Nutrition in Children Flashcards
What drives growth in infants, children and adolescents respectively?
- Infant growth is nutrition led.
- Child growth is growth hormone led.
- Pubertal growth is sex-steroid led.
What do the centiles of a WHO growth chart show?
- The optimum range of weights and heights.
- The ‘centile’ describes the percentage expected to be below that line.
- E.g. 91% will be below the 91st.
- Half of all children shoud be between the 25th-75th centile.
Describe the assessment of a child where there is a concern about height.
- If there are concerns about an infant’s length or a child’s length or height, if possible obtain the biological parents’ heights and work out the mid-parental height centile.
- If the child’s length or height centile is below the range predicted from parental heights (more than 2 centile spaces below the mid-parental centile):
- Undernutrition
- Primary growth disorder
What is the definition of weight status in children 2-18 years?
What is the guidance on milk in the first year of life?
- Breastfeed exclusively for the first 6 months.
- Then:
- Continue breastfeeding for at least the first year
- OR
- Infant formula (based on cows’ or goat’s milk) - only suitable alternative to breast milk for the first 12 months.
- Use of soya-based formula should only be on medical advice.
What are the health benefits of breastfeeding?
- Decreased infections:
- Ear
- Respiratory
- Eye
- Urinary
- Decreased D&V - fewer hospital visits
- Breastfeeding exclusively for 6 months decreases the risk of SIDS.
- Reduced risk of obesity since protein and total energy intake are higher among formula-fed infants.
- Decreases the risk of the following diseases in adulthood:
- CVD
- T2DM
- Hypertension
- There is a greater likelihood of a higher IQ at age 7.5
What factors influence whether a baby is ready for solids?
- Can they:
- Stay in a sitting position and hold their head steady?
- Coordinate their eyes, hand and mouth?
- Swallow?
- It is a myth that infants who are big for their age need solid foods earlier than other infants.
What is the nutrition advice for children who are 6+ months?
- Most infants should not start solid food until around age 6 months.
- Breast milk, infant formula and water should be the only drinks offered at 6 months.
- No unmodified cow’s milk should be given as a main drink under 12 months.
- Full fat cow’s milk can be used in small amounts in cooking from 6-9 months.
- Semi-skimmed milk should not be given before 2 years.
- Skimmed milk should not be given before 5 years.
What are the guidelines on complementary feeding?
- First foods should be GF if <6 months.
- Baby rice, cooked & mashed fruits and vegetables, peeled and mashed banana.
- Sugar and salt should not be added. Avoid salty food.
- Foods that may cause allergies should be introdued one at a time (cereals with gluten, eggs, nuts, soya, fish, other milk).
- Give foods rich in absorbable iron regularly (red meat, canned fish, well-cooked eggs).
- Give low sugar breakfast cereal fortified with iron.
- Avoid whole nuts and seeds until 5 years.
- Frequent intake of foods and drinks high in sugar should be limited.
- Teeth should be cleaned gently twice per day as soon as they appear using 1000ppm fluoride toothpaste.
What are the principles of adequate, appropriate and safe complementary feeding?
What are the thresholds for concern in children with faltering growth?
- A fall across 1 or more weight centile spaces if birthweight was below the 9th centile.
- A fall across 2 or more weight centile spaces, if birthweight was between 9th-91st centiles.
- A fall across 3 or more weight centile spaces, if birthweight was above the 91st centile.
- When current weight is below the 2nd centile for age, regardless of birthweight.
Describe the different types of malnutrition.
- Deficiencies, excesses or imbalances in individuals’ intake or energy and/or nutrients.
-
Undernutrition:
- Wasting (low weight for height)
- Stunting (low height for age)
- Underweight (low weight for age)
-
Micronutrient-related:
- Micronutrient deficiencies (lack important vitamins and minerals)
- Micronutrient excess
-
Obesity and diet-related NCD
- Overnutrition
- Heart disease, DM, cancer, stroke
Describe the iron needs of a baby <6 months.
- Healthy term infants of normal birthweight have little or no need for exogenous iron around the first 6 months of life.
- Endogenous iron is adequate for the first 6 months.
What is calcium used for in infants and young children?
- Teeth and bone mineralisation
- Nerve impulse transmission
- Wound healing
- Cellular metabolism
- Muscle contraction
What are the factors which increase and decrease the risk of dental caries in children?
What are the factors associated with a child being overweight or obese?
- Overweight / obese mother
- Frequent snacking on sweets and crisps as a toddler
- Skipping breakfast
- Not eating main meal in dining area at home
- Low parental supervision
- Mother has a long-term health problem
- No ‘child-friendly’ neighbourhood
What are the consequences of childhood obesity?
What is the appropriate way to ‘raise the issue’ of childhood obesity with a parent?
Raise the topic sensitively using the 5As approach.
