Acute malnutrition (undernutrition) refers to changes in weight in relation to height. - % of IBW @ 50%Wt/Ln >90% Grade 0 (normal) 80%-89% Grade 1 (mild) 70% -79% Grade Il (moderate) <70>95% Grade 0 (normal) 90%-94% Grade I (mild) 85%-89% Grade II (moderate) <85 xss=removed>2kg = 20-30g/d 0-4 month infant growth velocity: - 23-34g/d 4 - 8 month infant growth velocity: - 10 - 16g/d Growth velocity infant 8 - 12 mo - 6-11 g/d 12- 24 month infant growth velocity - 4-9g/d Infant nutritional history, assess: - 1. Current method of feeding 2. Type of milk/formula per feed 3. Number of times per day, child is breastfed or takes bottle 4. Duration of feed and abnormal symptoms (including sweating, increased work of breathing, choking or coughing) 5. Method for preparation (i.e. ratio of formula to water and source of water) 6. Special formula including rationale for modification 7. Number of meals/snacks per day (assess meal content) 8. Assess for developmental delay, oral aversions 9. Frequency of wet diapers and stooling patterns, stool consistency and frequency 10. Feeding history to include milestones, texture, progression, and variety 11. Food allergies/intolerances 12. Vitamins minerals herbal and/or food supplements (quantity, frequency, and duration) 13. Review social, economic and environmental factors Protein Needs in the Critically III Child - 0 - 2 years 2 - 3g /kg/day 2-13 years 1.5 -2g /kg/day 13 - 18 years 1.5g /kg/day According to the American Academy of Pediatrics, energy and protein needs during adolescence should be based on ___________ rather than ____________. - Height, Weight Cerebral Palsy (age 5-12 yr) ambulatory vs non-ambulatory - 13.9 kcal/cm height ambulatory 11.1 kcal/cm height non-ambulatory Cerebral Palsy (severely restricted) - 10 kcal/cm height Athetoid Cerebral Palsy energy needs: - up to 6000 kcals/day (adolescence) Down Syndrome2 Boys (5-12 yr) Girls (5-12 yr), energy needs - Boys (5-12 yr) 16.1 kcal/cm height Girls (5-12 yr) 14.3 kcal/cm height Myelomeningocele (Spina Bifida) energy needs: - Approximately 50% of recommended daily allowances for age after infancy May need as little as 7 kcal/cm height Prader-Willi Syndrome energy needs: - 10-11 kcal/cm height for maintenance 8-9 kcal/cm height for weight loss individual diets may be as low as 800 - 1000 calories, under medical supervision. Vitmain D conversion from mcg to IUs: - /0.025 Vitmain D conversion from IUs to mcg: - x 0.025 Vitamin D requirements for infants 0-12months - 10mcg (400IUs) Vitamin D requirements for 1 year and up to 70y: - 600 IUs Calcium requirements for 0-12mo - 260 mg Calcium requirements 1-3years - 700mg Calcium requirements 4-8 years - 1000mgs Calcium requirements 9-30yrs - 1300mgs Iron requirements 7-12months - 11mg Iron requirements 1-3 yrs - 7 mgs Iron requirements 4-8 yrs - 10mg