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Child Development (W2 KPH) Flashcards

1
Q

why are routine measurements of babies a standard practice?

A

to identify or rule out growth disorders
to identify and monitor obesity
to assess feeding
to assess disease impact

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2
Q

what measurements are normally distributed in healthy individuals?

A

height
haemoglobin
BP
plasma sodium
protein intake

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3
Q

what statistics would be useful to determine a normal BMI?

A

median
IQR (25th-75th centile)
2nd and 98th centile

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4
Q

how are infant growth charts constructed?

A

collecting samples of data at each age and gender from hundreds of healthy children

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5
Q

what factors are important in considering what population growth charts should be based on?

A

increasing height over generations
ethnic differences in growth
breastfed infants gain weight differently than bottlefed infants

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6
Q

what is the standard for a population representing an ideal growth chart?

A

healthy, breastfed infants who live in an ‘optimal’ growth potential environment

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7
Q

what ways can be used to judge if measurements are normal?

A

plotting on a growth chart
calculating BMI
assessing growth over time

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8
Q

describe the mid-parental centile

A

the point inbetween the mother and father’s percentile
most children aew within +/- 2 centile spaces of the mid-paternal centile

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9
Q

what is the breast made up of and comprised of?

A

made up of the nipple, areola, mammary glands and supporting CT

comprised of fat, blood, lymphatic vessels and nerves

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10
Q

explain the prevalence of alveoli in the breast

A

contained within lobes (~20 per breast)
lactocytes (milk-producing cells) within alveoli
surrounded by myoepithelial cells (smooth muscle)

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11
Q

what is the role of oxytocin in the breast?

A

stimulates myoepithelial cells to contract, pushing milk into lactiferous ducts towards the nipple

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12
Q

what is the role of montgomery tubercles in the breast?

A

glands secreting sebaceous fluid that lubricates the nipple and protects the skin
the fluid has an individual aroma attracting the infant

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13
Q

explain the hormonal control in breast development

A

oestrogen promotes mammogenesis by developing the ductal system
progestorone and human/placental lactogen enhance milk producing structures

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14
Q

explain the posterior pituitary mechanism of lactation

A

suckling -> stimulus to hypothalamus -> posterior pituitary secretes oxytocin -> contracts myoepithelial cells -> milk released into lactiferous ducts

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15
Q

explain the anterior pituitary mechanism of lactation

A

suckling -> anterior pituitary produces prolactin -> allows lactocytes to secrete milk into alveoli

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16
Q

compare the protein composition of breast milk and infant formula

A

breast milk - whey based (alpha lactalbumin)

formula - bovine serum albumen

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17
Q

compare the carbohydrate composition of breast milk and infant formula

A

breast milk - lactose (~40%) improves Ca absorption

formula - lactose (+ sucrose, fructose and glucose)

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18
Q

compare the fat composition of breast milk and infant formula

A

breast milk - long chain fatty acids

formula - vegetable or egg based

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19
Q

compare the vitamin/mineral composition of breask milk and infant formula

A

breast milk - present in small quantities

formula - extras added to the powder

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20
Q

what substances are present in breast milk that are not present in human milk?

A

growth factors
immune cells
enzymes
stem cells
lactoferrin
milk lipids

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21
Q

name some of the benefits provided by breast milk not present in formula milk

A

prevents pathogenic entry (IgA on gut surface)
improves immune response (Il-7 increases thymus size)
Promotes healthy bacteria growth (oligosaccharides)

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22
Q

how does a mother transfer her microbial heritage to her infant?

A

vaginal birth
skin-skin contact
breastfeeding

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23
Q

what are the functions of an infants microbiome?

A

produces vitamin K, biotin and folate
immune system development
prevents toxin absorption
provides energy sources for enterocytes

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24
Q

what is colostrum?

A

the first milk produces from breasts
thick, yellowish fluid increasing in amount over first 3-4 days to accomodate infants needs

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25
what are the main components and functions of colostrum?
rich in vitamin A creates acidic environment contains Ig's, antibodies and anti-inflammatory molecules contains EGF is a mild purgative (laxative) high in viral fragments and white cells
26
explain how breastfeeding can result in immunity for the infant against pathogens
the mother creates sensetised lymphocytes which create secretory antibodies in the breast then transferred through breast milk to infant
27
name 3 developmental advantages to breastfeeding
promotes brain development (long chain fatty acids) promotes maturation of gut protects mothers health
28
what are the benefits of skin-skin contact in mothers/infants?
triggers lactation and mothering hormones triggers calming hormones stimulates digestion stimulates instinctive feeding behaviour provides protective bacteria for infant
29
explain the positioning of effective breastfeeding
keep baby close tilt baby's head back so chin can lead keep baby's head and body in line nose to nipple positioning for effective attachment (acronym - CHIN)
30
what is responsive breastfeeding?
the sensitive, reciprocal relationship developed between mother and infant during breastfeeding
31
why might women choose not to breastfeed?
negative public attitude breast pain/discomfort perception of inadequate breastmilk supply mother and infant routine reasons
32
name some of the societal reasons why women may not breastfeed
cultural/social barriers public breastfeeding frowned upon little support for longer-term breastfeeding can be seen as a sign of sexual display
33
what is complimentary feeding?
mothers express milk with a pump and give it to the infant in a bottle breastfeeding can later be introduced this is often done if there is maternal breastfeeding complications
34
what is the role of the health visitor in breastfeeding?
measure growth/development of infant promote skin-skin contact ensure adequate breastfeeding technique
35
what are some of the clinical features of childhood obesity?
acanthosis nigricans asthma skin striae obstructive sleep apnoea constipation
36
how can childhood obesity impact the immune system?
metabolic inflammation - fat in adipose tissue activates immune response causing chronic inflammation (cytokines, macrophages etc) also linked to MS
37
what are the biological determinants of obesity?
genetics, leptin and appetite regulation
38
what are the psychological determinants of obesity?
personality, impulse regulation, attachment security, self esteem
39
what are the social environment determinants for obesity?
time, money, food insecurity
40
what are the physical environment determinants of obesity?
walkability, greenspace, fresh food availability
41
what is the main commercial determinant of obesity?
production and marketing of processed unhealthy foods (often appealing)
42
what are some of the common negative effects of childhood obesity?
CV disease type 2 diabetes psychosocial problems malignancies orthopaedic problems
43
what is an obesogenic environment?
an environment promoting obesity
44
what is food insecurity?
uncertain or unreliabe access to food for individuals or household can be mild (worry), moderate (compromise/reduction) or severe (regular hunger)
45
explain the 2 aims of immunisation programmes
to protect those at highest risk (selective) to eradicate, eliminate or contain diseases (mass)
46
what might put someone in a high risk category for a vaccination? give an example for each
travel (typhoid) occupational risk (hep B) high risk groups (boosters for asplenic patients) outbreak control (hep A)
47
what is the aim of an ideal vaccine?
produce same immune protection as natural infection without causing disease generate long-lasting immunity interrupt infection spread
48
what are some of the contradictions or precautions with vaccines?
those with immunodeficiency those on immunosuppressing therapy pregnant women
49
what are live vaccines?
attenuated strain which replicates in host attenuated = weakaned pathogen so no disease e.g: MMR, BCG
50
what are inactive vaccines?
do not contain a pathogen capable of replicating and causing disease e.g Hep B, Polio
51
what are the pros and cons of live vaccines?
pros - long lasting immunity, strong immune response cons - poor stability, can revert to virulence
52
what are the pros and cons of inactivated vaccines?
pros - unable to cause infection, stable, constitutents clearly defined cons - shorter immunity, may need several doses
53
what is herd immunity?
a threshold level of infected population if threshold reaches, infectious agent unable to transmit between population
54
name an example of a herd immunity disease and the infection threshold necessary
measles 95% must be vaccinated
55
what is passive immunity?
an immediate but temporary form of immune protection given to those at high risk of severe disease doesnt stimulate immune system to produce any antibodies e.g transplacental antibodies
56
what are the pros and cons of antibody preparations?
pros - rapid, preventative, given to those where vaccine contradicted cons - expensive, no lasting immunity, potential for adverse events
57
what can be some of the outcomes of poor breastfeeding attachment?
painful/danaged nipples engorgement baby feeds more frequently decreased milk production baby struggles to gain weight
58
what are the signs and symptoms of iron deficiency in infants?
lethargy breathlessness cognitive impairment impaired immune function decreased capacity for physical activity
59
what factors should be taken into consideration when creating a vaccine programme?
aim/cost of programme population accessibility cultural attitudes/practices facilities available
60
what are age recommendations for vaccines based on?
age-specific risks for disease/complication ability to respond to vaccine immune system interference from different antibodies (maternal antibodies)
61
name a vaccine administered at each key age group
primary - rotavirus infant - MMR adolescent - HPV adults - shingles
62
what is vaccine equity?
vaccines are distributed based on need and priority rather than evenly distributed to all regions/locations
63
what are some of the challenges of global immunisation?
funding uptake violence (war) different priorities in different areas

1st Year Med (52 decks)

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