Nutritional Requirements

Question 1

TPN volume
Protein
Lipid
Glucose

Answer 1

TPN: 60-80ml/kg/day
then advance by 20ml/kg as tolerated
goal: 150-160ml/kg/day (TPN+ Enteral)

Protein: 1.5-2g/kg/day

Lipid: 2g/kg–> max 3g/kg (cholesterol<200)

Glucose: 6mg/kg/day to max 11-12mg/kg/day

Question 2

Preterm/term infants goal weight gain

Answer 2

Premature: 15-20g/day

Term: 20-30g/day x 3 mo
15-20g/day x 3-6 mo
10-15g/day x 6-12mo

Question 3

percentage of calories from each macronutrient

Answer 3

Carb: 40-60%
Fat: 30-50%
Protein: 8-12%

Question 4

Colostrum content

Answer 4

secreted first few days
Rich in IgA, leukocytes, Lactoferrin, developmental factors

preterm milk has less protein (add LP), higher fat, less mineral
colostrum has high protein
mature milk has high fat content

Question 5

counterindications for Soy formula

Answer 5

1. Prematurity
2. WT <1800
3. fructose intolerance
4. renal disease (rich in Al+)

Question 6

Indications for semi-elemental formula

Answer 6

contains higher MCT, DNT need bile acids thus easier absorption in CF, lymphangiectasia, liver disease, SBS..etc

1. Short bowel syndrome
2. Food protein allergy
3. autoimmune enteropathy
4. HIV associated enteropathy
5. PA insufficiency (CF)
6. Liver disease

Question 7

Indications for elemental formula

Answer 7

1. CMPA
2. SBS
3. EoE

Question 8

Formulas for:
Epilepsy
Chylothorax
Renal disease

Answer 8

KetoCal
monogen or protagen (high MCT)
low iron, low mineral