peds- nutrition Flashcards
Benefits of breast feeding
- Superior nutritional composition: higher whey:casein ratio eases digestibility
- immunological components (anti-bodies passed on, lower chance of illness + allergies)
- weight loss for mom
- mother-infant bond
- self-regulation of intake
benefits of bottle feeding
- can assess amount of calories baby is taking
- can concentrate easily if increased calories needed
- options for allergies or intolerances
- convenient
infant feeding guidelines: 0-4 months
Breast milk/Formula Only
infant feeding guidelines: 4-6 months
introduce iron-fortified oat cereal
infant feeding guidelines: 6-7 months
introduce Vegetables, fruit
infant feeding guidelines: 7-8 months
introduce Strained meats, toast, crackers
infant feeding guidelines: 8-12 months
introduce Finger foods, soft table foods, yogurt/dairy
infant feeding guidelines: 12+ months
Breast milk/formula until 12 months, then transition to whole milk via cup
what foods to avoid: infants and toddlers? (3)
- Citrus fruits (until 1 year of age) – rash, acid/stomach upset
- Honey (until 1 year of age)- infant botulism
- Choking hazard foods: grapes, nuts, seeds, hard candy, hot dogs, peanut butter
when do you know they are ready to transition to solids? around what age, what 4 signs
4-6 months
- Extrusion reflex dissipates (stops sticking out tongue)
- Able to sit independently
- Opens mouth as spoon approaches
- Desires more than 40 oz of formula/breast milk per day
pre-school: how many fruits + veges a day?
5
2 rules for school- aged child?
Do not force the child to clean his plate
Do not use food as a reward
calorie needs in pregnant mother
need very high calorie intake
adolescent food: encourage foods rich in what 4 things?
Encourage foods rich in Calcium, Iron, Vitamin A, Vitamin C
what are the calorie needs for girl/boy teens?
Increased energy needs (2500-2800 kcals/day for boys and 2000 kcals/day for girls)- even more if active in sports
5 general pediatric feeding guidelines
- At least 5 fruits and vegetables per day
- Limit juice to 2-4 oz per day (NONE ideal)
- 3 cups of milk per day (whole milk until age 2)
- Limit soda, sugary drinks, fried foods, chips, candy, and processed foods
- Activity for at least 60 minutes per day; limit screen time to 1 hour per day
energy and protein needs for each age group (kcal, + protein): 0-6 months, 6-12 months, 1-3, 4-6, 7-10,
11-18- (girls/boys)
Age Kcal/kg g pro/kg 0-6 months 108 2.2 6-12 months 98 1.6 1-3 years 102 1.2 4-6 year 90 1.2 7-10 years 70 1 11-18 girls 40-47 0.9-1 11-18 boys 45-55 0.8-1 * calories start 108- go down about 10, protein start 2.2 and down by about 0.6-0.2
what are the “standards” for calorie needs of healthy child
Estimated Energy Requirements (EER) & Physical Activity (PA) Coefficients
Children with normal growth who are metabolically normal
“standards” calorie needs for acutely ill children?
WHO and Schofield equations
Healthy children who are acutely ill in hospital setting
“standards” calorie needs for overweight children (BMI >95%)
TEE (total energy expenditure)
“standards” calorie needs for failure to thrive children?
Peterson’s:
[RDA for weight age (kcal/kg) x IBW for height] / Acutal weight
what is MOST important in determining calorie needs of a child?
Most importantly ( over the calculations) , follow weight velocity, weight curves and growth trends
RDA stands for what?
recommended daily allowance
3 “standards” guidelines for protein needs (healthy, critical care, FTT)
healthy: RDA
critical care: ASPEN clinical guidelines
FTT: Peterson’s:
[Protein Required for Weight Age x Ideal Weight for Age]/ Actual Weight
3 supplementation vitamins for infants (and at what age for each)
- Vitamin K at birth ( all infants receive this)
- Vitamin D 400 IU per day for…
exclusive breast-fed babies
Infants taking less than 500 mL of formula per day - iron (6+ months)
Vit D recommendations: 0-12 months vs 1+
400 IU for age 0-12 mo
600 IU for age 1-70 yo
what 4 groups will have special calc. for calorie intake?
Special calculations for CP, Down Syndrome, Prader-Willi Syndrome, Spina Bifida
kwashiokor vs marasmus (kinda weeds)
Kwashiorkor: protein malnutrition (developing countries)
Symptoms include edema, growth failure, thinning of hair, dermatitis, decreased immunity, protuberant belly
Marasmus: protein-calorie malnutrition
underweight / Muscle wasting, absence of subcutaneous fat stores, hair loss, listlessness, hanging skin folds
what are the guidelines to prevent deficiencies
- Iron-fortified formula or breast milk until 12 months of age
- Milk 3-4 cups per day
- Fruits and vegetables 5 per day
- Meats, beans, egg, peanut butter
- Iron-fortified cereals 1 – 2 servings per day
- multi-vit or nutritional supplement
5 general Consequences of obesity in childhood and later life
- In infancy, delayed gross motor skill development
- Early heart disease, liver disease/fatty liver, insulin-resistance, HTN, orthopedic problems
- Psychosocial/Emotional disturbances
- Bullying and teasing from peers
- Early puberty
In younger children, management strategy for obesity should be to …. over ….
grow into weight vs. losing weight
___% loss of weight results in improvement of comorbid factors- this should be the initial goal
10%
0.5lb -1lb per week
