Pediatric Nutrition Flashcards
Why do infants need more nutrition?
-lack of caloric reserve
-increased metabolic rate
-growth rates higher in infancy
-increased demands during illness
how much does weight increase by 4-6 months for infants
weight doubles
how much does infant weight increase by 12 months?
weight triples
how much does infant length increase by 12 months
increases by 50%
what are the growth patterns for ages 2-6
growth is slow but constant
adipose tissue distribution begins after age 2
what are the growth patters for ages 7-10
steady growth
females > males in height and weight
what is the growth patter in 11-18
begins after puberty and continues until growth is complete
rate of weight gain increases
what are the different growth charts for peds
WHO < 2 years old
CDC 2-20 years old
are growth charts the same for boys and girls?
no they are different
how much of neonate’s basal energy is used by the brain
50%
define pediatric malnutrition
deficiencies or excesses in nutrition intake, imbalance of essential nutrients or impaired nutrition utilization
what is the main acute illness that comes from pediatric malnutrition
refeeding syndrome
What is a z-score
number of standard deviations away from median
what is failure to thrive (growth faltering)
fall of 2 major percentiles
weight < 3-5th percentile
what are 3 causes of malnutrition in peds
inadequate caloric intake
inadequate absorption
excessive energy expenditure
what are the AAP recommendations for breastfeeding
exclusive breastfeeding for first 6 months
continue for at least 1 year
may extend up to 1 year
what are components and percentages of breast milk
-Lipids 50%
-Proteins
-Carbohydrates
what are the newborn advantages of breastfeeding
-optimal nutrients
-dec risk of infection
-dec risk of immune mediated diseases
-psych and cognitive advantages
what is the caloric density of breast milk
20 kcal/oz
what are the mother advantages of breastfeeding
-dec post-partum bleeding
-faster time to attainment of pre-pregnancy weight
-dec risk of breast and ovarian cancer
-inc bonding
what are the contraindications of breastfeeding
-active untreated TB
-HIV positive
-Ebola
-Use of illicit drugs
-Untreated brucellosis
-Human T-cell lymphotropic
-DRUGS
What are the 2 main categories of drugs to avoid in breastfeeding
-Harm the infant directly (immunosuppressants, chemo, radioactive agents)
-Drugs that reduce milk production (antihistamines)
what are things to consider for maternal meds
-risk benefit of therapy
-infant characteristics
-drug characteristics
What drug characteristics increase absorption into breast milk
-Non-ionized
-Small molecular wt
-Low protein binding
-High lipid solubility
-Long half life
-Low volume of distribution
what are human milk fortifiers
-added to breast milk to increase calories, minerals, vitamins, and protein
-increase calorie content to 22-28 kcal/oz
What are term formulas
modeled after breast milk
carb source is lactose
when to use specialty formulas
if infant has allergy
What vitamin is cholecalciferol
Vitamin D3
how is cholecalciferol dosed
dosed in mCg or international units (IU)
400 IU = 10mCg
when is cholecalciferol indicated
Premature neonates
Term infants that are partially or fully breast fed
how much cholecalciferol should term infants receive
breast fed: 400 IU (10mCg) daily
formula: 200-400 IU until receiving 1000mL/formula/day
How much iron should premature neonates receive
2mg/kg/day (elemental)
How much iron should term infants receive
not routinely indicated for breastfed, healthy infants
deficiency: 3mg/kg/day (elemental)
what is the conversion between ferrous sulfate and elemental iron
ferrous sulfate is 75mg/mL = 15 mg elemental iron/mL
How to calculate iron
calculate dose of iron
determine product
find mL needed
calculate mg dose of iron salt
what can deficiency in zinc look like
dermatitis, diarrhea, infections, altered wound healing
how much zinc sulfate is equal to elemental zinc
zinc sulfate 44mg = 10mg of elemental zinc
when to introduce complementary foods
typically at 6 months
introduce single ingredient foods first
what food should never be given to children < 1 yr
honey
cow’s milk
choking hazards
potential allergens
what is the holliday-segar method
-Up to 10kg: 100mL/kg
-10-20kg: 1000mL + 50mL/kg for every kg > 10
-20kg: 1500mL + 20mL/kg for every kg > 20
how to calculate feeding requirements
convent wt to kg
calculate caloric needs
calculate volume of formula
calculate total fluid requirements
how to calculate feeding for failure to thrive patients
use weight that corresponds with 50th percentile on growth chat
