Nutrition Guidelines and Growth Fundamentals

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Questions and Answers

What is the main purpose of dietary fat intake in infants?

To promote brain development (correct)

To aid in the absorption of carbohydrates

To support skeletal muscle development

To provide quick energy supplies

Which statement regarding energy requirements as children age is accurate?

Energy needs per unit body weight decrease over time (correct)

Protein requirements remain static across childhood

Daily caloric needs increase with age

Fat intake requirements increase significantly after infancy

At what age is most brain growth complete for life?

By 2 years

By 12 months

By 6 years

By 4 years (correct)

What is indicated as a nutritionally acceptable alternative to breast milk?

Commercial iron-fortified infant formula Signup and view all the answers

Which food or substance is contraindicated during breastfeeding due to its potential effect on neurodevelopment?

Alcohol Signup and view all the answers

What is the recommended approach for introducing complementary foods to infants?

Introduce at 4-6 months when infants are developmentally ready Signup and view all the answers

Which condition makes breastfeeding contraindicated, but expressed breast milk is still acceptable?

Untreated tuberculosis Signup and view all the answers

What outcome is associated with inadequate nutrition in children?

Inadequate growth Signup and view all the answers

What is the primary concern when infant formula is prepared too concentrated?

Hypernatremia Signup and view all the answers

Which of the following is a micronutrient requirement for all full-term infants consuming less than 32 ounces of formula per day?

Vitamin D3 Signup and view all the answers

When is it acceptable for infants older than 6 months to drink water?

Up to 8 ounces per day Signup and view all the answers

Which food should be avoided in infants under 12 months due to the risk of botulism?

Honey Signup and view all the answers

What is the recommended approach for introducing allergenic foods to infants?

Introduce one food at a time after 4 months Signup and view all the answers

For infants with severe eczema or an egg allergy, what should be done before introducing peanuts?

Perform a peanut-specific IgE test Signup and view all the answers

What can result from diluting infant formula excessively?

Hyponatremia Signup and view all the answers

Which of the following groups should receive a multivitamin with iron daily to prevent anemia?

Preterm infants Signup and view all the answers

Study Notes

Macronutrients and Micronutrients

Macronutrients are needed in large amounts: fat, carbohydrate, protein, and water.
Micronutrients are needed in small amounts: vitamins and minerals.

Growth and Nutrition

Rapid growth occurs in infancy and adolescence.
By 12 months, body weight triples, length increases 55%, head circumference increases 33%, and brain weight triples.
Most brain growth is complete by 4 years old.
Inadequate nutrition leads to inadequate growth.

Energy Requirements

Daily calorie requirements per unit body weight decrease with age.
Daily protein, carbohydrate, and fat requirements also decrease with age.
Dietary fat is critical for infant brain development and should not be restricted.

Nutrition Guidelines

Dietary Guidelines for Americans, 2020-2025 and American Academy of Pediatrics provide guidelines.
Infants 0-12 months:
- Breast milk is usually best.
- Exclusive breastfeeding is recommended for the first 4-6 months.
- Breast milk with complementary foods is recommended from 4-6 months to 12 months.
- Solid foods and some breast milk are recommended for 12 to 24 months.
- Iron-fortified infant formula is the only acceptable alternative to breast milk.
- Homemade formulas, cow's milk, goat's milk, and plant milks are not nutritionally adequate.
- Complementary foods (infant cereals, commercial and homemade infant foods, table foods) should be introduced around 4-6 months when infants are developmentally ready.

Breast Milk Contraindications

Mothers with HIV, human T-cell lymphocytic virus types 1 or 2, or untreated brucellosis.
Infants with certain inborn errors of metabolism, e.g., galactosemia.
Mothers taking certain medications, e.g., chemotherapeutic agents.
Breast milk is still recommended if access to clean water and/or infant formula is not reliably available.

Breastfeeding Contraindications (Expressed Breast Milk Is Ok)

Active HSV lesions on the breast.
Untreated tuberculosis.
Varicella.
H1N1 influenza.
Breastfeeding and breast milk are not recommended while consuming alcohol or illicit substances.

Indications for Infant Formula

When mothers choose to provide formula.
When breast milk and breastfeeding are contraindicated.
When there is insufficient maternal breast milk supply.
Use formula for supplementation when breast milk alone doesn't meet growth demands (e.g., prematurity, congenital heart disease).
Fortify breast milk with formula to increase calories, macronutrients, and micronutrients.

Commercial Infant Formula Formats

Ready to feed: no need to add water, most expensive.
Concentrate: mix with equal parts water.
Powder: mix 1 scoop of powder to 2 ounces of water, least expensive.

Micornutrient Requirements

Vitamin D3 400 I.U. daily for all full-term infants consuming < 32 ounces of commercial infant formula per day. This helps prevent vitamin D deficiency rickets.
MVI with iron daily for all preterm infants. This helps prevent iron deficiency anemia and rickets.
Preterm means born before 37 weeks gestation.

Contraindicated Foods for Infants < 12 Months

Cow’s milk, goat’s milk, and plant milk (inappropriate nutrient composition).
Homemade infant formula (inappropriate nutrient composition).
Fruit juice (dental caries, diarrhea, less nutritious than eating whole fruit).
Unpasteurized dairy products (food-borne illness).
Undercooked meat, eggs, seafood (food-borne illness).
Honey (botulism).
Foods that are small, round, and hard (choking hazards, e.g., whole grapes).
Foods high in sodium and added sugars.
Water: Up to 8 ounces of water per day is safe for infants 6 months and older. Infants under 6 months should not be given water to drink. Their kidneys are not mature enough to process free water. This can lead to hyponatremia.

Allergenic Foods

Peanuts, tree nuts, sesame seeds, soybeans, cow milk, eggs, fish, shellfish, and wheat.
Introduce these after 4 months of age to build immune tolerance and reduce risk for food allergies.
Peanut introduction caveat:
- For infants with severe eczema or egg allergy, check a peanut-specific IgE first.
- If < 0.35 kUA/L, peanut ingestion is safe.
- If ≥ 0.35 kUA/L, hold peanut and refer to a pediatric allergist.
- For infants with mild to moderate eczema, introduce peanut after 6 months old.
Introduce one new food at a time and monitor for allergic reaction (e.g., vomiting, hives, wheezing).
Infants with signs of a food allergy should be evaluated by a pediatric allergist.

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Description

This quiz explores the essential macronutrients and micronutrients required for growth and development, particularly in infants and adolescents. It also covers energy requirements and current dietary guidelines critical for ensuring adequate nutrition at different life stages.