Term
| Why Is Nutrition Important? |
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Definition
• Energy of daily living
• Maintenance of all body functions
• Vital to growth and development
• Therapeutic benefits
- Healing
- Prevention |
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Term
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Definition
Rapid body growth and brain development
during the first year:
• Weight increases 200%
• Body length increases 55%
• Head circumference increases 40%
• Brain weight doubles |
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Term
| Major Determinants of Caloric Needs |
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Definition
• Basal metabolic rate (BMR)
• Activity level
• Growth (2x BMR during first year)
• Stress (infection, surgery, illness)
• Miscellaneous (thermic effect of food) |
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Term
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Definition
Use updated growth charts
- www.cdc.gov
• Monitor trends in growth, not just one value,
using Wt, Ht, HC (< 2 yrs), BMI
• In general, normals fall within 5th–95th %ile
• Evaluate changes in %iles
• Malnutrition results in:
- Decreased weight (acute), then height, then head
circumference (chronic). |
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Term
|
Definition
What are the options?
• Breast feeding
- The American Academy of Pediatrics recommends
exclusive breast feeding for 6 months.
• Formula feeding |
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Term
| Breast Feeding Advantages to Infants |
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Definition
• Immunologic benefits (>100 components)
• Decreased incidence of ear infections,
UTI, gastroenteritis, respiratory illnesses,
and bacteremia
• Convenient and ready to eat
• Reduced chance of overfeeding?
• Fosters mother-infant bonding |
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Term
| Breast Feeding Advantages to Mothers |
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Definition
• May delay return of ovulation
• Loss of pregnancy-associated adipose
tissue and weight gain
• Suppresses post-partum bleeding
• Decreased breast cancer rate |
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Term
| Assessment of Breast Feeding |
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Definition
• Weight pattern—consistent weight gain
• Voiding—number of wet diapers/day, soaked?
• Stooling—generally more stools than formula
• Feed-on-demand ~ every 2–3 hours
• Duration of feedings—generally 10–20
minutes/side
• Need for high fat hind milk
• Activity and vigor of infant |
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Term
|
Definition
• Discontinue the iron formula, it may be
constipating.
• Give 1 tsp of mineral oil per day until baby goes.
• Give a suppository each day until baby goes.
• Add cereal to the bottle to help baby’s bowels
and to sleep.
• Dilute to give more water.
• Give 1 oz apple juice per day until baby goes.
• Do nothing, since breast-fed infants may not
have a bowel movement for up to 7 days |
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Term
| Supporting Breast Feeding |
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Definition
• Ask patients if they plan to breast feed.
• Give prenatal guidance, materials, and support
numbers.
• Support hospital initiatives to encourage breast
feeding, such as lactation counselors.
• Ask about breast feeding support available to
mother.
• Become familiar with how to manage common
problems such as mastitis and inverted nipples.
• Understand issues related to pumping and helping
moms return to work or wean the infant. |
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Term
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Definition
3 forms:
1. Ready to feed—most expensive, does
not require water
2. Concentrate—requires mixing with water
in equal parts
3. Powder—requires mixing with water |
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Term
Composition of
Standard Infant Formula |
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Definition
• Caloric density: standard formulas contain 20 calories/oz
(0.67 calories/cc).
• Protein content: ratio of whey to casein varies—most are
60:40, similar to human milk.
• Fat: most provide ~50% of calories from fat from
saturated and polyunsaturated fatty acids.
• Carbohydrate: lactose, beneficial effect on mineral
absorption (Ca, Zn, Mg), and on colonic flora.
• Micronutrients: higher vitamin and mineral content than
human milk to cover 97% of the population |
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Term
|
Definition
• Soy: used for vegetarians, lactase deficiency,
galactosemia
• Lactose free: cow’s milk-based formula
• Protein hydrolysate: infants who cannot digest or
are allergic to intact protein
• Free amino acids: infants with multiple allergies
• Pre-term infant: unique for premies, predominant
whey protein, cow’s milk-based, higher protein
and calcium, 20–50% MCT(medium chain trigs) |
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Term
| Feeding Skills Development |
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Definition
- 4–6 months: experience new tastes
• Give rice cereal with iron
- 6–7 months: sits with minimal support
• Add fruits and vegetables
- 8–9 months: improved pincer grasp
• Add protein foods and finger foods
- 10–12 months: pulls to stand, reaches for
food
• Add soft table food, allow to self-feed
- 12–18 months: increased independence
• Stop bottle, practice eating from a spoon
- 18 months–2 years: growth slows, less
interest in eating
• Encourage self-feeding with utensils
- 2–3 years: intake varies, exerts control |
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Term
| Preschool (1 to 6 Years) growth |
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Definition
• 1–2 years: on average, grows 12 cm,
gains 3.5 kg
• Rate of growth slows by 4 years
- 6–8 cm/year
- 2–4 kg/year
• Brain growth triples by 6 years |
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Term
| Developing Healthy Habits |
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Definition
• Offer a variety of healthy foods and snacks.
• Encourage fruit and vegetable intake.
• No junk food snacking.
• Limit intake of juices (4 oz per day).
• Increase intake of water (no soda).
• Encourage low fat dairy products (3–4 servings/day).
• Make fun physical activity a habit.
• Limit TV to no more than 1 to 2 hours per day.
• Track growth and development carefully.
• Be a good role model |
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Term
Nutritional Concerns in
Childhood and Adolescents |
|
Definition
• Malnutrition and poverty
• Growth spurt—onset of menses for
girls—changes in body size/image
• Food fads, vitamins, athletes
• Eating disorders: anorexia and bulimia
nervosa
• Overweight and obesity
• Hyperlipidemia and heart disease.
• Bone mineralization and osteoporosis |
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Term
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Definition
- Physiological growth stage (Tanner staging) rather than
chronological age, is the best indicator for establishing
requirements or evaluating intake.
- Females: 11–14 years
• Grow 8.4—9.0 cm/year
• Girls deposit more total body fat
- Males: 13–16 years
• Grow 9.5—10.3 cm/year
• Boys deposit more muscle mass
• Boys tend to gain more weight at a faster rate and skeletal
growth continues longer than girls |
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Term
| Eating Disorders in Adolescents |
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Definition
• An estimated 20% of teens engage in
some type of abnormal eating.
• 5% of high school girls have been
diagnosed with an eating disorder.
• Adolescents are frequent users of OTC
diet pills.
• Multiple factors contribute: thin “ideal,”
family pressure, exhibiting body control. |
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Term
Diagnostic Criteria
for Anorexia Nervosa |
|
Definition
• Refusal to maintain body weight over a
minimal normal weight
• Intense fear of gaining weight or becoming
fat, even though underweight
• Denial of low body weight
• In females, absence of at least three
consecutive menstrual cycles
• Specific types: restricting or binge purging |
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Term
| Diagnostic Criteria for Bulimia Nervosa |
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Definition
• Recurrent episodes of binge eating characterized by:
- Eating a larger amount of food than most people would eat in a specific period of time
- A sense of lack of control over eating at this time
• Recurrent inappropriate compensatory behavior to
prevent weight gain (vomiting, laxatives, exercise)
• Binge eating and other behaviors occur, on average, at
least twice a week for three months
• Self-evaluation is unduly influenced by body shape
/weight
• Specify type: Purging type or non-purging type |
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Term
| Obesity in Childhood and Adolescents |
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Definition
• >20% of children/adolescents are overweight.
• Increased by 50–100% over last 20–30 years:
- More sedentary lifestyle and behavior (TV/video
games)
• Prevalence increasing more rapidly among
African Americans
• Obese children and adolescents become obese
adults
• Recent reports indicate approx 45% of newly
diagnosed pediatric patients with diabetes are
diagnosed with Type 2 |
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Term
| Obesity: Health Consequences |
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Definition
• Cardiovascular disease risk
• Type 2 diabetes (epidemic)
• Hypertension
• Orthopedic
• Sleep apnea
• Gallbladder disease/steatohepatitis
• Psychosocial problems |
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Term
Pediatric Obesity:
Etiology |
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Definition
• Genetic predisposition: 80% risk if both
parents obese
• Environment
• Dietary intake
• Physical activity/sedentary activity |
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Term
Pediatric Obesity:
Treatment |
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Definition
• Multidisciplinary and comprehensive
• Formal behavior modification
• Family-based |
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Term
| Prevention of Cardiovascular Disease |
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Definition
• Atherosclerotic process begins in
childhood.
• Childhood cholesterol levels are
associated with degree of early
atherosclerotic changes. |
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Term
Prevention of CVD
Current Recommendations |
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Definition
• NCEP guidelines apply to children over 2 years.
• Diet: <30% fat, <10% saturated fat, <300 mg
cholesterol/day
• Check fasting lipid profile when there is a
positive family history of early CVD, or elevated
cholesterol (hyperlipidemia) in a first-degree
relative
• Combine dietary intervention with healthy
lifestyle for maximum benefits. |
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Term
|
Definition
• Bone mineralization peaks in teenageyoung
adult years.
• Maximizing peak bone mineralization may
decrease the risk of adult osteoporosis.
• Maximizing bone mineralization:
- Diet • Calcium • Sodium, protein, phosphorus
- Weight-bearing exercise |
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Term
Disease Prevention
Developing Healthy Eating Habits |
|
Definition
• Discourage dieting and obsession with weight.
• Pack healthy lunch at least twice a week.
• Limit fast-food eating out.
• Encourage a balanced diet.
• 5 servings of fruits/vegetables a day.
• Encourage low fat dairy products (3–4 servings/day).
• Prepare meals that kids and teens enjoy.
• Encourage teens to learn to cook healthy food.
• Teach kids and teens label reading.
• Be a role model. |
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