Test 2- Nutr 301

newborn body weight- double and tripled at what ages

first 6 months and 12 month

corrected gestational age formula

Chronological Age - Weeks Premature.

iron difference in first year of life

0-6 months- 0.27 mg

7-12 months- 11 mg

vitmain D in first year of life

10 mcg or 400 IU

how long do you breastfeed for

6 months exclusively and dont stop until 12 months

what changes in diet at 6 months

introduce infants to nutrient-dense foods, iron forified foods

energy needs of infants

energy needs per kg of weight higher than any other time

ranges from 80-120 cal per kg weight

protein needs of infants

Birth to 6 months: 1.52 g per kg

body weight

7 to 12 months: 1.2 g per kg

body weight

BMI rebound

Normal BMI increase at age 4-6; early rebound = higher obesity risk.

Iron supplementing for infants

through 12 months- 2-4 mg per kg

Breastfed infants- 1 mg daily at 4 months and 11 mg daily at 7 months

formula fed- no supplementation is needed

when do you start preparing infants to drink from a cup

6-8 months

AAP Dentristry recommends infants drink from a cup as they approach the 1 and wean off of bottle 12-18 months

inapporpriate and unsafe food choices for infants

before 1 year- cows milk, plant based milks, 100% fruit juices

in general- sugar sweetend beverages

when can babies have water

6-12 months- 0.5-1 cup daily

recognizing infants' hunger and satiety cues

three steps to the process

parents' understanding matures

influence of infant food preference

infants exposed to flavors in the uterus, genetic preferences, and rejection

Iron deficiency in infant risk

associated with poor cognitive, motor, and socio-emotional development

in later childhood- poor cognition and school achievement

risk factors of iron deficiency in infants

low birthweight, high cow milk intake, low intake of iron-rich complementary foods, low socioeconomic status, and immigration status

Extremely low-birthweight (ELBW), very low birthweight (VLBW), and low-birthweight (LBW) infants

<1000 g; ,1500g; ,2500g

EER factors

age, gender, height, weight, and activity level

what conditions require the same energy intake

• Cleft palate

• Phenylketonuria (PKU)

what conditions require the higher energy intake

• Preterm infants

• Infants with congenital heart disease

• Infants with bronchopulmonary dysplasia

cystic fibrosis

renal disease

ambulatory children with diplegia

AIDS

Bronchopulmonary dysplasia (BPD)

what conditions require the lower energy intake

• Down syndrome (Chromosome 21 trisomy)

• Spina bifida

Nonambulatory children with diplegia

Nonambulatory children with short stature

Prader-Willi syndrome

The American Academy of Pediatrics recommends that premature infants need how many kcal per kg

110-130 kcal per kg

preterm infants- protein needs

• Many illnesses interfere with digestion

• Partially or extensively hydrolyzed proteins may be helpful

preterm infatns- fat needs

• Adequate fat intake essential to support rapid growth and

development as well as high-energy requirements in infancy

• Low-fat diets are not recommended

• Fats may be difficult to digest; medium chain triglycerides beneficia

preterm infants- vitamin and mineral needs

• Preterm infants have increased iron needs

Enteral (special health care needs)

delivering nutrients directly to the digestive system

Parenteral (special health care needs)

delivery of nutrients directly into the bloodstream

When can you start using BMI

2 years old

Children 2 years or older- overweight and obese BMI percentiles

overweight- ≥ 85th percentile- < 95th percentile

obese ≥ 95th percentile

How to know if children less than 2 years of age are overweight based on percentile

overweight- a weight-for-length greated > 95th percentile

underweight todler percentile- all age

> 5th percentile

Toddler-sized portions average

1 tablespoon per year of age

establish regular but flexible meal and snack time

development of feeding skills in preschool-age children

can use utensils and a cup well

eating becomes less frequent

adult supervision is still imperative

Feeding behaviors of preschool-age children

Appetite is related to growth; increases prior to the "spurts"

Involve child in meal selection and preparation

when new foods rejected initially

may take 8-10 exposures to accept

what kind of foods do pre-school age children naturally prefer

sweet and slightly salty, rejects sour and bitter

Appetite, Satiety

ability to adjust caloric intake based on caloric needs

late preschool age become more responsive to external cues than their innate ability to self-regulate increasing risk of obesity

important that parents/ caretakers model healthy eating behaviors

What are DRI's based on

gender, age, height, weight, and physical activity level

Common nutritional problem in children- iron

iron-deficiency anemia- 9-18 months at highest risk

can cause long-term delays in cognitive behavioral disturbances

diagnosed by hemaocrit and/or hemoglobin value

Healthy People 2030 focus on this

Common Nutritional Problems: Dental Prevalence

23% children 2-5 have atleast 1 cavity

10% children 3-5 have untreated decac

Healthy People 2030 focus on this

cause of dental problems in children and prevention

bedtime bottle with juice or milk, streptococcus mutans, and sticky carbohydrate foods

prevention- fluoride

Common Nutritional Problems- Food Security

a concern for growing children, since food may hinder growth and development

Common Nutritonal Problems- Food Safety

children very vulnerable to foodborne illnesses

Vitmain and Mineral Supplement for kids

diet is the highly preferred method

if given the children, supplements should not exceed DRI for the age

Fat intake percentage for 1-3 year olds

30-40%

Fat intake percentage for 4-18 year olds

25-35%

iron needs for 1-8 years

1-3 year- 7 mg/day

4-8- 10 mg/ day

calcium needs for 1-8 years

1-3 years- 700 mg/day

3-8 years- 1000 mg/day

zinc needs for 1-8 years

1-3 years- 3 mg/day

3-8 years- 5 mg/day

• Questions to answer to identify increased nutrition interventions

• Is growth on track? (weight, length, head circumference)

• Is food and nutrient intake adequate?

• Are feeding or eating skills age appropriate?

• Does medical or nutritional diagnosis affect nutrition needs?

juice take recommendation by the AAP for 1-6 years

4-6 ounces per day

hopotonia or hypertonia

child may have difficulty sitting upright for meals

difficulty self-feeding with a spoon

tube feeding may be needed

Nutrition-Related Conditions: Failure to Thrive

• Weight for age <5th percentile on multiple occasions

• Weight deceleration of two major percentile lines on growth chart results from a complex interplay of factors

Middle childhood and preadolescence age

middle- 5-10 years

preadolescence- girls- 9-11, boys- 10-12

Protein intake for 9-13 year olds

0.95 g per kg

what are the trend in overweight and obesity in school-age children

it is inreasing alarmingly fast

6-8- 32.8% children

9-11- 35.6% of children

class I obesity

>95th% for age

class II obesity

> 120% of 95th percentile or BMI > 35

Class III obesity

>140% of the 95th percentile or BMI >40

predictors of obesity in children

age at onset of BMI rebound and home environment

Nutrition and prevention of cardiovascular disease in school-age children

fat intake 25-35% total calories

omega 3 fatty acids, two servings of fish

limit fruit juices, sweets, salt, sat and trans fat, and cholesterol,

when should lipid screening happen

9-11 years

vitamin D needed for school age children

600 IU/ day

how long should children engage in physical activity

60 minutes daily

national school lunch program

financial assistance provided to schools by the federal government

national school lunch program requirements

Lunches based on nutrition standards

No discrimination, must be accountable, nonprofit status

National School Lunch Program componenets

fruits and veggies daily

increase whole grains

only fat free or low fat milk

limit calories

reduced sat and trans fat and sodium

meet disabled needs

allow adequate time (20 minutes)

Children Prader-Willi syndrome need ________ energy because _______

less; lower metablosim and muscle mass

Children with ASD or increased activity levels (ADHD) have __________ energy needs

increases

what specific vitamins and minerals need to be monitored in children with chronic conditions

vitamin D and calcium

what physical characteristics do children with down syndrome have

short stature

low muscle tone weight

what physical characteristics do children with cerebral palsy and spina bifida have

altered muscle size

Conditions with variable growth patterns that do not have growth charts

• Cystic fibrosis

• Spina bifida

• Type 1 and type 2 diabetes

• Rett syndrome

what should nutrition intervention for special needs children consider

family context, quality of life, avoiding hospitalization, and ability of parents to work and take care of other family member

Fluid needs are often increased for children with special health care needs or chronic conditions because of all of the following EXCEPT:

A. Uncontrollable drooling

B. Low fluid intakes

C. Prescribed medications

D. Slow drinking pace

slow drinking pace

What does cystic fibrosis affect

all exocrine organs, lung complications, and can cause death

what does cystic fibrosis cause

nutrient malabsorption because of a lack of pancreatic enzymes

what does the weight gain look like for cystic fibrosis

slower weight and height gain and higher energy needs

treatment for cystic fibrosis

monitor growth

assess food and nutrition intake

increase protein and energy in the diet

pancreatic enzyme therapy replacement

diabetes treatment

insulin injections or pump

timing and composition of meals and snacks

ketogeic diet for seizures

high-fat, low carb diet

3-4 g of fat for ever 1 g carb and protein

prescribed by physician and carefully monitored by a dietitian

Cerebral Palsy impacts what

brain damage is not progressive

scoliosis, contractures, reflux, and constipation

spastic quadriplegia

athetosis (cerebral palsy)

uncontrolled movement which increases energy expenditure

cerebral palsy treatment

monitor growth and weight gain

feeding and eating challenges,

constipation

untreated children with ADD or ADHD struggle with

satying seated for a meal and have decreases food intake

ADHD nutrion treatment

monitor growth; may need to adjust timing of medications with meals

most common allergens

milk, soy, egg, wheat, peanuts, tree nuts, fish, and sesame

Anaphylactic reactions to peanuts account for _______ of deaths from ingesting food allergens

60%

You work in the kitchen at the elementary school. A first-grader with PKU forgets her lunch at home. She is upset and doesn't feel like she can eat any of the foods for lunch. It is ok for the staff to give her fruits and vegetables.

True or False

true

Adolescents following vegetarian diets found

to be slightly lower in weight and enter puberty later than peers

Vegan diets at risk for low intake of multiple nutrients

• Calcium; zinc; iron; long-chain fatty acids; vitamins D, B6, and B12

Physical Activity Guidelines for Americans recommendations

• 60 minutes of moderate- to vigorous activity daily

• Muscle- and bone-strengthening activities 3/weekPhysical Activity Guidelines for Americans recommendations

• 60 minutes of moderate- to vigorous activity daily

• Muscle- and bone-strengthening activities 3/week

• Nutrients of public health concern among adolescents

• Magnesium, vitamin D, choline • Females: also include protein, iron, folate, vitamins B6 and B12

adolescents typically Exceed recommendations for

total and saturated fats, cholesterol, sodium, and added sugars all risk factors for chronic disease and obesity

Adolescents' inadequate intake consist of (food groups)

fruits, vegetables, whole grains, and dairy

how do we use BMI for children

you use calculated BMI for age percentile and results

what is IHBLT?

Intensive health behavior and lifestyle treatment guidelines include a multidisciplinary team approach

diagnosis criteria for bulimia nervosa

recurrent episodes of binge eating recurrent inappropriate compensatory behavior these occur on average at least once a week for 3 months can not be this if they are underweight

diagnosis criteria for binge-eating disorder

recurrent episodes of binge eating episodes are associated with 3 different traits