Nutrition

Question 1

when to assess to nutrition?

Answer 1

at every visit; well & sick. Get more details at well visit like what they are eating at each meal, how many servings of veg, fruit, and protein, what kind of milk are they drinking

Question 2

For well visit regarding nutrition

Answer 2

Age specific standards based on maturity. Get more details at well visit like what they are eating at each meal, how many servings of veg, fruit, and protein, what kind of milk are they drinking, if they are breast feeding (then if mom is vegetarian, etc) Educate parents on healthy shopping

Question 3

infant weight within first year of life

Answer 3

Expected to double by 4- 6 months and triple by 10- 12 months.

Question 4

infant height

Answer 4

should increase by about 1 inch per month in the first year.

Question 5

infant weight within first few weeks of life

Answer 5

10% loss of weight from the time of birth to the time they leave the hospital is normal, but should be back to birth weight in 10- 14 days. Goal for weight gain is 1oz per day (don’t check daily, bring them back in 3- 5days)

Question 6

Infant Formula Act

Answer 6

makes formula in the US regulated by the FDA, has to meet certain standards. Lots of different formulas- cows milk, soy products, also formulas for older infants (meaning 1 year +)

Question 7

cow’s milk

Answer 7

have high solute levels, can effect renal system, also need to be supplemented with additional components, kids could be allergic. Breast milk always best

Question 8

infants daily nutritional requirements

Answer 8

100 calories/ kg/ day
2.2 grams protein/ kg/ day
150 ml fluid/ kg/ day

Question 9

breast fed infants supplemented with what?

Answer 9

Vitamin D, fluoride (unless receiving fluoridated water as a supplement) and Vitamin B 12 if mom is vegan.
-Trivisol is a good supplement for breast fed babies, 1ml/ day

Question 10

FTT

Answer 10

below 5% or if growth rate decreases in percentile 2% or more. Can hinder brain growth- will demonstrate psycho- motor delays, emotional disturbances, and later in life reading delays. Organic is underlying medical condition. Inorganic just not feeding baby enough- poverty etc.

Question 11

tx for FTT

Answer 11

If organic treat underlying medical condition. if inorganic- feed baby!

Question 12

breast feed only for how long if possible for best benefits

Answer 12

6 months

Question 13

introducing solid foods- milestones to signify readiness

Answer 13

Milestones occur 4- 6 (formula babies earlier- usually 4 mos) months and include holding head up, controlling the torso and the neck, sitting without support, and moving food into pharynx, doubling weight and drinking 8oz yet being hungry in 4 hours.

Question 14

Education for parents on introducing solid foods.

Answer 14

schedule long office visit takes long ti schedule long office visit takes long time to educate parent. Teach them that infants are still learning to move food to back of mouth to swallow, may take time- they may spit food out bc of this, doesn’t mean they don’t like the food. If baby/ mom getting too upset- try again later and keep trying. Also introduce 1 food at a time (wait 4- 7 days) to assess for allergies. Also stool will change as they advance their diet. Should also be decreasing frequency/ amount of liquid foods as you are advancing solid foods

Question 15

first infant feeding should be?

Answer 15

iron fortified rice cereal from a spoon, never in a bottle. Followed by strained fruits and vegetables (5- 6moths) and then by meat, egg yolk, mashed potatoes, and crackers (9- 12 months)

Question 16

baby bottle tooth decay

Answer 16

distinctive pattern of tooth decay in infants and young children most commonly affecting maxillary incisors, although other teeth can be affected. They get it from presence of fermentable carbohydrate and pathogenic organisms- when babies are allowed to fall asleep with bottle or other sugary substances in their mouth

Question 17

when to wean from bottle

Answer 17

9- 12 months, should be using sippy cup at this point

Question 18

dental caries

Answer 18

composition and diet and an individuals eating habits are factors in developing dental caries. Fewer cariogenic snacks should be emphasized and protein foods such as cheese nuts and meat should be eaten with sticky foods to help protect against cavities

Question 19

iron deficiency

Answer 19

very common 9% of toddlers. Linked to lower test scores. Labs to order- CBC with diff at 6/9/12 months infants (also include lead screening- binds to hemoglobin) If low, give OTC ferrisol 1ml/ day with vit C for better absorption. (give via straw to not stain teeth) Test again in 2- 4 weeks since it takes some time to have an effect. If hasn’t improved in that time- refer to hematology

Question 20

most common food allergy

Answer 20

cows milk- 90% allergic! (lactose intolerance not the same) to tx- use soy based products, should see improvement in 2 days. 40% of babies show allergy through skin, but could also have GI sx, fatigue, or behavior changes. Also can outgrow food allergies- don’t outgrow lactose intolerance

Question 21

If kid is drinking milk what kind should they be drinking?

Answer 21

Toddlers up to 2 years old should be on whole milk, after that switch to lower fat foods/ 2%

Question 22

preschoolers age 4- 6

Answer 22

picky eaters

Question 23

school ages 7- 10

Answer 23

should be eating a wide variety of foods

Question 24

to assess nutrition in older kids

Answer 24

ask about the past several days to assess if they have a balanced diet, should be getting wide variety but its ok if its over the course of a couple of days

Question 25

child obesity

Answer 25

epidemic. prevention important- impacts adulthood and decreases life span of person. No drugs approved for HTN, HLP for kids under 16 but we are seeing that. This is a family problem, need to involve family. Watch out for self esteem issues/ bullying

Question 26

adolescents 11- 18 years

Answer 26

encourage development of sense of identity with nutrition shared with peers in social settings. if vegetarian watch protein, give vitamin supplements. Diets in this age group tend to be high fat, low fiber and vitamins. Males and females need about 1300mg of calcium daily for bone growth. Vitamin C is used rapidly d/t stress. Zinc is needed for male sexual maturity

Question 27

Girls and puberty

Answer 27

20% of their weight gain needs to be in fat in order for them to maintain enough estrogen in their system to allow reproductive system to mature/ function. Girls will gain weight then normally grow and lean out

Question 28

Sports nutrition

Answer 28

binging/ gaining weight or not eating to get into a certain weight class in wrestling not allowed in schools anymore. Hydration important- when playing sports kids should drink water and/or gatorade- no caffeinated drinks because they dehydrate cells even more

Question 29

female athlete triad

Answer 29

very active, losing weight, irregular periods. Watch for this.