A child fed exclusively on cow's milk may have deficiency of?

RUHS, Jaipur, M.Sc Nursing Entrance Exam-2021

Child Health Nursing (Pediatrics)

Easy

Appeared in: RUHS, Jaipur, M.Sc Nursing Entrance Exam-2021

Explanation

Cow's milk is notoriously low in iron content, providing insufficient amounts to meet a growing child's needs.
The high levels of calcium and casein in cow's milk significantly interfere with the body's ability to absorb non-heme iron.
For infants under 12 months, cow's milk protein can cause microscopic bleeding in the gastrointestinal tract, leading to a gradual loss of iron.
Excessive milk intake can displace iron-rich solid foods from the diet, further exacerbating the risk of deficiency.

Option B: Whole cow's milk contains Vitamin A, which is a fat-soluble vitamin. Deficiency is not typically associated with a milk-based diet unless it's skim milk with no fortification.
Option C: Cow's milk is considered an excellent source of Riboflavin (Vitamin B2). An exclusive milk diet would provide more than adequate amounts of this vitamin.
Option D: Cow's milk contains Thiamine (Vitamin B1). While not as rich as in other foods, it's generally sufficient to prevent deficiency in a diet where milk is a staple.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Nutritional deficiencies associated with exclusive cow's milk diet in children as background academic context rather than a clinical decision trigger.
Nurses must educate parents that cow's milk is not a suitable primary drink for infants under 12 months old due to the risk of iron deficiency anemia and potential renal stress.
A key nursing assessment for toddlers includes dietary history. Excessive milk intake (>24 oz/day) is a major red flag for iron deficiency anemia, prompting screening (e.g., CBC).
Patient teaching should emphasize limiting cow's milk for toddlers and introducing iron-rich foods like pureed meats, beans, lentils, and iron-fortified cereals.

How to Approach the Question

First, identify the core of the question: it asks for a specific nutrient deficiency caused by an exclusive diet of cow's milk.
Recall or deduce the nutritional composition of cow's milk, particularly in the context of an infant's needs.
Remember the key nutritional drawback of cow's milk for infants: it is very low in iron.
Evaluate each option. Consider whether cow's milk is a good or poor source of Vitamin A, Riboflavin, and Thiamine.
Conclude that iron is the most well-known and significant deficiency associated with an exclusive cow's milk diet in early childhood.

Concept Tested & Keywords

Concept Tested: Nutritional deficiencies associated with exclusive cow's milk diet in children.
Stem keywords: child, fed exclusively, cow's milk, deficiency
Lead-in keywords: deficiency of
Clinical cues: Exclusive diet of cow's milk is a key indicator for specific micronutrient deficiencies.

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