Nutrition

Question 1

maternal contraindications to breastfeeding in the US

Answer 1

HIV

TB (active only)

herpes lesions on the nipple

active varicella

drugs of abuse and alcohol abuse

medications (look them up at LactMed)

Question 2

what is a drug of abuse that allows women to sometimes breastfeed?

Answer 2

methadone

Question 3

what are infant contraindications to breastfeeding in the US?

Answer 3

galactosemia

tyrosinemia

PKU

Question 4

urine ouput should be what in the newborn?

Answer 4

number per day = day of life

Question 5

1st stool in the newborn should occur when?

Answer 5

1st 48 hours

Question 6

how many stools per day in a breastfed infant?

Answer 6

4-5 mustardy, seedy per day is normal

can stool with every feed

Question 7

how many kcal per ounce is in typical infant formula?

Answer 7

18-20 kcal/oz

Question 8

what are the possible causes of lactose intolerance in an infant?

Answer 8

primary is RARE

secondary - after gastroenteritis (rare), celiac disease

Question 9

when should solid food be initiated?

Answer 9

no earlier than 4-6 months

there is head control and tongue thrust dies down

Question 10

who should foods be introduced?

Answer 10

one new food every 3-5 days (helps with allergy identification)

Question 11

when should cow’s milk be introduced?

Answer 11

not before 12 months

whole milk 12-24 months

low fat/skim > 24 months

no bottles (too much milk, not enough food)

Question 12

what vitamin supplement should be taken for breastfeeding vegan mothers?

Answer 12

B12

Question 13

1 in ___ US households with children are food insecure?

Answer 13

6

Question 14

what is anaphylaxis?

Answer 14

acute onset of illness (minutes to hours) with involvement of:

skin and/or mucosa

and either

respiratory compromise or hypotension/end-organ dysfunction

Question 15

if a person is known to have an allergy and an exposure, then what symptoms might you see in anaphylaxis?

Answer 15

vomiting

abdominal pain

Question 16

what is the dose for epinephrine in children?

Answer 16

0. 15 mg < or equal to 25 kg
1. 3 mg > or equal to 25 kg (adult dose)

Question 17

what is the appropriate disposition in a child with analphylaxis episode?

Answer 17

observation in ED at least 4-8 hours

decision to admit based on:

need for >1 dose epinephrine

IV fluids for hypotension

laryngeal edema

severe asthma

ingestion as trigger

Question 18

how often does GER occur in infants age 1-6 months?

Answer 18

up to 100x a day!

peaks at 3-4 months

usually resolves by 12 months (95%)

Question 19

what are the s/sx of pyloric stenosis?

Answer 19

usually appears early, between 3-6 mos

vomiting that becomes projectile and forceful

weight loss

hypertrophied pylorus (olive) can be palpated in some cases

hypochloremia, hypokalemia, metabolic acidosis, dehydration

Question 20

what is the prevalence of pyloric stenosis?

Answer 20

6-8:1000 births

Males>females

white>other races

most commom surgical disorder in neonates

Question 21

what is volvulus?

Answer 21

life-threatening condition associated with malrotation and twisting of the intestine

suspect in any child with bilious emesis

Question 22

if you see intussusception in an child over three years, what do you need to think of asa primary cause?

Answer 22

meckel’s diverticulum

polyp

vascultis from HSP

lymphoma