E: Maternal & Peds Nutrition

Front 1

What two vitamins are important for pre-conception?
- how long whould they be given before conception?

Back 1

Folate and Choline help to prevent NTDs.
- ideally, 30 days prior to conception.
+ note that egg yolks are a great source of choline.

Front 2

During pregnancy, when are nutrient reserves particularly important? Intake?

Does EtOH move freely across the placental barrier?

Back 2

1st trimester

2nd and 3rd trimesters

yes.

Front 3

total calories per day increase by ~___ during pregnancy?

Back 3

~300kcal/day

Front 4

From the following list, name the items that should be increased >1x DRI pre-pregnancy:
- A, C, Cu, D, P, Ca, B-6, iron, B-12, folate, zinc, riboflavin, thiamin, magnesium

Back 4

C, B-6, iron, B-12, folate, zinc, thiamin, riboflavin, Mg.

Front 5

Re: bones, why can adolescent pregnancy be a risk?

Back 5

Ca is released from maternal bone stores @ a v. high rate during pregnancy (highest in 3rd trimester). This may decrease eventual bone mass achieved as part of adolescence.

Front 6

What does Breastfeeding promote via BW?

Exclusive breastfeeding is recommended for the first ___m of life.

Is breastmilk always the same composition?

Back 6

weight loss.

6m.

no, there are 3 stages:
- colostrum (1st few days, v.high in protein/Antibodies and v's)
- transitional
- mature (occurs about two wks after birth = content varies w/ each feeding.

Front 7

In general there are 3 types of formula. What are they?

Back 7

(1) Cow's milk formulas
Most infant formula is made with cow's milk altered to resemble breast milk; most babies do well on cow's milk formula

(2) Soy-based formulas
For babies intolerant or allergic to cow's milk formula or lactose; also useful if desire to exclude animal proteins from your child's diet; babies allergic to cow's milk may also be allergic to soy milk

(3) Protein hydrolysate formulas
for babies who have a family history of milk or soy allergies; easier to digest/less likely to cause allergic reactions

Front 8

AAP recommends exclusively and partially breastfed infants receive supplements of ____ shortly after birth.

necessary for formula fed babies?

Back 8

400 IU/day of vitamin D shortly after birth

no, they contain D.

Front 9

Healthy babies are born w/ iron stores to last ___m.

Back 9

6months.

Front 10

when are most infants ready for the transition to solid foods (complimentary feeding)?
- what should be avoided before age 1?

Back 10

4-6m range.
- No cow's milk, citrus or honey before age 1

Front 11

Deficiencies in the following nutrients lead to what sort of compromised fx?
- Ca
- Zn
- A
- Pyridoxine
- Iron

Back 11

- linear growth
- growth, wound healing, appetitie
- immune fx, skel development
- immune fx, growth
- growth, cog development (psychomotor skills)

Front 12

Does BMI vary w/ age in children?

Back 12

yes.
BMI changes substantially with age. After about 1 year of age, BMI-for-age begins to decline and it continues falling during the preschool years until it reaches a minimum around 4 to 6 years of age. Here you see BMI-for-age tracking on the 95th percentile.

Front 13

The rebound or increase in a child's BMI that occurs after it reaches its lowest point is referred to as what?
- if this is early (before 4-6y) what effect might that have?

do we *know* for sure that these variations in body mass index are due to adipose tiss?

Back 13

"adiposity" rebound. This is a normal pattern of growth that occurs in all children.
- increase risk of adult obesity.

no, could have something to do w/ lean mass or bone.

Front 14

>95th BMI-per-age = ?
<5?

85-95th?

Back 14

obese
underweight

overweight

Front 15

What special concerns about nutrition are present in CF?
- is lung fx linked to higher BW?
- Usually require ___% (or more) of normal caloric intake for age and gender to prevent underweight
- other dietary managements?

Back 15

Pancreatic insufficiency is common, causing maldigestion and malabsorption of fat and fat soluble vitamins

- yes, A balanced, high-calorie diet with salt, fat, and protein ensures normal growth, promotes good lung function
- 120-150%
- they, in general, can eat a bunch more of fat and protein. don't need quite as many carbs. their Na intake is unrestricted. Sugar is unrestricted.

Front 16

What foods are gluten free?

some overlooked sources of gluten?

Back 16

corn, rice, potato flour, flax, soy, amaranth, millet.

beer, soy sauce, breadking, marinades, imitation bacon/seafood, playdough, etc.

Front 17

Diet for kids w/ CKD?
- what is most affected?
- does protein restriction delay dz progression?
+ in adults?

- concerns w/ dialysis?
- hemodialysis restrictions?

Back 17

usually unrestricted because growth and WG are concerns w/ CKD.
- Na, P, K, protein, calories, fluid.
- no current evidence
+ low energy and high proten is associated w/ worsening fx in adults.

- P restriction may be needed (dairy); increase protein, frequent small meals may help.
- Na, K, Fluids, P