Semantic module 16. Partial breast feeding of children.

Concrete aims:

• To explain term partial breast feeding of children

• To collect anamnesis of feeding of child of breast age and estimate it, prevent progress of hypogalactia in mother.

• To expect daily volume of meal and necessary amount of meal on one feeding to the child, that is on the partial breast feeding depending on age.

• To make one-day menu for the child of breast age, that is on the partial breast feeding.

• To organize the correct partial breast feeding, interpret to its efficiency.

• To correct the feed to the child, which is on the partial breast feeding.

Theme 5. Mixed feeding of children.

Semantic module 17. Feeding of children elder one year.

Concrete aims:

• To collect anamnesis of feed of child elder one year.

• Estimate accordance of feed to necessities for valuable physical and psychomotor development of child.

• To compose one-day menu for the healthy child elder one year taking into account necessities in nutrients.

• To correct the feed the child elder one year.

Theme 6. Organization and principles of rational feed of children elder one year.

Theme of practical training: Partial breast feeding of children. Technician and rule of partial breast feeding. Scheme of the partial breast feeding of children of the first year of life. Weaning and correction of feed. Daily necessity of child in proteins, fats, carbohydrates and calories at the partial breast feeding. Organization and principles of rational feed of healthy children elder one year.

Place: an educational room in somatic department.

Professional orientation of students: The unbalanced feed in children’s age is one of the most essential problems, which stand before humanity and call serious obstacles on the way of social and economic development. Character of feed of child has influence on growth and differentiation of his organs and systems. By the nutrition it is possible purposefully to influence on metabolism, physical and neuropsychological development.

Base level of knowledge and abilities:

№	Disciplines	To know
1.	Normal and pathological physiology, propedeutic of children’s diseases.	To know the anatomic and physiologicfeatures of organs of digestion in children in age aspect.
2.	Biochemistry, normal physiology.	To know the role of food ingredients (proteins, fats, carbohydrates, vitamins and others) in functioning of organs and systems of child.
3.	Hygiene.	To know the role of the balanced feed of children.
4.	Propedeutics of pediatrics.	To be able to collect food anamnesis.

Plan of conducting of training.

№	Elements of practical training	Time (minutes)
1. 2. 3. 4. 5. 6.	Verification of presents. Test control with the purpose of estimation of initial level of knowledge and its analysis. Theoretical questioning. Collection of anamnesis of feed of child. Analysis of typical tasks from the partial breast feeding. Independent decision of tasks on the theme of partial breast feeding. Composition of one-day menu for a healthy child, elder 1 year, taking into account necessities in food ingredients. Correction of feed of healthy child. Final control of knowledge, solving of situation tasks. Results of training and final estimation of knowledge and abilities of students and task for independent preparation to a next training.	15 min. 30 min. 45min. 40 min. 20 min. 10 min. Total: 160 min.

List of theoretical questions:

1. Definition of partial breast feeding of children of breast age and its characteristic.

2. Main reasons on the partial breast feeding of children (whether present indications to the partial breast feeding of children):

a) from the mother side;

b) social character.

3. Hypogalactia, reasons of origin, classification, methods of prophylaxis and treatments.

4. Basic principles of the partial breast feeding of children of the first year of life:

a) rules of partial breast feeding:

b) diet of child

5. Classification of milk formulas which are used for partial breast feeding of children:

a) adapted;

b) unadapted (simple).

6. Requirements in basic food ingredients and energy for the children of the first year of life, that are on the partial breast feeding.

7. Introduction of physiology weaning of children, that are on partial breast feeding:

а) terms and rules of introduction of products of weaning;

b) rules, technique and types of weaning.

8. Estimation of daily ration of child on the partial breast feeding and conducting of correction of feed.

9. Anatomic and physiologic features of organs of digestion in children elder 1 year.

10.Diet of children in different age periods.

11. Requirements of child in proteins, fats, carbohydrates and calorie. Volume of daily ration for children elder 1 year.

12. Rules of composition of menu to the children elder one year.

Method of conducting of practical training:

1. After verification of presents and announcement of theme of training with pointing on its actuality a teacher conducts the writing entrance control of knowledge.

2. Analysis of the executed tests and consideration of errors

3. Theoretical questioning of students.

4. Analysis of typical tasks on partial breast feeding.

5. Independent decision by the students of tasks about partial breast feeding of children.

6) Algorithms of composition of one-day menu for a healthy child, elder 1 year.

Task on practical work of student.

№	Task	Pointing of teacher to the students	Notes
	To collect feed anamnesis and give its estimation.	To find out age of child. Time of the first applying to the breast. Feeding on the first year of life. To find out an order and terms of introduction of basic food products.
	To make a menu to the child, taking into account its age features.	To specify volume of meal. To define caloric necessity and distribute it between meals. To appoint introduction of new products To give recommendations about use of sweet, extract foods, facultative products.

5. Students design protocol of one-day menu for a healthy child, elder 1 year

6. A teacher conducts an analysis and signature of protocols.

7. A teacher conducts final control of knowledge of students on this theme with the use of situation clinical tasks.

8. A teacher works out the resume of training, gives estimation of knowledge and abilities of students. Assigns for independent preparation to a next training.

Forms and methods of self-control

Tests and situation tasks for the control:

1. Partial breast feeding of children of low level is feeding of children of the first 5-6 months by breast milk and artificial milk formulas, when the volume of artificial formulas exceeds at:

A. 4/5 of daily amount of meal

B. 1/4 of daily amount of meal

C. 1/5 of daily amount of meal

D. 1/2 of daily amount of meal

E. 2/3 of daily amount of meal

2. Indications to the partial breast feeding of children of the first year of life:

A. Primary hypogalactia in mother

B. Disease of mother, which needs limitation of number of feedings

C. Mother’s job not allows to conduct exclusive breast feeding of child

D. Secondary hypogalactia in mother

E. all listed

3. Complementary feeding is conducted:

A. before breast feeding

B. after breast feeding

C. between the meals

D. only in the morning

E. only at the evening

4. Ratio of proteins and fats in children elder 1 year makes:

A. 1 : 1

B. 1 : 2

С. 2 : 1

D. 1 : 3

Е. 3 : 1

5. Daily volume of meal in children from 1 to 3 years makes:

A. 1100-1200 ml.

B. 1300-1400 ml.

С. 1500-1600 ml.

D. 1000-1200 ml.

Е. 900-1000 ml.

Standards of answers:

1. A

2. Е

3. B

4. A

5. A

Task №1

2 months child was born with mass of body 3500 g, length - 50 cm. From 1 month he is on the partial breast feeding. At a mother there is only 200 ml of milk. Define the level of feeding, necessity of child in proteins, fats, carbohydrates and calories and make the ration of feed on 1 day.

Task №2

16 weeks child was born with mass of body 3400 g. From 2nd week age he on the partial breast feeding: 1/3 of volume of meal gets as an adapted formula. Define the level of feeding and necessity of child in proteins, fats, carbohydrates and calories and make the ration of feed on 1 day.

Task №3.

15 months child was born with weight of body – 3200 g. He was before 1 year on the breast feeding. Make rational daily menu.

Answer:

1. Daily volume of meal – 1200 г.

2. Requirement in energy is 100 kcal/kg

3. 5 meals on a day

4. Distribution of energy: 20% every meal

Menu:

8.00 - breakfast: mashed potatoes,1 egg, tea with the milk, bread and butter

12.00 – lunch: soup vegetarian, vegetable puree, chicken, salad, bread, fruit juice

15.00 - dinner: cottage cheese baked pudding, milk

17.00 - midday snack: yogurt, cake, banana

20.00 - supper: milk buckwheat porridge, tea, toasts

Hardwares and material providing of training:

1) Tables: “Necessities in proteins, fats, carbohydrates and energy of children of the first year of life at different types of feeding”

2) Set of test tasks of entrance control (10 copies).

3) Set of situation tasks from the partial breast feeding of child

(5 copies).

4). Methodical developments:

а) “Features in the feed of children after 1 year”.

b) “Diet of children of different age groups”.

c) “Composition of menu for children, elder 1 year”.