PMS III Week 3 - Pediatric Nutrition

Why is pediatric nutrition important?

Pediatric nutrition supports normal physical growth, neurologic development, organ development, bone health, immune function, resistance to infection, and long-term metabolic health.

Approximately what percentage range of children may experience acute malnutrition according to the lecture?

Approximately 6%-51%, depending on the population studied.

Approximately how many U.S. children are affected by food insecurity?

Approximately 1 in 5 U.S. children.

Approximately what percentage of U.S. children and adolescents have obesity?

Approximately 19.7%.

What are the major nutrition-related roles of pediatric healthcare providers?

Nutrition counseling, early identification of nutritional problems, assessment of growth, review of feeding practices, and referral for additional support when needed.

Why is the healthcare provider often important in identifying pediatric nutrition problems?

The provider may be the first point of contact for the child and family.

When does nutrition begin to influence pediatric health?

Before birth, beginning during the preconception period.

Why is preconception nutrition important?

It helps build maternal nutrient stores needed to support fetal development during pregnancy.

What long-term effects may result from poor nutrition before pregnancy?

Low birth weight, developmental disorders, congenital defects related to nutrient deficiencies, and increased risk of later metabolic disease.

How can maternal micronutrient deficiencies affect the fetus?

They may interfere with normal development and result in congenital defects.

What major fetal processes are supported by adequate maternal nutrition?

Fetal tissue growth, organ development, appropriate weight gain, neurologic development, and bone and tooth development.

How do calorie needs change during the first trimester?

There is generally no increase from the mother's baseline calorie needs.

How do calorie needs change during the second and third trimesters?

Calorie intake generally increases by approximately 340-450 kcal per day.

Why must pregnancy calorie recommendations be individualized?

Actual needs may be higher or lower depending on the patient's nutritional status, health, activity, and healthcare-provider recommendations.

What is the recommended total pregnancy weight gain for a patient who is underweight before pregnancy?

28-40 pounds.

What pre-pregnancy BMI defines underweight in the lecture?

A BMI below 18.5.

What is the recommended total pregnancy weight gain for a patient with a normal pre-pregnancy BMI?

25-35 pounds.

What pre-pregnancy BMI range is considered normal weight?

18.5-24.9.

What is the recommended total pregnancy weight gain for a patient who is overweight before pregnancy?

15-25 pounds.

What pre-pregnancy BMI range is considered overweight?

25.0-29.9.

What is the recommended total pregnancy weight gain for a patient with obesity before pregnancy?

11-20 pounds.

What pre-pregnancy BMI defines obesity?

A BMI of 30.0 or higher.

What is the major role of folate during pregnancy?

Prevention of neural tube defects.

What are the major roles of iron during pregnancy?

Prevention of maternal anemia and support of fetal red blood cell production, oxygen delivery, and growth.

What are the major roles of calcium and vitamin D during pregnancy?

Supporting fetal bone and tooth development.

What is the major role of iodine during pregnancy?

Supporting fetal brain development.

What is the major role of choline during pregnancy?

Supporting fetal brain development.

What is the major role of protein during pregnancy?

Supporting fetal growth and development.

What are the major roles of dietary fats during pregnancy?

Providing energy and supporting fetal organ development.

What age range defines infancy?

Birth through 12 months of age.

How does the lecture define a preterm infant?

An infant born before 37 weeks of gestation.

How does the lecture define a term infant?

An infant born after 37 weeks of gestation.

What does AGA mean?

Appropriate for gestational age.

What does LGA mean?

Large for gestational age.

What does SGA mean?

Small for gestational age.

What birth weight defines extremely low birth weight?

Less than 1,000 g.

What abbreviation is used for extremely low birth weight?

ELBW.

What birth-weight range defines very low birth weight?

1,000-1,499 g.

What abbreviation is used for very low birth weight?

VLBW.

What birth-weight range defines low birth weight?

1,500-2,500 g.

What abbreviation is used for low birth weight?

LBW.

Why is the first year of life nutritionally important?

It is a period of rapid physical growth and developmental change.

What provides sufficient nutrition for most infants during approximately the first 4-6 months?

Breast milk, infant formula, or a combination of both.

What is considered the gold standard for feeding during the first six months?

Exclusive breastfeeding.

When should breastfeeding ideally be initiated?

Within the first hour after birth.

What does exclusive breastfeeding mean?

The infant receives breast milk without other foods or liquids, including water.

For how long does the WHO recommendation in the lecture support exclusive breastfeeding?

The first six months of life.

How does breast milk support the infant's immune system?

It contains antibodies and other components that help build immune protection.

Breastfeeding decreases the incidence of which ear-related condition?

Ear infections.

Breastfeeding is associated with a decreased risk of what sleep-related infant condition?

Sudden infant death syndrome.

Breastfeeding decreases the incidence of which respiratory problems?

Respiratory infections and possibly asthma.

Breastfeeding decreases the incidence of which gastrointestinal infections?

Gastrointestinal tract infections.

Breastfeeding is associated with a decreased risk of what serious intestinal condition in infants?

Necrotizing enterocolitis.

What does NEC stand for?

Necrotizing enterocolitis.

Breastfeeding may reduce the risk of which allergic or dermatologic conditions?

Atopic dermatitis and eczema.

Breastfeeding may reduce the risk of which immune-mediated gastrointestinal disorders?

Celiac disease and inflammatory bowel disease.

Breastfeeding may reduce the risk of which metabolic diseases?

Type 1 diabetes mellitus, type 2 diabetes mellitus, and possibly obesity.

What financial advantage does breastfeeding provide?

Breast milk is free.

What convenience advantage does breastfeeding provide?

It is naturally available and ready to feed.

How may breastfeeding affect postpartum weight?

It may support postpartum weight loss.

How may breastfeeding affect menstruation?

It may delay the return of menstruation.

How may breastfeeding affect spacing between pregnancies?

It may increase child spacing.

Breastfeeding is associated with a decreased maternal risk of which cancers?

Breast and ovarian cancer.

Breastfeeding is associated with a decreased maternal risk of which autoimmune disorder?

Rheumatoid arthritis.

Breastfeeding is associated with a decreased maternal risk of which broad cardiovascular outcome?

Cardiovascular disease.

What are common breastfeeding problems related to milk transfer?

Inadequate milk production and inadequate milk extraction.

What are common painful breastfeeding problems?

Nipple pain and breast pain.

What infectious complication may occur during breastfeeding?

Breast infection.

What are the three stages of breast milk production?

Colostrum, transitional milk, and mature milk.

When is colostrum produced?

Approximately days 0-4 after birth.

What are the major characteristics of colostrum?

Small volume, thick, yellow, high in fat, high in electrolytes, and rich in antibodies.

When is transitional milk produced?

Approximately during the first one to two weeks.

What is transitional milk?

A mixture of colostrum and mature milk with increased fat and calorie content.

When is mature milk produced?

Approximately two weeks after birth and onward.

What are the major characteristics of mature milk?

It is lower in protein, higher in fat and carbohydrates, and changes according to the infant's needs.

How do maternal calorie needs change during breastfeeding?

They increase.

What vitamin should breastfeeding mothers generally continue?

A prenatal vitamin.

What additional supplement may be needed by a vegan breastfeeding mother?

Vitamin B12.

What daily vitamin D supplement is recommended for a breastfed infant?

10 mcg daily.

Why does a breastfed infant require vitamin D supplementation according to the lecture?

Vitamin D is not adequately passed through breast milk.

Which infants may need additional iron or multivitamin supplementation?

Preterm infants.

What infant metabolic condition is a contraindication to breastfeeding?

Galactosemia.

What group of infant disorders may contraindicate breastfeeding?

Certain inborn errors of metabolism.

What maternal infectious disease is a breastfeeding contraindication when active and untreated?

Tuberculosis.

What does the lecture recommend when active herpes simplex lesions are present on the breast?

Avoid breastfeeding from the affected breast.

Which maternal street drugs are listed as breastfeeding contraindications?

PCP, cocaine, and cannabis.

How can maternal medications affect breastfeeding?

Certain medications may make breastfeeding unsafe or require interruption.

What feeding method is suggested in the lecture when the mother has chickenpox?

Expressed breast milk.

What are the three major infant-formula preparations?

Powder, concentrate, and ready-to-feed.

What are the three main formula categories?

Standard formula, hydrolyzed formula, and elemental or amino-acid-based formula.

What additional formula categories are discussed in the lecture?

Soy-based, specialty, and preterm formulas.

What is the standard caloric density of most routine infant formulas?

20 kcal/oz.

What type of formula is first-line after breast milk?

Standard cow's-milk-based formula.

What are the main features of standard formula?

It is cow's-milk based, iron fortified, and contains intact protein.

When may hydrolyzed formula be indicated?

Milk allergy, soy allergy, or malabsorption.

What type of protein does hydrolyzed formula contain?

Protein broken down into peptides or amino acids.

Are hydrolyzed formulas generally lactose-containing or lactose-free according to the lecture?

Lactose-free.

When is an amino-acid-based formula indicated?

Severe allergy, multiple food allergens, or severe malabsorption.

What is another term for amino-acid-based formula?

Elemental formula.

What is the usual standard concentration of preterm formula?

22 kcal/oz.