Gremlin: Growth, Development and Nutrition Flashcards
kcal in breast milk
20 kcal/oz
how long should a baby be breast fed
through 6 months PNA but there’s support for doing so through the first year
Vitamin D supplement
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
fluoride supplementation
0.5mg/day in breastfed infants > 6 months
- do not give kids < 2yr fluoride toothpaste
iron supplementation
- 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
GER affects about _ of infants
2/3, usually resovles by age 12-14 months
methods to help with GER
- 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
complications of GERD
- reflux esophagitis
- hemorrhage
- stricture
- barret esophagous
- weight loss
risk factors for gerd
- male
- bottle fed
- tobacco exposure
- intake of fatty foods
- neurologic impairment
- obestiy
- esophageal atresia
- COPD
- prematurity
H2RA agents
- famotidine
- nitazidine
- cimetidine
GERD treatment
- PRN use: H2RA, antacids
- maintenace: H2RA, PPI (esp if mod-severe)
erosive esophagitis treatment
- first line: PPI
- (H2RA or PPI) + sucralafate
prokinetics use in peds
may be useful in pts with delayed gastric emptying
H2RA advantages
- quick onset
- data in peds
- cost effective
- no need to taper on dc
- liquid form available
PPI advantages
- most potent
- helas esophagitis
- no meal induced acid secretions
PPI disadvantages
- 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
prokinetics agents
- metoclopramide
- erythromycin
- bethanechol
prokinetics disadvantages
- significant ADR
- reduced efficacy compared to H2RA and PPI
- limited data
antacids advantage
- quick onset
- variable dosage forms
- low ADR
antacids disadvantage
- frequent admin
- reduced efficacy coimpared to H2RA and PPI
sucralafate advantages
- coat may gheal mucosa
- low risk of ADR
sucralafate disadvantages
- limited data
trial acid suppriosn (IS/IS NOT) recommended for infants and young children as a dx terst for GERD
NOT
