60 MCQs in Nutrition and Dietetics (Part 7)

For heartburn management, the sources advise “Small frequent meals,” “avoid late night meals,” “Fluid between meals,” and to “Avoid spicy food,” “Chocolate, fatty food, alcohol that can relax oesophagus before sleeping”. The recommendations also include sleeping propped up and avoiding bedding immediately after eating, which contradicts lying down flat.

The sources advise to “Avoid Toxoplasmosis {Toxoplasma gondii] : can cause vision problem” and recommend women “to avoid unwashed food, raw or under cooked meat”. Pica, specifically craving soil, is also mentioned as a risk factor for toxoplasmosis.

The sources identify adolescent pregnant women as being “less likely to eat healthy & less likely to meet the requirement of calcium and iron -> iron def. anemia”, which contradicts option b. The other options (low birth weight, premature delivery, anemia, difficult labour) are listed as risks for this group.

Under “Dietary Recommendations” for infants and preschoolers, the sources state that “Healthy fats, low fibre” contribute to “growth & development of CNS”.

The guidelines for pregnancy care include the instruction to “Take Vt A tablet immediately after delivery”.

The sources provide the guideline to take “Iron supplement during pregnancy & at least 3 months post partum” to “prevent anemia”.

The sources clearly state that excessive alcohol intake can lead to Fetal Alcohol Syndrome (FAS), which presents with “FAS: Facial & CNS effect, growth retardation, cardiac & GU abnormalities”.

The sources highlight “BREASTMILK” as containing “ELF ; essential long chain fatty acids” and “Oligosach that can reduce constipation -> Maintain normal brain development”.

The sources state that constipation “happens in 4 in 10 women” due to “movement of GIT is lower in pregnancy,” and note that “Some women can restrict their water intake”. However, increasing fluid intake is generally recommended for constipation, not discouraged.

The sources specify that for “Obese or overweight” women, the recommended average weight gain is “7-11.5kg”. The rate of 0.4kg per week and the ranges of 10-12.5kg or 11-16kg are typically for women with a normal Body Mass Index (BMI).

The sources explicitly state that “Overgain” by the mother can lead to “Infant macrosomia”. “Low birth weight” and “subsequent effect on lung health” are consequences of “Undergain”. Perinatal mortality is a general risk for vulnerable groups like adolescents or overweight/obese women, but not specifically tied to infant macrosomia.

The sources describe “Pica” as “Characterised by persistent craving for non edible & non nutritious objects” and specifically list examples like “Coal, clay, Chalk, match boxes, soil”.

The sources explicitly advise, “Use iodine salt to help baby brain development”. While Vitamin A and Iron supplements are mentioned, their purpose is different (preventing anemia, general health). Folic acid is for pre/early pregnancy.

Under “INFANTS (Benefits),” the sources state, “Everything infant need in first 6 months of life is there”, implying the completeness of breastmilk. The advice “No extra Small meals like eating for two, just one extra Small meal is okay” relates to the mother’s diet during pregnancy.

Among the benefits for the mother, the sources mention, “Helps women lose excess weight gain from pregnancy”. Breastfeeding also helps “Stimulate uterine contraction that help stimulate returning the uterus to normal size”. The sources also state it reduces the mother’s risk of premenopausal breast cancer.

The sources explicitly state, “BREASTMILK – best choice for infant” and describe “Colostrum (first milk)”.

Under “Vulnerable Groups in Pregnancy,” adolescents are listed with the consideration: “They are less likely to eat healthy & less likely to meet the requirement of calcium and iron -> iron def. anemia”.

The sources note that heartburn is “Usually 3rd trimester when the fetus pushes up”.

The sources describe “MORNING SICKNESS {Pregnancy Sickness}” as “Characterised by nausea & vomiting, although vomiting can happen any time of the day”.

The sources specify, “Rate: 0.4kg per week (Average 10-12.5kg for women of normal BMI)”. The 7-11.5 kg range is for obese or overweight women.

The sources list “Listeriosis [Listeria monocytogenes]” and note that it “can cause miscarriage”.

The sources clearly state, “Alcohol: recommendation of alcohol is abstinence at least in 1st trimester; excessive intake can lead to FAS (Fetal alcohol Syndrome)”.

The sources indicate that “Caffeine! can contribute to low birth weight by ? fetal heart rate” and “should be taken in moderation”.

The sources state, “Avoid excessive intake of retinol [Vitamin A] and avoid eating of liver – can lead to a teratogenic effect”.

The sources emphasize that “A mother’s nutritional status 3 months before conception and 2-3 months of pregnancy is very important”.

The source states that a mother should be exposed to “Folic Acid Supplement 400mcg before pregnancy and up to 12 weeks of pregnancy to prevent neural tube defect in someone with no history”. The 5000 mcg dosage is for someone with a history.

Under “Good hygiene practices,” it is recommended to “Store the foods to be given to your baby in a safe, clean place” to prevent diseases. This is part of overall good hygiene to prevent illnesses, including diarrhoea.

According to the “Food Variety” counselling card, “Eggs” are listed as contributing “2 stars”. Other 2-star foods include Flesh foods (meat, chicken, fish, liver, crayfish, snails, and grubs/insects) and Dairy products (milk and milk products).

For complementary feeding from 6 up to 9 months, the recommended “Thickness” is described as: “Give mashed/pureed family foods”. As the baby grows, the consistency progresses to “chopped family foods, finger foods, and sliced foods” for 9-12 months, and then “small pieces, finger foods, and sliced food” for 12-24 months.

The sources state that the “Fore milk has more water and satisfies the baby’s thirst”. It also notes that the “hind milk” has more fat and satisfies the baby’s hunger.

The sources categorize food groups by “stars” for nutritional value. “Vitamin A-rich fruits and vegetables” (e.g., papaya, passion fruit, watermelon, tomatoes, dark green leaves, carrots, yellow sweet potato, and pumpkin) contribute “4 stars”. This highlights their importance in the baby’s diet.

The notes for community workers clearly state: “If you are not sure if the weight gain is adequate, refer the child to the nearest health facility”. This indicates that professional medical evaluation is necessary for insufficient weight gain.

For babies aged 9 to 12 months, the recommended frequency for complementary foods is “3 times a day plus snacks”. This represents an increase in feeding frequency compared to the 6-9 month period.

The sources specifically recommend, “Use iodised salt to help your baby’s brain and body develop well”. This highlights the importance of iodine for infant development.

Counselling Card 16 on Food Variety states that it is important to “Try to offer at least four (4) foods from all of the following food groups in addition to breastmilk” daily. This emphasizes the importance of a diverse diet for the child’s development.

To boost the energy density of complementary foods, the sources advise, “If you prepare food for the baby, add fat to increase energy”. Conversely, sugary drinks and sweet biscuits should be avoided.

The sources provide specific guidance for such situations: “If your baby is ill or sleepy, wake him or her to offer the breast often”. This ensures the baby continues to receive essential nutrients and hydration even when unwell or less active.

Good hygiene practices are crucial for preventing diseases like diarrhoea. A specific recommendation is to “Wash your hands with soap and water before preparing foods and feeding baby”.

A key indicator for a community worker to reassure a mother that her baby is getting enough milk is if the baby is “gaining weight – refer to the baby’s health card (or growth velocity table if available)”. Other positive signs include the baby not being visibly thin and being responsive and active for their age.

While continuous breastfeeding is encouraged day and night, from 12 up to 24 months, breastmilk contributes to approximately one-third (1/3) of the baby’s energy needs. Before 12 months, breastmilk is considered the most important part of the baby’s diet.

The sources explicitly warn, “Do NOT use feeding bottles, teats, or spouted cups since they are difficult to clean and can cause your baby to become sick”. This highlights the importance of hygiene in feeding practices.

For complementary feeding from 6 up to 9 months, the guideline for frequency states to “Feed your baby complementary foods first a few spoonfuls a day, then gradually increase amount and frequency”. The target amount is to gradually increase to half a cup (250 ml-cup) per day.

To effectively build up your breastmilk supply, it is advised to breastfeed your baby on demand, both day and night, 8 to 12 times. More frequent suckling, especially with good attachment, promotes greater breastmilk production.

During breastfeeding, adolescent mothers, whose bodies are still growing, need to eat two extra small meals or “snacks” (extra food between meals) each day to provide sufficient energy and nutrients for themselves and their growing baby. They also need to take extra care, have more food, and get more rest than an older mother.

The sources indicate that early signs your baby wants to breastfeed include restlessness, opening their mouth and turning their head side-to-side, putting their tongue in and out, and suckling on their fingers and fists. Crying may be a late sign of hunger or could signal another problem.

Counselling Card 16 on Food Variety states, “It is important to feed four growing child groups in addition to breastmilk.” It further advises to “Combine at least four (4) food items from the above groups in addition to breastmilk to create an adequate meal”.

The star system indicates that Animal-source foods are 1 star, Staples are 2 stars, Legumes and seeds are 3 stars. Both Vitamin A-rich fruits and vegetables (such as papaya, mango, dark green leaves, carrots, yellow sweet potato, and pumpkin) and Other fruit and vegetables (like banana, pineapple, avocado, and cabbage) are categorized as 4 stars.

The sources specify that for babies from 12 up to 24 months, breastmilk continues to supply about one-quarter (1/4) of their energy needs. Breastfeeding remains important for the child’s health and strength during this period.

For babies aged 9 up to 12 months, the frequency recommendation is to feed your baby complementary foods “3 times a day” (excluding meals and snacks), with a gradual increase in amount and frequency. For 6-9 months, it’s 2 times a day, and for 12-24 months, it’s also 3 times a day but potentially more.

For complementary feeding from 6 up to 9 months, the recommended thickness for food is “Thick porridge, mashed foods”. For babies 9-12 months, it progresses to “chopped/finely chopped foods, finger foods, sliced foods”.

The sources advise, “Breastfeed your baby first before giving other foods”. This emphasizes the continued importance of breastfeeding even after complementary foods are introduced.

For babies from 6 up to 9 months, breastmilk continues to supply about one-third (1/3) of their energy needs. Breastmilk remains the most important part of their daily diet during this period.

The sources note that after 6 months, or whenever you stop exclusively breastfeeding, you can no longer use the Lactation Amenorrhoeal Method (LAM) for birth spacing. It also mentions that a mother may need to use another family planning method even if her menses have not returned.

Good hygiene (cleanliness) is important to prevent diseases, including diarrhoea. A key practice is to wash your hands with soap and water before preparing foods and feeding your baby. Hands should also be washed before eating, and after using the toilet or cleaning the baby’s bottom.

A community worker can reassure a mother if her baby is not visibly thin (or is gaining fatter/putting on weight), is responsive and active, and passes light-coloured urine 6 times a day or more while being exclusively breastfed. If weight gain is not adequate, the child should be referred to a health facility.

The sources explicitly state, “Do NOT use feeding bottles, teats, or spouted cups. They are difficult to clean and can cause your baby to become sick”. Instead, clean spoons or cups should be used for liquids.

The sources explain that ‘fore milk’ has more water and satisfies the baby’s thirst, whereas ‘hind milk’ has more fat and satisfies the baby’s hunger. It is recommended to let the baby finish one breast before offering the other to ensure they receive both types of milk.

Early signs that your baby wants to breastfeed include restlessness, opening the mouth and turning the head from side-to-side, and putting the tongue in and out or suckling on fingers and fists. Crying is noted as a late sign of hunger or an indication of another problem.

To build up breastmilk supply, it is recommended to breastfeed your baby on demand, both day and night, 8 to 12 times. More frequent suckling with good attachment also helps to make more breastmilk.

The sources state that adolescent mothers need extra care, more food, and more rest than an older mother because their own bodies are still growing. During breastfeeding, they need to eat two extra small meals or “snacks” each day to provide energy and nutrients for both themselves and their growing baby.