Pediatrics Flashcards
What is the most important indicator of proper nutrition in children?
Growth
What is the timeframe for infancy, preschool years, middle childhood, and adolescence?
0-2
3-6
7-10
11-18
What is the timeframe for the first growth chart used for pediatrics?
0-36 months
What is the timeframe for the second growth chart used for pediatrics?
2-18 years
When is BMI used?
2+ years old
What are the four things assessed in the 0-36 month age range?
Weight/age
Length/age
Weight/age
Head circumference
What are the three things assessed in the 2- 18 year growth chart?
Weight/age
Height/age
BMI/age
How is BMI used in children as compared to adults?
BMI trends more important than the numerical value in children
Growth is highest at what age?
Infancy
what percent of weight gain comes from fat in months 1-4? months 24-36?
40%
3%
True or false: there is a 6% weight loss in the first 7-10 days of life
True
Children should (BLANK) their weight by 6 months, and (BLANK) their weight by 1 yr
Double
Triple
True or false: there is no difference in weight gain between breastfed and formula fed infants
False
What is the rough stomach capacity of newborns? Infants 3 days old? 10 days old?
5 ml
25 ml
70 ml
Fats are essential for what development of what in infancy?
CNS development
What percent of calories should come from fat for infants? Carbs?
50% = fat
50% carbs
Where should carbs come from in children?
Solid foods
Exclusively breastfed infants need supplement of what vitamin?
D
Why are infants given a vitamin K injection?
Since bacteria synthesize it
When should infants get an Fe supplement?
4-6 months
Fe deficiency in infancy can lead to what?
Developmental and behavioral issues
When should solids be introduced in a child’s diet?
6 months
Why is breast milk preferable to formula?
immune factors
Bioavailable
What are the 4 stages of human milk expression
- Colostrum
- Transition milk
- Mature milk
- Extended lactation
When does transition milk occur?
1-2 weeks after birth
When does mature milk form?
2 weeks postpartum
What happens to Ig levels as milk matures? Nutrient levels?
Lower Ig, but higher nutrients
What are the three immunologic substances that colostrum has?
IgA
Lactoferrin
Lysozyme
Why does vitamin and mineral content of breast milk decline in mature milk?
Child is now receiving other sources of nutrition
There is generally (more/less) stools when infants are breast fed
More
How often do infants feed?
2-3 hours
How long do feedings last for infants?
10-20 minutes
Should you ever dilute infant formula?
No
Should you ever add cereal/other food to infant formula?
No
True or false: some infants can go days without stooling
True
Can Fe fortified formula can cause constipation?
Yes
When can a child be given juice?
When they can drink from a sippy cup
What are the three forms of infant formula?
Ready-to-feed
Concentrate
Powder
True or false: formula is fortified with vitamins and minerals to ensure it covers the entire population
True
how many calories/oz of are formulas?
20
When should soy formula be used? (2 diseases)
Galactosemia
Congenital lactase deficiency
True or false: soy formula has a lower protein content than other formulas?
False
Why do soy formulas have higher content of Ca, Phosphorus, Zn, and Fe?
Soy phytates and fiber interfere with absorption
When are protein hydrolysate formulas used?
When infant has an allergy to intact AA
When should a child be weaned from a bottle?
1 year
Cow’s milk is not recommended until 1 year of age why? (2)
Renal solute load is too high
Not enough minerals
Weeks for a term infant?
37-42 weeks
Weeks for a preterm infant?
Weeks for post-term infant?
> 42 weeks
Low birth weight is considered what weight?
Very low birth weight is considered what weight?
Extremely Low birth weight is considered what weight?
What is the formula for the correction factor corrected age?
Chronological age - (40 wks - birth GA)
Most nutrients are deposited when in gestation?
last 3 months
Why is it necessary to get premies fat?
Since much fat is lost with each lost Kg
When is enteral nutrition used in infants?
To avoid aspiration/necrotizing enterocolitis
When is parenteral nutrition used in infants?
VLBW and ELBW
What is the adiposity rebound?
Adolescence fat surge
What is the weight and height increases until 11 ish yo?
2-3 kg/year
7 cm/year
How do you assess energy in children?
Based on growth and development
When is protein particularly needed in development?
Infancy and adolescence
Should you give a child a vitamin supplement?
no
True or false: head circumference is used to determine failure to thirve
True
What is primary FTT? Secondary?
Social or environmental deficits
Disease states
True or false: you should never put a child on a “diet”
True
When is necrotizing enterocolitis a concern?
Premies
What is the treatment for NEC?
PN with increased proteins, kcals
What is a common GI issue with CF?
Fat soluble vitamin deficiency
What is the “at risk” sign of malabsorption for 0-2 years of age?
weight for length 10-20%
What is the “at risk” sign of malabsorption for 2-20 years of age?
BMI 10th-25th
What is the “at risk” sign of malabsorption for 20+ years of age?
BMI 19-20
What is the “nutritional failure” sign of malabsorption at 0-2 years of age?
Height
What is the “nutritional failure” sign of malabsorption at 2-20 years of age?
BMI
What is the “nutritional failure” sign of malabsorption at 20+ years of age?
BMI
What is the etiology of acute diarrhea? Chronic?
Diet related
Chronic = diseases
What are the causes of inflammatory diarrhea?
infx
celiac
IBS
What is the RDI for fiber in children?
Age +5g
True or false: gastroesophageal reflux is common in infants, and is generally not concerning
True
When does gastroesophageal reflux usually resolve?
1 year
When is gastroesophageal reflux concerning?
Weight loss/slow of gain
