Pediatric Nutrition

Question 1

Neonates risk factors for nutritional deficiency

Answer 1

Low birth water: less than 2500 g
Birth weight less than 3% for age
Acute weight > 10%

Question 2

Children risk factors for nutritional deficiency

Answer 2

Less than 10% wt/ht for age
>90% wt/ht for age
Increased metabolic requirements
Intolerance/inability for enteral feedings
Inadequate weight gain or significant weight loss

Question 3

Subjective Assessments

Answer 3

Temperment
Infant "norms"
Feeding patterns
Medical history
Dietary habits/restrictions

Question 4

Objective Assessments

Answer 4

Growth curves
Different norms in lab values - acute factors
Development
Laboratory

Question 5

Infant growth - After birth

Answer 5

Lose up to 10% of birth weight but should regain that by 2 weeks

Question 6

From birth to 1 year, normal infants =

Answer 6

trible their weight and increase their length by 50%

Question 7

By 4 months,

Answer 7

birth weight is doubled

Question 8

Failure to Thrive =

Answer 8

Less than 2-5% for age wt/ht

Fall over 2 major % lines

Question 9

Pediatric BMI

Answer 9

Less than 5% underweight
5-85% Normal
85-95% Overweight
>95% Obese

Question 10

Increased MF requirements:

Answer 10

Fever
Hyperventilation
Sweating
Hyperthyroidism
Diarrhea
Burns
Phototherapy

Question 11

Decreased MF requirements:

Answer 11

Renal dysfunction

CHF

Question 12

Carb Requirement for Peds

Answer 12

20-30 g/kg/day for adequate growth

60-70% of non-protein calories

Question 13

Carbs calories

Answer 13

3.4-4 calories per gram dextrose

Question 14

Lipid calories

Answer 14

9 calories/g

Question 15

Lipids Requirement for Peds

Answer 15

30-40% of non-protein caolires

Question 16

Advantages of breastmilk

Answer 16

Low is salt and potassium
Anti-infective properties
Longterm immunity
Cheap
Bonding
Weight loss
Reduce obesity, diabetes
Increase IQ???

Question 17

Define colostrum

Answer 17

Milk produced first 3-5 days postpartum
Low in fat
High in protein

Question 18

Define Transitional milk

Answer 18

Days 5-15

Question 19

Define Mature Milk

Answer 19

> 15 days postpartum

High in fat

Question 20

Protein + Breast Milk

Answer 20

Whey: casein ration 80:20 colostrum and 60:40 mature

Question 21

Whey is

Answer 21

soluble, non curdling

Remains a solution in stomach

Question 22

Casein

Answer 22

Forms micelles
Insoluble –> curdles
More allergic

Question 23

Fat + Breast Milk

Answer 23

Major source of energy
Primarily TG
Has lipase to aid in digestion

Question 24

Carbs + Breast Milk

Answer 24

39% of calories
Lactose - major
Enhances absorption of Ca and Mg

Question 25

If a baby can't tolerate formula but handled breast milk, what the reason?

Answer 25

Formula has protein in it and breast milk doesn't

Question 26

Milk-Protein Based Formulas Indication and examples

Answer 26

Healthy term infants | 20 cal/oz

Question 27

Milk-Protein Based Formulas Protein

Answer 27

1.4-1.5 g protein/100 mL | Casein or whey

Question 28

High casein content may

Answer 28

slow GI emptying GI distress or constipation

Question 29

Milk-Protein Based Formulas Carbs

Answer 29

Lactose, corn syrup, cornstartch | Can be lactose-free

Question 30

Milk-Protein Based Formulas Fat

Answer 30

More digestible forms (cows milk) | Others: palm olein, coconut, soybean

Question 31

Milk-Protein Based Formulas Iron

Answer 31

7-10 mg/L of iron but if problems with constipation drop down to 1.5 mg/L

Question 32

Docosahexaenoic acid (DHA) uses and minimum

Answer 32

Brain, eye and nervous system development | 0.2%

Question 33

Arachidonic acid (ARA) uses and minimum

Answer 33

Eicosanoid formulation for immunity, blood clotting, etc | 0.2%

Question 34

Prebiotics Supplementation?

Answer 34

Non-digestible food ingredient that selectively stimulates the growth and/or activity of one or a limited number of bacteria in the colon - Resist host digestion and absorption in stomach --> large bowel unmodified - Shows as oligosaccharides

Question 35

Reason for prebiotic supplement

Answer 35

Breast milk contains 100 different oligosaccharide like molecules - Bifidobacteria and/or lactobacilli

Question 36

Probiotic supplementation

Answer 36

Microbes that protect the host and prevent disease Benefit on grwoth and reduced colic, diarrhea, and abx use - bifidobacterium and lactobacillus

Question 37

Soy protein indications

Answer 37

Cow's milk protein intolerance Lactose intolerance Vegetarians Galactosemia

Question 38

Soys are converted to:

Answer 38

estrogens so can this effect the baby, maybe?

Question 39

Soy Protein Formulas Protein

Answer 39

Modified soy proteins

Question 40

Soy Protein Formulas Carbs

Answer 40

Lactose free | Sugar free

Question 41

Protein Hydrosylate Formula Indication

Answer 41

``` Milk protein intolerance Soy protein intolerance Failure to thrive or feeding problems Malabsorption syndrome BROKEN DOWN PROTEINS ```

Question 42

Protein Hydrosylate Formula Protein

Answer 42

Milk protein hydrolyzed into low molecular weight peptides (improve absorption)

Question 43

Amino Acid Formulas Indication

Answer 43

Intolerance to hydrolyzed infant formulas - Most expensive - Nasty

Question 44

Amino Acid Formulas Proteins

Answer 44

Free amino acids

Question 45

Premature Infant Formulas Indication

Answer 45

Premature infants under 2000 g | Infants with fluid restrictions

Question 46

Pediatric Formulas Indications

Answer 46

Greater than 6-12 months | Tube fed

Question 47

Infants will feed

Answer 47

EVERY 3 TO 4 HOURS (8 to 6 feedings)

Question 48

30 mL = ___ oz

Answer 48

1