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Pediatric Nutrition

 


- Enteral Feedings in the Pediatric Patient:

- advance feedings as follows:

- begin w/ 10-15 ml Pedialyte qq 2-3 hrs;

- incr by 2-5 ml increments overe the next 12-24 hrs until infant

is receiving 30-45 ml of Pedialyte q3hr;

- pt is then begun w/ half strength formula for 24 hrs followed

by full strength formula q 3-4 hrs at volumes calculated to meet

child's fluid and nutritional requirements;

- in early post operative period, non lactose containing formulas

such as Isomil or ProSobee may be better tolerated;
Composition of Infant Formulas

Formula

Kilocalories

Na

K

Ca

P

Fe

Osm
Breast Milk
0.67 kcal/ml

7

14
340
162

1.5
100
Cow's
Milk
0.67

25

35
1240
950

1.0
270
Enafamil

0.67

11

19
546
462

-

285
Nutramigen

0.67

14

21
630
473
13.0
460
Portagen

0.67

14

21
630
473
13.0
210
Progestimil
0.67

14

17
630
473
13.0
311
ProSobee

0.67

18

19
788
525
13.0
250
Similac

0.67

11

19
580
430

-

285

Electrolyte Content of Body Fluids (Pediatrics)

Fluid

Na:mEq/l K:mEq/l Cl:mEq/l HCO3

-------

Gastric

10-115
5-35

10-155

0

Pancreatic
115-150
5-10

55- 95
115

Ileal

105-145
5-30

90-135
30

Cecal

50

10

40

Bile

130-165
5-15

90-120
15

Saliva

35- 60

10

35
50

@RXDIARREA[Diarrhea

50

35

40
45

-------

Adluts

Children

-------------

Na (as NaCl)
80-120 mEq/24hr

3-4 mEq/kg/24hr
[ 3gm NaCl = 130 mEq

Cl

80-120

K

50-100

2-3 mEq/kg/24hr

Mg

20

Ca

1-
3 gm/day

--------------
Infant Formulas:
Formula

Indications

Comments
------------
Enfamil

Full term Infants; supplement
Contains Nonfat Milk, Lactose,
Similac

to breast feeding;

soy, & coconut oil; Vit; w/ &
SMA

w/o Fe, has 20 cal/oz;
ProSoBee

Milk Sensitive Infants

Lactose-free; contains corn syp
Isomil

solids, soy proteins, soy/coc-

anut oil; Vit & Fe; 20 cal/oz
Pregestimil
Disaccharidase deficiency;

Enzymatically hydrolzyed to re-

food allergy; defects in dig-
duce allergenicity; Vit & Fe;

estion or absorption;

MCT & Corn Oil
Pedialyte
Supplies H20 calories & electo-
Contains H20, Dextrose, Na, K,
Lytren

lites for maintenance when usual
Citrate, Mg, Ca, Cl; Pedia-

feedings are held; replace mild-
lyte 6 cal/oz; Lytren 9cal/oz

mod fluid losses
-------------
Daily Electrolyte and Mineral Requirements

Amount
Element

Neonates

Infants and Children
--------
Sodium

1.6- 9.0 mEq/kg

2- 4
mEq/kg
Potassium

1.4-10.0 mEq/kg

2- 3
mEq/kg
Chloride

1.1- 4.5 mEq/kg

2- 3
mEq/kg
Phosphorous

1.0- 2.0mmol/kg

1- 2
mmol/kg
Magnesium

80.0 mEq/kg

30-60
mEq/kg
Calcium gluconate
150.0 mEq/kg

400-1200 mEq/kg
--------
Note: Specific Electrolytes:
Potassium: Premature infants may require additional K, noting immature

renal function or if infants is on diuretics;
Calcium and Phosphorous: Note that Serum Ca may not reflect needs for Bone

growth;

 


Original Text by Clifford R. Wheeless, III, MD.


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