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13. October 24.pdf

57 Pages

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NUTR 2050
Simone Holligan

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Infancy NUTR*2050 Fall 2013– Lecture 14 Infancy •Assessing growth • Common nutrition problems • Preterm infants Rules of Thumb for Healthy Grow !th •______ : birth weight by 4- 6 months •______ : birth weight by 1 year Assessing Growth and Development Physical Growth Assessment •Growth reflects: •_____________ adequacy •Health status •___________ & environmental adequacy •Calibrated scales & recumbent length measurement board required for accurate measures Physical Growth Assessment Interpreting Growth in Children •standard __________ that apply for all   children - i.e., BMI > 30 = overweight •Infant/child height and weight must be interpreted in the context of ____ and __________ Interpreting Growth in Children •We use percentile rankings to interpret height and weight of children th for their age and gender percentile  for  weight”   •Rank the individual child as compared to a ____________ population Who is the reference population? •The reference population is based on nationally representative samples of US children. •Data from 1963-1994; _______________, ____________ sample of children. •Both breastfed and formula fed infants. Percentile What does it mean if a child is at the th 25 percentile for weight for age? Percentile Whathdoes it mean if a child is at the 25 percentile for weight for age? •This child weighs the _____________ than 25% of the reference population. • OR this child weighs less than ____ of the reference population. How determine percentile? •Use charts developed by World Health Organization for Canada •Separate for ______ and ______ •Similar to charts from the Center for Disease Control (CDC) WHO Growth Chart for Canada (Girls) How  to  use  the  chart…. CDC Growth Chart (Girls) CDC Growth Chart (Boys) OK135S053 Plotting height & weight on a growth chart • Infant girl weighs 12 lbs at 3 months of age. Plot her weight and indicate the percentile she falls in. • Infant girl weighs 31 lbs at 30 months of age. Plot her weight and indicate the percentile she falls in. CDC Growth Chart (Girls) Interpretation of Growth Data • Measures over time identify change in _______ _______ and whether there is a need for an intervention • Warning signs: • ________ of Weight or Length gain • Plateau in Weight or Length for > 1 month • Drop in Weight without regain in a few weeks • Fast gain in Weight Patterns of Growth Food Allergies, Food Intolerances, Colic What percentage of children less than 4 years of age have a food allergy? a. Less than 10% b. 10-30% c. 30-40% d. Over 50% Food Allergies •About ___% of children < 4 yrs have allergies •Absorption of intact proteins causes allergic reactions – response induced by IgE •Common symptoms are __________ and/or skin rashes •Treatment may consist of baby formula that contains hydrolyzed proteins The  problem  with  ‘allergies’ ... • Diagnosis is challenging- • Family history, diagnostic test, food challenge • Families seeking testing is increasing- • Increased # of false positives • _________________ is common • Families  determining  ‘allergic’  without testing • Self-inflicted removal of intolerant or potentially allergic foods • _____________ food intake Current Recommendations At what age able to have egg whites? •_________ At what age able to have peanut butter? •9 months, unless have ________ of food allergy •If history of food allergy, wait until after 1 year Current Recommendations At what age able to have honey? •_________ (This is due to concerns about botulism not al)ergies Some new thoughts on allergies •Food avoidance/postponement may lead to ____________________ •Rethinking when commonly allergic foods are introduced to infants/toddlers •Oral Tolerance Induction [experimental] • Idea of slow ____________ especially for milk, soy, egg, wheat • Overcome risk of allergy by consuming tiny but increasing portions of the food • Train (immature) immune system Recommendations from EatRightOntario Lactose Intolerance •________ to digest the disaccharide lactose •Characterized by cramps, nausea and pain and alternating diarrhea and constipation •Treated with soybean-based or lactose-free cow’s  milk  formulas •Many  infants  “outgrow”  lactose  intolerance • GI tract _______ and produces necessary enzymes Colic • Colic - the sudden onset of irritability, fussiness or crying • Typically disappears by ____________ or 4 • Cause is unknown • No evidence that change in maternal or child _______ is effective • Recommendations for treatment: swaddling, rocking, white noise Preterm and low birth weight infants Key goals: •To reduce mortality and severe __________ among these infants while helping in their growth and neurodevelopment. (WHO, 2013) Some  key  terms… •Very preterm birth: a gestational age less than 32 com
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