Nutrition and Breastfeeding MCQs

According to Cloherty & Stark, 90% neonates void urine within 24 hours and 99% do so by 48 hours. Neonates without any risk factor can pass urine anytime before 48 hours of life. Until then we need to observe and feed the child. If more than 48 hours have passed, the baby needs to be shifted to the ICU and evaluated for volume status & investigated. Reference: Cloherty and Starks manual of neonatal care, SA ed., pg. 128

Points to remember regarding breastfeeding Breastfeeding should be started as soon as possible after birth. As per WHO, UNICEF it must be started within 1 hr of birth Exclusive BF till: 6 months of age. Then start complementary feed and continue to breastfeed till 18-24 months. Reference: OP Ghai 10 th Edition, Page 142

Treatment for mild and self-limited HSP is supportive, with an emphasis on ensuring adequate hydration, nutrition, and analgesia. Corticosteroids are most often used to treat significant GI involvement or other life-threatening manifestations. Glucocorticoids such as oral prednisone (1-2 mg/kg/day), or in severe cases, intravenous (IV) methylprednisolone for 1-2 wk, followed by taper, reduce abdominal and joint pain but do not alter overall prognosis. Corticosteroids are not routinely recommended for prevention of complications such as nephritis. Corticosteroids may also be needed in any orchitis, CNS involvement and pulmonary hemorrhage Reference: Nelson 21 st Ed, Chapter 192, OP Ghai 10 th Ed, Page 661

Explanation: According to current recommendations by World Health Organization (WHO) and American Academy of Pediatrics (AAP), solid foods should be introduced to an infant while continuing breastfeeding at around 6 months of age. At 6 months, infants have typically developed the necessary oral motor skills to handle solid foods, including loss of the tongue-thrust reflex, ability to sit with support, and adequate head and neck control . Breast milk or formula remains the primary source of nutrition during the first year, with complementary foods gradually introduced to meet increasing nutritional demands, especially for iron and zinc. Breastfeeding can go up to 2 years of age or till the time the mother wants.

In human colostrum, sugar content, i.e., Lactose content is low. Types of breast milk Colostrum- Secreted in the first 72 hr of life. Small in quantity, yellow coloured, thick in consistency, contains IgA, Vit A, D, E and K. Contains good amino acids but has lower lactose content Transitional Milk- Secreted between 4 days to 14 days. Protein content falls while fat and lactose content increase Mature Milk- Secreted after 2 weeks. Has high lactose, low fat and very low protein. Watery in consistency but contains all nutrients needed for the growth and development of the child. Reference: OP Ghai 10 th Edition, Page 144

UNDERWEIGHT WEIGHT FOR AGE IS An underweight child can be wasted or stunted or both STUNTING HEIGHT FOR AGE IS It indicates chronic malnutrition. WASTING WEIGHT FOR HEIGHT IS It indicates acute malnutrition Tags : Topic : ASSESSMENT OF NUTRITION Difficulty level : MUST KNOW PYQ : INICET NOV 2023 Reference : Ghai essential pediatrics, 8 th ed., pg. 93

INDICATIONS FOR ADMISSION Poor oral intake Persistent vomiting Convulsions Stridor at rest Severe malnutrition Tags : Topic : PNEUMONIA & COMPLICATIONS Difficulty level : GOOD TO KNOW PYQ : FMGE JUNE 2022; AUG 2020; DEC 2021 Reference : Nelson textbook of pediatrics, 21 st ed., pg. 2266