Growth/Development/Nutrition Flashcards
What growth charts do you use for children <2 years?
WHO growth charts
What growth charts do you use for children >2 years?
CDC growth charts
How fast are term infants expected to grow?
20g/day (birth weight doubled by 4 months)
How fast are children 2-10 years expected to grow?
2-3kg/year
Why do newborns have an immediate decrease in weight?
Contraction of extracellular fluid and significant diuresis
- Weight should be regained by the first 1-2 weeks of life
To what weight are infants generally expected to grow by the end of the first year of life?
Triple birth weight
What is “failure to thrive” defined as?
- Weight-for-age <5th percentile on multiple occasions
OR - Weight deceleration that crosses two major percentile lines on a growth chart
How can we treat FTT?
- Proper breastfeeding
- Formula supplementation (concentrated)
T/F: Medications and growth hormone should be avoided in FTT infants
TRUE
How many kcal dose breast milk contain?
20kcal/oz
How long does the AAP recommend breastfeeding for?
First 6 months, with support for up to 1 year and beyond
What is the energy requirement for a boy age 0-2 months?
107 kcal/kg/day
What is the energy requirement for a boy age 3 months?
95 kcal/kg/day
What is the energy requirement for a boy age 4-35 months?
82 kcal/kg/day
What is the energy requirement for a girl age 0-2 months?
104 kcal/kg/day
What is the energy requirement for a girl age 3 months?
95 kcal/kg/day
What is the energy requirement for a girl age 4-35 months?
82 kcal/kg/day
What is the vitamin D recommendation for infants?
400IU/day
When can vitamin D supplementation be waived?
If the infant takes >1000mL/day of Vitamin-D fortified formula
What is the vitamin D recommendation for adolescents?
400IU/day if not receiving at least 600IU from fortified milk
When is fluoride supplementation indicated?
Exclusively breastfed infants at least 6 months old
When can children start using fluorinated toothpaste?
2 years
What is the iron requirement for a breastfed full term infant?
1mg/kg/day from months 4-12
What is the iron requirement for a breastfed pre-term infant?
2 mg/kg/day from months 1-12
What is the iron requirement for a formula-fed full term infant?
Fortified formula containing Fe 4-12 mg/L until 12 months
What is the iron requirement for a formula-fed pre-term infant?
Fortified formula containing Fe 4-12 mg/L + additional 1 mg/kg/day to bring total daily dose to 2 mg/kg/day
T/F: Gastroesophageal reflux disease is common in infancy and usually resolves by 12-14 months
FALSE: this is true for gastroesophageal reflux (GER)
Up to ________ of infants experience recurrent regurgitation and vomiting within first 4 months, but only _____% have symptoms past 1 year
2/3, 5%
What s/s point towards GERD?
- Heartburn
- Excessive regurgitation
- Food refusal
- Abdominal pain
What are possible complications of GERD?
- Reflux esophagitis
- Hemorrhage
- Barrett esophagus
What is treatment for GER?
Assuring parents it’s normal and will go away***
- Sleep in supine position
- Change volume/frequency of feeding
- Anti-reflux or hypoallergenic formula
- Thicken formula to increase calories
What is a risk factor for GERD?
Bottle-fed (as opposed to breastfed)
T/F: A trial of acid suppression may be completed to diagnose GERD
FALSE!!! NOT recommended!!
How can mild GERD be treated?
First line: PRN H2RAs
How can moderate-severe GERD be treated?
First line: PPIs
How can erosive esophagitis be treated?
First line: PPIs
When should prokinetic agents be used in pediatrics?
Can be considered in delayed gastric emptying but usually not recommended
When do pediatrics have LOW CYP activity?
6-12 months
When do pediatrics have HIGHER CYP activity than adults?
1-4 years
T/F: Children ages 1-10 required a higher dose of PPIs
TRUE: higher CYP3A4, CYP2C19 activity
How long should PPIs be used for GERD?
12 weeks, then reassess
Taper off over 4 weeks
