Paediatrics

Question 1

How to weigh Infants?

Answer 1

For newborns and infants <12 months of age or <10kg:

Use baby scales.
Bare weight - all clothing and nappy removed

Newborns: record to the nearest 10g

Infants: record to the nearest 100g

Question 2

What is considered faltering growth?

Answer 2

–Crossing 2 or more percentile bands (weight-for age, height-for-age) over 6
months
–Growth persistently below the 3rd percentile (not explained by parental
stature/genetic potential)
–Weight > 2 percentiles below height percentile
–Weight-for-height < 5th percentile

Question 3

What does Malnutrition in children cause?

Answer 3

Poor growth
Impaired cognitive
development
Decreased immunity
Impaired wound healing
Increased LOS
Increased morbidity and
mortality

Question 4

How to diagnose malnutrition?

Answer 4

Weight for Height/length z score:

Mild: -1 to -1.9 Moderate: -2 to -2.9 Severe: ≤ -3

Weight Loss (2- 20yrs):

Mild: 5% Moderate: 7.5% Severe: 10%

Deceleration in Weight for Height/Length z scores:

Mild: 1 Z Moderate: 2 Z. Severe: 3 Z

Inadequate nutrient intake:

Mild: 51% - 75% Moderate: 26% - 50% Severe: ≤25%

Question 5

Possible PESS Statment:

Answer 5

Severe Malnutrition related to not eating estimated energy and protein requirements (25%-50%)-evidenced by Wt: 5.2kg (<1st centile), W/L: <1st centile, Z Score -3.19,

Question 6

What are the Nutrition Intervention for Breast Fed Infants?

Answer 6

Ensure adequate volume over 24hrs
Lactation consultation

Top up with EBM after feeds

Top up with fortified EBM after feeds (using term formula powder)

Increased strength formula top-ups ( e.g. 1.1/4 strength formula)

Question 7

What are the Nutrition Intervention for Formula Fed Infants?

Answer 7

Check Daily Volume

Check timing of feeds and volume

Check Formula preparation- recipe and technique

Formula changes

Consider increasing strength of formula 1 1/4 if baby is usually drinking normal.

Consider adding carbohydrates or fat.

Question 8

How to monitor and evaluate an infant?

Answer 8

Check Weight/height gain- gained 160g/wk
 Check Tolerance of bottle top ups
 Check Frequency of bowels 
 Check  for how many Wet nappies 
 Cue for Q4Hly feeds
 Showing readiness signs for solids– provided education

Question 9

In which instance would you use a CDC growth chart Vs. A WHO growth chart?

Answer 9

WHO 0-2 years

CDC 2-20 years

Question 10

When do we stop correcting for gestational age in perterm infants

Answer 10

24 months of corrected gestational age

Question 11

What is the paediatric malnutrition screening tool used in QLD hospitals?

Answer 11

Paediatric Malnutrition Screening Tool (PNST)