Lecture 9 - Nutrition Assessment of Infants, Children, and Adolescents Flashcards
When we are looking at the history information, what info are we looking for?
Past/Present diagnosis and medical conditions Pregnancy Delivery Breastfed/formula/eating behaviours Growth Family and social history Physical and emotional environment
What are we looking for in the history of medication and supplements?
Meds
- Drug nutrient interactions
- Some meds can increase or decrease appetite
Vitamin and mineral supplementation
- depends on breast-fed/bottle
- Vitamin D
Alternatives therapies
-what are they using and why
What is the anthropometric data for infancy growth?
Most rapid growth Average Birth weight 7 1/2lbs BW x 2 by 5-6 months BW x 3 by 1 yr Length increases by 50% by 1yr Head circumference increases by 40% -Growth and development of internal organs
How much does weight and length increase in the first year?
Wt 200%
Ht 50%
What is the weight velocity for an infant?
Rapid
0-6 15-35g/day
6-12 10-15g/day
Slower
12motnh-10years 1.7-3kg/year
What does birth weight indicate?`
Indicator for future health status
- LBW <2500g
- VLBW <1500g
- ELBW< 1000g
How dow weeks correlates with what term gestational you are?
Extremely preterm <28wks Very preterm 28-32wks Preterm <37wks Term 38-42wks Post term >42wks
What are the percentiles for gestational birth weight?
Small for gestational age <10%tile
Appropriate (10-90%)
Large for gestational age >90%tile
What is the main tool for assessing growth in infants/kids?
Growth charts because we can see the growth patten from birth
- asses past and present growth
- predict future
- Trends very important than single point in time
What are the 2 kinds of growth charts?
CDC
- only American babies (Breast and formula), didn’t look at them over a long period of time, just one.
- 5% and 95%
WHO
- World babies, breastfed, looked at over a period of time
- 3rd and 97%
What is the difference between Wt gain in breast fed vs formula?
Wt gain in breastfed infants is healthy and slower than that of formula fed infants
What is the age cut off for CDC growth charts?
Birth to 36months & 2-20yrs
8 charts for boys
8 charts for girls
2 new for BMI for age 2-20yrs
In CDC curves what replaced wt for ht curves in kids greater than 2 y.o.
BMI for age
What standards to kids following the WHO curve have to have?
Breastfed for 6 months, then formula fed
-raised according to Current Canadian and international health an nutrition recommendations
Which index does WHO emphasize?
BMI for age ans index of Wt relative to Ht starting at 2 yrs
-for normal healthy population
How do you correct growth standards for postnatal age for prematurity?
weeks-[40weeks-gestaitonal age in weeks] and compare it with a chart
-until 24 or 36months
Why was the WHO chart updated?
revised in 2014 of growth reference for school age children and adolescents 5-19yrs
-updated to address obesity epidemic
What are the change in percentiles for the revised WHO charts?
BMI for age suggestive of overweight (85-97th%) and obesity >97th%
When plotting a point on a growth curve what do you need to remember?
Round age to nearest 1/4 year or month for kids <2yrs
Ages 0-36 plot all:
- Wt
- Length
- HC
- Wt for Length
> 2years
- Wt
- Ht
- BMI
How soften should we measure growth?
1,2,4,6,9,12,18,24,36 months
-to monitor patterns of growth over time
Wt, length then HC are affected by malnutrition in that orders
How do we interpretation of length/stature for age?
<3rd%tile results in stunting or shortness
-stunting can result from long term malnutrition
How do we interpretation HC for age on growth charts?
<3rd%tile or >97%tile can lead to potential health nutrition or developmental issues
How do we interpret Wt for length/stature on growth charts?
<3rd%tile leads to underweight or wasting due to recent malnutrition, dehydration, genetic disorders
> 97%tile higher chance of obesity
How do we interpret BMI for age?
<5th%tile leads to underweight or wasting due to recent malnutrition, dehydration, genetic disorder
> 85% but <95% overweight
> 95% obesity