Prediatric Nutrition Assessment

1. Prediatric Nutrition Assessment

2. Infancy (0-12 months). • Preschool (1-5 years). • School Age (5-11years). • Adolescent (11-19 years).

3. Birth Classification Definitions: Gestation: • Preterm < 37 week gestation • Term 37-42 week gestation • Post Term > 42 week gestation

4. Birth Classification Definitions: Birth Weight: • Low birth weight < 2,000 g • Very low birth weight <1,500 g • Extremely low birth weight < 1000 g

5. Correcting Gestational Age • Calculate the number of weeks the infant was premature: { 40 weeks (term) – birth gestation } • Number of weeks early = the correction factor • Chronological age – correction factor= adjusted age for prematurity.

6. Example • 40 weeks (baseline age for full term gestation) – 28 weeks gestation = 12 weeks ( 3 months premature). • 3 months is the correction factor. • 5 months (chronological age) – 3 months corrected factor = 2 months (adjusted age).

7. APGAR Score: • Appearance, Pulse, Grimace, Activity, Respiration. • The APGAR test is done by a doctor, midwife, or nurse. • The health care provider will examine the baby's: Breathing effort, Heart rate, Muscle tone Reflexes, Skin color. • The APGAR rating is based on a total score of 1 to 10. The higher the score, the better the baby is doing after birth.

8. Assessment: • Wt/age • Ht/age • IBwt/age • IBwt/Ht • %Wt • %ABwt/Ht • HC/Age • Current age • BMI (for children of age 2-20 years)= Wt/Ht2

23. Assessment: • Acute Nutritional Status: Actual Weight 50th Percentile Weight/Height • Chronic Nutritional Status: Actual Height 50Th Percentile Height/Age 100 100

24. These Results can be used to determine the severity of Malnutrition:

25. Percentage Of Weight Change: • % Weight change= Usual body weight _ Current weight Usual Body weight • % Usual Body Weight= Actual weight Usual Weight • % Ideal Body Weight= Actual weight IBW at 50 th percentile for age 100 100 100

26. Assessment of weight change:

27. Biochemical • Albumin • Hemoglobin/Hematocrit • Cholesterol • TG • Serum glucose

28. Energy and Protein needs

29. Requirements Fluids: • 1st 10 kg  100 ml/kg • 11-20 kg  1000 + 50 ml/kg above 10 • >20 kg  1500 + 20 ml/kg above 20 Carbohydrates: • 50-65% Fat: • 30-40% Vitamins and Minerals

30. Clinical Assessment • Prenatal History • Dietary History • Formula Preparation • Solid food intake • Current medical condition • Physical

31. Failure To Thrive • Poor Weight gain and physical growth over an extended period of time in infancy. • Organic Failure to Thrive: Inadequate weight or height gain resulting from a diagnosis medical illness. • Non Organic Failure to Thrive: Inadequate weight or height gain without an identifiable biological cause, so that an environmental cause is suspected.

32. Estimating Calorie&Protien for Catch-up Growth: • Catch-up growth requirements (kcal/kg/day)= Calorie required for weight age (kcal/kg/day) Ideal weight for age (kg) Actual Weight (kg) • Protein Requirements (g/kg/day)= Protein required for weight age (g/kg/day) Ideal Weight for age (kg) Actual Weight (kg)

36. Types Of Formula • Cow’s milk-based formula. • Soy-based formula. • Protein hydrolysate formula. • Free amino acid formula. • Lactose free formula (LF). • Anti regurgitation (AR). • Hypo Allergenic (HA). • Special formula. • Follow up formula.

39. Early Feeding Problems • Formula Intolerance. • Constipation. • Gastroesophageal Reflux (GER)

42. Adolescent Requirements

43. Thank you