Pediatric Nutrition and Hydration - Block 4 Flashcards
Estimated average requirements (EARs)
Nutrient intake that meets the needs of half of the healthy persons in a group
Recommended daily allowances (RDAs)
Nutrient intake that meets the needs of almost all persons in a designated group
Adequate intakes (AIs)
Average intake for the designated group that appears to sustain growth or other indicator of health
Reserved for nutrients for which no EAR or RDA has been determined
Tolerable upper intake levels (ULs)
Maximum nutrient intake unlikely to pose adverse effects in almost all persons in a designated group
Stress factors in children?
Why does formula have problems with constipation?
Breast milk has glycerin (osmotic laxatives)
Fat nutrition in infants?
Fat intake is critical for CNS growth <3YO:
* 30-40% of energy in 1-3YO
* 25-35% of energy in 4-18 YO
Fat-restricted diets (skim milk) should not be imposed until after the age of 2 to 3 years except under medical supervision
Fiber requirements in infants?
19g/day for 1-3YO
24 g/d for 4-8 YO
26-31 g/d for 9-13 YO
What are the fluid requirements for children?
Factors that increase fluid requirements?
- Fever
- Radiant warmenrs
- Diuretics
- Vomiting
- Diarrhea
- DI
- Hyperventilation
- Sweating
- Increased metabolism
Facotrs that decrease fluid requiremnts?
- FLuid overload
- HF
- Decreased UO
- Kidney failure
- Hypoalbuminemia
- SIADH
Early stages of life is the time to ___?
Embed healthy eating habits
Nutrition for birth to 6 months?
Breastmilk or infant formula:
* Breastmilk if possible but lacks Vit D
* Formula lacks anti-infective properties, growth factors, digestive enzymes, and hormones found in breastmilk
Nutrition for 6 months to 1 year?
Introduction of solid foods at 4-6 months:
* Introduce a variety of food from all the food groups
Continue breastmilk/formula feeding as needed to achieve satiety:
* Watch iron and zinc consumption
When does nutritive sucking ability develops?
34 weeks
Stomach capacity of a newborn?
20-90 mL
Gastric capacity increases from 90 to 180 mL by 1 month of age
- Human milk empties from the stomach at a faster rate than formula
Human milk benefits for infants?
- COmplete nutrition
- Growth and development
- Bonding
- Decreased infection
- Higher IQ
Benefits of mothers breastfeeding?
- Bonding
- Decreased postpartum bleeding
- Decreased time to uterus involution
- Decreased rate of depression and other cormorbidities
- Faster return to pre-pregnancy weight
- Decreased cost
Benefist to society for breast feeding?
- Bonding
- Decreased cost for formula
- Decreased lost time from work due to infant illnesses
- Decreased overall healthcare costs; decreased disease burden
What are the contents of human milk?
- Fat provides 50% and lactose provides 40% of the total energy
- By 2 to 4 weeks, human milk is considered mature and provides approximately 18 to 20 kcal/oz depending on the fat content
What is colostrum?
First fluid secreted by the breast after delivery is an intense yellow fluid (high in carotenoids)
CI to breastfeed?
- Chemo
- amphetamines, ergotamine, and statins
- Phencyclidine, cocaine, or cannabis
- Active brucellosis
- Infants with galactosemia who require a lactose-free diet
What is the infant formula act of 1980?
Must include 9-29 ingredients
Exempt formulas require a prescription for use and cannot be sold in retail
What are the forms of infant formulas?
Ready to feed, powder for reconstitution, and concentrated liquids
Formulas used for lactose allergy or vegans?
Soy based
Types of carbs?
monosaccharides, disaccharides (sucrose, lactose), oligosaccharides, polysaccharides
Sources of carbs in formulas?
lactose, corn syrup solids (glucose), maltodextrin, sucrose, and corn, tapioca, and potato starch
Sources of proteins in formulas?
cow milk protein (casein and whey), soy protein, and casein and whey hydrolyzed to peptides and amino acids
SOurces of fat in infant formulas?
coconut, corn, soy, sunflower, or safflower oil
Pre mature iron intake?
2mg E Fe/kg should be given at beginning 1 month of age and continuing through 12 months
Iron supplementation (1 mg/kg daily) is recommended beginning at 4 months of age for term infants receiving exclusive human milk feeding or less than 50% of their daily feedings as iron-fortified formula
Vitamin D supplementations in infants?
400 IU (10 mcg) daily starting a few days after birth regardless of their mode of feeding until they are receiving at least 32 oz
After 12 months of age, the recommended intake in children and adolescents is 600 IU/day
How do you screen and diagnose obesity?
How do you evaluate obesity?
How do you treat childhood obesity?
S/s of mild-moderate dehydration?
Restlessness
Irritability
Sunken eyes
Rapid pulse
Increase thirst, dry mouth
Mild skin tenting
Decrease urine output
Dark urine
Decreased tears
Depressed fontanelle
Slow capillary refill
Severe dehydration s/s?
Lethargy
Unconsciousness
Significant thirst, very dry mouth
Prolonged skin tenting
Weak or absent pulse
Low blood pressure
Minimal to no urine output
Poor capillary refill
How do you calculate rehydration fluid for dehydration?
What if the degree of dehydration?
The difference between the pre-illness and illness weights divided by the pre-illness weight, then multiplied by 100
Every 1 kg of weight lost is equivalent to 1 L of fluid loss
What is the treatment for mild-mod dehydration?
Oral rehydration
Fluids for PO rehydration contains?
Na and glucose: 75 mEq/L (mmol/L) of sodium and 13.5 g/L of glucose resulting in a solution with an osmolality of 245 mOsm/L
CI for PO rehydration?
Altered mental status due to risk of aspiration, abdominal ileus, underlying intestinal malabsorption syndromes
Ex of ORT?
Pedialyte
