Study sets, textbooks, questions
Upgrade to remove ads
Terms in this set (195)
Born at or before 37 weeks gestation
Problems will occur if a baby is born....
Earlier than 34 weeks
Problems that can occur in premature babies
Organ function limited, immature physiological systems, nutrient stores limited, motor, developmental and cognitive problems can occur---most catch up though
Real problem is a combination of....
Premature and SGA
Plotting Growth Charts in Premature Infants..
IHDP- Infant Health and Development Program growth charts are used (once discharged from the hospital they are plotted on a regular chart
Feeding Difficulties for Premies
Motor skills needed to feed are not developed until ~34 weeks gestation, non nutritive suck, inadequate hunger and safety signals, fatigue quickly, low tolerance to volume, disorganized feeding, some won't have rooting reflex
3 Differences between pre-term and full-term
centeral nervous system does not signal hunger, unstable eating position, oral hypersensitivity
Signs of feeding problems less than 6 months old
Weak suck, constant hunger, sleepy during feedings, swallowing problems
Feeding problems over 6 months old
Poor spoon feeding techniques, poor acceptance of solids, little mouth exploration, no satiety cues given
Tips to feeding the premature infant
Breat feeding of possible, pre=term milk is ideal, somethings breastfeeding is not possible or advisable though, high caloric needs
Feeding sessions for pre-term babies
Breast or bottle, preterm formula available (22-24 kcal/oz), may need eternal, parenternal or gavage feedings, may need microlipid and/or polycose
By 37 weeks a preterm baby can usually....
Decreased growth velocity and appetite and increased socialization and independence
Age of Toddlers
Age of Preschoolers
Latent growth period is in the..
School age children (girls ages 6-10 and boys ages 6-12)
Neurodevelopment in Childhood
Walking, talking, etc.
Cognitive developmont in childhood
Asking questions, can understand but not always talk
Asking parents before taking
Age age 1....
Start to loose baby fat-- jaw widens, start to look older
Sit next to eachother and place but do not share toys
Should walk by...
Should know about _____ words by age 2 and full sentences by age ____
Orbit around parents, no boundaries, learning customs of family, exploring environment, fears, temper tantrums......
Toddlers (age 1-3)
At 12-15 Months
At 15 Months
Crawling up stairs
At 18 Months
At 24 Months
Up and down stairs one food at a time
At 30 Months
Up and down stairs alternating feet
At 36 Months
Can ride a tricycle
Increased autonomy, expand socially, language skills increased, magical thinking, learning to limit behavior themselves
Preschoolers (3-5 years old)
Move out into the world, growth slow and steady, body comp remains constant, emerging body image, food attitudes influenced by outside world, more reasonable, better with focusing
School Age Children (boys 6-12 and girls 6-10)
Can start to over eat by age....
Sex differences in young years
Males are taller and heavier than females from age 6, by age 9 height is the same but females weigh slightly more than males
Girls gain weight by....
Age 9 due to hormonal changes
Smaller at birth (growht rapidly during first two years of life)
Tend to be smaller
Tend to be shorter and heavier
Body composition of school aged children
Have by age 2-3--Become leaner, longer arms and legs, brain growth is 75% complete by age 3 and adult, fat constant by LBM increases
Fluid during body composition
Extracellular fluid decreases and intracellular increases----less vulnerable to dehydration
Bone Growth Increases
Growth plate closes when done growing
Growth charts used..
For ages 2-20 (BMI included at age 2)
Progressive regular growth pattern, genetically controlled, influenced by nutrition and health (look at size of parents)
Starting to gain weight for some reason-- look for emotional problem (nutritional if been happening all life)
Organic cause? Short time malnutrition
Anthropometrics- Height, weight, BMI, TSF
Biochemical- Hematocryte, urinalysis, lead screening
Clinical- Look for symptoms and malnutrition signs
In nutritional assessment look at....
Hair, nails, medical record, etc. (children usually seen once a year by pediatrition
Factors that influence food intake in children...
Parents and family, parent child interactions, mealtime environment, physical comfort and safety, food and menu, non-nutritive use of foods
Reluctance to accept new foods
This is when a trait is influenced by multiple factors, like genotypes and the environment
Milk intake in children
Intake goes down (average 2-3 oz)-- if milk intake is low you need to encourage other sources of calcium
No skim/lowfat milk until..
Age 2-- serve whole milk (1-2% can be served after age 2)
Average intake of meat and eggs...
1-3oz a day (children prefer ground meat)
Well acccepted group...
Breads, cereals and pasta-- children like rice potato pasta and cereal
Way to increase protein intake
Add cheese and meat to pasta
Ways to increase milk intake
Add milk to pancakes, cereal and waffles
Butters, oils and fats
Add flavor and consistancy to food-- children need some fat (reccommended to have 1-2 T/day)
Goals for development of food patterns
Children should be allowed to eat in a matter-of-fact way, manage the feeding process independently and be willing to try new foods
Common problems with childhood feeding
Fatique, lack of exercise, swallowing difficulties, vegetable wards, fondness for sweets, dislike of meat, excessive consumption of milk/juice
Energy needs for children
Very diverse- calories depend on BMR +growth +activity-- physical activity can vary energy needs by as much as two times
Best indicator of adequate caloric intake is...
To use growth charts
Estimated Energy Requirement for 13-36mo=
(89 x Wt in kg -100) + 20 --- age 3 and up based on PAL
Physical activity level
Assume mixture of animal and vegetable proteins
Protein needs for age 1-3
Protein needs for age 4-8
Protein needs for ages 9-13
At least 130 grams/day-- more complex, less simple sugars
Intake of less than 20% daily kcals not recommended
Fiber needs for 1-3 years
Fiber needs for ages 4-8
Fiber needs for ages 9-13
Do not over use...
Fiber-- too much will give them diarreah and they will loose nutrients
Nutrient needs for vitamin D
Sunlight and dairy products
Nutrient needs for Fluoride
0.5 mg/kg body weight
Nutrient needs for fluids
Cold water is best
Nutrients for concer...
Iron, calcium, zinc
Based on growht....vitamin D is important also
Calcium needs for ages 1-3
Calcium needs for ages 4-8
Calcium needs for ages 9-13
Peak age for iron deficiency
Children prefer non-heme sources like vegetables and cereals--cows milk does not have a lot-- Include some vitamin C for absoprtion.
Don't like meat much until
they are 18 Months old
Learn to self feed from age
Most master self-feeding by
At 15 months...
They will still have difficulty with spoon
Well defined ulnar deviation by
16-17 months old
Inner and larger bone of the forearm on the side opposite the thumb-- control will result in coordinated movement beween wrist and hand
Handedness is not developed until..
Age 1 (refined pincer during first year--finger foods)
Wean of bottle...
9-10 months old
Manage well by 15 months and have mastered by 18-24 months
Start erupting about 6 months
Teeth at one year=
Teeth at two 1/2 years=
All 20 teeth
Teeth at 5-6 years
Will loose first teeth
Slow by age one, prefer five meals a day, don't like large portions, evening meal the worst, appetites erratic
Serve dry foods with
Serve milk flavors with
1 soft, 1 cripst, 1 chewyy at each meal
Children love green, orange, yello and pink
Bizarre rituals are common
Color plate, things mixed, foods can't be touching, want things cut certain ways
Common in children
when a child will only eat one food item meal after meal
Difficult during times of rapid growth, strict vegetarian diets may pose risks, must be carefully planned
Nutrients of concern if vegetarian child
Calcium, iron, protein, zinc, vitamin b6, b12, riboflavin
Dental caries are also known as
Loosing fluoride if...
Only drinking from bottled water
Any substance that produced tooth decay
Initiation of dental caries involvecs the interaction between....
The susceptible tooth, cariogenic bacteria, sustrate
Sugar-- lactose can do with if they are brining their bottle to bed
Process of cavity formation
Plaque is on teeth, CHO metabolized by bacteria, fermentation produced organic acids which lowers pH, invades enamel and then causes tooth decay
Tooth decays can occur at
Very protective...acts as a bugger and promotes the exchange of phosphorus and calcium in teeth (very positive)
When pH falls...
To 5.7 or below bacteria can invade the teeth
Problem with not brushing your teeth before bed...
When sleeping you don't produce as much saliva---if you eat sweets without brushing or leave bottle overnight theres not as much of a protectice barrier there
Most important factors with tooth decay
Frequency and adhesiveness (stickiness)
Example of frequency
Things that stick to the teeth are the worst
Protein and fats buffer sugar-- have milk with cake or water with raisens
Treatment for tooth decay
Calcium and vitamin D in diet, plaque control, good dental hygiene, nutrition education for parents and kids, prevention, fluoride
First visit to....
Dentist at 2 years old
toxic condition produced by the absorption of excessive lead into the system (lead poisoning)
Primary environment health threat to infants and children-- 2.2% under five have high levels of lead
High levels of lead=
>10 ug/dl -- symptoms are vague until blood levels are very high
Lead paint was banned...
In 1978-- because of this cases have decreased but it is still very common in NE due to old houses
Reases for decreasing lead poison cases..
Screened aggressively, awareness, banning--- but it is more common with low income/poverty families
Example of place where a child can ingest lead
Old toy from garage sale or a dog with dust particles playing with child
Children eating wall paint, furniture, old toys, pottery
Exposures to lead through..
Pica, water from lead pipes, used to be used in imported canned foods---- greatest risk from dust particles in old houses that become air borne
Exposure to lead can lead to..
Lower IQ, impaired learning, impaired visual and motor sills, behavioral changes, learning disabilities, damage to CNS, kidney and blood
Diagnosing lead poisoning...
Can sometimes be falsely diagnosed as ADD or ADHA---- calcium & iron are very important.
Children most vulnerable to lead poisoning..
Poor diets make children more vulnerable, low iron diets exacerbate the problem allowing lead to be absorbed more readily, younger children are at the greatest risk---bran, CNS and kidnets are very susceptible
Children absorb lead...
More easily than adults (50% vs. 10%)
Lead poisoning screening- AAP (2005)- screen 9-12 months and repeat at 24 months
Lead poisoning screening at local and state level (WIC also does screening)
Agents given orally-- sometimes used for treatment of lead poisoning-- they bind to lead and remove through the stool
Lead poisoning can lead to permanent damage of...
RBC, nerves and kidneys
Things that people blieve result in behavioral changes in children
Sugar and carbs, additives, artificial flavors and colorings, aspartame and saccharine
Attention Deficit Hyperactivity Disorder-- inattention, excessive motor activity, hyperactivity
Onset of ADHD
Before age 7-- affects 3-7% of school-aged chidlren (diet is not related to this)
Treatment for ADHD
Medications, behavioral intervention strategies, parent training, ADHD and school
Medications for ADHD
Psychostimulants-- Ritalin/Adderell, or Non-Stimulants
Frequent side effects of psychostimulants
Anorexia - lack of appetite (take medication with meals and monitor growth carefully and often)
Side effects with Non-stimulants
Less side effects- weight loss may be a problem
Hypersensitive response to food-- symptoms are milk to anaphylaxis-- milk protein is more common allergen to kids, 2-8%
Severe allergic reaction that develops quickly
Reaction due to extreme sensitivity to certain foods, chemicals, or other normally harmless substances
A negative reaction to a food or part of food caused by a metabolic problem, such as the inability to digest parts of certain foods or food components
Allergic responses to food..
Seen at all ages but most common in children (2-8% have them) -- most children outgrow them with age--excepet for peanuts
Symtoms for allergies
GI-- within 2 hours, systemic within 2-24 hours
Swelling of nerves
Skin hives, rash
Serious Otitis Media
Coughing, cold, lungs
Other clinical manifestations of food allergies..
Itching, diarrhea, GI bleeding, coughing, wheezing, etc.
Diagnosis for skin allergies
Complete history taken, skin prick test, RAST blood test and food challenge
Radioallergosorbent Test- blood test used to diagnose allergies
Localized area of edema (skin test for allergies)
Area of reness (skin test for allergies)
Gold Standard for Diagnosis
Double-blind, placebo controlled food challenge-- if positive food is elimated for 6-12 weeks (re-challenge with same food)
Treatment of allergies
Avoid offending food -- there are 8 foods responsible for 90% of food allergies
90% of all food allergies come from...
8 specific foods
National Institute of Allergy and Infectious Diseases
Summary of NIAID
Do not restrict maternal diet during pregnancy and lactation, infants should be exclusively breast fed until 4-6 months of age, soy infant formulas should not be used as a strategy for preventing allergies
More summary of NIAID
Hydolyzed formulas can be used for infants at risk for food allergies who are not exclusively breast fed, introdcution of solids should not be delayed beyong 4-6 months, potentially allergenic foods can be introduced at 4-6 months as well
Iron Deficiency Anemia
Most common nurition deficiency in children-- highest incidence is infants 9-18 months (hemoglobin and hematocrit used in screening
Iron-containing protein in red blood cells that carries oxygen for delivery to cells
A measurement of the percentage of packed red blood cells in a given volume of blood
Iron level that represents total amount of iron stored in the body (stored iron status)
Iron Carrier (measurement of total iron-binding capacity)
Low RBC (very pale)
With IDA RBC's are....
Microcytic and hypochromic (very immature and cannot carry iron)
High risk for IDA
High milk intake, low iron diet, low income, chronic disease, lead poisoning, prematurity
Screening for IDA
Between 9-12 months and annually from 2-5 years
IDA can cause..
Cognitive, behavioral and developmental problems (kids diagnosed are easy to treat and do great!)
Less oxygen to the brain or reduced neurotransmitter receptors
Diagnosis usually made for age 1-2 years if....
Hemoglobin is <11.0 g/dL and hematocrit is <32.9%
Diagnosis usually made for age 2-5 years is...
Hemoglobin is <11.1 g/dL and hematocrit is <33%
Diagnosis usually made for ages 5-8 years is...
Hemoglobin is <11.5 g/dL and hematocrit is <34.9%
Diagnosis usually made for ages 8-12 years if...
Hemoglobin is <11.9 g/dL and hematocrit is <35.4%
Infants and toddlers with IDA (ages 0-24 months)
Unhappy, tense, fearful, less responsive to surroundings, withdrawn and apathetic, perform poorly on developmental tests, iron helps replention
IDA in preschool and school-aged children
Perform poorly on cognitive tests, have poor school performance, often seen as behavioral problem, iron replention helps (sometimes though to have ADHD should check hematocrytes first)
Supplementation for IDA
Theraputic dose = 3mg/kg/d for 4 months, re-check blood work at this time, maintenance dose 10 mg/day, continue to recheck blood values, encourage high iron intake, dont forget to take vitamin C!
Prevention for IDA
Breast milk or iron fortified formula for one year, iron fortified ceral (vit.C) at 4-6 months, avoid excessive milk intake from 1-5 years (>24 oz/day), offer high iraon foods-- both heme and nonheme
Sets with similar terms
NSCI 3223 exam 2 (chapters 10 and 11)
Ch. 12 Nutrition During Infancy, Childhood, and Ad…
NUTR Through Life Cycle - CH 10 & Review
Nutrition Ch. 15
Other sets by this creator
Research Methods Week 4
Research Methods Week 3
Research Methods Week 2
Research Methods Week 1
Recommended textbook solutions
Pharmacology and the Nursing Process
Julie S Snyder, Linda Lilley, Shelly Collins
Medical Assisting: Administrative and Clinical Procedures
Kathryn A Booth, Leesa Whicker, Terri D Wyman
Total Fitness and Wellness
Scott Powers, Stephen L. Dodd
William's Basic Nutrition and Diet Therapy