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Pediatric Nutrition
| Question | Answer |
|---|---|
| What is the definition of a premature infant? | < 38 week gestation |
| What are the energy requirements for a premature infant? | 110-130 kcal/day |
| What is the predicted growth in weight for premature infants? | 10-15g/kg/day |
| How do you measure adequacy of nutritional regimens for a growing term infant? | weight and length |
| What is the average weight of a healthy term newborn? | 3.5 kg |
| By what age is the birth wait of a term infant regained by? | 2 weeks of age |
| What are the energy requirements of a term infant at 0-3 months? | 100-116 kcal/kg/day |
| What are the energy requirements for a term infant between 6-12 months? | 91-100 kcal/kg/day |
| What are the energy requirements for a term infant at 12 months of age? | 100 kcal/day by the end of the 1st year |
| What is the expected weight gain of a term infant between 0-3 months? | 25-35 g/day |
| What is the expected weight gain of a term infant between 3-6 months? | 12-21 g/day |
| What is the expected weight gain of a term infant between 6-12 months? | 10-13 g/day |
| What is the characteristics of colostrum? | It is the 1st milk produced after delivery. It is high in protein High in immunoglobulins and Secretory IgA It gradually changes to mature milk over 7-10 days after delivery |
| How many calories does breast milk provide | approximately 20 Kcal |
| What nutritional supplementation is needed for term infants being breasfed? | Vitamin K Vitamin D Iron and Flouride |
| When do breastfed infants need supplementation of iron? And why? | Not until after 6 months Maternal stores of iron plummet after 6 months. |
| What nutrient needs are increased during pregnancy and/or lactation? | Protein, vitamins A, B6, C and D, calcium, iron and zinc |
| What are the benefits of frequent, early and unrestricted infant nursing? | 1. Provides colostrum 2. Helps decrease jaundice because of the laxative effect 3. Allows the baby practice time before milk volume increases. 4. Stimulates uterine contractions 5. Prevents infant hypoglycemia |
| What are signs of insufficent milk intake in the newborn? | 1. failure to regain birth weight by 2 weeks. 2 Weight gain of less than 7oz in 7 days. 3. less than 4 lbs in 4 months |
| What are the GI/GU signs of insufficent milk intake in a newborn? | Fewer than 3-4 stools by day 5 and fewer than 6 urinations by day 5. |
| What is the color of formula stool? | yellow seedy |
| What is the color of meconium stool? | Sticky tar like |
| By what time should all the meconium be excreted? | It should be completely gone in a day. |
| What is the recommended action for an infant that has jaundice? | Continue breastfeeding at least every 2 hours ATC |
| What are objective measures to determine if an infant is getting enough milk? | Weight gain. # of stools. # of urinations |
| True or False? Healthy breastfed newborns do not need formula, water or juice? | True |
| How do you assess infant formula? | What type of formula. How is it prepared. How much formula is in the bottle. How many bottles does the baby consume |
| When should an infant begin to receive whole milk? | After 12 months of age |
| When should an infant begin recieving skim milk or low fat milk? | It should not be given before 2 years of age. |
| When should solids be added to the infants diet? | Between 4-6 months. Closer to 6 to reduce risk of food allergies. |
| What are the factors that indicate if an infant is ready for solids? | 1. Current weight twice that of birth weight or about 13 lbs 2. more than 32 oz of formula/d, >8-10 feedings/d, persistent dissatifaction due to hunger |
| How much juice should an infant get and at what age? | 4 oz/day by 4-6 months |
| What are examples of "first-stage" foods? | Strained infant juices, single grain cereals and pureed fruits and vegetables. |
| What foods should be avoided while an infant is getting "first-stage" foods? | Wheat, eggs, milk and citrus |
| What are examples of "second-stage" foods? | Smooth, mixed-ingredient foods, such as mixed vegetables or meat dinners, such as chicken noodle |
| At what age does an infant get "first stage" foods? | 4-6 months |
| At what age does an infant get "second-stage" foods"? | 6-9 months |
| When is a child ready for "third stage" foods? | Can sit well without support, have some teeth, and have begun self feeding. |
| When can finger foods be introduced? | When the infant develops the pincer grasp |
| At what age should "third stage" foods be introduced? | 9-10 months |
| What food should be avoided in the first year of life and why? | Honey due to risk of botulism |
| When should peanut butter be avoided? | During the first year of life due to risk of allergies. 3 years if there is a family hx of peanut allergies |
| What is the average growth weight of a child in the US? | birth weight quadruples by age 2 |
| What is the average growth length? | Birth length doubles by age 4 |
| When is the growth spurt for an average American boy? | 12 to 15 |
| When is the growth spurt for an average American girl? | 10-13 years of age |
| What is the role of the parent in the feeding process? | Determines when and what the child will eat |
| What is the role of the child in the feeding process? | Determines if and how much s/he will eat |
| What is the calorie consumption guideline for a toddler? | about a 1000 calories/day for the average toddler |
| What foods should a child under 3 avoid | Hot dogs, hard candies, nuts, seeds, popcorn and chunky peanut butter. |
| How many times per day should toddlers eat? | 4-6 times / day |
| How much should the total fat intake be? | No more than 30% of total cal and no less than 20% |
| How much dietary cholesterol should be consumed? | less than 300 mg |
| What is the most common nutrition deficiency in the US? | lack of iron |
| How much milk shoudl toddlers consume? | 16-24 ounces of milk per day |
| True or False? Most children in the US need vitamin and mineral supplmentation? | False (p. 17) |
| How much Vitamin D should infants get? | 200 IU per day |
| Under what circumstances should breastfed babies receive vitamin D supplmentation? | All breastfed infants should receive vitamin D supplmentation unless they are weaned to at least 500 ml per day of vitamin D fortified formula |
| True or False? All nonbreastfed infants who are ingesting less than 500 ml per day of vitamin d-fortifed formula should receive vitamin D supplementation? | True |
| How is overweight in children defined? | BMI = 95th percentile |
| When is a child at risk for overweight? | BMI between the 85th and 95th percentile |
| What laboratory tests should you do if you suspect anemia? | CBC, reticulocyte count, serum iron, ferritin and total iron binding capacity |
| What labs would you order to assess protein staus? | Serum albumin, total protein and prealbumin |
Created by:
lknightly
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