peds- nutrition

Question 1

Benefits of breast feeding

Answer 1

• 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

Question 2

benefits of bottle feeding

Answer 2

• can assess amount of calories baby is taking
• can concentrate easily if increased calories needed
• options for allergies or intolerances
• convenient

Question 3

infant feeding guidelines: 0-4 months

Answer 3

Breast milk/Formula Only

Question 4

infant feeding guidelines: 4-6 months

Answer 4

introduce iron-fortified oat cereal

Question 5

infant feeding guidelines: 6-7 months

Answer 5

introduce Vegetables, fruit

Question 6

infant feeding guidelines: 7-8 months

Answer 6

introduce Strained meats, toast, crackers

Question 7

infant feeding guidelines: 8-12 months

Answer 7

introduce Finger foods, soft table foods, yogurt/dairy

Question 8

infant feeding guidelines: 12+ months

Answer 8

Breast milk/formula until 12 months, then transition to whole milk via cup

Question 9

what foods to avoid: infants and toddlers? (3)

Answer 9

1. Citrus fruits (until 1 year of age) – rash, acid/stomach upset
2. Honey (until 1 year of age)- infant botulism
3. Choking hazard foods: grapes, nuts, seeds, hard candy, hot dogs, peanut butter

Question 10

when do you know they are ready to transition to solids? around what age, what 4 signs

Answer 10

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

Question 11

pre-school: how many fruits + veges a day?

Answer 11

5

Question 12

2 rules for school- aged child?

Answer 12

Do not force the child to clean his plate

Do not use food as a reward

Question 13

calorie needs in pregnant mother

Answer 13

need very high calorie intake

Question 14

adolescent food: encourage foods rich in what 4 things?

Answer 14

Encourage foods rich in Calcium, Iron, Vitamin A, Vitamin C

Question 15

what are the calorie needs for girl/boy teens?

Answer 15

Increased energy needs (2500-2800 kcals/day for boys and 2000 kcals/day for girls)- even more if active in sports

Question 16

5 general pediatric feeding guidelines

Answer 16

1. At least 5 fruits and vegetables per day
2. Limit juice to 2-4 oz per day (NONE ideal)
3. 3 cups of milk per day (whole milk until age 2)
4. Limit soda, sugary drinks, fried foods, chips, candy, and processed foods
5. Activity for at least 60 minutes per day; limit screen time to 1 hour per day

Question 17

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)

Answer 17

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

Question 18

what are the “standards” for calorie needs of healthy child

Answer 18

Estimated Energy Requirements (EER) & Physical Activity (PA) Coefficients
Children with normal growth who are metabolically normal

Question 19

“standards” calorie needs for acutely ill children?

Answer 19

WHO and Schofield equations

Healthy children who are acutely ill in hospital setting

Question 20

“standards” calorie needs for overweight children (BMI >95%)

Answer 20

TEE (total energy expenditure)

Question 21

“standards” calorie needs for failure to thrive children?

Answer 21

Peterson’s:

[RDA for weight age (kcal/kg) x IBW for height] / Acutal weight

Question 22

what is MOST important in determining calorie needs of a child?

Answer 22

Most importantly ( over the calculations) , follow weight velocity, weight curves and growth trends

Question 23

RDA stands for what?

Answer 23

recommended daily allowance

Question 24

3 “standards” guidelines for protein needs (healthy, critical care, FTT)

Answer 24

healthy: RDA
critical care: ASPEN clinical guidelines
FTT: Peterson’s:
[Protein Required for Weight Age x Ideal Weight for Age]/ Actual Weight

Question 25

3 supplementation vitamins for infants (and at what age for each)

Answer 25

1. Vitamin K at birth ( all infants receive this)
2. Vitamin D 400 IU per day for…
   exclusive breast-fed babies
   Infants taking less than 500 mL of formula per day
3. iron (6+ months)

Question 26

Vit D recommendations: 0-12 months vs 1+

Answer 26

400 IU for age 0-12 mo

600 IU for age 1-70 yo

Question 27

what 4 groups will have special calc. for calorie intake?

Answer 27

Special calculations for CP, Down Syndrome, Prader-Willi Syndrome, Spina Bifida

Question 28

kwashiokor vs marasmus (kinda weeds)

Answer 28

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

Question 29

what are the guidelines to prevent deficiencies

Answer 29

1. Iron-fortified formula or breast milk until 12 months of age
2. Milk 3-4 cups per day
3. Fruits and vegetables 5 per day
4. Meats, beans, egg, peanut butter
5. Iron-fortified cereals 1 – 2 servings per day
6. multi-vit or nutritional supplement

Question 30

5 general Consequences of obesity in childhood and later life

Answer 30

1. In infancy, delayed gross motor skill development
2. Early heart disease, liver disease/fatty liver, insulin-resistance, HTN, orthopedic problems
3. Psychosocial/Emotional disturbances
4. Bullying and teasing from peers
5. Early puberty

Question 31

In younger children, management strategy for obesity should be to …. over ….

Answer 31

grow into weight vs. losing weight

Question 32

___% loss of weight results in improvement of comorbid factors- this should be the initial goal

Answer 32

10%

0.5lb -1lb per week