Failure to thrive-O'Connor Flashcards Preview

Block 11; Week 1 > Failure to thrive-O'Connor > Flashcards

Flashcards in Failure to thrive-O'Connor Deck (23):

What is marasmus?

wasting of subcutaneous tissue over thorax w/ prominent ribs


How common is failure to thrive?

5-10% of kids seen in primary care


Which communities/pop is FTT more common in?

poor & rural communities
children w/ special health care needs


What are the nutritional causes of FTT?

Inadequate calorie and nutrient intake
Inadequate nutrient uptake or absorption
Increased metabolic demand/increased calorie requirements


What are some common causes of inadequate energy intake?

Breastfeeding problem
Improper formula preparation
Discoordination of suck/swallow/ breathe

Cleft lip or palate
Mood disorder
Eating disorder
Irritable bowel syndrome
Dental Caries


What are some psychosocial causes of inadequate energy intake?

parental depression, learning disability, neglect, drug abuse, eating disorder
sensory disorder, food phobia


What are some malabsorption problems for FTT?

GI malformation
Inborn error of metabolism
Food intolerance or allergy

Celiac disease
Renal Disease


What are some things that can cause high metabolic needs & FTT?

Chronic infection or immunodeficiency disease
Pulmonary disease
Congenital heart disease or heart failure

Seizure disorder
Thyroid disease
Chronic pulmonary disease; asthma
Heart disease or failure


What are some red flags for a medical cause of FTT?

Cardiac findings suggesting congenital heart disease of heart failure
Developmental delay
Dysmorphic features
Recurrent or severe infections
Recurrent vomiting, diarrhea, or dehydration


What are some signs on PE of inadequate nutrition?

Hair: easily pluckable, changes in pigmentation
Skin: dry, scaly
Behavior: irritable, apathetic, socially unresponsive
Bloated abdomen


What is the clinical workup for FTT?

**if appropriate--test for HIV or TB
swallowing studies
genetic testing
cardiac fcn
pulmonary fcn
Stool ph & culture
fecal fat


What is a good latch for breastfeeding?

latching onto the areola, not just the nipple (hard on the mom & can't squeeze the glands)


What's best for newborns feeding?

exclusively breast for first 6 months
up to 12 mo +


What are the health benefits of breastfeeding?

Composition uniquely tailored to changing needs of growing infant
Fewer allergies, intestinal upsets, ear infections in infancy
Lower rates of diabetes and asthma in later life
Association between breastfeeding and improved school performance
Helps uterus regain pre-pregnancy size more rapidly
Women who breastfeed have lower rates of breast and ovarian cancer and fewer hip fractures in later life


What are good feeding practices during early infancy?

feed on demand, every 2-3 hrs

Signs of hunger: opening the mouth, suckling sounds, waving hands, hand-to-mouth, rooting, pre-cry fussing, crying
May need to wake baby to feed if longer than 4 hours
Burp midway through and after feeding
Breast: 20-45 minutes per feeding
Bottle: 2+ ounces per feeding


First foods should be offered at 4-6 months. Wht are some signs that you are approaching this time?

Offer at 4-6 months:
digestive system has matured some
tongue protrusion reflex is disappearing
head and neck control are improving
can sit with little or no assistance


What are good first foods?

rice cereal + iron made thin


When can kids eat mashed foods? Whole foods? Food hazards?

7-10 mo finely chopped foods
can't chew until age 4
danger foods:
can feed themselves at 8-9 mo, master at 14-18 mo
Avoid uncut foods like hot dogs, grapes, cherry tomatoes, large chunks of meat , hard candy, popcorn, nuts, etc.


When should you take measurements of your baby?

0-9 months: every 4-6 weeks
10-24 months: every 3-4 months
2-5 years: every 6 months


When there is a fall in measurements, which go first?

Weight goes down first
then length
head circumference is last.


What is considered underweight?

<5th %ile weight/length or BMI


What is considered growth faltering?

Child’s rate of weight gain has slowed or stopped after it has previously been established


What are some ways to increase energy density for a child?

Change formula to 24 or 27 kcal/oz
Concentrate standard 20 kcal formula with different proportions powder to water
Foods: add fat/oil, avocado, Polycose, Moducal

Use whole milk
Add cream, powdered milk, instant breakfast powder
Add peanut butter, avocado, sour cream, yogurt, butter, cream cheese, ranch dressing
Avoid low energy dense foods (jello, juice, popsickles, candy)