Midterm 2 Flashcards
(180 cards)
1
Q
typical weight of full term infant
A
2500-3800 g
5.5-8.5 lb
2
Q
typical height of full term infant
A
47-54 cm
18.5 to 21.5 in
3
Q
full term infant born…
A
37-42 weeks
4
Q
___% are born full-term
A
88%
5
Q
infant mortality
A
death that occurs in first year
6
Q
major causes of infant mortality
A
low birth weight (<25000g)
congenital malformations
SIDS
7
Q
newborns have ___ reflexes
A
strong
8
Q
motor development is top down
A
controls head first, lower legs last
9
Q
muscle development from ___ to ___
A
central to peripheral
10
Q
factors that impact cognition
A
sensorimotor development interactions with environment adequate energy and protein stimulation of social and emotional growth genetics
11
Q
critical periods
A
fixed periods of time which certain behaviors or developments emerge, necessary for sequential behaviors or developments
12
Q
newborns ___ birth weight by ___ months and ___ by 1 year
A
double by 4-6 months
triple by 1 year
13
Q
___and ___ are important components of health assessment of infants
A
weight and length (recumbent length measurement boards)
14
Q
CDC 2000 infant growth charts show
A
weight for age
length for age
weight for length
head circumference for age
15
Q
____ kcal/kg/day from birth to 6 months
A
108 (range from 80 to 120)
newborn 4 kg (8.8lb) = 432kcal/day
16
Q
____ kcal/kg/day from 7-12 months
A
98
7 month old 8kg (17.6 lb) = 784 kcal/day
17
Q
___ g/kg/day of protein from birth to 6 moths
A
2.2 g
newborn 4 kg (8.8 lb) = 8.8 g
18
Q
____ g/kg/day of protein from 6-12 months
A
1.6 g
6 month 8 kg (17.6 lb) = 12.8 g
19
Q
____ g/day of fat from birth to 6 months
A
31 g
20
Q
____ g/day of fat from 7- 12 months
A
30 g
21
Q
breast milk contains about ____% calories from fat
A
55%
breast milk contains short-chain and medium-chain fatty acids (easier to digest)
22
Q
infants need cholesterol for ___
A
gonadal and brain development
23
Q
AAP and Academy of Nutrition and Dietetics recommend exclusive breast feeding for ___
A
1st 6 months and continuation to 1 year
24
Q
standard formula provides ___ cal/fl oz
A
20
25
formula intake for birth to 1 month
16-20 fl oz / day
8-12 feedings/day
1-2.5 fl oz per feeding
26
formula intake for 1-2 months
18-26 fl oz/day
8-10 feedings/day
2-4 fl oz / feeding
27
formula intake for 2-3 months
22-30 fl oz /day
6-8 feedings /day
3-5 fl oz / feeding
28
formula intake for 3-4 months
24-32 fl oz /day
4-6 feeding / day
4-8 fl oz / feeding
29
cow's milk during infancy
should not be used
linked to iron deficiency anemia (low iron availability in cows milk, high calcium and casein inhibit absorption of iron)
30
breast milk calories from protein, carbs, and fat
7% from protein
38% from carbs
55% from fat
31
cow milk calories from protein, carbs, and fat
9-12% from protein
41-43% from carbs
48-50% from fat
32
soybean - based formula
use should be limited
has compounds with estrogen properties
11-13% from protein
33
formula intake for birth to 1 month
16-20 fl oz / day
8-12 feedings/day
1-2.5 fl oz per feeding
34
formula intake for 1-2 months
18-26 fl oz/day
8-10 feedings/day
2-4 fl oz / feeding
35
formula intake for 2-3 months
22-30 fl oz /day
6-8 feedings /day
3-5 fl oz / feeding
36
formula intake for 3-4 months
24-32 fl oz /day
4-6 feeding / day
4-8 fl oz / feeding
37
cow's milk during infancy
should not be used
linked to iron deficiency anemia (low iron availability in cows milk, high calcium and casein inhibit absorption of iron)
38
breast milk calories from protein, carbs, and fat
7% from protein
38% from carbs
55% from fat
39
cow milk calories from protein, carbs, and fat
9-12% from protein
41-43% from carbs
48-50% from fat
40
soybean - based formula
use should be limited
has compounds with estrogen properties
11-13% from protein
41
at 4-6 weeks reflexes for food intake regulation....
start to fade
| infant begins to purposely signal wants and needs
42
at 4-6 months...
infants move tongue from side to side indicating readiness for solid foods
43
at ___ months offer small portions of semisoft foods ___ each day
~6 months, twice a day
44
can swallow pureed soupy food at ___ months
4-6 months
iron-fortified baby cereal mixed with breast milk
pureed fruits and vegetables at 6 months
45
can swallow very soft, lumps food at __ months
6-8 months
46
can eat soft mashed foods
8-10 months
| soft table foods 9-12 months
47
Ellyn Satter's Division of Responsibility in Feeding
parents/caretakers provide structure, support, and opportunities (what)
children choose how much and whether to eat from what the parents provide (how much)
48
fluoride supplements for infants
for breastfed infants after 6 months or if in any area with no fluoridated water
49
iron supplements for infants
after 4-6 months if breastfed
50
vitamin B12 supplement for infants
for vegans
51
Vitamin D supplements for infants
needed if exclusively breastfed
52
FTT
failure to thrive
inadequate length or weight gain (suspected calorie deficit)
reason social service agencies become involved with families
53
organic FTT
diagnosed medical illness in infant
| gastroesophageal reflux (GER) or infection
54
nonorganic FTT
not based on medical diagnosis
| maternal depression, inappropriate infant care, over dilution of formula, etc
55
colic
sudden onset of irritability and crying for extended periods with no reason
appears during first 2 weeks - 3rd or 4th month
associated with GI upset, GER, feeding, etc.
no accepted medical treatment
56
Iron deficiency anemia in infants
uncommon because prenatal iron stores of mother
more common in low income
supplements and iron fortified cereal at 4-6 months
57
iron DRI for infants
.27 mg/day up to 6 months
| 11 mg/day 7-12 months
58
infants usually have ___ stools/day
2-6
59
most states screen for....
3-6 different conditions that may cause disability or death
| ex: phenylketonuria (PKU), galactosemia
60
Children with special health care needs
Federal category of services for infants, children or adolescents with, or at risk for, a physical or developmental disability, or with a chronic medical condition caused by or associated with genetic/metabolic disorders, birth defects, prematurity, trauma, infection, or perinatal exposure to drugs
family can benefit from nutritional and medical interventions without specific diagnosis
61
developmental delay
conditions represented by at least 25% delay by standard evaluation methods
may be replaced with more specific type of medical diagnosis when child is older
62
LBW (low birth weight)
<5 lb 8 oz
| 8% of live births in US ?
63
very low birth weight (VLBW)
<1500 g (3 lb 5 oz)
64
extremely low birth weight (ELBW)
<1000 g (2lb 3 oz)
65
neonatal death
from birth to 28 days after birth
66
perinatal death
after 20 weeks gestation to 28 days after birth
67
infant morality
within first year of life
68
advances in health care have reduced infant mortality by ___% between ____
45% between 1980 and 2008
69
infants weighing 500-600 g (~23 wks gestation) have ____ chance of survival
~30% chance
70
infants weighing 900 - 1000 g (~29 wks gestation) have ___% chance of survival
~88% chance
71
result or reduced infant mortality...
more infants with specialized nutritional needs
72
NICHD's "neonatal research network" tracks infants...
with BW between 501 and 1501 g
73
infant health and development growth charts
```
for VLBW (<1500g) premature
has head circumference, weight, and length adjusted for gestational age
```
74
increased calories required for premature infants
120 kcal/kg/day
| may be higher with illness
75
decreased calories recommended for...
spina bifida or down syndrome
76
protein for infants at risk
1.5 g/kg if growth and digestion no affected
3-3.5 g/kg for premature or recovery from illness
4 g/kg for ELBW
hydrolyzed protein
77
provide up to ___% calories from fat (for infants at risk?)
55%
78
about ____ VLBW born in US each year
60,000
79
survival rate of VLBW
90%
80
parenteral feeding
nutrients directly to blood stream
81
enteral feeding
directly to GI tract
82
oral-gastric
mouth to stomach
83
transpyloric
nose/mouth to small intestine
84
gastrostomy
surgical opening to stomach
85
jejunostomy
surgical opening into small intestine
86
congenital anomaly
condition diagnosed at or near birth usually as a genetic and chronic condition
87
examples of congenital disorders
diaphragmatic hernia (1 in 4,000)
tracheoesophageal atresia/disconnection (1 in 4500)
cleft lip and palate
genetic disorders (maple syrup urine disease)
88
maple syrup urine disease
1 in 180,000
deficiency of metabolic enzyme, leading to buildup of branch chain aa's (leucine, isoleucine, and valine) in blood and urine
coma and death
diet restricted of branch chain aa
89
toddlers
1-3
| rapid increase in gross and fine motor skills
90
preschool age
3-5
11.8 million in US
increased autonomy, broader social circumstances, increasing language skills, expanding self control
91
toddlers gain ___ per year
2.7 kg (6.1 lb) and 12 cm (4.7 in) per year
92
preschoolers gain ___ per year
4.4 lb and 2.8 inches
93
weigh and measure toddlers under age 2...
without clothes or diaper
recumbent length
(over 2 with light clothes and stand with no shoes)
94
2000 CDC growth charts
```
gender specific
age specific (birth to 36months and 2-20 years)
weight for age
length for age
head circumference per age
BMI for age
```
95
WHO growth charts
birth to 5 years
| international growth standards regardless of ethnicity or socioeconomic status
96
toddler progress by month
```
15- crawl up stairs
18- run stiffly
24 - walk up stairs on foot at time
30 - alternate feet going up stairs
36- ride tricycle
```
97
leading cause of death in toddlers
unintentional injury
| no sense of danger
98
cognitive development of toddlers
orbit around parents
10-15 works at 18 months, 100 at 2 years
3 word sentences by 3 years
99
completely weaned at...
12 to 14 months
100
gross and fine motor development
12 months refined pincer
| 18-24 months - able to use tongue to clean lips and have developed rotary chewing
101
feeding behaviors in toddlers
hallmark is rituals in feeding
food jags common (strong preferences and dislikes)
imitate parents and siblings
include child in meal prep
102
toddler sized portions
1 tablespoon per year of age (give less and ask for more)
103
central issue of preschool age
control
| separate from parents vs. limits
104
vocab expands to___ during preschool age
>2000 words (complete sentences)
105
temperament
behavioral style of a child
106
3 main temperaments
40% easy - adapts to regular schedules and accepts new foods
10% difficult - slow to adapt, negative to new foods
15% slow to warm up - negative to new but can learn
intermediate low and intermediate high
107
estimated energy requirement for 1-3 year olds
89 x weight(kg) -100+20
108
RDA protein 1-3
1.1 g/kg/day or 13 g/day
109
RDA protein 4-8
.95 g/kg/day or 19 g/day
110
RDA iron, zinc, calcium 1-3
iron: 7 mg/d
zinc: 3 mg/d
calcium: 700 mg/d
111
RDA iron, zinc, calcium 4-8
iron: 10 mg/d
zinc: 5 mg/d
calcium: 1000 mg/d
112
___ three year olds are given vit and mineral supplements
1 in 2
113
___% of children (4-8) consume fast food
25%
114
___ mins of physical activity each day
60 (for preschool? )
115
percentages of children with disabilities
5%-31% of children
| 90% of children wit disabilities have a nutritional problem
116
FTT may result from...
```
digestive problems
asthma/breathing problems
neurological conditions
pediatric AIDS
abuse/medical neglect
```
117
recovery from FTT...
catch up growth
118
cystic fibrosis
```
hereditary disorder affecting cells that produce mucus, sweat, saliva, and digestive enzymes
think and sticky mucus
plug up ducts (in pancreas)
1 in 1500-2000
mutation in CFTR on chromosome 7
```
119
CFTR
regulates normal movement of sodium and chloride in and out of cells
1500 mutations identified
120
symptoms of cystic fibrosis
```
vary depending on severity
wheezing, coughing
respiratory infections
bulky/greasy stools
blockage of bowels
cirrhosis of liver
delayed growth
```
121
cystic fibrosis nutrition
high calorie, enteric-coated oral pancreatic enzymes
122
bronchopulmonary dysplasia
damage of underdeveloped lungs
123
asthma
lungs unable to exchange air due to lack of expansion of air sacs
5.8% of children <5 yo
may be result of food allergy
124
___% of ELBW infants develop chronic lung problems
~80%
125
breathing problems increase nutrient needs due to...
extra energy expended in breathing and lower interest in eating
126
autism spectrum disorders
```
brain development disorder
impaired social skills
restricted and repetitive behavior
onset < 3 yo
~1/166
```
127
pathophysiology of autism
excess of neurons
disturbed neuronal migration
unbalanced excitatory-inhibitory networks
abnormal formation of synapses
128
autism diet
no scientifically proven diet for prevention of treatment
| gluten free and casein free have been recommended via groups
129
Rett Syndrome
sporadic mutation in MECP gene on X chromosome(transcriptional-creating equivalent RNA copy from DNA - repressor)
development normal until 12 -18 months
1 in 10,000
loss of hand use, growth retardation, gait difficulties, seizures, loss of speech, feeding problems
130
cerebral palsy
group of disorders, impaired muscle activity and coordination present at birth or early childhood
2-2.5/1000 (40-50% of LBW-ELBW)
131
Prader-Willi syndrome
```
partial deletion of chromosome 15
1 in 25,000
poor muscle tone and motor skills
short stature
hypogonadism
learning disabilities
behavioral problems
characteristic facial features
FTT in 1st year
overweight
**low energy needs
```
132
celiac disease
sensitivity to gluten in wheat, rye, barley
| results in diarrhea
133
toddler diarrhea typically caused by...
excess sucrose from fruit juices
| limit to 4-6 fl oz per day for 1-6 yo
134
food allergies seen in _____% of children
2-8%
| milk, eggs, wheat, peanuts, walnuts, soy, fish
135
middle childhood
5 to 10 years
| school age
136
preadolescence
9 to 11 for girls
10 to 12 for boys
(school aged)
137
2000 CDC growth charts based on data from...
National Health and Examination Survey
national health and nutritional examination surveys I, II, and III
(III data for children >6 not included bc overweight)
138
body fat minimum
in early childhood
16% in females
13% in males
139
cognitive development of middle childhood
```
self-efficacy (know what to do and do it)
focus on several aspects
cause and effect
sense of self
independence
peer relationships
```
140
EER school age males
4-8 yo; 1742 kcal/d
| 9-13 yo; 2279 kcal/d
141
EER school age females
4-8 yo; 1642 kcal/d
| 9-13 yo; 2071 kcal/d
142
protein DRI for 4-13 yo boys and girls
.95 g/kg body wt
143
acceptable range of fat for 4-18
25% to 35% of energy
144
linoleic fatty acids
```
omega 6
seeds, nuts, whole grain cereals
precursor for arachidonic acid - cell membrane in CNS
4-8 = 10 g
boys 9-13 = 12 g
girls 9-13 = 10 g
```
145
alpha-linoleic fatty acids
```
omega 3
fish, flaxseed, soy oil, canola oil
precursor for EPA and DA (heart beat, blood pressure)
4-8 = .9 g
boys 9-13= 1.2 g
girls 9-13 = 1 g
```
146
fiber
```
prevention of chronic disease
fruits, vegetables, whole grains
4-8 = 25g
boys 9-13 = 31 g
girls 9-13 = 26 g
```
147
RDA iron, zinc, calcium 9-13
iron: 8mg/d
zinc: 8 mg/d
calcium: 1300 mg/d
148
soft drinks add ___ kcal/d and ____ mg caffeine to 6-11 yos' diets
229 kcal/day
| 35-50 mg caffeine
149
___% consume up to 8.9 ounces of soft drink/day
32%
150
___% consume >= 9 ounces of soft drink/day
32%
151
___% are non-consumers of soft drinks
36%
152
only ___% of middle and junior high schools require daily physical activity
8%
153
only ___% of 5-15 yo children walk to school and ___2% ride their bike to school
35%
| 2%
154
iron deficiency
less common in children than toddlers
4% in 6-11
5% in 3-5
7% in 1-2 (toddles)
155
adiposity rebound
7 y = late
156
for each additional hour to tv, prevalence of obesity increased by ___%
2%
157
children age ____ have highest rates of daily tv time
11-13
158
4 stage approach to treatment of overweight/obesity
prevention plus
structured weight management (SWM)
comprehensive multidisciplinary intervention (CMI)
tertiary care intervention (severely obese adolescents)
159
treatment for BMI 85th-94th %
weight maintenance or slowing of rate of weight gain while gaining height until <85th % achieved
160
treatment for BMI >95th - 98th %
weight maintenance/slowing rate of grain or gradual weight loss of <85th%
161
treatment for BMI >99th%
weight loss of <85th
162
Individuals with Disabilities Education Act (IDEA)
federal legislation that require the last restrictive environment resulting in inclusive setting for children ex: children in wheelchairs or with Down Syndrome spend time in regular classroom
163
increased calories for
autism, ADHA (low impulse control, and short attention span)
164
high protein needs for
cystic fibrosis
| increases to 150% DRI
165
supplement for cystic fibrosis
fat- soluble vitamin supplements due to poor intestinal absorption
166
galactosemia supplement
calcium due to restricted dairy intake
167
type 1 vs type 2 diabetes
1: autoimmune disease
2: insulin resistance, obesity, varies with ethnicity
consequences: organ damage, premature death
168
seizures/epilepsy
uncontrolled electrical disturbance in brain
| 3.5/1000
169
postictal state
time after seizure of altered consciousness
170
treatment for seizures
medication - may impact growth/appetite
| ketogenic diets: very low CHO diet (ketones instead of glucose are main fuel sources)
171
cerebral palsy in childhood/pre adolescence
1.4-2.4/1000
| resulting from brain damage...
172
spastic quadriplegia
mots severe form of cerebral palsy
173
other brain damage with cerebral palsy...
39-44% have mental retardation
26-36% have seizures
14-18% have visual impairment
174
athetosis
uncontrolled movement with increases energy expenditure (need higher calories)
175
phenylketonuria (PKU)
inborn error of metabolism
1/12,000 births
body lacks enzyme to metabolize phenylalanine
completely avoid meat, eggs, dairy, nuts, soy
176
ADHD
most common neurobehavioral problem
5-8% of school age children
Ritalin or Adderal
177
___ people living with HIV
34 million
178
___ acquired HIV in 2011
2.5 million
179
___ people with HIV in USA
682,668
180
___ people living with AIDS in USA
490,696
