Infants & Early Childhood Flashcards
(93 cards)
1
Q
Importance of nutrition in infants
A
- vital to growth & development
- maintenance of all body function
- fluid balance & electrolyte maintenance
- healing & prevention
2
Q
Weight doubles by what age?
A
5 months
3
Q
Weight triples in what age?
A
1 year
4
Q
Length increases ______% by 5 months of age
A
30%
5
Q
Length increases ______% by 1 year
A
50%
6
Q
The brain is ______% of adult size at birth
A
25%
7
Q
The brain reaches ____% of adult size by 1 year
A
75%
8
Q
What are the 5 things you look at in nutrition assessment in infants?
A
- Anthropometry & growth
- Diet history
- Social & environmental considerations
- Physical assessment
- Estimating nutrient needs
9
Q
Anthropometry of infants
A
- weight
- length/height
- weight for length (proportion)
- head circumference
10
Q
How long do you measure head circumference?
A
First 3 years of life
11
Q
Weighing an infant
A
Should be nude or wearing only clean, dry diaper
12
Q
Measuring length/height in infant
A
- 2 people often needed to get an accurate measurement
13
Q
______ can help separate normal growth patterns from abnormal ones
A
Growth charts
14
Q
Growth charts
A
- use WHO & CDC
- information is only as good as the accuracy of measurements, age determination and plotting
15
Q
What charts are recommended by WHO to use in 0-2 years?
A
- weight for age
- length for age
- weight for length
- head circumferance
16
Q
What charts are recommended by CDC in years 2-20 years?
A
- weight for age
- stature for age
- BMI for age
17
Q
Infants used to construct WHO charts were…
A
- breastfed at least 4 months
- introduced to complementary foods between 4-6 months
- continued to be breastfed until 12 months
18
Q
Charts published by the CDC are based on pooled data from ____ national health and nutrition examination surveys
A
5
19
Q
Why use WHO growth charts?
A
- growth of breastfed infant has been established as norm for growth
- provides better description of physiological growth in infants
- based on high quality study designed explicitly for creating growth charts
20
Q
Monitoring growth
A
- use appropriate growth chart
- monitor trends in growth, not value
- normals fall within 5-95%
- evaluate changes in percentiles
21
Q
BMI > ____ percentile is classified as overweightin children
A
85th
22
Q
Diet history of infant
A
- formula
- foods consumed (as applicable)
- fluids consumed
- frequency of feedings
- vitamin/mineral supplement
- use of nutrition support (tube, parenteral)
- diarrhea or vomiting?
- feeding environment
- allergies
23
Q
Social and environmental considerations in child nutrition
A
- family structure
- insurance & financial situation
- culture & religious considerations (diet, fasting, vegan)
24
Q
Physical assessment in nutrition in children
A
- evaluation of muscle & subcu fat mass
- appearance of skin, eyes, hair, lips & nails
25
Evaluation of muscle & subcu fat mass reflects what in children?
Adequacy of protein & calorie provision
26
Appearance of skin, hair, eyes, lips and nails can reflect what in infant nutrition
Hydration status and nutrient deficiencies
27
What do you look at in estimating nutrient needs in infants?
- calories
- protein
- fluid
- vitamins/minerals
28
What are the major determinants of caloric needs in infants?
- BMR
- activity level
- increased needs of growth
- stress (infection, surgery, illness)
- others (thermic effect of food)
29
What are 2 equations you can use to estimate the energy needs of a child?
DRI (dietary reference intake)
| EER (estimated energy requirements)
30
EER for infants
Kcal/day
(89 x wt -100)
+ 175: 0-3mo
+56: 4-6mo
+22: 7-12mo
+20: 13-35mo
31
EER 3-18 years
Different charts for boys vs girls
- height in meters
32
When do you start to look at physical activity values in children?
3-18 years
33
Sedentary
Typical daily living activities
34
Low active
30-60 min daily moderate activity
35
Active
>60 min daily moderate activity
36
Very active
>60 min daily moderate activity + 60 min vigorous activity or 120 min moderate activity
37
Estimating maintenance fluid needs chart
2-10kg: 100ml/kg
11-20kg: 1000ml + 50ml/kg
>20kg: 1500ml + 20ml/kg
38
Feeding options for newborns
Breastfeed
| Formula
39
Breastfeeding guidelines
- minimum of 4 months, preferably 6 months
| - continue through at least 1st year of life
40
What is the best alternative to breast feeding in the first year of life?
Iron fortified formula
41
T/f whole milk, 1%, 2%, goat’s milk can be used in first 12 months of life
FALSE!
Too much protein
Can irritate GI
42
Breastfeeding advantages
- immunological benefits
- decreased incidence of (ear infections, UTI, gastroenteritis, respiratory illness, bacteremia)
- convenient & ready to eat
- reduced chance of overfeeding
- eliminates preparation errors
- fosters mother infant bonding
43
Contraindications to breastfeeding
- galactosemia
- mom invected with HIV
- infectious lesions close to breast (herpes)
- mom on drugs
44
Galactosemia
Disorder that affects how the body processes galactose
45
3 forms of infant formula
- ready to feed
- concentration
- powder
46
Fat amount in formula
50% kcals
47
Protein amount in formula
8-10% kcals
| ratio of hey to casein varies, most 60-40
48
Carbohydrate amount in formula
40-45% kcals
49
Caloric density in formula
standard formula: 20 cal/oz
50
Micronutrients in formula
higher vitamin/mineral content than human milk to cover 97% of population
51
Soy formula uses
- vegetarians
- lactose deficiency
- galactosemia
- IgE mediated allergy to cow's milk
52
Pre-term infant formula
- unique to premies
- predominant whey protein
- cow's milk based
- higher protein/calcium
- 20-50% MCT
- 20-24 calories/ounce
53
Protein hydrolysate/elemental formula uses
- infants who cannot digest or are allergic to intact protein
- free amino acids
54
Uses for elemental formulas
- milk soy protein intolerance (MSPI)
- intractable diarrhea
- biliary atresia
- short gut syndrome
- protein maldigestion/malabsorption
- eosinophilic esophagitis
55
Similac PM 60/40 lower in:
- calcium
- phosphorus
- potassium
- sodium
56
Calcilo-XD lower in:
- very low in calcium
| - vitamin D free
57
T/F Solids can be eaten by infants 3 months old
False!
- no nutritional need for solids before 6 months
- some infants may be developmentally ready between 4-6 months
- early introduction of solids can have negative effect
58
Signs of developmental readiness for starting solid food
- can sit up in high chair with minimal support
- can hold/support their own head
- loss of tongue thrust reflex
- baby should be able to lean forward with open mouth to express hunger and lean back with closed mouth to express satiety
59
T/F solids can be fed in infant feeder or bottle
False!
| - should be fed with spoon
60
Feeding skills by 4-6 months
experience new tastes
| give rice cereal with iron
61
Feeding skills by 6-7 months
sits with minimal support
| add fruits/veggies
62
Feeding skills by 8-9 months
improved pincer grasp
| add protein foods/finger foods
63
Feeding skills by 10-12 months
pulls to stand and reaches for food
add soft table food
allow to self feed
64
Feeding skills by 12-18 months
increased independence
stop bottle
practice eating from a spoon
65
Feeding skills by 18months - 2 years
growth slows
less interest in eating
encourage self feeding with utensils
66
Feeding skills by 2-3 years old
intake varies
| exerts control
67
The brain triples in size by what age?
6
68
Psychological and social changes in toddlers
- need to develop independence
- limits must be set
- control issues
- ned to feel successful
69
Rule of thumb for toddler food
serve about 1/4 - 1/3 of an adult portion OR 1 tbsp of food/year of age
70
T/F when in doubt give less food and let child ask for more in toddlers
true
71
What vitamins should be required for children under 6 months who receive iron fortified infant formula?
only vitamin D
72
When should fluoride be supplemented in infants?
fluoride in areas where content of local water supply less than 0.3ppm
Over 6 months
73
When should you start iron supplement in infant?
- start by 4-6 months preferably with complimentary foods
- esp those who breastfeed (low in iron)
- premature babies (fewer iron stores)
74
When should you screen for iron deficiency and iron deficiency anemia in infants?
12 months
75
Vitamin B12 in infants
breastfed infant or vegetarian mother
76
How much vitamin D should infants have?
ALL infants 4000 IU/day from beginning of birth to childhood
77
Who is vitamin supplementation recommended for in infants?
- malabsorption & liver disease
- children from deprived families or abuse
- poor appetite and eating habits, fad diets
- chronic disease
- in dietary program for obesity
- pregnant teens
78
Nutritional concerns in children and adolescents
- malnutrition and pregnancy
- overweight & obese
- hyperlipidemia & heart disease
- bone mineralization & osteoporosis
- food fads
- overuse of vitamins
- eating disorders
79
Malnutrition in infants leads to...
- Weight loss (acute <3 months)
- Diminished height velocity (chronic >3 months)
- Head circumference (Chronic >3 months)
- delayed wound healing
- loss of lean body mass
- infections
- immune dysfunction
80
ASPEN defines malnutrition in infants as imbalance between nutrient requirement and intake resulting in deficits of what?
- energy
- protein
- micronutrients
81
Based on etiology, malnutrition in childhood is either:
- illness related (>1 diseases/injuries directly result in nutrient imbalance
- Environmental/behavioral
or both
82
When dose atherosclerotic process begin?
in childhood
83
T/F childhood cholesterol levels associated with degree of early atherosclerotic changes
true
84
Treatment of cardiovascular disease in childhood
- healthy lifestyle (diet/exercise)
| - achieve and maintain healthy body weight (monitor trends in weight)
85
When does bone mineralization peak?
teenage and young adult years
86
Strategies to maximize bone mineralization
Diet: calcium, vit D, Na, P
| Weight bearing exercise
87
T/F maximization of peak bone mineralization may decrease the risk of adult osteoporosis
true
88
T/F 1/2 of children/adolescents are overweight/obese
False
| 1/3
89
T/F prevalence has more than quadrupled in children and doubled in adolescents in the past 30 years
False
Doubled children
Quadrupled adolescents
90
Etiology of pediatric obesity
- genetic (80% if both parents obese)
- environment
- dietary intake
- physical intake/sedentary activity
91
Treatment of pediatric obesity
- multidisciplinary and comprehensive
- formal behavior modification
- family based
- establish healthy habits
92
WIC
supplemental nutrition program for women, infants and children
93
Healthy habits in pediatrics
- offer variety of healthy foods and snacks
- avoid short order cooking
- encourage fruit and veggie intake
- no junk food snacking, avoid grazing, limit fast food
- encourage reading food labels
- limit intake juice (4oz/day)
- increase water
- encourage low fat dairy products
- make fun physical activity a habit
- limit TV to no more than 1-2 hours/day
- track growth and development carefully
- be good role model
