Pediatrics

Question 1

How to know if getting enough nutrition?

Answer 1

Growth really only marker, 150ml per kg about. Behavioral ques

Question 2

Cons of starting complimentary feeding early?

Answer 2

Not before 17weeks (choking, digestion). Reduce milk intake, lot of effort with not much reward

Question 3

Const of starting cf late?

Answer 3

Iron deficiency (starts to drop after 6 months), delayed learning of eating behaviours, delayed introduction of allergens

Question 4

Average growth?

Answer 4

Use growth charts, 240/210, 130/120 80/75, 65/60

Question 5

Requirements

Answer 5

about 150ml/kg, D-vitamin from birth if not formula at least 500ml

Question 6

Why does breastfeeding stop?

Answer 6

It is not easy. Lack of education. Lack of support from professionals/family, perception that bottle feeding is easier, babies sleep more etc Latching problems. Mother tired. Worry about baby getting enough.

Question 7

Advantages for breastfeeding?

Answer 7

Health benefits: antibodies, allergens. Easier to “supply”: cheap, does not require preparing, does not require sterile environment, portable. Bond with baby. Health benefits to mother from breastfeeding: weight loss. Promotes responsive feeding

Question 8

Purpose of complimentary feeding?

Answer 8

6-12m, More of learning experience rather than nutrition. Window to get baby used to various textures and flavours. Important time for learning feeding behaviours such as: Moving food around the mouth, chewing, hand-eye coordination and fine motor skills.

Question 9

Signs baby is ready for cf?

Answer 9

Is able to sit alone with support, can move food around mouth (less tongue thrust), able to pick up object with palm grasp (and put to mouth)

Question 10

Foods to avoid until 1y?

Answer 10

Honey, hard pieces of fruit/veg, any food that might have gone off (dented, out of date), high-fibre foods, salty or sweet. Whole nuts

Question 11

Allergens?

Answer 11

Good to introduce common allergens at 6 months at small amount, nuts, eggs, fish

Question 12

Feeding tips?

Answer 12

Try foods an hour before milk to ensure baby is hungry but not starving. Let baby be messy - finger foods, relaxed environment where baby can observe adults eating.

Question 13

Faltering growth?

Answer 13

Weight loss normal at first 2-4 days but should return to birthweight by 3 week

Question 14

If concerned?

Answer 14

Weight and measure baby - compare to centile charts and discuss feeding behaviour

Question 15

Faltering growth by centile chart?

Answer 15

Based on birth weigths. Drop of 2 between centiles 91st and 9th, 3 if above 91st, drop of 1 under 9th centile always be concerned if on/under 2nd centile

Question 16

Risk of faltering?

Answer 16

Undertake full assessment
Take a detailed feeding history
Ask about developmental milestones
Consider observing at mealtimes

Question 17

Factors that might contribute to small baby?

Answer 17

Preterm, Neurodevelopmental concerns
Maternal postnatal depression or anxiety
Interaction between infant and parents/carers