Nutrition

Question 1

Dietary Requirements based on weight:
<10kg
10-20kg
>20kg

Answer 1

Weight < 10 kg = 100 kcal/kg/day
Weight 10-20kg = 1,000 cal + 50 kcal/kg/day per kg>10
Weight > 20 kg = 1,500 cal + 20 kcal/kg/day per kg>20

Question 2

Dietary Recommendations

Answer 2

0-6 months = Exclusively breastmilk unless CI’d
Supplements required: Vit D (400 IU/day), Fluoride (>6 months), Iron (6-12 months if no fortified foods)

> 6 months = Introduce solid food (2-3 per week, wait 2 days between each); lumpy, mashed, pureed

9-24 months = Homo milk (3.25%) 16oz/day to non-breast feeding infant
3 meals + 1-2 smaller snacks
Veggies, fruits, grains and full-fat milk after iron-rich foods
Encourage self-feeding and open cup by 18 months

Avoid honey until >12 months, added sugar/salt, excessive milk, juice

2-6 years = switch to 2% milk (500 ml/day)

Question 3

Breastfeeding:
Contents
Advantages
Contraindications

Answer 3

Content

• Colostrum (first few days) = clear, high P low F, IgA
• Mature milk = 70:30 whey:casein ratio

Advantages

• Easy digestion, immunologic (IgA, macrophages, lymphocytes, lysozymes, lactoferrin)
• Bonding, economical, convenient

Contraindications

• Chemotherapy or radiation
• HIV/AIDS, untreated TB, Herpes on breast
• Medications that cross (antimetabolites, bromocriptine, chloramphenicol, diazepam, ergots, gold, metronidazole, tetracycline, lithium, cyclphosphamide

Question 4

Signs of inadequate intake

Answer 4

• <6 wet diapers/day after first week
• <7 feeds/day
• Sleepy/lethargic, sleeping all night <6 weeks old
• Weight loss >10% of birth weight
• Jaundice