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newborn birthweight ____ by 5 months and __ by 1yr
doubles, triples
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average newborn length
50cm=50%ile
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how does length increase after birth?
- increases by 50% by age 1
- doubles by age 4
- triples by age 13
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nml head circumference and growth
35cm
- 1 cm per motn (0-6 months)
- 1/2 cm per month for (6-12 months
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degrees of MR by iq:
-mild
-mod
-severe
-profound
- -mild: 50-69
- -moderate: 35-49
- -severe: -20-34
- -profound: below 20
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At what ages should the folowing deficiencies prompt worry:
1. Lack of visual attention
2. Lack of tracking
3. Lack of steady head control
4. Failure to turn to sound
5. Inability to sit
6. Lack of babling
7. Inability to walk independently
8. Failure to use single words
9. Failure to speak in 3-word sentences
10. Unintelligible speech
- 1. Lack of visual attention: 2 ms
- 2. Lack of tracking 4ms
- 3. Lack of steady head control 4 ms
- 4. Failure to turn to sound 6 ms
- 5. Inability to sit 9 ms
- 6. Lack of babbling 9ms
- 7. Inability to walk independently 18ms
- 8. Failure to use single words 24ms
- 9. Failure to speak in 3-word sentences 36ms
- 10. Unintelligible speech >36 ms
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Dx of autisim
- 1. social skills
- 2. langauge
- 3. compuslive behaviors
- 4. <36 months
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Rett syndrome dvlpmt is normal until
1 yr
-
when can a child
1. hold a rattle?
2. track across midline
3. draw 4 body parts
4. walk up stairs alternating feet
5. be perfectly intelligible to a stranger?
6. walk backwards
7. sit up
8. walk with one hand held
9. identify one part of their bodies
10. say mama and dada
- 1. hold a rattle? 4 mos
- 2. track across midline 2 mos
- 3. draw 4 body parts 4 yrs
- 4. walk up stairs alternating feet 3yrs
- 5. be perfectly intelligible to a stranger? 4 yrs
- 6. walk backwards 5 yr
- 7. sit up 6 mos
- 8. walk with one hand held 1 yr old
- 9. identify one part of their bodies 18 months
- 10. say mama and dada 1 yr
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Deficiency and toxicity of
1. vit A (retinol)
2. Vit B1 (thiamine)
3. B2 (riboflavin)
4. B3 (niacin)
5. B6 (pyridoxine)
6. B9 (folate)
7. B12 (cyanocobalamin)
8. Vit C (ascorbic acid)
9. Vit E
- 1.Def: blindness; Tox: pseudotumor cerebri
- 2. Def: Beriberi (confusion, paralysis, tachycardia, cardiomegaly), tox: n/a
- 3. Def: anemia, angular stomatitis, seb derm (esp preemies on phototherapy because it depletes riboflavin)
4. Def: Pellegra: dermatitis, diarrha, dementia. Tox: vasodilation
5. Tox: neuropathy
- 6. Def: macroglossia, anemia. Tox: irritability
- 7. anemia
- 8. Def: bleeding gums, scurvy, poor wound healing
- 9. Def: hemolytic anemia in premies, neuro deficits in older children
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toddler is yellow, but anicteric
too much b-carotene (carrots)
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vit D toxicity
hper ca, hyper pho, n/v/ wkness, renal failure
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why does liver failure cause rickets?
decrease bile salts in gut and decreased absorption of vit D
-
zin def
copper def
acrodermatitis enteropathica
mekes kiny hair syndrome
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caloric requirements for
20kg child
- -100 cal/kg (for 1st 10kg)
- -50 cal/kg (next 10kg)
- -20 cal/kg (any more kgs)
1500 cal for first 20kg, then 20ca/kg for each additional
-
term and preterm infants require how mnay calories
120 kcal/kg/day
-
protein requirements for
-preterm
-full term
- -preterm 3.5 g/kg/d
- -term 2.5
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recommended concentration of iron in iron-fortified formula
12 mg/L
-
who needs iron supplementation?
- -high risk babies (LBW, preterm) even if breast fed
- -all babies after 6 months
-
FPIES
- food protein-induced enterocolitis syndrome (non igE mediated milk protein intolerance)
- -first 3 months
- -heme+
- -can affect breast fed if mom drinks lots of milk
- -switch to hydrolysate formula
-
What deficiency?
-scaly dermatitis with alopecia and thrombocytopenia
-fatty acid. rx iv lipids, focus on linoleic acid
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why can premies have fat -soluble vit deficiences?
lack of bile acids.
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when does the app suggest exclusive breast feeding?
exclusive until 6 months, and continue until 1 yr
-
how does freezing breast milk work?
can freeze, but use after 48h thawing and don't microwave
-
do bottles need to be sterilized?
not anymore
-
what are the differences nutritionally between colustrum and mature breast milk?
- -Arachidonic acid and DHA decreases in mture milk
- -Zinc
- -Ergo-cholecalciferol (low levels in colustrum)
-
which is higher in whey breast or cow's milk. why does that matter?
breast. easier to digest
-
caloric content of breast milk/standard formula
20kcal/oz=.67kcal/cc
-
full term neuborn will gain how many grams per day
20-30
-
-
s/sz of kwashiorkor
- -pitting edemia
- -frai reddish hair
- -deaquamating rash
- -belly
-
-ssx of rickets
- -frontal bossing
- -bad tooth enamel
- -widening physes
- -bowing of long bones
- -pigeon chest
- -rachitic rosary (enlargement of costochondral joints)
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