GERD

A
  • reflux esophagitis
  • hemorrhage
  • stricture
  • barret esophagous
  • weight loss
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9
Q

risk factors for gerd

A
  • male
  • bottle fed
  • tobacco exposure
  • intake of fatty foods
  • neurologic impairment
  • obestiy
  • esophageal atresia
  • COPD
  • prematurity
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10
Q

H2RA agents

A
  • famotidine
  • nitazidine
  • cimetidine
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11
Q

GERD treatment

A
  • PRN use: H2RA, antacids
  • maintenace: H2RA, PPI (esp if mod-severe)
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12
Q

erosive esophagitis treatment

A
  • first line: PPI
  • (H2RA or PPI) + sucralafate
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13
Q

prokinetics use in peds

A

may be useful in pts with delayed gastric emptying

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14
Q

H2RA advantages

A
  • quick onset
  • data in peds
  • cost effective
  • no need to taper on dc
  • liquid form available
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15
Q

PPI advantages

A
  • most potent
  • helas esophagitis
  • no meal induced acid secretions
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16
Q

PPI disadvantages

A
  • limited liquid form
  • CYP genetic polymorphism (2C19 and 3A4)
    - 2C19 activity varies with age (low at birth, adult value at 6-12 months, > adult 1-4 yrs and then back down to adult during puberty → higher dose for pts age 1-10 yrs
  • ADR
  • cost
  • increased risk of infection
  • rebound GERD → try to limit therapy to 12 weeks and then taper off over 4 weeks when therapy complete
17
Q

prokinetics agents

A
  • metoclopramide
  • erythromycin
  • bethanechol
18
Q

prokinetics disadvantages

A
  • significant ADR
  • reduced efficacy compared to H2RA and PPI
  • limited data
19
Q

antacids advantage

A
  • quick onset
  • variable dosage forms
  • low ADR
20
Q

antacids disadvantage

A
  • frequent admin
  • reduced efficacy coimpared to H2RA and PPI
21
Q

sucralafate advantages

A
  • coat may gheal mucosa
  • low risk of ADR
22
Q

sucralafate disadvantages

A
  • limited data
23
Q

trial acid suppriosn (IS/IS NOT) recommended for infants and young children as a dx terst for GERD

A

NOT