Peds Growth & Development Flashcards
How does brain compare to TBW & BEE in an infant?
10% of TBW
44% of BEE
Since when have growth charts been around? When was the last update?
1977, updated in 2000
How many total growth charts are there?
16
When is head circumference used as an anthropometric measure?
< 36 months
What charts are age-based?
1) stature
2) weight
3) BMI
What anthropometric measurements are used in growth charts?
1) height
2) weight
3) length
4) head-circumference
When does the anterior fontanelle close?
6 months
When does the posterior fontanelle close?
12 months
What are the cranial sutures?
1) metopic
2) coronal
3) lambdoid
4) sagittal
How many bones make up the normal skull?
5
What is craniosynostosis?
congenital defect when the occipital fontanelle prematurely closes
What percentile ranks signal overweight?
> 95th% in..
1) BMI-for-age
2) weight-for-length
What percentile rank signals “at risk for overweight?”
85-95% in…
1) BMI for age
2) weight for length
What percentile rank signals underweight?
< 5% in…
1) BMI for age
2) weight for length
What percentile rank in what chart signals short stature?
<5% in stature-for-age
What percentile rank signals developmental problems?
upper/lower 5% in head circumference-for-age
What percentile rank in what charts signals FTT?
<5% in…
1) primarily weight-for-age
2) weight-for-height
3) height-for-age
What are the complications of FTT?
1) decreased development & cognitive function
- - brain development in 1st year = rest of life
Caloric requirement if 0-6 months.
108 kcal/kg
Caloric requirement if 6-12 months?
98 kcal/kg
Caloric requirement if 11-3 years?
102 kcal/kg
Caloric requirement if 4-6 years?
90 kcal/kg
Caloric requirement if 7-10 years?
70 kcal/kg
Caloric requirement if 11-14 years?
55 (47) kcal/kg
Caloric requirement if 15-18 years?
45 (40) kcal/kg
Protein requirement if 0-6 months?
2.2 g/kg
Protein requirement if 6-12 months?
1.6 g/kg
Protein requirement if 1-3 years?
1.2 g/kg
Protein requirement if 4-6 years?
1.1 g/kg
Protein requirement if 7-10 years?
1.0 g/kg
Protein requirement if 11-14 years?
1 (1) g/kg
Protein requirement if 15-18 years?
0.9 (0.8) g/kg
What are the advantages of breastfeeding for the mom?
1) decreased uterus size
2) better calorie utilization
3) decreased risk of breast cancer
4) convenient
5) cheap
6) maternal-infant bonding
UCCCCB (U foresee a Boob)
What are the advantages of breastfeeding for the infant?
1) faster GI emptying
2) fewer GI diseases
3) immunoprotective
4) fewer allergies
5) bonding
BIG-A
What immunoprotective compounds are passed by the mother via milk?
1) lactoferrin
2) immunoglobulins
What are the disadvantages of breastfeeding?
1) increased risk of unconjugated hyperbilirubinemia (jaundice)
2) time
3) local tenderness
If no fluoride in the water, and infant is breasfeed, what is the appropriate supplement?
10 mcg/day F for 6 months
If not enough sunshine is being obtained and the infant is breastfed, what is the appropriate supplement?
Vit. D 10 mcg/day
If the baby is premature and breastfed, what is the appropriate supplement?
Fe
When is breastfeeding contraindicated?
1) infant/maternal dz
2) cosmetic breast surgery
3) galactosemia of the infant
What is the usual standard formula for breastfeeding replacement?
Cow’s Milk formula
How is cow’s milk formula supplied?
1) concentrated (40 kcal/(oz or tbsp))
2) ready to use
How do cow’s milk formulations vary?
1) CHO from lactose
2) protein content
3) whey:casein ratio
4) Fe supplementation
What is notable about Enfamil premium & Similac Advance?
Contain FAs DHA & ARA for potential visual/neuro benefit
Which cow’s milk formula is 100% whey?
Carnation goodstart
Which cow’s milk formulas are low-lactose?
Lactofree
Similac sensitive
What population is a candidate for protein-modified formula?
1) cow or soy- sensitive
2) lactose intolerant/galactosemic
3) hi-risk for atopic dz
4) severe/chronic malabsorption
How do protein-modified formulas vary?
1) hydrolyzed
2) phenylketonuria
3) AA-based
4) Soy-based
What population is a candidate for fat-modified formula?
1) difficult fat digestion
2) CF or pancreatic insufficiency
3) bile acid deficiency
What type of fat is supplied by fat-modified formula?
MCTs (passive diffusion)
What population is a candidate for CHO-modified formula?
suspected/confirmed CHO intolerance
What formulas are CHO-modified?
323A
Ross CHO Free (RCF)
What population is a candidate for Preterm Infant Formula?
pre-term/VLBW infants
What is different about preterm infant formulas?
1) 24 kcal/oz
2) 40-50% MCT
3) more minerals, vitamins
What formulas are pre-term (but not transitional)?
1) Enfamil Premature
2) Similac Special Care
What formulas are pre-term transitional?
Similac Neosure
EnfaCare
When should cow’s milk be introduced?
1 year
When should iron-fortified rice cereal be introduced?
4-6 mos
When should strained veggies & fruits be introduced?
5 months
When should finely minced foods & meats be introduced?
8 months
What are the various types of infant formulas?
1) cow’s milk
2) protein-modified
3) fat-modified
4) CHO-modified
5) pre-term infant
When should infant formulas be used?
1) if not breasfed
2) if inadequate weight
What is the normal feed volume for 0-1 wk?
30 - 90 mL
What is the normal feed volume for <1 month?
60 - 120 mL
What is the normal feed volume for 1-3 mos?
120 - 180 mL
What is the normal feed volume for 3-6 months?
180 - 210 mL
What is the normal feed volume for 5-9 months?
210 - 240 mL
What is the normal feed volume for 9-12 months?
210 - 240 mL
What is the general rule for feed volume?
6 oz/kg/day
