Paediatric Nutrition Flashcards by Leah Redford

What are the 3 main phases of post-natal growth?

Infant
Child
Pubertal

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Describe the speed of and the biggest influence of growth in the infant stage of post-natal growth

Rapid growth - birth weight is trebled in the 1st year of life
Mainly nutrition led

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Describe the speed of and the biggest influence of growth in the child stage of post-natal growth

Slower growth from ~2y/o until puberty

- Mainly growth hormone led

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Describe the speed of and the biggest influence of growth in the pubertal stage of post-natal growth

Very rapid growth

- Mainly sex steroid and growth hormone led

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Define estimated average requirements (EAR)

The average energy requirement of a population

50% will require more and 50% will require less

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Define reference nutrient intake (RNI)

Nutrient intake which is sufficient for 97.5% of the population
(2SD’s above the mean)

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Define lower reference nutrient intake (LRNI)

Nutrient intake which is sufficient for 2.5% of the population.

(2SD’s below the mean)

This will not be sufficient for the majority of the population

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What is meant by malnutrition?

Deficiencies, excesses or imbalances in an individuals intake/energy/nutrients

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What are the 4 categories of undernutrition?

Wasting (low weight for height)
Stunting (low height for age)
Underweight (low weight for age)
Micronutrient deficiencies

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What do…
- Wasting (low weight for height)
- Stunting (low height for age)
… indicate?

Wasting - usually indicates recent weight loss e.g., after illness

Stunting - usually indicates chronic undernutrition

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What is the reference nutrient intake (RNI) of protein for infants aged 4-18 months?

12.7 - 14.5g

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In Scotland, mean protein intake is below the RNI for children aged 4-18 months. T/F?

False

Mean protein intake is above the RNI for children aged 4-18 months

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How is estimated average requirement (EAR) calculated in children aged 0-12 months?

EAR = energy deposited in new tissues + total energy expenditure

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How is estimated average requirement (EAR) calculated in children aged 1-18 years?

EAR = total energy expenditure + BMR x adjusted physical activity levels

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The % of children exceeding the estimated average requirement (EAR) for energy decreases with age. T/F?

False

The % of children exceeding the estimated average requirement (EAR) for energy increases with age.

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Intake of sodium is commonly exceeded/deficient in children

Exceeded

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What is the recommended daily salt intake for children aged…
-0-12 months
-1-3 years
?

0-12 months: <1g (<400mg Na+)

1-3 years: <2g (<800mg Na+)

Healthy term babies require little or no exogenous iron in the first 6 months of life. T/F?

True

Mean intake of calcium in infants aged 4-18 months is below the RNI. T/F?

False

4-7 months: ~RNI
7-18 months: >RNI

The majority of Scottish children do not consume their 5 a day. T/F?

True

What is the recommended source of food for infants aged…
0-6 months
6-12 months
?

0-6 months: exclusive breast feeding

6-12 months: breastfeeding + complementary feeding

What does complementary feeding include?

Solid foods
Formula milk
Water

Why should solid food be introduced at ~6 months?

Breastmilk is no longer enough to meet nutritional needs

Unmodified cows milk cannot be given as the main drink in children under the age of…?

12 months

Semi-skimmed milk and skimmed milk should not be given before the ages of X and Y respectively

Semi-skimmed: 2 years | Skimmed: 5 years

Breast feeding rates are increasing in Scotland. T/F?

True

What are the recommended first foods to feed an infant?

- Vegetables - Baby rice mixed in milk - Fruit New foods should be introduced gradually

Foods that often cause allergy (e.g., gluten, eggs, fish) should not be introduced at 6 months. T/F?

False Also introduce these foods at ~6 months of age Introducing after 6-12 months can actually increase risk of allergy

Babies who are (breastfed/formula fed) should take a daily vitamin D supplement e.g., free vitamin D drops

Breastfed

What are the developmental signs that an infant is ready for complementary feeding (think ~6 months)

Gross motor: sitting, can control head Fine motor/vision: can pick up food/spoon Oral development: can swallow food

List 4 negative effects that late weaning (introduction of complementary feeding) can result in

- Faltering growth and malnutrition - Microdeficiencies, esp. iron and zinc - Delay in reaching development milestones e.g., chewing, accepting new tastes/textures - Increased risk of allergy to foods

From what age are children recommended to follow the Eatwell Guide?

From 5 years

From what age are children recommended to follow the Eatwell Guide?

From 5 years

List 6 health benefits of breastfeeding (esp. exclusive)

- Reduced infections - Reduced diarrhoea and vomiting illnesses - Reduced risk of SIDS - Reduced childhood obesity (breastmilk contains satiety hormones which are not present in formula milk) - Reduced CVD in adulthood e.g., hypertension, T2DM - Increased likelihood of a higher IQ

What is faltering growth?

A lower weight, or rate of weight gain, than expected for a child's age, height and sex

What is the biggest risk factor for dental caries?

High frequency intake of free sugars (esp. sugary drinks)

How should teethbrushing be started in children?

Clean teeth gently 2x per day as they appear using 10000ppm fluoride toothpaste

List some risk factors for overweight/obesity in childhood

- Living in more deprived areas - Overweight/obese mother - Snacking on crisps and sweets as a toddler - Skipping breakfast - Not eating main meals in dining area at home - Mother with long-term health problem - Low parental supervision - No 'child-friendly' neighbourhood for active play

What is the Best Start welfare food scheme?

- Scottish programme for low-income mothers and mothers < 18 y/o - Provided with a card which allows them certain foods for free for their child every week - Also free access to vitamin D drops for all children < 1 year in Scotland

List 5 public health nutrition interventions

- Best Start welfare food scheme - Childsmile dental programme - Child Healthy weight service - Physical activity programmes in schools - Community food and health programmes