Paediatrics Nutrition

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PAEDIATRICS - NUTRITION

NUTRITIONAL VULNERABILITY OF INFANTS

Reasons for Vulnerability

* Low Nutritional Stores: * Newborn infants (particularly preterm) have poor stores of fat and protein * The smaller the child, the less the calories reserve and shorter period of withstanding starvation

* High Nutritional Demands for Growth: * Nourishment required is greatest in infancy due to rapid growth * At 4 months, 30% of infant’s energy intake used for growth * By 1 year, this falls to 5% and then by 3 years 2% * Risk of growth failure from restricted energy intake greater in first 6 months of life

* Rapid Neuronal Development: * Brain grows rapidly during last trimester of pregnancy and first 2 years of life * At birth, brain accounts for 2/3 of basal metabolic rate * Process appears sensitive to undernutrition * Even modest energy deprivation increases risk of poor neurodevelopment outcome

* Acute Illness or Surgery: * Catecholamine secretion increases after brief anabolic phase causing increased requirements due to increased metabolic rate * Nitrogen losses from urine / burns / severe sepsis * Only be corrected after several weeks due to replacement of previously lost tissue * Catch-up growth only if energy intake is as high as 150-200 kcal/kg/ day

Long-term Outcome of Early Nutritional Deficiency

* Linear Growth of Populations: * Mean height reflects nutritional status as seen in developed countries * Height adversely affected by lower socioeconomic status and increasing number of children in families

* Disease in Adult Life: * Undernutrition in utero resulting in IUGR: * Associated with increased incidence of: Coronary heart disease / Stroke / Type 2 Diabetes Mellitus /…...

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