Infancy + Childhood Feeding Part II Flashcards
Definitions:
Allergy
Food intolerance
Food sensitivity
Food allergy: Adverse reaction to a food or ingredient in a food that involves the body’s immune system
- symptoms which crossover other types: Nausea, stomach pain, diarrhea, vomiting
Food intolerance: Abnormal physical response to food or additive
Food sensitivity: Difficulty digesting a particular food
- Onset of symptoms slower and may last longer
Common food allergies
Diagnosis methods
Cow’s milk, egg, peanut, tree nut, soy, wheat, fish, and shellfish
Skin prick test, radioallergosorbent test (RAST) blood test, and oral food challenge with trial elimination diet
Precautions for choking <3
Avoid small round shaped foods like grapes
Supervision
No running/playing
Remove bones, pits from fruit
Grate or cut foods
Fe def
Most common in the world among children
40% among toddlers without fortification in foods - greatest risk under 5 years old
Meats difficult to chew
Associated with excessive cow’s milk intake and lead exposure
IDA symptoms
Lack of energy, poor appetite, irritability, difficulty concentrating, slow weight gain and recurrent infections, pallor, dizziness or lightheadedness, headaches, cold hands and feet, and rapid or irregular heartbeat
Lead exposure
Impacts
Children absorb 4-5x more bc pollutants precipitate onto ground, esp undernourished
Impacts: brain, CNS, irreversible effects, stored in teeth and bones, renal tubular function
- Upregulation of DMT1 then increases Pb uptake (competitive inhibition)
Fe/Ca def ↑ absorption of Pb and Cd and interferes with Fe/Ca functions like heme
Children 1-3 AMDR
Children 4-18 AMDR
Fat: 30-40
Protein: 5-20
Fat: 25-35
Protein: 10-30
CHO, n-6, n-3 stay same as adult
Adults fat: 20-35
Adult protein: 10-35
Higher fat recs in children
Benefits of dairy intake
Children oxidize more fat than adults in relation to total energy expenditure
- small stomachs req nutrient density
Gradual reduction of fat with end of linear growth (growth stunting without suff. fat)
- risk of micronutrient def
Dairy intake: high bone mass, lower blood pressure, dental carries, overweight
- release of satiety peptide hormones by intestinal cells: cholecystokinin and glucagon-like peptide 1
Feeding problems most common complaint
Associated with:
Physical: Diarrhea, constipation, colic and refusal to eat
Mental: Some may be induced by parents (high anxiety, ill health of mother, breast-feeding problems)
Associated with: Behavioral problems, failure to thrive, impaired growth & recurrent infections at 2 y.o.
- by year 4: May experience catch-up growth but may still have feeding difficulties & hyperactivity
Definitions of feeding disorders according to DSM-IV-TR
Age 6 or <
No wt gain or wt loss for > 1 month
No GI or other medical condition causing the eating problem
Not caused by a mental disorder or the unavailability of food
Not eating an adequate amount of food, not following normal weight gain curve for age, or has lost weight in one month or more
Failure to thrive definition
Growth faltering definition
Complex clinical syndrome that describes infants and children who require nutrition intervention because of unexplained deficits in growth
Occurs when weight crosses 3 percentiles on standard growth charts over 3 months in infancy and over 6 months in the second and third years of life
Growth faltering diagnoses FTT
Wasting v. stunting
Prevention
Wasting: too thin for height due to malnutrition
Stunting: failure to grow physically/mentally due to chronic or recurring malnutrition
Prevention:
Nutrition focused physical exam: identify signs of malnutrition (loss subcu fat, edema and muscle wasting)
Causes of FTT
Results of FTT
Associated with:
Organic = disease, non-organic = environmental causes
- refusal to eat
Results: delayed motor, language, social
Sign of undernourishment
Associated with poor utilization of calories and nutrients (cystic fibrosis, milk intolerance, allergy, parasites) or food not well retained after feeding
- ~50% of children: general behavioral problems and problems specifically related to eating
Patterns of FTT
decreased head circumference below 5th %
- cog impair
weight impaired with normal ht and hc
- chronic disease
lower weight + very low height + normal hc
- normally malnutrition related
- insufficient vitamin D, calories, protein, Fe, riboflavin
Organic causes of FTT
Inorganic causes of FTT
Congenital heart defect, malabsorption syndromes (cystic fibrosis, chronic liver disease, and celiac disease), infections, anemia, heart and renal problems, endocrine problems, prematurity, intellectual developmental delay or conditions like autism
Abnormal development and behavior of child
Distorted relationship between care-giver and child
May be associated with deprived background or high income parents with distorted health beliefs
