Nutrition Flashcards
Advantages of breastfeeding in infants and children?
- Decreased frequency and severity of:
- Diarrheal illness
- Respiratory infections
- Necrotizing enterocolitis
- Otitis media - Decreased rate of:
- urinary tract infection
- bacterial sepsis - Lower risk of neonatal and infant death:
- Overall infant mortality
- Sudden infant death syndrome (SIDS) - Likely lower risk of chronic illness:
- Leukemia (ALL, AML)
- Diabetes (types 1 and 2)
- Obesity
- Atopic dermatitis and asthma
- Celiac disease and Crohn’s disease
Advantages of breastfeeding for the mother?
With cumulative lactation of 12 months or greater)
1. Reduced risk of cancer:
- Breast cancer risk (OR = 0.72)
- Ovarian cancer risk (OR = 0.63)
2. Reduced risk of cardiovascular disease:
- Obesity (OR = 0.92)
- Hypertension (OR = 0.88)
- Hyperlipidemia (OR = 0.81)
- Cardiovascular disease (OR = 0.91)
3. Reduced risk of diabetes type 2 (among women without gestational diabetes; OR = 0.80)
HIV infection and breastfeeding?
Exclusive breast feeding for 6 months
Complimentary feeding thereafter until 24 months
Mother be on lifelong antiretroviral medications
Baby on nevirapine (NVP) within 72 hours of birth
NVP continued for 6 weeks
What are micronutrients?
- vitamins
- trace elements <0.01% of the body weight
Factors contributing to trace elements deficiencies in children?
- Increased demand of growth
- Organs (e.g brain) can sustain permanent damage due to trace element deficiency (iron, iodine) - Gastroenteritis and malabsorption can cause loss of:
potassium, magnesium, vitamin A, and zinc
Describe zin deficiency?
Epidemiology - developing world
Associated conditions - malnutrition, iron deficiency
Chronic deficiency associations - dwarfism, hypogonadism, dermatitis, and T-cell immunodeficiency
Importance of zinc - supplementation reduces the incidence and severity of diarrhea, pneumonia, and possibly malaria
Production of vitamin D?
Cutaneous synthesis is the most important source [conversion of 7-dehydrochlesterol tovitamin D3(3-cholecalciferol)]
Factors that decrease cutaneous synthesis of vitamin D?
Increased skin pigmentation
Less time outside
Away from equator
Covering skin or sunscreens
Natural dietary sources of vitamin D?
- Fish liver oils
- Fatty fish andegg yolks
Note: Breast milk has a lowvitamin Dcontent.
Clinical manifestations of vitamin D deficiency?
- rickets
- hypocalcemia
- Laryngospasm (occasionally fatal)
- Increased risk of pneumonia and muscle weakness; delay in motor development
Features of rickets?
Genu varum (bowed legs)or genu valgum (knock knees)
Thickened wrists and ankles
Prominence of the costochondral junctions (rachitic rosary)
Indentation of the lower anterior thoracic wall (Harrison groove)
Frontal bossing
Craniotabes
Vitamin k deficiency? Deficiency causes?
Necessary for the synthesis of clotting factors II, VII, IX, and X
Deficiency can result in clinically significant bleeding
Causes of vitamin K deficency?
Breastfed infants (lowvitamin Kcontent of breast milk; formula is fortified);
Delayed feeding is an additional riskfactor
Newborn gut is sterile has no intestinal synthesis ofvitamin K2
Poor transfer ofvitamin Kacross the placenta
Occult malabsorption ofvitamin K (e.g biliary atresia)
Maternal medications (Warfarin, phenobarbitone, phenytoin)
Poor intake PLUS use of broad-spectrum antibiotics
Clinical manifestation of vitamin K deficiency?
Vitamin k deficiency bleeding
1. Gastrointestinal (GI) tract
2. Mucosal and cutaneous tissue
3. Umbilical stump
4. Postcircumcision site
5. Intracranial bleeding (can cause convulsion, permanent neurological sequalae or death.
Prevention and treatment of vitamin K deficiency?
- Discontinuing the offending medications before delivery
- Administration ofvitamin Kto the mother may be helpful
- Neonatal parenteralvitamin Kimmediately after birth
- Fresh frozen plasma if parenteralvitamin Kdoes not correct the coagulopathy
