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Therapeutics I - Spring 2017 > Pediatric Nutrition > Flashcards

Pediatric Nutrition Flashcards

1
Q

Infant weight double by _______

A

4 -6 months

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2
Q

Infant weight triples by ______

A

12 months

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3
Q

Infant length increase 50% by _______

A

12 months

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4
Q

Do babies store a lot of calories?

A

NO - therefore they need to be given more calories - they are mainly water

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5
Q

Do babies have higher or lower metabolic rates

A

higher

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6
Q

Ways to define pediatric malnutrition

A
  • Anthropometry (WHO charts /z-scores if less than 2 years old, MUAC)
  • Etiology/Chronicity
  • Mechanism
  • Imbalance of nutrients
  • outcomes
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7
Q

At Preschool Age (4 - 6 yo):

______ tissue distribution begins after age 2

A

ADIPOSE

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8
Q

At Preschool Age (4 - 6 yo):

Growth ______ but is ______

A

slows, constant

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9
Q

At Middle Childhood: ( 7 - 10 yo)

  • Steady growth
  • Females _(> or
A

> (females are bigger than males at this age normally)

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10
Q

Assessing growth:

Goal = child to be AT or ABOVE the ____ percentile

A

50th

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11
Q

2 signs that there is “failure to thrive”

A
  • fall of 2 major percentiles

- weight < 3 - 5th percentile

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12
Q

If no contraindications: Breastfeeding is recommended…

  • Exclusively for the first ________
  • optimal to continue for at least _______
  • May go beyond _______ if desired
A

6 months; 1 year; 1 year

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13
Q

Breastfeeding Advantages:

For newborn and For mother

A

Newborn: OPTIMAL NUTRIENTS; decrease risk of infection and decrease risk of immune mediated diseases; psychological and cognitive advantages

Mother: Lose “baby” weight faster; decrease post partum bleeding; decrease risk of breast and ovarian cancer; increases “child spacing”; mother-infant bond

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14
Q

Contraindications for breastfeeding

A

Infections (Maternal HIV positive status; Infectious TB; Human T-Cell lymphotrophic virus, bruecllosis)
OR
Certain drugs

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15
Q

2 main drug categories for breastfeeding mothers to avoid

A
  • drugs that will DIRECTLY harm the baby (immunosuppresants, chemotherpay, lithium, amphetamines, radioactive agents)
  • drugs that will decrease milk production (Antihistamines, decongestants, Ergots)
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16
Q

Examples of drugs that will directly harm baby (important for breastfeeding mothers to avoid these drugs)

A

immunosuppresants, chemotherpay, lithium, amphetamines, radioactive agents

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17
Q

Examples of drugs that will decrease milk production (important for breastfeeding mothers to avoid these drugs)

A

Antihistamines, decongestants, Ergots

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18
Q

“Pharmacokinetics” of breastfeeding - will it get into the breast milk?

  • if the drug has a high molecular weight
A

less will be in breast milk

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19
Q

“Pharmacokinetics” of breastfeeding - will it get into the breast milk?

  • if the drug has high lipid solubility
A

lots in breastmilk then (bc breastmilk is very lipophilic)

20
Q

“Pharmacokinetics” of breastfeeding - will it get into the breast milk?

  • if the drug has high protein binding
A

less can get into breastmilk

21
Q

“Pharmacokinetics” of breastfeeding - will it get into the breast milk?

  • if the drug has a high volume of distribution
A

less will be in milk

22
Q

“Pharmacokinetics” of breastfeeding - will it get into the breast milk?

  • if the drug has short half life
A

less will be in milk

23
Q

Caloric density of breast milk

A

20 kcal/oz = 20 kcal/ 30 ml

24
Q

Lipid components of breast milk: notable factors

A

lipids are 50% of breast milk; breast milk has long chain fatty acids in it which are important for neural/retinal development

25
Protein components of breast milk: notable factors
70% whey; 30% casein
26
whey vs casein: | which one helps with gastric emptying and which one is easier to digest
whey - easier to digest; | casein - helps with gastric emptying
27
Carbohydrate components of breast milk: notable factors
lactose - helps baby grow "good bacteria" in its gut!
28
What 2 things are typically supplement to babies (newborns or term infants)
Vitamin D and Iron
29
What to supplement a term infant
vitamin D (not iron though)
30
what is a human milk fortifier
it is added to breast milk when breast milk is not adequately meeting the nutritional needs of a preterm infant - it will calories/vitamins and protein
31
How does a human milk fortifier comes in what form
liquid or powder
32
Indications for formula feeding
- substitute/supplement feeds for mothers who do not/cannot breastfeed - infants that cant tolerate human milk - mother chemotherapy - maternal infection that can be transferred - infants failing to gain weight despite optimization of breastfeeding
33
Characteristics of formula for Term babies
``` - modeled after breast milk ~ 20 kcal/oz - lactose is carb source - has COWS MILK PROTEIN - Vit. D supplementation NOT needed - get iron-fortified formula ```
34
Downsides of using formula
- will not have the long chain fatty acids | - no immune benefits
35
Types of speciality formulas
- soy based - lactose free - hypoallergenic/ non-allergenic - antireflux
36
When to start introducing foods
4 - 6 months
37
How to introduce new foods to an infant
- start with SINGLE ingredient foods - do new food q4 - 5 days - emphasize all food groups - gradually increase serving size
38
The "Dont's" of introducing new foods to a baby
- dont put anything other than formula/breast milk in a bottle - If under a year do NOT give them honey, cow's milk (not exclusively); choking hazard foods, potential allergens (strawberries, egg yolk)
39
Calculating fluid requirements for a infant: | If up to 10 kg:
100 mL/kg
40
Calculating fluid requirements for a infant: | If 10 - 20 kg
1000 mL + (50 mL/kg for every kg greater than 10 kg)
41
Calculating fluid requirements for a infant: | > 20 kg
1500 mL + (20 mL/kg for every kg greater than 20 kg)
42
What information is needed for calculating feeding requirements
age; IF preterm or not; underlying medical conditions; current weight; number of feedings a day
43
Steps to calculating feeding requirement
- get weight (in kg) - Calculate kcal needs - Calculate total fluid requirements - Use the formula conversion (20 kcal/30 mL) to calculate how much formula is needed (fluid amount can be over calculate fluid requirement)
44
How to calculate feeding requirement for a "failure to thrive" infant
- use the 50th percentile WEIGHT you WANT them to be at | - use that weight to find calories per day
45
When/why do we use Enteral and Parenteral nutrition for infants
- consumption issues (no coordination) - digestion issues - high energy needs - poor growth - malnutrition

Therapeutics I - Spring 2017 (17 decks)

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