Liver and infant nutrition

Question 1

How is growth led as an infant?

Answer 1

Nutrition led

Question 2

How is growth led as a child?

Answer 2

Growth hormone led

Question 3

How is growth led in puberty?

Answer 3

Sex steroid led

Question 4

Why is nutrition important?

Answer 4

Growth, change in body structure, composition, function
Disease prevention (breast feeding)
Primary treatment - metabolic disease, exclusion diets

Question 5

How is birth size and weight determined?

Answer 5

Maternal size
Placental function
Gestation

Question 6

What is the average weight gain for 0-3mo?

Answer 6

200g

Question 7

What is the average weight gain for 3-6mo?

Answer 7

150g

Question 8

What is the average weight gain for 6-9mo?

Answer 8

100g

Question 9

What is the average weight gain for 9-12mo?

Answer 9

75-50g

Question 10

After 1yr what is the weight gain and growth like?

Answer 10

2kg

5cm/yr until puberty

Question 11

Why is breast milk best for full term babies?

Answer 11

Well tolerated
Less allergenic
Low renal solute load
Improves cognitive development
Reduces infection

Question 12

What are the benefits of breast milk vs formula?

Answer 12

Suckling/bonding
‘Perfect’ nutrition for first 6mo
Passive immunity
Increases development of active immunity
Increases development of infant’s gut mucosa
Reduced infection
Antigen load minimal

Question 13

What are the factors to consider about of formula?

Answer 13

Can be good for up to a year
No anti-infection properties
Risk of contamination
No transition of BBVs/drugs
High antigen load
Expensive
Accurate feed volumes
Provides vit K
Less jaundice

Question 14

What are the UNICEF baby friendly ‘ten steps’?

Answer 14

Advice to help mums breast feed

Question 15

When is formula feeding common?

Answer 15

Breast feeding not possible

Question 16

What is the basis of all formula feeds?

Answer 16

Cows milk based

Question 17

What are types of formulae?

Answer 17

Standard
Specialised
Pre-term formulae
Nutrient dense formulae

Question 18

What is the specialised milk formulae for?

Answer 18

For cows milk protein allergy

Question 19

What is the first line feed choice for a cows milk protein allergy?

Answer 19

Extensively hydrolysed protein feeds

E.g. Aptamil Pepti 1 and 2

Question 20

What are second line feeds for cows milk protein allergy?

Answer 20

Amino acid based feeds

Question 21

Who should receive second line feeds?

Answer 21

Babies with severe colitis/enteropathy

Question 22

What is lactose intolerance due to?

Answer 22

Reduced level of lactase

Question 23

What is secondary lactose intolerance?

Answer 23

Short lived condition e.g. post gastroenterritis

Question 24

Who should soya milk be recommended to?

Answer 24

Milk allergy when hydrolysed formulae refused
Vegan families (not breast fed)
Children >1yr on milk free diet

Question 25

At what age can you introduce non formula milks?

Answer 25

Over 1yr

Question 26

Rice milk is not advised to children under what age?

Answer 26

<5yrs

Question 27

Who are goats’ and sheep’s milk not recommended to?

Answer 27

<1yrs

Question 28

What is the problem with organic milks?

Answer 28

No calcium supplemented

Question 29

What calories and calcium are found in full fat cows milk /100ml?

Answer 29

65kcal/100ml

120mg/100ml

Question 30

How much calcium fortified ‘milk’ do you need to meet calcium requirements?

Answer 30

400-500ml

Question 31

What can you supplement with if not meeting calcium requirements?

Answer 31

Alliance calcium liquid or (if >3yr) calcium softies

Breast feeding mums: Accrete or Cacit D3

Question 32

When should weaning start?

Answer 32

5-6mo

Question 33

When should lumps and finger foods be started?

Answer 33

6-7mo

Question 34

When should a cup be introduced?

Answer 34

7mo

Question 35

Why wean?

Answer 35

Milk alone inadequate
Need source of vitamins
Encourage tongue and jaw movements for speech

Question 36

Who should take Vit D?

Answer 36

Dark skinned children not on vitamin drops

Prolonged breast feeding and mum not on vit D

Question 37

When can you not synthesise vit D?

Answer 37

Sept-April

Question 38

Who should be supplemented with vitamins?

Answer 38

All breast fed babies from 1mo
Bottle fed babies taking <500ml formula
All children 1-4yrs

Question 39

What are examples of healthy start vitamins?

Answer 39

Abidec/Dalivit 0.3ml (<1yr), 0.6ml (>1yr)