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MB2: Child health > Nutrition > Flashcards

Nutrition Flashcards

1
Q

benefits to infant with breastfeeding

A

less risk resp/ear/gi infection
higher IQ
reduced malocclusion and reduced risk infant mortality
less risk T2DM, CVD, HTN

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2
Q

benefits to mother with breastfeeding

A

less risk of ovarian cancer and breast cancer

less risk T2DM

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3
Q

true/false - mothers with HIV should avoid breastfeeding to avoid risk of transmission

A

true - but only if there is other nutritionally available breastmilk available

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4
Q

infection spread of HIV to child?

A

labour
breastfeeding
pregnancy

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5
Q

reducing risk of HIV spread to neonate

A

antiretroviral treatment for mother and infant

avoid breastfeeding

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6
Q

if a mother with HIV decided to breastfeed, how should she be managed

A

breastfeed exclusively

stay on antiretrovirals to keep viral count low or undetectable

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7
Q

how often does breastfeeding occur in the first 48 hours

A

infrequently, but occurs sometimes

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8
Q

how often does breastfeeding occur >72 hours

A

6-15 feeds per 24 hours

depends on baby

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9
Q

true/false - breastmilk compositions stays the same

A

false - it changes start to end of feed and to meet nutritional requirement of infant

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10
Q

describe the production of breastmilk in the mother

A

stimulated by prolactin, released in response to suckling
oxytocin is higher in mother/baby contact
milk ejection when feeding action and oxytocin increase

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11
Q

when is breastmilk production highest

A

when there is the least breastmilk, as this causes the least -ve feedback of prolactin

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12
Q

poor infant feeding effecrs on the mother

A

pain
mastitis
engorgement
low milk supply

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13
Q

poor infant feeding effects on the infant

A

unsettled
frequent feeding
failure to thrive

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14
Q

what is tongue tie and what can it lead to

A

tightness of lingual frenulum
difficulty attaching to breast and achieving suckling
may need division of lingual frenulum

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15
Q

when is milk expression indicated

A 
breasts full and uncomfortable 
infant too small or sick to feed 
hospitalisation of mother 
mother away from child for a few hours 
mother returning to work where there is little opportunity to feed
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16
Q

encouraging flow of breastmilk for expression

A

comfortable, relaxed, quiet and private place
close contact with infant
warm bath or shower
gentle massaging of the breast or stroking towards the nipple
change breasts every few mins

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17
Q

storage of expressed breastmilk

A

5 days in fridge
frozen for 2 weeks
frozen for 6m if -18

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18
Q

mother related problems with feeding

A

painful nipples
engorgement
mastitis
concern about not having enough milk

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19
Q

how long should infants be exclusively breastfed

A

6 months

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20
Q

when would a concern about nother not having enough milk be possible

A

poor weight
<6 wet nappies/24hr
<3 dirty nappies/24hr

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21
Q

what are the disadvantages to formula milk over breastmilk

A

less infant protection and immunity

powdered milk isnt sterile

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22
Q

how does the growth pattern of a formula fed baby differ to that of a breastfed baby

A

they put on more weight in 4-6 months

increased risk diabetes

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23
Q

when should leftover formula milk be discarded

A

2 hours after

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24
Q

true/false - baby should be encouraged to finish bottle

A

false - it can lead to overfeeding

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25
Q

true/false - breastfed babies can be offered water on hot days

A

true - it must be boiled and cooled

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26
Q

when can soys milk be used in babies

A

> 6m

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27
Q

true/false - follow on milk can be used at 7m

A

false - it is recommended for >1y

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28
Q

risk factors for becoming unwell due to powder milk

A

young infant
preterm
immunocompromised
low birthweight

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29
Q

storage for formula milk?

A

one at a time if possible
store in fridge no longer than 24hr
stand in hot water to heat

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30
Q

risks of formula feeding o mother and infant

A 
increased risk illness 
bacterial contamination 
excess weight gain 
childhood obesity 
maternal - diabetes, breast, ovarian cancer
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31
Q

what feeding factors are required before discharging a preterm infant

A

feeding well

stable blood glucose

32
Q

management of mastitis?

A

self help for 12-24hr with expressing milk

fluclox if unsuccessful or erythromycin if allergic

33
Q

a lump in breast whilst in feeding window is likely?

what would you do?

A

abscess
urgent refer to clinic
USS, drain and culture

34
Q

define the estimated average requirement

A

nutritional need where 1/2 populaiton need more and 1/2 need less

35
Q

define the reference nutrient intake (RNI)

A

nutritional need that is enough for 97.5% of population

36
Q

define the lower reference nutrient intake

A

nutritional need for lowest 2.5% of population

37
Q

what is wasting growth

A

low weight for height

38
Q

what is stunted growth

A

low height for age

39
Q

how much protein does 4-18m old need

A

12.7-14.5g

40
Q

describe the trend of infant nutrition and estimated average intake

A

around half of early infants consuming over estimated average intake
increases to 90% by 18m

41
Q

sodium intake requirement for <12m

A

400mg

1g salt

42
Q

sodium intake requirements for 12-36m

A

800mg

2g salt

43
Q

true/false - most infants/children do not consume enough sodium in dietary salt

A

false - almost all age groups studied consume too much

44
Q

breastfeeding is exclusively recommended for ___ months

A

6

45
Q

what fluids can infants consume after 6m

A

water
formula
breastmilk

46
Q

when can full fat unmodified cows milk be given to an infant

A

12m or older

47
Q

when can semi skimmed milk be given to a child/infant

A

over 2

48
Q

when can skimmed milk be given to a child

A

over 5

49
Q

when should complementary feeding begin roughly?

A

6m

50
Q

complementary feeding allows for development of what

A

gross motor, fine motor and vision
oral motor development
infant-carer

51
Q

causes for early introduction of complementary feeding

A 
maternal grandmother 
deprivation 
personal disagreement to wait or lack of support 
free samples 
smoking 
obesity 
formula feeding
52
Q

how does feeding at school age help development

A

eating patterns
independence
behaviour pattern

53
Q

how does feeding at adolescent age help development

A

further independence

physical development and growth

54
Q

what decreases risk of dental caries

A

fluoride toothpaste
hard cheese
chewing gum - sugar free

55
Q

what increases risk of dental caries

A

free sugars

deprivation

56
Q

what is regarded as faltering growth

A

> 1 centile drop if <9th centile
2 centile drops if 9-91st centile
3 centile drops if >91st centile
<2nd centile at any time or weight

57
Q

consequences of overfeeding on the child

A 
bullying 
mental health issues 
stigma 
school absence 
high cholesterol, HTN, bone and joint problems, diabetes 
cancer
58
Q

risk factors and causes leading to increased chance overfeeding

A 
deprivation 
obese mother 
frequent snacking 
skipping breakfast 
not eating main meal in dining room 
low parental supervision 
not child friendly 
maternal chronic health issue
59
Q

public health interventions for child nutrition?

A 
best start 
childsmile 
child healthy weight 
physical activity programmes 
community food and health programmes
60
Q

what centile is overweight

A

> 91st

61
Q

what centile is obese

A

> 98th

62
Q

risk factors for being oberweight at 3

A 
overweight parents 
black
high birthweight 
smoking antenatal 
single mother 
pre-preg overweight 
low SE status 
solid foods before 4m
63
Q

what factor is protective against being overweight at 3

A

breastfeeding for >4m

64
Q

features of prader-willi

A 
floppy 
poor suck reflex
food seeking 
lack satiety 
low muscle tone 
learning difficulty 
hypogonadism 
short stature
65
Q

features of bardet-biedl

A 
visual impairment 
renal issues 
learning difficulty 
lack satiety 
hypogonadism 
obese 
hyperphagia
66
Q

lifestyle behaviours contributing to obesity as child

A 
diet 
activity 
screen time 
sleep 
behaviour stragety
67
Q

when woyld you refer an overweight/obese child to paeds

A

serious obesity related morbidity needing weight loss

<24m and severely obese

68
Q

treatment goal for overweigt/obese children

A

maintain the weight as height will balance BMI

69
Q

physical activity requirement for <5 but walking

A

> 180 mins

70
Q

physical activity requirement for 5-18 year olds

A

60 mins

muscle and bone strengthening as well

71
Q

true/false - screen time in excess of 5 hours increases likelihood of being overweight or obese

A

false - occurs in >2hrs

72
Q

when would orlistat be considered for use in children and how long for

A

BMI >99.6 centile
not usually <12
6-12m

73
Q

when would surgical bariatric intervention be considered for use in children

A

pubertal adolescents with severe/extreme obesity with severe comorbidity

74
Q

what centile is severely obese

A

99.6th centile

75
Q

what centile implies being underweight for any reason

A

<2nd centile

76
Q

what centile is underweight and needs prompt referral

A

<0.4th centile

MB2: Child health (12 decks)

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