Nutrition, Normal Growth & Development

Question 1

In the first 10 days of life for a term baby, what is likely to happen to its weight?

Answer 1

Loss of 10% of birth weight due to water weight loss and establishing on feeding, more than 15% is concerning

Question 2

When would you be concerned about failure to thrive

Answer 2

Height or weight dropping between centiles

Centile of <2

Question 3

When is the earliest to wean a baby

Answer 3

Not before 6 months

Question 4

When can you introduce cow’s milk

Answer 4

Not before 12 months

Question 5

What is a nutrient deficiency associated with breast milk/cow’s milk based diet?

Answer 5

Iron deficiency

• pallor, microcytic, hypochromic aneamia with low ferratin stores, pica might be a presenting factor

Question 6

What is normal weight gain for a baby?

Answer 6

30g/day (210/week)

Question 7

When should birth weight have doubled by?

Answer 7

5-6 months

Question 8

When would you expect birth weight tripled by?

Answer 8

12 months

Question 9

What is a neonate/infant dependant on for growth and how does this compare to childhood and puberty?

Answer 9

Nutrition is the limiting factor for a neonate

Childhood - growth hormone
Puberty - sex steroid hormones

Question 10

When would you expect to see pubertal changes in girls and boys?

Answer 10

Girls - 11.5 years (breast bud formation) (range = 9-13 years)
Boys - 12 years (testicular volume increases) (range 10-15)

Question 11

What is the first and last sign of puberty in females

Answer 11

Breast formation is first (8 years) and menarche is last (12/13 years)

Question 12

What is tanner staging of breast fomation

Answer 12

Stage 1 - breast bud formation
2 - Breast bud enlarges 
3 - areola enlarges 
4 - areloa gets pigmented 
5 - mature adult breast

Question 13

What is the Tanner staging of pubic hair?

Answer 13

1 - fine and downy hair 
2- darker
3 - curly 
4 - more of it 
5 - v formation with some at lateral tighs

Question 14

Cons of breastfeeding

Answer 14

1. Nipple fissures
2. Transmission of drugs (anti-thyoid, anticonvulsants, lithium) or diseases (HIV, Hep B or C)
3. Breastmilk jaundice
4. inability to assess exact volume of feed

Question 15

Pros of breastfeeding

Answer 15

1. Improved immunity due to maternal IgA and Lactoferrin
2. Reduced long term risk of asthma/atopic diseases
3. cheap
4. bonding
5. contraceptive effect
6. Best nutritional content for baby
7. naturally low pH encourages the growth of gut biome

Question 16

Biochemistry tests to check for rickets/vitamin D

Answer 16

Calcium, phosphate and ALP

Question 17

What testicular volume would herald the onset of puberty?

Answer 17

> 4ml