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Pharmacotherapy 1 > Pediatric Nutrition > Flashcards

Pediatric Nutrition Flashcards

1
Q

What are some unique aspect of infant nutrition?

A 
lack of caloric reserve
increased metabolic rate
high growth rate
icnreased demands from illness
dependence/independence
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2
Q

What is used to determine pedatric malnutrition?

A

anthropometry: the scientific study of the measurements and proportions of the human body.

WHO charts for <2 yrs w z-scores, MUAC

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3
Q

How much does an infant’s weight change in the first 4-6 months of life?

A

doubles

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4
Q

How much does an infant weight change in the first year?

A

triples

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5
Q

How much does the infant’s length change in the first year?

A

increases 50%

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6
Q

Describe child growth for ages 2-6.

A

growth slows but is constant

adipose tissue distribution begins

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7
Q

Describe child growth for ages 7-10.

A

steady growth

females > males in ht and wt

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8
Q

Describe child growth for ages 11-18.

A

Begins before puberty and continues until growth is complete.
Rate of wt gain increases.

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9
Q

What is the best tool for assessing a child’s growth?

A

grwoth charts for
length
wt
head circumference

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10
Q

What is the goal for a child’s wt assessment?

A

stay at or above 50th percentile

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11
Q

What is failure to thrive?

A

in pediatrics when a child’s growth falls 2 major percentiles or weight is <3-5th percentile

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12
Q

How many kcal/kg/d are necessary for a pre-term infant?

A

100-120+

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13
Q

How many kcal/kg/d are needed for a 0-6 mo infant?

A

100-110

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14
Q

How many kcal/kg/d are needed for a infant 6-12 mos?

A

90-100

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15
Q

How many kcal/kg/d are needed for a 1-7 yo?

A

60-80

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16
Q

How many kcal/kg/d are needed for a 7-12 yo?

A

50-60

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17
Q

How many kcal/kg/d are needed for a 12-18 yo?

A

30-50

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18
Q

What are the AAP recommendations for breastfeeding?

A

exclusive for first 6 mos
optimal to continue for at least 1 yr
may extend beyond 1 yr if desired

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19
Q

What are the adv of breastfeeding for a newborn?

A

optimal nutrients
decr risk of infx
decr risk of immune-related diseases
psychological and cognitive adv

20
Q

What are the adv of breastfeeding for a mother?

A 
decr post partum bleeding
fasting time to attinment of pre-pregnancy wt 
decr risk of breast and ovarian cancer
incr child spacing
mother-infant bond
21
Q

Contraindiciation to breastfeeding.

A

material HIV pos-status
infectious TB
Human T-cell lymphotrophic virus type I or II
Untreated brucellosis

Certain drugs

22
Q

What types of drugs are avoided in breastfeeding?

A

immunosuppressants, chemotherapy, lithium, amphetamines, radioacive agents, etc.

drugs that reduce milk production: ergots, decongestants

23
Q

What drug characteristics make it less likely to be presnt in breast milk?

A 
high MW
low lipid solubility
high protein binding
high volume of distribution 
short t1/2
24
Q

How many times will term, healthy infants feed a day?

A

6-9 ties

25
Q

What is the caloric density of breast milk? **

A

20 kcal/oz

26
Q

What are the components of breastmilk?

A

lipids are 50% of calories:long-chain FAs

protein: 70/30 whey/casein
carb: lactose

27
Q

What supplements are necessary for premature neonates?

A

Vitamin D:
<1.5 kg: 200 U/d
>1.5 kg: 200-400 U/d

Iron: 2 mg/kg/day (elemental)

28
Q

What supplements are necessary for term infants?

A

Vitamin D: partially or fully breastfed: 400 IU daily

iron: not indicated for breastfed, healthy infants

29
Q

What is the additional calori content added to human milk by fortifiers?

A

24 kcal/oz for 1 pk per 25 mL

22 kcal/oz for 1 pk per 50 mL

30
Q

What are indications for formula feeding?

A
  • substitute or supplement feeds for mother who do not or cannot breastfeed
  • human milk intolernace
  • maternal infection transmittable
  • maternal chemotherapy
  • failing to gain wt despite optimization of breastfeeding
31
Q

What are the nutrtional contents of term formulas?

A

20kcal/oz, 19 kcal/oz
carb: lactose
cow milk protein

Vit D supp not needed
–>all should get iron fortified

32
Q

Describe pre-term formulas.

A

more calorie dense:
24 kcal/oz

available as ready-to-feed bottles
$$

33
Q

Describe enriched formulas.

A

more calorie dense: 22kcal/oz

liq or pulv

34
Q

What are examples of specialty formulas?

A

soy-based
lactose-free
hypoallergenic or non-allergenic
antireflex

35
Q

How are transitional formulas used?

A

for premature infants being discharged home from the hopsital

  • designed for initiation at 1800g or 34 weeks PCA
  • d/c at 52-56 weeks PCA
  • usually 22 kcal/oz
36
Q

when and how should formula be concentrated?

A

pre-term already conc’d

for TERM formulas decr amt of water to incr caloric content–> families should not do this on their own

37
Q

When are complementary foods initated for infants?

A

btw 4-6 mo

introduce single ingredient foods first

38
Q

How should complementary foods be introduced to an infant?

A

introduce 1 new food q4-5 d
increase serving size gradually
emphasize all food groups

39
Q

What should not be done when iniating complementary foods in infants?

A 
never put anything but breast milk or formula in a bottle
-don't give <1 yr: 
honey
cow's milk
choking hazards
potential allergens
40
Q

Describe the Holliday-Segar method of calculating child fluid requirements.

A

<10 kg: 100 mL/kg
10-20 kg: 1000mL + 50 ml/kg for kg>10
>20 kg: 1500 mL + 20 mL/kg for q kg >20

41
Q

What would be the amt of maintenance fluids for a 14 kg child?

A

1200 mL/24 hrs

42
Q

What would be 1.5x the mainteance fluids for a 25 kg child?

A

2400 mL/24hrs

43
Q

How should feeding reqs in a failture to thrive child be calculated?

A

use catch-up grwoth plan
for caloric need use 50th percentile wt
multiply desired wt by kcal/kg/d for age to get the new daily req

44
Q

Which ped pts are candidates for nutritional supplementation?

A 
ability to eat but stunted growth/devo
oral aversions/picky eaters
-req specialized diet
-delayed intro of oral feeding
-unpleasant oral-tactile situations
45
Q

Define pre-term.

A

<37 wks gestational age.

Pharmacotherapy 1 (26 decks)

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