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Therapeutics 1 Kappa Epsilon Version > 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
Q

Protein components of breast milk: notable factors

A

70% whey; 30% casein

26
Q

whey vs casein:

which one helps with gastric emptying and which one is easier to digest

A

whey - easier to digest;

casein - helps with gastric emptying

27
Q

Carbohydrate components of breast milk: notable factors

A

lactose - helps baby grow “good bacteria” in its gut!

28
Q

What 2 things are typically supplement to babies (newborns or term infants)

A

Vitamin D and Iron

29
Q

What to supplement a term infant

A

vitamin D (not iron though)

30
Q

what is a human milk fortifier

A

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
Q

How does a human milk fortifier comes in what form

A

liquid or powder

32
Q

Indications for formula feeding

A
  • 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
Q

Characteristics of formula for Term babies

A 
- 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
Q

Downsides of using formula

A
  • will not have the long chain fatty acids

- no immune benefits

35
Q

Types of speciality formulas

A
  • soy based
  • lactose free
  • hypoallergenic/ non-allergenic
  • antireflux
36
Q

When to start introducing foods

A

4 - 6 months

37
Q

How to introduce new foods to an infant

A
  • start with SINGLE ingredient foods
  • do new food q4 - 5 days
  • emphasize all food groups
  • gradually increase serving size
38
Q

The “Dont’s” of introducing new foods to a baby

A
  • 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
Q

Calculating fluid requirements for a infant:

If up to 10 kg:

A

100 mL/kg

40
Q

Calculating fluid requirements for a infant:

If 10 - 20 kg

A

1000 mL + (50 mL/kg for every kg greater than 10 kg)

41
Q

Calculating fluid requirements for a infant:

> 20 kg

A

1500 mL + (20 mL/kg for every kg greater than 20 kg)

42
Q

What information is needed for calculating feeding requirements

A

age; IF preterm or not; underlying medical conditions; current weight; number of feedings a day

43
Q

Steps to calculating feeding requirement

A
  • 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
Q

How to calculate feeding requirement for a “failure to thrive” infant

A
  • use the 50th percentile WEIGHT you WANT them to be at

- use that weight to find calories per day

45
Q

When/why do we use Enteral and Parenteral nutrition for infants

A
  • consumption issues (no coordination)
  • digestion issues
  • high energy needs
  • poor growth
  • malnutrition

Therapeutics 1 Kappa Epsilon Version (17 decks)

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