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Chapter-03 Nutrition

BOOK TITLE: IAP Management Algorithms for Common Pediatric Illnesses

Author
1. Elizabeth KE
2. Bindusha S
ISBN
9789352501977
DOI
10.5005/jp/books/12810_4
Edition
1/e
Publishing Year
2016
Pages
14
Author Affiliations
1. Government Medical College and SAT Hospital, Thiruvananthapuram, Kerala, India, SAT Hospital, Govt. Medical College, Thiruvananthapuram, Kerala, India, SAT Hospital, Govt. Medical College, Thiruvananthapuram, India, SAT Hospital, Govt. Medical College, Thiruvananthapuram, India., Government Medical College and SAT Hospital, Thiruvanthapuram, India, SAT Hospital, Government Medical College Thiruvananthapuram, Kerala, India; IAP TVM Branch 2012, Sree Avittom Thirunal Hospital, Government Medical College, Thiruvananthapuram, Kerala, Medical College and SAT Hospital, Trivandrum, Kerala, India, Trivandrum Medical College, Thiruvananthapuram, Kerala, India, SAT Hospital, Government Medical College, Thiruvananthapuram, Kerala, India, Sree Mookambika Institute of Medical Sciences, Kanyakumari, Tamil Nadu, India, Sree Mookambika Institute of Medical Sciences, Kulasekharam, Tamil Nadu, India
2. Government Medical College, Thiruvananthapuram, Kerala, India, Sree Avittom Thirunal Hospital, Government Medical College, Thiruvananthapuram, Kerala, SAT Hospital, Government Medical College, Thiruvananthapuram, Kerala, India, Government Medical College Thiruvananthapuram, Kerala, India
Chapter keywords
Severe acute malnutrition, Iron deficiency, overweight range, micronutrient deficiency, aversive reactions, socioeconomic status, nasogastric feeding, osmolarity, Food refusal, picky eating, selective eating

Abstract

This chapter provides an overview of some of the factors regarding the nutrition of the newborn. Severe acute malnutrition (SAM) is diagnosed in infants and children when there is very low weight for height/length or the midupper arm circumference (MUAC)<115 mm due to visible wasting or when there is presence of nutritional bipedal edema. Early initiation of appropriate feeding is an important step in the management of SAM. Oral/nasogastric (NG) feeding using small, frequent, low osmolarity, low lactose feeds should be started. Babies less than 6 months of age should be treated with 130 mL/kg/day of F-100 diluted, in order to supply more fluid and protein. Only single dose folic acid is given for babies below 6 months. Vitamin A is given beyond 2 months only. Patient is discharged when the child does not have edema for at least 10 days and child has gained 15% of weight on admission/weight on the day free of edema and does not have any medical complications. Iron deficiency is the most common micronutrient deficiency in the world and affects all ages and all socioeconomic status. Oral iron in the form of ferrous salt is the most bioavailable form. Dose is 3–6 mg/kg/day. Obesity is a global public health problem. Prevalence of childhood obesity has increased many folds over the last decades. Adults with BMI greater than or equal to 30 are considered to have obesity and those with BMI 25–30 are in the overweight range. Children above 2 years with a BMI of greater than or equal to 95th centile are obese, where as those with BMI between 85th and 95th centile are overweight. Aversive reactions to some foods based on taste, texture, temperature or smell for at least a month is known as picky eating or selective eating. Food refusal is a rule in toddlers. But, children will eat when hungry. There is nothing to worry if the child is healthy and growing normally. Most children who are selective eaters require a daily multivitamin with focus on iron, calcium and vitamin D.

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