Introduction To Breast Feeding

 Nutrition  No Responses »
Nov 252012
 

Appropriate nutrition is of paramount importance for desired growth in children. For many well debated and scientifically proven reasons human breast milk remains the best option for neonates.

Why Breast Feed?

There are many advantages to breast feeding, in addition to being ready, available, low cost and at ready to feed temperature. It is nutritionally well balanced and is a complete diet for first 6 months of life.

Benefits To Babies

Human breast milk meets the nutritional need of the babies perfectly. It is

  • A complete food
  • Easily digested
  • Has enough water
  • It promotes bonding with the mother
  • Always available, 24 hours a day at the right temperature.
  • Protects against diseases.
  • It is hygienic and has immune factors as well as prevents from allergies.

Benefits of Colostrum

  • Contains all nutrients that a new born needs
  • Provides enough fluid
  • Immunizes the baby
  • Contains a mild laxative to clear meconium
  • Prevents jaundice

Advantages Of The Composition Of Breast Milk

1. Low protein:

  • Less stress on kidneys and less allergic.
  • It reduces the chances of developing allergic conditions like atopic dermatitis and asthma , even in children with family history of allergies.

2. High Lactulose:

  • It is a good energy source for the developing brain.

3. Fat composition:

  • Easily digested
  • Hind milk has more fat

4. High water content:

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Failure to Thrive – Differential Diagnosis

 Nutrition  No Responses »
Aug 142012
 

A child may present with failure to thrive and not gaining appropriate weight for his age. There are a number of different factors responsible for it and a doctor should consider the following differentials in his mind.

Inadequate Intake

May result from a swallowing problem, formula mixing error, lack of access to formula or other foods due to limited finances, inappropriate substitution of other liquids ( eg juices ) for formula or neglect.

Excessive losses due to Diarrhea

Consider infectious agents ( bacterial, giardia ), HIV, cystic fibrosis or inflammation due to food allergies.

Increased Needs

It may be due to hyper metabolic states or disease that cause increased work of breathing. Consider cystic fibrosis, hyperthyroidism and cardiac disease.

Metabolic or Genetic Abnormalities

Consider inborn errors of metabolism and chromosomal abnormalities.

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Introduction to Rickets

 Musculoskeletal System, Nutrition  No Responses »
Aug 012012
 

Rickets is a disease of growing bone that is unique to children and adolescents. It is caused by a deficiency or impaired metabolism of vitamin D, magnesium, phosphorus or calcium. It leads to softening and weakening of the bones.

Rickets is among the most frequent childhood diseases in many developing countries. The predominant cause is a vitamin D deficiency, but lack of adequate calcium in the diet may also lead to rickets .

Types of Rickets

Different types have been described and may include:

  • Nutritional Rickets
  • Vitamin D Resistant Rickets
  • Vitamin D Dependent Rickets
    • Type I
    • Type II
  • Congenital Rickets

Pathophysiology

Vitamin D deficiency rickets occurs when the metabolites of vitamin D are deficient. Less commonly, a dietary deficiency of calcium or phosphorus may also produce rickets. Vitamin D-3 (cholecalciferol) is formed in the skin from a derivative of cholesterol under the stimulus of ultraviolet-B light. It is converted into the active metabolite calcitriol after final hydroxylation in the kidney. Calcitriol acts to regulate the body’s calcium metabolism by the following mechanisms:

(1) it promotes absorption of calcium and phosphorus from the intestine; (2) it increases reabsorption of phosphate in the kidney; and, (3) it acts on bone to release calcium and phosphate. Calcitriol may also directly facilitate calcification. These actions result in an increase in the concentrations of calcium and phosphorus in extracellular fluid.

This increase of calcium and phosphorus in extracellular fluid, in turn, leads to the calcification of osteoid, primarily at the metaphyseal growing ends of bones but also throughout all osteoid in the skeleton. Parathyroid hormone facilitates the 1-hydroxylation step in vitamin D metabolism.

In the vitamin D deficiency state, hypocalcemia develops, which stimulates excess secretion of parathyroid hormone. In turn, renal phosphorus loss is enhanced, further reducing deposition of calcium in the bone.

Etiology

The body needs vitamin D to absorb calcium and phosphorus from food. Rickets can occur if thechild’s body doesn’t get enough vitamin D or if his or her body has problems using vitamin D Continue reading »

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