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