Download CURRENT Diagnosis & Treatment in Family Medicine by Jeannette South-Paul, Samuel Matheny, Evelyn Lewis PDF

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By Jeannette South-Paul, Samuel Matheny, Evelyn Lewis

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CURRENT Diagnosis & Treatment in Family Medicine

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Most toddlers cannot sit for longer than 15 minutes: prolonging the table time in the hopes of increasing the amount eaten may only exacerbate the already fragile parent-child relationship. And although many toddlers graze throughout the day, some are unable to take in appropriate calories with this strategy. The primary care provider should also discuss the family’s beliefs about a healthy diet. Some families have dietary restrictions, either by choice or culturally, that affect growth. Many have read the dietary recommendations for a healthy adult diet, but a low-fat, low-cholesterol diet is not an appropriate diet for a toddler.

Mahoney, MD, PhD, FAAFP born, unconjugated bilirubin is produced faster and removed more slowly than in the normal adult due to immaturity of the glucuronyl transferase enzyme system. The main source of unconjugated bilirubin is the breakdown of hemoglobin in senescent red blood cells. Newborns have an increased erythrocyte mass at birth (average hematocrit of 50% vs 33% in the adult) and a shorter life span for erythrocytes (90 days vs 120 days in the adult). The newborn cannot readily excrete unconjugated bilirubin, and much of it is reabsorbed by the intestine and returned to the enterohepatic circulation.

A fussy child may be more difficult for a particular parent to feed. A “good” or passive infant may not elicit enough feeding. Physical characteristics also affect parent-child relationships: organic disease not only may make feeding difficult but also may engender a sense of failure or disappointment in the parent. It is crucial to remember that each child is different; parents have unique relationships with each of their children. Therefore, a parent whose first child is FAILURE TO THRIVE / 15 Table 2–1.

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