Peds Breast feeding

Question 1

What age should breast milk be supplemented with iron?

Answer 1

4-6 months

Question 2

What is the most potent risk factor for Iron Deficiency Anemia (IDA):
For over 12 months of age

Answer 2

Over 12 months of age: Drinking cow’s milk in excess of 16 oz (.47 L) per day (roughly more than 0.5 L of cows milk per day.

Question 3

What is the most potent risk factor for Iron Deficiency Anemia (IDA):
For under 9 months of age

Answer 3

For under 9 months of age:
Maternal iron depletion
Prematurity.

Question 4

What is Iron Deficiency Anemia (IDA) Hemogram?

Answer 4

Microcytic hypochromic Elevated RDW

Question 5

Of the following children which 2 children are at greatest risk for IDA?

a. 3 month old who takes about 24 oz (0.71 L) of iron fortified formula per day
b. 11 month old, breast fed about 7 times a day, taking iron fortified cereal, fruit, and vegetables TID
c. 16 month old who drinks about 1 qt (0.95 L) whole milk and few solids.
d. 6 month old born at 30 weeks gestation is exclusively breastfed without additional supplements.

Answer 5

c. 16 month old who drinks about 1 qt (0.95 L) whole per milk and few solids.
d. 6 month old born at 30 weeks gestation is exclusively breastfed without additional supplements.

Question 6

True or False;
Children should also receive Vitamin D 400 IU as a daily oral supplement when their diet consists of milk and variety of vegetables.

Answer 6

TRUE

Question 7

Does 1 cup frozen collards have enough calcium?

Answer 7

Yes, has about 375 mg calcium, toddlers needs 500 mg Ca, preschool needs 800 mg and older children (9-18) needs 1300 mg.

Question 8

Which has the most Calcium content
1 cup milk, yogurt
1 cup collards, frozen, boiled, 
1 cup black eyed peas
1/4 block tofu
1 cup cottage cheese
1 cup soy milk
1 oz (24 nuts) almonds

Answer 8

1 cup collards, then milk and yogurt,

least would be almonds, However these should all be given.

Question 9

How much Calcium does toddler, preschool and older children need?

Answer 9

toddlers (1-3 years) needs 500 mg Ca,
preschool and school aged (4-8) needs 800 mg and
older children (9-18) needs 1300 mg.

Question 10

How much Vitamin D is needed daily?

Answer 10

400 IU daily.

Question 11

What is the AAP recommendation for Vit D on exclusively and partially breast fed infants?

Answer 11

Take Vitamin D supplements of 400 IU daily shortly after birth.
Once weaned, consume > 1 L/day of vitaminD fortified formula or whole milk.

Question 12

When should all children be screened for IDA?

Answer 12

Through hemoglobin measurement at age 1 year old.

Question 13

Which 2 drugs should not be prescribed for Mono

Answer 13

Ampicillin and amoxicillin because of risk of rash development if prescribed.

Question 14

What is a good breast feeding latch?

Answer 14

No clicking sounds, cheeks round, no dimples in cheek.

Question 15

For breastfeeding moms, what contraceptive is the best at 3 weeks?

a. Combined oral contraceptions
b. Estrogen only pills
c. Progestin only pills

Answer 15

Progestin only pills because the estrogen in the other two will alter the amount of breast milk production.

Question 16

For non-breastafeeding moms, what contraceptive is the best?

a. Combined oral contraceptions
b. Estrogen only pills
c. Progestin only pills

Answer 16

Before 3 weeks, doesn’t matter, as she is not breast feeding, so milk production doesn’t matter.
Do not take estrogen or combo pills before 2 weeks, as mother is in a hypercoaguable state to prevent bleeding and estrogen will make it worse, can be thrombotic.