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FN 2241 > Lecture 5 > Flashcards

Lecture 5 Flashcards

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1
Q

What is the cut of that makes an infant a premie?

A

<37wks

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2
Q

Premies have weak immunity, what are they more susceptible to?

A

Hypoglycemica

  • Low glycogen stores
  • decrease in gluconeogenesis and glycogenolysis
  • hyperinsulinemia

Poor temp control
-decrease subcutaneous fat

Necrotizing enterocolitis (NEC)

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3
Q

When you’re a premie, what decreases in nutritional stores do we see?

A 
Glycogen
Fat
Protein
Fat soluble vits
Ca
P
Mg
Trace minerals
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4
Q

How does rapid growth affect these nutritional stores?

A

Depletes them

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5
Q

Since premies are early, which physiological systems are still immature?

A
  • [Low] of digestive enzymes
  • GI motility and stomach capacity limited
  • Coordinated suck/swallow/breath not developed until 32-34wks
  • Immature renal function
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6
Q

What illnesses are premies susceptible to?

A 
Necrotizing enterocolitis (NEC) 
Respiratory distress syndrome
Bronchopulmonary dysplasia
Hyperbilirubinemia 
Sepsis
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7
Q

What is NEC?

A

Inflammation of the bowel

-2wks old

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8
Q

How much energy do infants require?

A

108kcal/kg/day from birth to 6 months

98kcal/kg/day from 6-12months

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9
Q

What are the factors that influence calorie needs in infants?

A 
Wt and growth rate
Sleep/wake cycle (active needs more)
Temp and climate
Metabolic response to food
Health status 
-fever needs more energy
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10
Q

What is the EER equation for infants?

A

TEE+ Energy deposition (energy deposited as protein and fat in growing tissues and organs)

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11
Q

Do infants have high or low basal metabolic rate?

A

Infants BMR is higher per kg than adults because babies have faster heart rate and respiration rate

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12
Q

When are growth rates the highest in infants?

A

Greatest during early months of life and then decrease as baby ages

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13
Q

What is the recommended protein intake for infants?

A
  1. 52g/kg/day from birth to 6mth

1. 2g/kg/day 7-12mth

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14
Q

When do infant protein needs increase?

A

When:

  • infection
  • illness
  • prematurity
  • inadequate energy intake
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15
Q

What can protein overload lead to in infants?

A

Puts stress on kidney and liver

Can cause diarrhea, fever, dehydration and acidosis

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16
Q

Why must carb intake be sufficient in infants?

A

TO spare protein from being used for energy

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17
Q

What % of breastmilk is carbs and what is the main carb in it?

A

39% carbs

90% of the carbs is lactose

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18
Q

what kind of fat does breastmilk contain?

A

short, medium and long chain fatty acids

-short and med are easier to digest and use because there is more breakdown that must occur in long chain fatty acids

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19
Q

What are the uses of fat in infants?

A 
Develop CNS
Maintain Body temp
Cushion for vital organs
Concentrated source of energy
Flavour and satiety
Provides essential fatty acids
Vehicle for fat soluble vitamin absorption
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20
Q

How good is infant water retention?

A

Lose water easily and there is a larger % of water in extra-cellular and vascular spaces in infants than adults

-infants have a greater % of water in their bodies than adults

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21
Q

Does breastmilk provide enough water for infants?

A

Yes, offers enough to stay hydrated

-will drink more in hot weather

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22
Q

What role does Ca play in infants?

A

Since infants undergo rapid skeletal growth and mineralization they need rapid increase in Ca content
-but if there is an excess, phosphorus can cause Ca loss from bones

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23
Q

What can cause a loss of Na in infants?

Study These Flashcards
A

Vomitting, diarrhea can cause loss of Na and water so its important to monitor Na

24
Q

What happens when you have too much K?

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A

Electrolyte inside cells and crucial to heart funciton

Excess can cause lower heart rate and abnormal heart rhythm and can cause that heart to stop

25
What is the purpose of Zn in infants?
Responsible for activating growth - since infants growth quickly, Zn needs are higher - [Zn] in breastmilk is low but its adequate - [Zn] in formula is low
26
What is the mist frequent nutrient deficiency in infants?
Fe deficiency anemia
27
What are the potential causes of Fe deficiency anemia?
Non fortified formula or cow milk under 12months Incidence increase with poor socioeconomic status
28
How do you decrease the risk of developing Fe deficiency anemia?
Incidences decrease with increased breastfeeding and Fe fortified formula and decrease cow milk <12 months
29
What are the signs and symptoms of Fe deficiency anemia?
``` Irritability Anorexia Poort wt gain Palenss Weakness/Fatigue Decreased resistance to infection Mental retardation and developmental delays ```
30
Do infants need fluoride?
For 6-12months -Breastfed infants dont need F supplement if mom is dreaming fluorinated water Formula should have 0.25mg/day supplement is they are getting: - Read to use formal made with water that has <0.3ppm of F - Or concentrate or powder that is made with water that has <0.3ppm of F
31
What can excess F cause?
fluorosis | -Change in enamel that can lead to tooth discolouration', staining and spots
32
At birth what does a nutrition assessment of infants look like?
Weight Length and receive and APGAR score
33
What is an APGAR score?
Range from 0-10 - 03: profound distress - 4-6: moderate distress - 7-10: normal adaptation
34
What does APGAR stand for?
``` Activity Pulse Grimace (reflex irritability Appearance (skin colour) Respiration ```
35
How do do an anthropometric assessment on infants?
Look at growth parameters like length, wt, and HC and compare to growth charts
36
What are the interpretation of growth data?
Wt for age Length for age Wt for length HC for age
37
What is growth retardation a sign of?
Poor nutritional status Nutrition intervention favours growth -1st step to increase cals or protein
38
What is the main indicator for future health status?
Low BW <2500g/5.5lbs VLBW<1500g/3.3lbs ELBW <1000g/ 2.2lbs
39
How do we interpret BW for gestational age?
Preterm, term and post term Birth weight: - Small for gestational age <10th% - LArge for gestational age >90%
40
When a baby is born what are the average parameters?
37-42wks 2500-3800g (5.5-8.5lbs) 47-54cm (18.5-21.5inch)
41
IN one day, how much wt can an infant lose?
Up to 7% of they birth weight within the first day of life
42
What is FFT and how to we characterize it?
Infant wt continues to decrease for more than 10 days Weight is not regained to reach birth wet by 3 weeks
43
What are the characteristics for being small for gestational age?
``` BW <10th% Growth retardation Cant catchup well Mentally impaired Increased risk of respiratory distress ```
44
What are the predictors for being SGA?
Maternal factors -malnutrition, substance abuse Factors involving the uterus and placenta -infection, decreased blood flow Factors related to the developing baby -infection, birth defect, multiples
45
Why do we use anthropometric data?
To assess growth and development over a period of time -individuals measurements are competed to reference standards on a growth chart
46
How does one fail in a growth chart?
If they fall below to the percentiles
47
What is the growth chart used for premature infants?
Fenton growth chart
48
How do we interpret WHOs HC for age ?
Less than 3 and greater than 97th -there is a potential health nutrition or developmental problems - Small:stopped growing - large: extra fluids
49
How do we interpret wt for age WHO chart?
less than 3% or greater than 99th - small: underweight due to recent malnutrition, dehaydration or genetic - large: child obesity
50
When do bread fed babies gain the most weight?
Fast wt gain in first 6months Slower in second 6month than formula fed infants
51
How quick does it take newborns to double their birth weight?
4-6months 1yr to triple
52
Ultimately what does growth reflect?
Nutritional adequacy Health status Economic and environmental adequacy
53
How many gram/day should infant be gaining?
0-3: 20-30 3-6: 15-21 6-12: 10-13
54
What are the warning signs off growth difficulties when looking at growth charts?
Lack of weight gain or length gain Plateau in weight, length or HC for >1month Drop in weight without regain within a few weeks
55
When doing biochemical and clinical data what is our main nutrient that we look for?
Fe status is assess to help determine signs and symptoms of malnutrition -increased risk in Fe deficiency >6months because of possible switch to cow milk or solid food
56
What are the 3 stages of Fe deficiency?
1. decrease in serum ferreting (Fe stores) 2. decrease in serum Fe and increase in blood transferrin 3. Decrease in Hemoglobin and hematocrit, and increase in erythrocyte protoporphyrin
57
When looking at dietary assessment, what do we start with?
``` Look at type of diet, quality and frequency of feeding Supplements Solid food intake Feeding behaviour Allergies ```

FN 2241 (12 decks)

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