CNSC, Nutrition Support of the Pediatric Patient Review Questions and Answers

Which of the following children is at greatest risk for iron deficiency anemia? 1: 3 month-old term infant exclusively fed human milk 2: 4 month corrected gestational age, former preemie on a transitional formula 3: 10 month-old switched from formula to whole milk 4: 17 month-old "picky eater" 3: 10 month-old switched from formula to whole milk Iron deficiency anemia is the most common nutritional deficiency in childhood. Term infants usually have adequate iron stores up to 6 months of age. Infant formulas are fortified with sufficient iron to meet the needs of growing infants. The iron content of breast milk, though efficiently absorbed, is much lower compared to infant formula. Exclusively breastfed infants require additional iron starting at 4-6 months of age. This can be provided by complementary foods or iron supplementation. The iron content of cow's milk is similar to human breast milk but the bioavailability is very low due to inhibitory effect of calcium on iron absorption. Due to the inadequate nutritional composition, cow's milk should not be introduced before 12 months of age. A child with picky eating habits may or may not be at increased risk of iron deficiency anemia depending on which foods they are willing to consume. Diet assessment should be done to determine if iron supplementation is warranted. References: Texas Children's Hospital. Texas Children's Hospital Pediatric Nutrition Reference Guide. 10th Baker RD, Greer FR, Committee on Nutrition. Diagnosis and Prevention of Iron Deficiency and Iron-Deficiency Anemia in Infants and Young Children (0-3 Years of Age). Pediatrics. (2010) 126: Sentongo, Timothy. "Assessment of Nutrition Status by Age and Determining Nutrient Needs." The A.S.P.E.N. Pediatric Nutrition Support Core Curriculum, 2nd Ed. Silver Spring: American Society for Parenteral and Enteral Nutrition, 2015. 531-566. An obese 12-year-old female is admitted to the hospital for an evaluation of sleep apnea. A diet history reveals that she drinks three cans of soda, 24 ounces of juice, and 8 ounces of chocolate milk daily. In what mineral may she be deficient? 1: Calcium 2: Phosphorus 3: Selenium 4: Potassium 1: Calcium