Nutrition Flashcards
When should skin-to-skin occur after birth?
Babies should have uninterrupted skin-to-skin with their mothers immediately after birth or until after the first feed
How long should babies be breastfed?
Exclusively x 6 mos, then up to 2 yrs and beyond with the introduction of complementary foods
Are formula companies allowed to advertise?
no! as part of the international code of marketing breast-milk substitutes, there is no advertising of products to the public / no free samples to mom / can’t idealize formula feeding (pictures)
In canada, how many babies are still breastfed at 6 mos?
approx 25%
Pacifiers - yes or no?
Hard to say
May decrease SIDS
Best to introduce after breastfeeding is established
The act of sucking on pacifier may be soothing to infant in NICU
Contraindications to breastfeeding
HIV positive
Receiving cytotoxic chemotherapy +/- radiation
Active TB
HSV on breast
Galactosemia (+/- PKU: should be on low phenylalanine formula)
What should you avoid doing while breastfeeding?
Drinking EtOH (passes freely into breastmilk)
Smoking
Nutrition issues frequently encountered in neurologically impaired children
GERD
Aspiration
Osteoporosis
How do you rehydrate someone with mild dehydration?
oral rehydration solution (50 mL/kg over 4 hrs)
replace ongoing losses
rehydration of someone with moderate dehydration?
oral rehydration solution (100 mL/kg over 4 hrs)
replace ongoing losses
how do you rehydrate someone with severe dehydration?
IV resuscitation (20 cc/kg x 1-3)
begin ORT when patient is stable
replace losses
What drinks are contraindicated in a patient with dehydration?
Plain water (can cause hyponatremia, hypoglycemia)
carbonated beverage and fruit juices are discouraged - high carb, low electrolytes
When do you need to supplement fluoride?
Drinking water contains < 0.3 ppm
Child does not brush BID
Child is high risk for caries
At what age would you start supplementing with fluoride (if needed)?
6 mos
What is the risk of too much fluoride?
Fluorosis (abnormal enamel development)
What fluoride level is a trade off between caries and fluorosis?
0.7 ppm
What should you recommend as the first complementary foods?
Iron-rich foods (cereal, meat)
By what age should a child have tried lumpy textures?
9 months
What kind of cup should a child use with the introduction of complementary foods?
open cup, with help
What are the recommendations for introducing cow’s milk?
3.25% (homogenized) milk until 2 yrs
delay until 9-12 months of age
limit to 750 mL (25 ounces) per day
When can a child have honey?
> 1 yr
increased risk of botulism < 1 yr
When can you use BMI as a measurement tool?
2 yrs and up
before that, use weight for height
After what age is it abnormal to change growth percentiles on the WHO growth chart?
after age 3
What is a medication that can stimulate appetite?
Cyproheptadine
Bottle-fed infant with colic and concern for CMPA. What is one thing you could do?
Two week trial of hypoallergenic (extensively hydrolyzed formula)
Breast-fed infant with severe colic and concern for CMPA. What are two things you could suggest?
- Hypoallergenic diet (eliminate milk, egg, wheat and nut)
- Eliminate cow’s milk protein from maternal diet x 2 weeks
Baby with congenital hypothyroidism taking a soy based formula. What should you do?
Monitor thyroxine levels closely, as the phytoestrogens can lower fT4 concentrations
What type of CMPA is most common? (IgE mediated or non-IgE mediated)
IgE mediated (60%)
non-IgE mediated is 40%
Child with CF on vitamins. Develops pseudotumour cerebrii. Why?
Hypervitaminosis A
What is pellagra?
niacin deficiency
photosensitive dermatitis
diarrhea
dementia
what is beri-beri?
thiamine deficiency
cardiomegaly
tachycardia
loud cry
cyanosis
preterm milk has more…
nitrogen, fat, protein
term milk has more….
carbs
what type of protein is in breast milk, ratio?
whey 70%
casein 30%
(whey promotes gastric emptying)
what types of protein are in cow’s milk, ratio?
whey 20%
casein 80%
BMI percentile for overweight?
> = 85th
BMI percentile for obesity
> = 97th
formula for BMI
kg/m2
Infant < 6 mos being fed goats milk. What should you supplement?
folate
