Nutrition Flashcards
what is the most appropriate replacement fluid for routine physical activity?
water is most appropriate replacement fluid for routine physical activity
- prolonged vigorous activity may require sports drinks
what are probiotics
LIVE MICROORGANISMS which can confer a health effect on the host when consumed in adequate amounts
- they are nonpathogenic in the normal host
what are prebiotics
NONVIABLE FOOD COMPONENTS which can confer a health benefit on the host by modulating intestinal microflora
what is antibiotic associated diarrhea
defined as ≥ 3 loose stools/day for ≥ 2 days occurring up to two weeks after the initiation of antibiotics
what are clinical conditions that may benefit from probiotic use (5)
antibiotic associated diarrhea acute infectious viral diarrhea to help prevent NEC may decrease symptoms of colic may decrease symptoms of IBS
if mom’s own milk is unavailable then what should be offered to the infant for feeding?
pasteurized donor milk
what does pasteurizing human breast milk do?
inactivated bacterial and viral contaminants
decreases IgA, IgG and eliminates IgM
when monitoring growth, how long do you use corrected age
up to 24-36 months
at what age should you start doing BMI
age 2
what is the gold standard chart for monitoring growth
WHO growth charts
at what age do we stop measuring head circumference
age 2
what BMI is considered underweight risk of overweight overweight obese for age 2-5
underweight <3rd %ile
risk of overweight: >85%ile
overweight: >97% ile
obese: >99.9%ile
what is considered stunting
severe stunting
<3%ile
<0.1
what BMI is considered: overweight obese severe obese for age 5-19
risk of overweight: -
overweight >85%ile
obese >97%ile
severe obesity >99.9%ile
supplemental floride is recommended if the concentration in the water is less than what?
<0.3ppm
what are some signs of fluorosis
enamel striations
snow-capped cusps
chalky white teeth
how does fluoride prevent dental caries (3)
- reduces plaque
- inhibits demineralization
- enhances remineralization of the enamel
when would you consider supplemental fluoride (3)
- fluoride in water <0.3ppm
- child does not brush their teeth BID
- high risk for caries
when should you introduce milk? what percentage? how much?
9-12 months
homogenized (no skim milk <2yo)
500mL per day
when should lumpy textures be introduced?
no later than 9 months of age
what should be a Childs first food
iron rich food at 6 months of age
what are the categories for causes of growth failure
poor nutritional intake- AN, child eating poorly
malabsorption- pancreatic disease (CF, shwachmann diamond), intestinal disease (celiac, Crohn’s), cholestatic liver disease
increased consumption- chronic disease, chronic infection
endocrine- GH deficiency, hypothyroidism
rare- renal tubular acidosis, diencephalic tumor
what is the basic workup for growth failure
Step 1
•Complete blood count
•Erythrocyte sedimentation rate or C-reactive protein
•Serum electrolytes, venous blood gas, blood glucose
•Blood urea nitrogen, creatinine
•Serum protein and albumin
•Serum iron, TIBC, saturation, ferritin
•Calcium, phosphorus and alkaline phosphatase
•Liver enzymes (AST, ALT, GGT)
•Serum immunoglobulins
•Tissue transglutaminases (accompanied by total IgA level)
•TSH
•Urinalysis
Step 2 •Sweat chloride •Vitamin levels •Fecal elastase •Bone age
Step 3
•Refer to specialist
what is an example of an appetite stimulant
cryoheptadine
what’s the equation for mid parental height
mom’s + dad’s +/- 13/2
Toddler 2.5 years old, mum concerned that not eating well, having a lot of battles to get him to eat. List 5 tips to help mom.
- Reassure parents that a decrease in appetite is normal for children two to five years of age
- Limit meal time to 20 minutes
- 1 TBSP of food per age
- Avoid distractions at meal times (TV)
- Eat together when possible
- Do not allow grazing during the day. Snacks mid way between meals
- Do not punish
- A 10 min to 15 min notice before any meal helps children to prepare and settle down before eating
- Explain that while parents are responsible for which foods children are offered to eat, the child is responsible for how much to eat
what is the criteria for infantile colic
Infants younger than 4 months of age
Paroxysms of irritability, fussiness, or crying that start and stop without obvious cause
Episodes last 3h or more per day, occur at least 3 days per week, for at least 1 week
No failure to thrive
what are the two situations where soy formula is recommended
- galactosemia
2. religious reasons (veganism)
Are prebiotics or probiotics recommended for the management of colic?
No! Insufficient evidence to recommend for or against the use of probiotics or prebiotics in the management of colic
what is one treatment option you could consider for colic?
If severe colic with concern of CMPA, can consider eliminating dairy from mom’s diet x 2 weeks
Ensure no reduction in breastfeeding, and adequate Ca and Vit D for baby and mom
Can try 2 weeks of extensively hydrolyzed formula if bottle fed
If there is no definite benefit after two weeks, the dietary restrictions should be lifted.
what babies should not get soy formula? (2) why?
congenital hypothyroidism
preterm babies
soy formula contains phytoestrogens and may inhibit thyroid peroxidase and lower free thyroxin levels
what formula is recommended for CMPA
extensively hydrolyzed formula
Contraindicated in non-IgE mediated CMPA since there is a high rate of overlap with soy allergy
the most effective measures to reduce iron deficiency, including: (4)
Delayed cord clamping
If formula feeding, providing iron-fortified formula
Feeding iron-rich complementary foods from age 6 months
Not using cow’s milk as the main milk source until infants are a year old, and limiting cow’s milk intake to 500 mL/day thereafter.
for low birth weight infants what is the recommendation for iron supplementation
Infants with a birth weight of 2.0 kg to 2.5 kg, should receive an iron supplement of 1-2 mg/kg/day for the first 6 months of age.
Infants with a birth weight less than 2.0 kg, should receive an iron supplement of 2-3 mg/kg/day for the first year of age.
