- 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.