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701 | LFT, liver function test; OA, organic acids; TFT, thyroid function tests; TSC, tuberous sclerosis complex; UE, urea and electrolytes; VLCFA, very long chain fatty acids; WES, whole exome sequencing; WGS, whole genome sequencing; XLID, X linked intellectual disability genes. Downloaded for mohamed ahmed (dr.mms2020gmail... |
702 | 2, preselection on clinical grounds can increase yield to 7.6 Next generation gene sequencing Detects inherited and de novo point mutations, especially in nonsyndromic severe intellectual disability Whole exome sequencing gives an additional yield of about 3040 Pilot studies of whole genome sequencing (WGS) reveal addi... |
703 | Cobalamin F Deficiency (tHcy) Ethylmalonic Encephalopathy (ACP) Glutaric Acidemia type I Hunter syndrome (MPS II) AGAT deficiency GAMT deficiency Mannosidosis Pyrimidine 5nucleotidase superactivity Molybdenum Cofactor Type A deficiency I.o. Argininosuccinic Aciduria HHH syndrome I.o. OTC Deficiency Phenylketonuria PDH ... |
704 | Child Health. 2014;19(9):469471. Downloaded for mohamed ahmed (dr.mms2020gmail.com) at University of Southern California from ClinicalKey.com by Elsevier on April 20, 2024. For personal use only. No other uses without permission. Copyright 2024. Elsevier Inc. All rights reserved. 356 Part IV u Learning and Developmenta... |
705 | children (Table 56.9). These problems are often detected later in children with ID. If untreated, the associated impairments may adversely affect the individuals outcome more than the ID itself. The more severe the ID, the greater the number and severity of associated impairments. Knowing the cause of the ID can help p... |
706 | error, cataracts, strabismus) Dental caries Lead poisoning from associated pica Sleep disorders (OSA, behavioral sleep dysfunction) Obesity Emotional disorders (anxiety, mood disorders, posttraumatic stress disorder) Obsessive compulsive disorder Behavioral disorders (self injurious behavior, aggression, adjustment dis... |
707 | is inappropriate for the childs mental or developmental age, rather than the chronological age. However, if the behavior is dangerous to the individual or the external world, intervention is required regardless of whether it is appropriate for their develop mental age. When intervention is needed, an environmental chan... |
708 | functioning, identify ing effective communication strategies, preserving and enhancing physical fitness and well being, supporting positive relationship building, and ensuring opportunities for the individual to partici pate fully in the community and find purpose and enjoyment in life activities. Goals should be indiv... |
709 | CDC Early intervention information https:www.cdc.govncbdddactearlyparentsstates .html CDC developmental milestones https:www.cdc.govncbdddactearlymilestonesind ex.html Special Education and Inclusion Parent Training and Information Centers (PTIs) https:www.parentcenterhub.orgfind your center Iris Center (Inclusion) htt... |
710 | the child and family, goals must be reassessed, and programming needs should be adjusted. A periodic review should include information about the childs health status and the childs functioning at home, at school, and in other community settings. Other information, such as psychologic or educational testing, may be help... |
711 | services. All states offer developmental disabilities programs that provide home and Table 56.11 Severity of Intellectual Disability and Adult Age Functioning LEVEL SUPPORT LEVEL FUNCTIONAL AGE EQUIVALENT AS ADULT ADULT ADAPTATION Mild Intermittent 9 11 yr Reads at fourth to fifth grade level; simple multiplication and... |
712 | are generally included in play activities with children who have typical development, adolescents with ID often do not have opportunities for enriching social inter actions. Community participation among adults with ID is much lower than that of the typical population even though these indi viduals tend to have the sam... |
713 | activities, religious groups, Special Olympics, Best Buddies, local clubs) Successful transition is difficult to achieve because of policies, sys tems, and services that are not comprehensive or coordinated. In moving from child to adult care, families tend to find that services are less readily available, more fragmen... |
714 | sufficient adap tive behavior skills that they no longer fit the diagnosis as adolescents or young adults, or the effects of maturation and plasticity may result in children moving from one diagnostic category to another (from Downloaded for mohamed ahmed (dr.mms2020gmail.com) at University of Southern California from ... |
715 | impairments, such as CP, behavioral disorders, epi lepsy, or sensory impairments, that further limit their adaptive func tioning. They can perform simple tasks in supervised settings. Most people with this level of ID can live in the community with appropri ate supports, though some may require a higher level of instit... |
716 | restriction Premature birth, polyhydramnios Inguinal or abdominal hernias 1year survival 10 ASD, Atrial septal defect; PDA, patent ductus arteriosus; VSD, ventricular septal defect. From Behrman RE, Kliegman RM. Nelson Essentials of Pediatrics, 4th ed. Philadelphia: Saunders;2002: 142. Downloaded for mohamed ahmed (dr.... |
717 | and behavior becomes obvious when caring for children with complex genetic disorders. Children with developmental disabilities often cannot adequately communicate the symptoms of illness. Challeng ing behaviors can also interfere with adequate assessment and inter vention. Too often, sources of distress, developmental ... |
718 | of AD Leukemia 1020 fold Fig. 57.4 Various conditions associated with Down syndrome with its causative genes. DST, Duodenal stenosis; IA, imperforate anus; HD, Hirschsprung disease; CHD, congenital heart disease; AVSD, atrioven tricular septal defects; VSD, ventricular septal defect; AD, Alzheimer disease. (From Asim A... |
719 | 42 (of CHD) VSD 2235 ASD 816 Tetralogy of Fallot 24 Acquired mitral, tricuspid, or aortic regurgitation PDA 57 Downloaded for mohamed ahmed (dr.mms2020gmail.com) at University of Southern California from ClinicalKey.com by Elsevier on April 20, 2024. For personal use only. No other uses without permission. Copyright 20... |
720 | concern about hearing should not preclude obtaining audiologic assessment. Aggres sive treatment of otitis media and middle ear effusion reduces the fre quency of hearing loss. Dental Children with DS often have delayed tooth eruption, malformed teeth, microdontia, permanent tooth agenesis, tooth impaction, malocclusio... |
721 | physical examination. Cardiology follow up will be based on echocardiogram findings. Signs of heart failure such as failure to thrive, tachypnea, easy fatigue, or sweating with feeds require expedited referral back to cardiology. Pulmonary hypertension can also occur in children with DS related to congeni tal heart def... |
722 | do not recommend routine celiac screening, but rather to maintain a high index of suspicion with GI complaints, growth faltering, or behavioral concerns. Many others, however, have performed routine screening because many patients with DS who have celiac disease are asymptomatic; there may be a lag of 2 3 years before ... |
723 | with hygiene. Menopause tends to occur early. Individuals with DS are at increased risk for sexual abuse, and care givers should discuss appropriate and inappropriate contact and rela tionships from an early age. Sexuality education should be included in their educational curriculum. Clinicians should discuss sexuality... |
724 | pathologic variants in JAK2. Treatment trials show lower response rates, higher recurrence rate, and higher treatment related mortality. Annual hemoglobin screening for anemia is recommended through out childhood with additional testing for ferritin and C reactive protein (CRP) when iron deficiency is suspected. The in... |
725 | Some concerns are easily explained and remediated and are responsive to appropriate therapeutic or behavioral interventions, but others may indicate an underlying neurobehavioral disorder such as autism, ADHD, depression, or anxiety (Table 57.6). Thinking through the cat egories that follow will help clinicians underst... |
726 | Elsevier Inc. All rights reserved. 372 Part IV u Learning and Developmental Disorders memory indicative of a specific language impairment (SLI). The frequency of such impairments requires comprehensive language assessment for all children with DS. The language impairment may be associated with decreased ability to expr... |
727 | age peer friends occurs predominantly in the context of common educational or community activities. Building healthy sustained friendships with both TD peers and those with developmental disabilities often requires active ongo ing caregiver and community support to prevent social isolation and loneliness as children tr... |
728 | with DS (see Chapter 50). From a clinical perspective, the diagnosis of ADHD relies on reports of ADHD symptoms from two different settings (usually parent and teacher) and dysfunction caused by the ADHD symptoms in areas such as learning, social ization, and safety. Medication use in ADHD has been shown to be effectiv... |
729 | can providing some additional time for the transition. Simplifying language can help avert communication frustration. Anxiety There is an increased prevalence of anxiety disorder in children with DS compared with typical peers. Generally, anxiety disorders are diagnosed based on verbal descriptions of fear or worry and... |
730 | interaction and restricted and repetitive behaviors. The presentation of ASD can vary significantly from one individual to another, as well as over the course of development for a particular child. There is currently no diagnostic biomarker for ASD. Accurate diagnosis therefore requires careful review of the history an... |
731 | exceed limited capacities, or may be masked by learned strategies in later life). D. Symptoms cause clinically significant impairment in social, occupational, or other important areas of current functioning. E. These disturbances are not better explained by intellectual disability (intellectual developmental disorder) ... |
732 | are less likely to share emotion or enjoyment with others. Adolescents and young adults have difficulty engaging in group interactions and navi gating romantic relationships. Restrictive and Repetitive Behavior A diagnosis of ASD requires the presence of two of the four symptoms of restrictive and repetitive patterns o... |
733 | may inappropriately touch the face or hair of others. Diagnosing ASD with DSM 5 criteria can be challenging in very young children because of reduced expression of repetitive behaviors, particularly stereotyped behavior and intense interests. Studies moni toring development in high risk young children who have an older... |
734 | by name or you or she or he beyond age 3 yr. Reduced andor infrequent use of language for communication (e.g., use of single words, although able to speak in sentences). Responding to Others Absent or delayed response to name being called, despite normal hearing. Reduced or absent responsive social smiling. Reduced or ... |
735 | Animal models and studies of individuals with ASD indicate changes in brain volume and neural cell density in the limbic system, cerebellum, and frontotemporal regions. One study documented changes in early brain development, character ized as hyperexpansion of cortical surface area, at age 6 12 months on brain MRI, wh... |
736 | disorder is also distinguished from ASD by the lack of restrictive and repeti tive behaviors. Children with ID or GDD may have delays in social and communication skills as well as stereotyped behavior. However, social and communication skills are typically commensurate with their cognitive and adaptive functioning. Chi... |
737 | conversation with others fails and whose attempts to make friends are odd and typically unsuccessful. Inflexibility of behavior causes significant interference with functioning in one or more contexts. Difficulty switching between activities. Problems of organization and planning hamper independence. From the Diagnosti... |
738 | anxiety, resistance to change, stubborn belief in the correctness of own point of view, difficulty seeing anothers point of view, poor awareness of the effect of own behavior on others, or no interest in social compliance. Eating disorders 1021 Avoidantrestrictive food intake may lead to nutrient deficiencies and poor ... |
739 | as anxiety, sensory overload, or disruption of routines. Could also become a repetitive habit. Could cause tissue damage and need for restraint. Pica 36 More likely in individuals with intellectual disability. Could be a result of a lack of social conformity to cultural categories of what is deemed edible, or sensory e... |
740 | up to 70 of children with ASD. Epilepsy occurs in up to 3546 of chil dren with ASD and presents in two peaks: in early childhood and in adolescence. Children with ID, female gender, and lower gestational age are at higher risk for having seizures. Overall, between 70 and 90 of children with ASD are identified as having... |
741 | American Academy of Pediatrics recommends screening for ASD for all children at age 18 months and 24 months (see Chapter 28). Screening should also occur when there is increased risk for ASD, such as a child with an older sibling who has ASD, or whenever there is concern for possible ASD. Screening can be done by a par... |
742 | examination should include measurement of head circumference, careful evaluation for dysmorphic features, and screening for tuberous sclerosis with Wood lamp exam. Children with ASD should have genetic testing, an audiol ogy examination to rule out hearing loss, and in children with pica, a lead test (Table 58.8). Ther... |
743 | Generation Sequencing Whole exome sequencing (WES) can identify single nucleotide vari ants, including pathogenic loss of function mutations and missense mutations; studies have identified a molecular diagnosis in nearly 30 of individuals tested because of the presence of a neurodevelopmental disorder. If the initial g... |
744 | can help build vocabulary, comprehen sion, and pragmatic skills. Children with ASD benefit from visual supports for comprehension, understanding expectations, and communicating their needs. Augmentative communication approaches using photographs or picture icons can improve comprehension and ability to communicate (see... |
745 | be needed even for adolescents with strong cognitive and academic function, because they may struggle with social per ception and may be vulnerable to exploitation by others. There continue to be disparities in regard to accessing care, with racially and ethnically minoritized groups and children from low income famili... |
746 | Autism Resources for Families Autism Speaks First 100 Days kit https:www.autismspeaks.orgfamily servicestool kits100 day kit Autism Speaks Toolkitsdental, transition, guardianship https:www.autismspeaks.orgfamily servicestool kits AACAP Autism Spectrum Disorder Parents Medication Guide https:www.aacap.orgAppThemesAACAP... |
747 | social or cognitive functioning. There is evidence to support the use of stimulant medications, atomoxetine, and agonists for ADHD in ASD. Selective serotonin reuptake inhibitors (SSRIs) can be used for anxiety and OCD and in adolescents may also be useful for depression. Benzodiazepines may be useful for situational a... |
748 | limited evidence to inform families, who often learn about these treatments from friends and family members, alternative medicine providers, or the internet. For most therapies, evidence is insufficient to show benefit. There is strong evidence that secretin and facilitated communication are not effective. Some therapi... |
749 | indi vidualized for the adult with ASD and the family. OUTCOME ASD is a lifelong condition. Although a minority of individuals no longer meet criteria for the diagnosis, most will make progress but continue to have some impairment in social, behavioral, learning, language, or emotional functioning as adults. Adult outc... |
750 | 59.1). Females affected with FXS show varying degrees of intellectual disability andor learning disabilities, and they may present with symptoms of ADHD and anxiety as well. Children with FXS are at increased risk for ophthalmologic, feed ing, and orthopedic problems, as well as recurrent otitis media in early childhoo... |
751 | c9588237 6031 4f21 b273 34970f89cd2e. Updated June 14, 2021. Copyright Elsevier. All rights reserved; with data from Hersh JH et al. Health supervision for children with fragile X syndrome. Pediatrics. 2011;127(5):9941006, Table 1; and Saul RA et al. FMR1 related disorders. In: Pagon RA et al, eds. GeneReviews internet... |
752 | repeat testing is negative. Downloaded for mohamed ahmed (dr.mms2020gmail.com) at University of Southern California from ClinicalKey.com by Elsevier on April 20, 2024. For personal use only. No other uses without permission. Copyright 2024. Elsevier Inc. All rights reserved. Chapter 59 u Fragile X Syndromes 385 MANAGEM... |
753 | auditory, visual, or tactile stimuli. Tan trums, and occasionally aggression, can emerge when children with FXS are overstimulated. Sensory seeking behaviors can also be present in individuals with FXS. These may include repetitive movements, narrowed interests, rigid routines, and atypical sensory exploration. Behavio... |
754 | tend to increase with age. Individuals who exhibit ongoing aggression also typically present with more significant intellectual impairment, communication delays, and anxiety. Aggression can put a strain on caregivers or lead to injury and therefore often emerges as a primary focus of treatment. Behavior management tech... |
755 | are currently no approved treatments for the core symp toms of FXS, but many individuals will benefit from medication to address some of the commonly co occurring behavioral symptoms associated with absence of FMRP. If behavioral strategies are not sufficient to address hyperactivity or impulsivity, a young child (5 ye... |
756 | some health outcomes. Although the anteced ents are numerous and occur earlier, the major risk period for linear growth faltering or stunting (length or height for age z score 2) is between 6 and 24 months of age. Therefore it is critical to identify nutrient deficiencies promptly and to address them aggressively early... |
757 | W. Waldrop, and Nancy F. Krebs Table 60.1 Equations to Estimate Energy Requirements INFANTS AND YOUNG CHILDREN: EER (KCALDAY) TEE ED 0 3 mo EER (89 weight kg 100) 175 4 6 mo EER (89 weight kg 100) 56 7 12 mo EER (89 weight kg 100) 22 13 36 mo EER (89 weight kg 100) 20 CHILDREN AND ADOLESCENTS 3 18 YR: EER (KCALDAY) TEE... |
758 | providing adequate intake of other nutrients. It is suggested that the maximal intake of added sugars be limited to providing no more than 10 of energy. 0 6 mo 60 7 12 mo 95 Children 1 yr 130 Pregnancy 18 yr 175 19 30 yr 175 TOTAL FIBER Improves laxation, reduces risk of coronary artery (heart) disease, assists in main... |
759 | 10 Males 9 13 yr 12 14 18 yr 16 19 21 yr 17 Females 9 13 yr 10 14 18 yr 11 19 21 yr 12 Pregnancy 18 yr 13 19 21 yr 13 Lactation 18 yr 13 19 21 yr 13 Continued Downloaded for mohamed ahmed (dr.mms2020gmail.com) at University of Southern California from ClinicalKey.com by Elsevier on April 20, 2024. For personal use only... |
760 | all nine indispensable amino acids in adequate amounts and are considered complete proteins. Protein from plants, legumes, grains, nuts, seeds, and vegetables tend to be deficient in 1 of the indispensable amino acids and are called incomplete proteins. Vegan diets adequate in total protein content can be made complete... |
761 | recommended dietary allowance (RDA), and the tolerable upper limit of intake (UL) (Figs. 60.1 and 60.2). In addition, the concept of the DRI is also applicable to the esti mated energy requirement (EER) and the acceptable macronutrient distribution range (AMDR). The EAR is an estimated average of the daily nutrient int... |
762 | relative to body weight, are approxi mately twice those for adults because of the increased metabolic rate and energy requirements for weight maintenance and growth. The EER was not devised for, and does not necessarily apply to, children with acute or chronic diseases who may have altered energy requirements due to ch... |
763 | es timated average requirement (EAR), the recommended dietary allow ance (RDA), and the tolerable upper limit of intake (UL). This figure shows that the EAR is the intake at which the risk of inadequacy is esti mated to be 0.5 (50). The RDA is the intake at which the risk of inad equacy would be very small, only 0.02 0... |
764 | (found primarily in animal fat and dairy products), trans fats (found in hydrogenated margarines and oils), and cholesterol increase the low density lipoprotein (LDL) fraction of serum cholesterol, which is a risk factor for the development of atherosclerosis. Autopsy stud ies demonstrate that atherosclerosis begins ea... |
765 | fat consumed. Because of their high energy density, excessive intake of all types of fatty acids has the potential to increase the risk of obesity. Humans are incapable of synthesizing the precursor 3 ( linolenic acid ALA) and 6 (linoleic acid LA) long chain PUFAs and depend on diet for these two essential fatty acids.... |
766 | and functional roles in every cell in the body. Dietary protein intake is required to maintain and replenish the turnover of protein and to meet amino acid needs for growth. Dietary protein also provides approximately 4 kcalg as an energy substrate when intake is in excess of needs or derived from endogenous sources du... |
767 | Health and Nutrition Examination Survey (NHANES) data from 2015 to 2016, the average daily intake of protein for males and females age 2 4 years and 5 8 years is within rec ommended ranges. In children age 9 13 years, average protein intake barely meets the lower end of recommended intake for both males and females. Fo... |
768 | sources (e.g., legumes and corn) and using a variety of food sources to provide all of the required amino acids are strategies advocated for vegetarians and vegans (see Chapter 61). CARBOHYDRATES Carbohydrates are abundant in many foods, including cereals, grains, fruits, and vegetables, and provide approximately 4 kca... |
769 | fructose corn syrup, which is ubiquitous in the U.S. diet. Added fructose increases HDL and triglyceride production in the liver and serum uric acid, which increases systolic blood pressure and is associated with nonalcoholic fatty liver disease and metabolic syndrome. Excessive fructose intake, such as in the form of ... |
770 | 2006. Downloaded for mohamed ahmed (dr.mms2020gmail.com) at University of Southern California from ClinicalKey.com by Elsevier on April 20, 2024. For personal use only. No other uses without permission. Copyright 2024. Elsevier Inc. All rights reserved. Chapter 60 u Nutritional Requirements 395 degradation may also pla... |
771 | of recommended daily fiber intake in grams Age (years) 5 to 10 grams per day. The recommendations do not specify type of fiber and predate the newer definitions of fiber. A UL has not been established for fiber, which is not thought to be harmful to human health. Some types of fiber, such as fermentable oli gosaccharid... |
772 | are iron and zinc, concen trations of which are unrelated to maternal intake. In the early post natal months, infants rely on body stores and iron available from the relatively high erythron (especially with delayed cord clamping), and thus the actual dietary requirement for iron is very modest. Infants born prematurel... |
773 | with peak bone mass being achieved by the second to third decade of life. Calcium recommen dations include a change from an AI to RDA, in terms of strength of evidence for recommendations, and increased UL in 9 to 18 year olds (Table 60.6). There are no adequate biomarkers to assess calcium status in healthy children b... |
774 | plan. WATER The daily water requirement and water content as a proportion of body weight are highest in infants and decrease with age. Water intake is achieved with liquid and food intake, and losses include excretion in the urine and stool, as well as insensible and evaporative losses through the skin and respiratory ... |
775 | 3,500 Lactation (mgday) 18 yr 550 3,000 19 21 yr 550 3,500 Continued D ow nloaded for m oham ed ahm ed (dr.m m s2020 gm ail.com ) at U niversity of Southern C alifornia from C linicalK ey.com by Elsevier on A pril 20, 2024. For personal use only. N o other uses w ithout perm ission. C opyright 2024. Elsevier Inc. A ll ... |
776 | (mgday) 9 13 yr 12 20 14 18 yr 14 30 19 21 yr 14 35 Pregnancy (mgday) 18 yr 18 30 19 21 yr 18 35 Lactation (mgday) 18 yr 17 30 19 21 yr 17 35 D ow nloaded for m oham ed ahm ed (dr.m m s2020 gm ail.com ) at U niversity of Southern C alifornia from C linicalK ey.com by Elsevier on A pril 20, 2024. For personal use only. ... |
777 | products, bread and bread products, mixed foods whose main ingredient is grain, ready to eat cereals No adverse effects associated with vitamin B1 consumption from food or supplements have been reported; however, high intakes still should be taken with precaution. Persons being treated with hemodialysis or have a malab... |
778 | B6 from food have been reported; however, high intakes still should be taken with precaution. Sensory neuropathy, ataxia, and nausea have occurred from high intakes (1,000 mgday) of supplemental forms. Deficiencies often occur when other B vitamins in the body are low, particularly vitamin B12 and folic acid. Risk of d... |
779 | 21 yr 85 2,000 Lactation (mgday) 18 yr 115 1,800 19 21 yr 120 2,000 Vitamin E ( tocopherol) tocopherol includes RRR tocopherol, the only form of tocopherol that occurs naturally in foods, and the 2R stereoisomeric forms of tocopherol (RRR , RSR , RRS , and RSS tocopherol) that occur in fortified foods and supplements I... |
780 | numbers are adequate intake (AI) and bold numbers are RDA. RDAs and AIs may both be used as goals for individual intake. RDAs are set to meet the needs of 9798 of members in a group. For healthy breastfed infants, the AI is the mean intake. The AI for other life stage and gender groups is believed to cover the needs of... |
781 | for sweat losses for persons engaged in recommended levels of physical activity. Persons engaged in activity at higher levels or in humid climates resulting in excessive sweating might need more than the AI. UL applies to apparently healthy persons without hypertension; it thus may be too high for persons who already h... |
782 | sunlight. Maintains serum calcium and phosphorus concentrations Infants (gday) Fish liver oils, flesh of fatty fish, liver, eggs from hens that have been fed vitamin D, fortified milk products, fortified cereals Elevated plasma 25(OH)D concentration causing hypercalcemia Patients receiving glucocorticoid therapy might ... |
783 | development; important catalyst for 100 specific enzymes Infants Meats, shellfish, legumes, fortified cereals, whole grains Acutely, zinc supplements cause GI irritation and headache; chronic effects of zinc supplementation include impaired immune function, changes in lipoprotein and cholesterol levels, and reduced cop... |
784 | intake. The AI for other life stage and gender groups is believed to cover the needs of all members of a group, but lack of data prevents specifying with confidence the percentage covered by this intake. UL is the maximum level of daily nutrient intake that is likely to pose no risk of adverse effects. Unless otherwise... |
785 | Disease Control and Prevention (CDC) and AAP recommend the use of the WHO charts to monitor growth of all infants and children (human milkfed and infant formulafed) from birth to 2 years, and the use of the CDC 2000 growth charts for children 2 20 years (see Chapters 19 and 27). The WHO growth charts are derived from l... |
786 | weight for length are used in the WHO growth charts from birth to 2 years. Body mass index (BMI) can be calculated but is not recommended for use in children 2 years. Stature, weight, and BMI are used in the CDC 2000 growth charts from 2 to 20 years of age. These charts can be used to categorize children as underweight... |
787 | Krebs, and Susan L. Johnson factors, such as education about breastfeeding, hospital breastfeeding practices and policies, routine and timely follow up care, family and societal support, and the health of the mother (Tables 61.4 and 61.5). Breastfeeding support from both professionals and lay individuals has a positive... |
788 | 2024. For personal use only. No other uses without permission. Copyright 2024. Elsevier Inc. All rights reserved. 410 Part V u Nutrition Table 61.2 Absolute and Relative Contraindications to Breastfeeding Because of Maternal Health Conditions MATERNAL HEALTH CONDITION DEGREE OF RISK HIV and HTLV infection In the United... |
789 | Have a Protective Effect INFANT MOTHER Diarrhea Otitis media Urinary tract infection Necrotizing enterocolitis Septicemia Infant botulism Insulin dependent diabetes mellitus Celiac disease Crohn disease Lymphoma Leukemia Recurrent otitis media Atopy Hospitalizations for respiratory illness Sudden infant death syndrome ... |
790 | permission. Copyright 2024. Elsevier Inc. All rights reserved. Chapter 61 u Feeding Healthy Infants, Children, and Adolescents 411 and has been used as a treatment option for ankyloglossia with increas ing frequency despite insufficient evidence that it improves breastfeed ing outcomes, making its use somewhat controve... |
791 | failure to return to birthweight by 7 10 days in an exclusively breastfed infant should trig ger an evaluation of breastfeeding effectiveness. Direct observation of breastfeeding can help identify improper technique, and test weighs (weighing the infant before and after feeding) may help assess milk transfer. If a larg... |
792 | or other fluids) to breastfeeding newborn infants unless medically indicated using standard evidence based guidelines for the management of hyperbilirubinemia and hypoglycemia Avoid routine pacifier use in the postpartum period Begin daily oral vitamin D drops (400 IU) at hospital discharge 3. All breastfeeding infants... |
793 | in optimal conditions and can be used as prescriptive standards rather than as normative ref erence curves. Charts are available for growth monitoring. The Centers for Disease Control and Prevention (CDC) recommends use of the WHO growth charts for infants from birth to 2 years and CDC growth charts for ages 2 to 20 ye... |
794 | storage guidelines vary based on preparation. Once opened, ready to feed and concentrated liquid containers can be covered and stored in the refrigerator for no longer than 48 hours. Manufacturer guidelines recommend storing powder formula in a cool, dry place but not in the refrigerator; once opened, cans can be cover... |
795 | approved concentrations and ratios. Long term studies are lacking on the relationship between routine supplementation of formula with long chain PUFAs and physi cal, neurodevelopmental, or visual outcomes of term infants. Lactose is the major carbohydrate in breast milk and in standard cows milkbased formulas for term ... |
796 | FORMULAS Amino acid (elemental) formulas are peptide free formulas that con tain mixtures of essential and nonessential amino acids. They are designed for infants with cows milkbased protein allergy who fail to thrive on extensively hydrolyzed protein formulas. The effective ness of amino acid formulas to prevent atopi... |
797 | eating with family members to the extent possible. Continued breastfeeding up to 24 months of age and use of infant formula until 12 months is encouraged. Some complementary foods are more nutritionally beneficial than others. Iron and zinc rich foods (such as fortified infant cereals, age appropriate meats, eggs, and ... |
798 | introduced at 12 months, and formula fed children are transitioned to milk at this time. In children 12 24 months, for whom overweight or obesity is a concern or who have a family history of obesity, dyslipidemia, or cardiovascular disease, the use of reduced fat milk may be appropriate. Otherwise, whole milk is recomm... |
799 | parents are choosing to give their infants finger foods rather than, or in combination with, purees. There is little evidence that BLW leads to improved nutrient status, weight gain, or food acceptance longitudinally. In general, all food textures, including purees, are encouraged to be included in the infants diet. Pa... |
800 | of easily dissolvable solids 9 12 Cup drinking Eats lumpy, mashed food Finger feeding for easily dissolvable solids Chewing includes rotary jaw action 12 18 Self feeding; grasps spoon with whole hand Holds cup with two hands Drinking with four to five consecutive swallows Holding and tipping bottle 18 24 Swallowing wit... |
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