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nutrition thru life > infancy/childhood > Flashcards

infancy/childhood Flashcards

1
Q

The period of fastest growth is _____. What is the expected weight increase?

A

first year

double by 4 months, should triple by 1 year

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2
Q

True/False: growth charts are used as a diagnostic tool

A

False; can only be used with other information to assess general health

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3
Q

___ and ___ are constantly monitored as an indicator of health and nutrition.

A

weight; height

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4
Q

Are there differences in growth of breast fed vs bottle fed infants?

A

yes; breast fed tends to be leaner (normal)

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5
Q

Do race and ethnicity play a significant role in infant growth rates?

A

No; major factor is environment and health

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6
Q

Describe the growth rates from infancy to adolescence:

A

fastest rate of growth in first year, slows gradually in preschool years, gradual growth until adolescent growth spurt

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7
Q

What type of cows milk should not be given until children are at least 2 years old?

A

skim or part skim; infants require high fat in diet (low fat milk has less energy, vitamins, EFA)

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8
Q

When can cow’s milk be given to infants?

A

not in first year (though can introduce small amounts around 1 month)

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9
Q

List in increasing order of fat content: formula, human milk, adult diet

A

adult diet < formula < human milk

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10
Q

The 3 stages of eating developmental patterns:

A 
nursing period (only milk, 4-6 months)
transitional period (some semi-solids, still mostly milk, 6-10 months)
modified adult period (mostly food, >10 months)
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11
Q

What are the risks associated with formula feeding? (5)

A

improper preparation (overdilute/underdilute)
water quality (need sterile water, should boil)
microwave uneven heating
nursing bottle syndrome
inappropriate substitutes (soy, plant milks, goat)

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12
Q

Goat milk is too high in ___, and too low in ____.

A

protein

folic acid, B12, B6

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13
Q

What is nursing bottle syndrome?

A

baby given bottle to go to sleep

sugar will cause dental caries

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14
Q

The low ___:___ ratio in goat milk can lead to ____, which is a painful contraction of the muscles.

A

Ca:P

hyperphosphatemic tetany

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15
Q

Plant milk generally has less: (2)

A

vitamin D, energy

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16
Q

what compounds in plant milks may make them harmful? (2)

A

Mn (high amounts, above UL in many brands - neurotoxicity)

Phosphates/phytic acid - affect nutrient absorption

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17
Q

A baby should be fed ___ times a day. What is a good way to judge how much a baby is feeding?

A

8 or more

number of soiled diapers

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18
Q

What is the risk of overdiluting or underdiluting formula?

A

overdilute: not enough nutrition
underdilute: too many solutes and protein -> dehydration, metabolic acidosis, hypernatremia (strains kidneys)

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19
Q

What are risks of introducing food too early?

A
  • rejection - EXTRUSION REFLEX
  • choking risk
  • allergies, possibly diabetes (allergen response)
  • morbidity risk
  • undernutrition (due to weaning)
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20
Q

What vegetables should be avoided in young infants (<5 months) and why?

What can be done to make them safe?

A

spinach/turnip/collard greens/carrot/beets
contain natural nitrites -> oxidize Hb -> METHEMOGLOBINEMIA (high levels of MetHb, lower ability to deliver O2 to tissues)

Can boil, throw away water

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21
Q

The introduction of semisolid foods is known as ___, and should happen when?

A

Beikost

4-6 months

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22
Q

What indicates that a baby is ready to try semisolids? (5)

A
  • can sit up, control head
  • weight has doubled
  • consumes large amounts of milk but still hungry
  • drinks milk but hungry short time later
  • tooth development, can swallow
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23
Q

With continued formula feeding past 6 months, the baby will become deficient in: (6)

A

protein, energy, vit A, vit D, Zn, Fe

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24
Q

What are common allergens, and what should be done as a precaution when introducing new food?

A

cow milk, egg white, peanuts
give small amount with supervision, wait 3 days
if no family history of allergy, introduce small amount early, can actually reduce allergy development risk

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25
Q

What are the risks of introducing food too late? (4)

A
  • baby no longer receptive to new food
  • undernutrition (milk not adequate anymore)
  • less growth
  • reduced immunity (immune system not developing)
26
Q

What are the effects of excess sorbitol in diet of the baby (2)?

A

alcohol derivative of glucose, poorly absorbed -> travel to colon, exert osmotic effect -> diarrhea

carb malabsorption (sorbitol or too much fructose) will cause gas (bacteria produced) -> intestinal pain -> colic

27
Q

What types of protein foods are not suitable for babies?

A 
deli meats: high salt and nitrates
large fish (mercury), smoked fish, raw fish (parasites)
soft tofu: high in water, so lower protein/Fe
28
Q

Infants should have limited consumption of :

A

harmful fats (shortening, hydrogenated oils)
sugar (all types!)
salt
sugar substitutes

29
Q

What drink should be limited and why (2)? If given, what type is preferable?

A

fruit juice; little nutritional value and displace other foods; dental caries

Grape is better (orange may cause allergy, apple or pear have too much sorbitol)

30
Q

What foods should a baby be started with? Give some examples.

A

iron rich foods

fortified baby cereal (sugar free, salt free, whole grain)
meat/poultry
fish
tofu
legumes
eggs
31
Q

The additional milk consumption during the weaning period will supply adequate ____, but food is needed to supply ____ in the form of ___ and ____.

A

protein

energy; carbs and fat

32
Q

When can cows milk and dairy be given to infants, and what are the general guidelines (amount, type, etc)?

A

9 month +

  • give whole pasteurized
  • <750mL/day (increase gradually)
  • give with IRON-RICH foods (milk low iron)
  • mild cheese, kefir, etc
  • no skim products until 2yr +
33
Q

By 2 years of age, what habits should be developed? (2)

A
  • taste, enjoyment, acceptance of VARIETY of foods

- healthy attitude/practices for lifelong healthy eating patterns

34
Q

How can we promote healthy eating habits in young children?

A
  • respect: allow for food preference, allow for caution towards new food
  • no coercion, eat until satisfied
  • small portions (less intimidating)
  • relaxed and casual
  • offer balanced variety
  • avoid distraction
  • serve HEALTHY dessert only when everyone is finished
35
Q

How should new foods be introduced to children (5), to avoid what potential issues? (2)

A

avoid rejection/allergies:

introduce @ beginning of meal (hungry)
small portion (tbsp per year age)
do not force to try or finish!
1 new thing at a time, no mixing
consider texture (crunchy is more acceptable)
36
Q

How do feeding patterns change as the child grows?

A

younger: smaller, more frequent feedings
older: larger portions, 3 meals + snacks

37
Q

What foods should be limited/avoided in young children? (3)

A

choking hazards: round, gummy, smooth, sticky foods
(should cut, debone, etc; supervise!)

honey: botulinum spores; may germinate in stomach (low pH) -> botulism

Caffeine, sweets, salt

38
Q

What could result from feeding an infant/young child honey?

A

botulinum toxin poisoning

SIDS, resp distress, decreased feeding, constipation, weakness

39
Q

___ deficiency is the most preventable nutrition deficiency in kids, and the greatest risk is in ______. It is associated with: (2)

A

iron
children <5yr
high cow milk intake (low iron), lead exposure

40
Q

How is cow milk associated with iron deficiency in children? (2)

A

displaces iron rich foods if more than 2-3 cups per day

if given too early -> microscopic GI bleeding -> further iron losses

41
Q

How can the absorption of iron be improved?

A

Increased intake of vit C (leafy greens, fruits) -> take with iron source

42
Q

how is lead and iron absorption related?

A

use the same absorption receptor (DMT1)
will compete competitively!
-> more lead -> less iron absorbed
or: very little iron -> more susceptible to lead

43
Q

lead exposure can come from: _____

What are the negative health effects?

A

food, air, pipes, cans, dust, paint, pollution, etc
- lower iron absorption
interferes with iron-dependent processes (less heme synthesis)

44
Q

Iron deficiency can lead to ______. What are the effects of this condition?

A

hypochromic microcytic anemia (small pale cells)

lack of energy, slow wt gain, poor cognitive performance, impair psychomotor performance, impair renal tubule function

45
Q

What are the differences in dietary fat recommendations as children age?

A

preschool/childhood: do NOT limit fat; focus on NUTRITIOUS food choices

early adolescence: energy intake adequate to SUSTAIN GROWTH, gradually lower fat intake

no more linear growth: <35% of diet should be fat (adult AMDR)

46
Q

Why is a low fat diet NOT recommended for children?

A
  1. does not improve serum cholesterol long-term
  2. micronutrient deficiencies (Ca, Zn, VitA, B2)
  3. growth stunting (low protein, Ca, Zn)
  4. predisposition to eating disorders
47
Q

How does a low fat diet contribute to micronutrient deficiencies?

A

tends to be low in animal products
-> more complex carbs -> more fibre -> binds to minerals

-> less Ca intake, vit A, vit B2, poorer absorption of fat soluble vitamins

48
Q

In quebec, the nutrient most frequently deficient in children is:

A

Ca

49
Q

The most common complaint by parents of young kids is ______. This could be due to issues with the infant: _______ or issues with the parent: ________.

A

feeding problems

infant: colic, diarrhea, constipated, refusal to eat
parent: anxiety, ill mother, breast-feeding issues

50
Q

Refusal to eat in children is associated with: (4)

A

failure to thrive
behaviour problems
impaired growth
recurrent infections

51
Q

Can the effects of feeding issues as a young child be reversed?

A

4yrs +: catch up growth is possible; but feeding difficulties can persists, may be hyperactive

52
Q

The diagnostic criteria for feeding disorder:

A

no underlying mental or medical issue
no wt gain/loss for >1month
no lack of available food
< 6 yrs age

53
Q

Define “failure to thrive:”

A

not disease or disorder: SIGN OF UNDERNOURISHMENT
downward deviation from normal growth curve for age/gender
(significant percentile drop, or in very low percentile: 3-5%)

54
Q

What is the usual cause of failure to thrive, and what are the effects?

A

refusal to eat (mostly nonorganic cause)
(but can have organic or nonorganic causes)

effects: delayed social/motor/language skills
may need hospitalization

55
Q

The organic vs nonorganic causes of failure to thrive:

A

organic (from child itself): cong. heart defect, malabsorption, infection, anemia, heart/renal/endocrine problem, intellectual delay, parasites, etc

nonorganic (external): not enough food ($, neglect, distorted health belief), eating too little (premature, dev delay, autistic, behaviour problems, bad relationship w/ caregiver)
*no underlying disease: 80% of cases!

56
Q

Compare stunting vs wasting:

A

stunting: low HEIGHT: severe prolonged malnutrition
wasting: low WEIGHT: acute malnutrition (most sensitive indicator; first to drop)
* both falling together is primary disorder of growth

57
Q

the 3 patterns of failure to thrive:

A
  1. small head circumference; wt/ht <5th percentile
    (intellectually handicapped; difficult to feed)
  2. normal HC, normal ht, LOW WT
    (malabsorption, chronic disease, allergies)
  3. normal HC, LOW WT, VERY LOW HT
    (malnutrition from poverty, behaviour problems; deficient in essential nutrients/calories)
58
Q

How might organic and nonorganic causes of failure to thrive be connected?

A

usually both involved;

organic cause -> baby less willing to eat -> struggle with caregiver to feed -> poor relationship (inorganic)

59
Q

The ___ the child, the greater the risk related to failure to thrive

What are the risks associated with nonorganic FTT?

A

younger

< 1 yr -> risk of cognitive delay
< 6 month -> (max period of brain dev) -> max risk of problems

60
Q

The prognosis of nonorganic FTT:

A

with treatment, can stabilize wt > 3rd percentile

may still have problems with behaviour associated with eating

61
Q

extreme FTT treatment may require:

A

doctor, social worker, dietician, occ. therapist, psychologist, speech therapist, specialists, etc

may need hospitalization, tube feeding (1.5x cal per day), medical/psych/social support

nutrition thru life (15 decks)

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