Week 1 L1-5 Flashcards
Give 5 reasons why play is important in childrens development?
- helps children deveop emotionaly, socially, intellectually and physically
- learn about their environment through practice of skills
- helps form their on identity and to exercise control
- express fears an fantasy and communicate these
- in hospital, play introduces normality in a strange environment
What are the 2 benefits of play therapy?
Encourages children to play out their frustrations and tensions
Negative feelings an be displaced onto toys
What leads the 3 phases of child growth in terms of nutrition?
Infant (nutrient led)
Child (growth-hormone led)
Pubertal (sex-steroid led)
Define the EAR?
Estimated average requirement = used for energy requirements of a population. About 1/2 will need more and 1/2 will need less
What is the reference nutrient intake?
RNI = Sufficient for 97% of the population
What is the LRNI?
Lower reference nutrient intake (LRNI) = suffiient for the 3% of the population with lowest needs
What are the UK guidelines in terms of physical activity for <18 year olds?
infants not yet walking - encourage from birth, floor and water based activities
children capable of walking - 180 minutes throughout the day
5-18 years - >60 mins/day of moderate to vigorous intensity physical activity
What is so important for the development of all <18 year olds in terms of activity?
Minimal time spent being sedentary
For how long is exclusive breast feeding recommened?
first 6 months of an infants life
After the 6 months of breast feeding, what is reommended?
Whey based formula for a year
In terms of milk, when should each type be introduced to an infant?
Full fat cows milk - as a drink from12 months
Semi skimmed - from 2 year
Skimmed - from 5 years
The first food stuffs a child had should ideally contain?
Gluten free
low salt
no added salt or sugar
allergy causing foods should be introduced one at a time
foods rich in absorbable meat should be given regularly
In early childhood what are children vulnerable to? How does this differ from school age children?
acute illness school age children: chronic disease disordered eating patterns supply/demand imbalance
What are adolesents vulnerable to?
eating disorders
obesity
early pregnancy
How can nutrition in infancy affect future health?
faltering growth - evidence of neglect and deprivation
obesity - assciated with maternal obesity, early weaning and rapid weight gain in first 2 months
Give some social and cultural factors that may affect weaning practices and food choices?
early solids - deprived areas
fewer car owners - can’t get to decent food
poor housing - poor food storage and preparation
less education - no knowledge of good food and what is required for children
unemployment - affordability of foods
List some public health nutrition interventions.
healthy start child healthy weight childsmile community food programmes physical activity programmes
What is standard deviation a measure of?
Variability
How does a child show normal growth?
measurements are in normal range compared to children their age
rate of growth is within the normal range compared to children their age
When is the child describes as being “on the x centile?”
the point is exactly on the centile line or within 1/4 centile space of the line
If not then “between centile x and y”
How should children be weighed properly?
Babies - without nappy or clothes
> 2 years - weighed in vest and pants only
How should head circumference be measured?
Using a narrow plastic or disposable paper tape where the head circumference is widest
What equipment is needed for length to be measured?
length board or mat - 2 measurments and average taken
When and how should height be measured?
From 2 years with rigid rule with T piece or stadiometer
What is the average for boys and girls to enter puberty?
Girls - 11 years
Boys - 11 years 6 months
When is PHV for boys and girls?
Boys - G4-5 14 years
Girls - B2-3 12 years
Define true central precocious puberty?
normal pubertal development occurring abnormally early < 8 years for girls and < 9 years for boys
Define delayed puberty.
the absence of secondary sexual development in a girl aged 13 or a boy aged 14 years.
What is genetic short stature?
healthy, well child who has inherited short stature from parents. No underlying endocrine abnormality and normal bone age.
What is a constitutional growth delay?
late maturation causing short stature. Cause usually unknown. May be genetic short stature component. Tends to present around puberty with delayed onset.
Give other causes of short stature.
dysmorphic syndromes, endocrine disorders, chronic diseases, psychosocial deprivation.
What is the obsogenic environment?
Used to describe the modern environment that encourages both foods high in energy density but low in nutrients and decreased physical activity levels
If a child is on the 91st centile what are they classed as?
Overweight
If a child is on or above the 98st centile what are they classed as?
Obese
If a child is on the 99.6st centile what are they classed as?
Severely obese
When can orlistat be prescribed?
Severly obese adolescents BMI > 99.6th centile) with comorbiities attending a specialist clinic
What is a side effect of Orlistat?
Diarrhoea
When can bariatric surgery be considered in children?
post-pubertal with very severe to extreme obesity
What is the maximum screen time a child should get?
2 hours per day
In terms of genetics what is described as normal?
Commonest form of gene sequence
What is array comparative genomic hybridisation?
Compares control DNA with patient DNA
detects unbalanced translocations not balanced translocations
What is the apgar score used for?
To decide how well a baby is at birth.
Taken at 1, 5 and 10 minutes post birth
What can make a baby floppy?
Septic low blood sugar genetic condition Neurologial disease (brain and/or muscle) Viral infection but uncommon
What genetic test is done first?
aCGH
