Pediatric Nutrition

Question 1

Why do infants need more nutrition?

Answer 1

-lack of caloric reserve
-increased metabolic rate
-growth rates higher in infancy
-increased demands during illness

Question 2

how much does weight increase by 4-6 months for infants

Answer 2

weight doubles

Question 3

how much does infant weight increase by 12 months?

Answer 3

weight triples

Question 4

how much does infant length increase by 12 months

Answer 4

increases by 50%

Question 5

what are the growth patterns for ages 2-6

Answer 5

growth is slow but constant
adipose tissue distribution begins after age 2

Question 6

what are the growth patters for ages 7-10

Answer 6

steady growth
females > males in height and weight

Question 7

what is the growth patter in 11-18

Answer 7

begins after puberty and continues until growth is complete
rate of weight gain increases

Question 8

what are the different growth charts for peds

Answer 8

WHO < 2 years old
CDC 2-20 years old

Question 9

are growth charts the same for boys and girls?

Answer 9

no they are different

Question 10

how much of neonate’s basal energy is used by the brain

Answer 10

50%

Question 11

define pediatric malnutrition

Answer 11

deficiencies or excesses in nutrition intake, imbalance of essential nutrients or impaired nutrition utilization

Question 12

what is the main acute illness that comes from pediatric malnutrition

Answer 12

refeeding syndrome

Question 13

What is a z-score

Answer 13

number of standard deviations away from median

Question 14

what is failure to thrive (growth faltering)

Answer 14

fall of 2 major percentiles
weight < 3-5th percentile

Question 15

what are 3 causes of malnutrition in peds

Answer 15

inadequate caloric intake
inadequate absorption
excessive energy expenditure

Question 16

what are the AAP recommendations for breastfeeding

Answer 16

exclusive breastfeeding for first 6 months
continue for at least 1 year
may extend up to 1 year

Question 17

what are components and percentages of breast milk

Answer 17

-Lipids 50%
-Proteins
-Carbohydrates

Question 17

what are the newborn advantages of breastfeeding

Answer 17

-optimal nutrients
-dec risk of infection
-dec risk of immune mediated diseases
-psych and cognitive advantages

Question 17

what is the caloric density of breast milk

Answer 17

20 kcal/oz

Question 17

what are the mother advantages of breastfeeding

Answer 17

-dec post-partum bleeding
-faster time to attainment of pre-pregnancy weight
-dec risk of breast and ovarian cancer
-inc bonding

Question 18

what are the contraindications of breastfeeding

Answer 18

-active untreated TB
-HIV positive
-Ebola
-Use of illicit drugs
-Untreated brucellosis
-Human T-cell lymphotropic
-DRUGS

Question 19

What are the 2 main categories of drugs to avoid in breastfeeding

Answer 19

-Harm the infant directly (immunosuppressants, chemo, radioactive agents)
-Drugs that reduce milk production (antihistamines)

Question 20

what are things to consider for maternal meds

Answer 20

-risk benefit of therapy
-infant characteristics
-drug characteristics

Question 21

What drug characteristics increase absorption into breast milk

Answer 21

-Non-ionized
-Small molecular wt
-Low protein binding
-High lipid solubility
-Long half life
-Low volume of distribution

Question 22

what are human milk fortifiers

Answer 22

-added to breast milk to increase calories, minerals, vitamins, and protein
-increase calorie content to 22-28 kcal/oz

Question 23

What are term formulas

Answer 23

modeled after breast milk
carb source is lactose

Question 24

when to use specialty formulas

Answer 24

if infant has allergy

Question 25

What vitamin is cholecalciferol

Answer 25

Vitamin D3

Question 26

how is cholecalciferol dosed

Answer 26

dosed in mCg or international units (IU)
400 IU = 10mCg

Question 27

when is cholecalciferol indicated

Answer 27

Premature neonates
Term infants that are partially or fully breast fed

Question 28

how much cholecalciferol should term infants receive

Answer 28

breast fed: 400 IU (10mCg) daily
formula: 200-400 IU until receiving 1000mL/formula/day

Question 29

How much iron should premature neonates receive

Answer 29

2mg/kg/day (elemental)

Question 30

How much iron should term infants receive

Answer 30

not routinely indicated for breastfed, healthy infants
deficiency: 3mg/kg/day (elemental)

Question 31

what is the conversion between ferrous sulfate and elemental iron

Answer 31

ferrous sulfate is 75mg/mL = 15 mg elemental iron/mL

Question 32

How to calculate iron

Answer 32

calculate dose of iron
determine product
find mL needed
calculate mg dose of iron salt

Question 33

what can deficiency in zinc look like

Answer 33

dermatitis, diarrhea, infections, altered wound healing

Question 34

how much zinc sulfate is equal to elemental zinc

Answer 34

zinc sulfate 44mg = 10mg of elemental zinc

Question 35

when to introduce complementary foods

Answer 35

typically at 6 months
introduce single ingredient foods first

Question 36

what food should never be given to children < 1 yr

Answer 36

honey
cow’s milk
choking hazards
potential allergens

Question 37

what is the holliday-segar method

Answer 37

-Up to 10kg: 100mL/kg
-10-20kg: 1000mL + 50mL/kg for every kg > 10
-20kg: 1500mL + 20mL/kg for every kg > 20

Question 38

how to calculate feeding requirements

Answer 38

convent wt to kg
calculate caloric needs
calculate volume of formula
calculate total fluid requirements

Question 39

how to calculate feeding for failure to thrive patients

Answer 39

use weight that corresponds with 50th percentile on growth chat