Case Study

Lecture activity on
PKU By
Dr. Doha Magdy Abo
Zahra Lecturer of
Nutrition
Faculty of Allied Medical
Sciences
PUA
• 5 months old baby girl, attended to Nutrition
clinic with her mother who claimed that her
daughter is suffering from PKU.
• She is asking for help regarding her feeding.
• The weight is 6 Kgs.
• Calculate the nutritional requirements for this
baby
Infant Formula
 Infant Formula
1. Standard formula(SF)
 Infant Formula
1. Standard formula(SF)
2.Phe free formula(Phe
FF)
Infant
Formula
 Infant
Formula
• Standard formula:
100 gms contain:
 Energy: 250
 Protein:1.2
 Phe: 0.2
 Infant
Formula
• Standard formula: • Phe Free Formula:
100 gms contain: 100 gms contain:
 Energy: 250  Energy:100
 Protein:1.2  Protein: 4

 Phe: 0.2
Step 1 determine the nutritional
requirements according to age:
Step 1 determine the nutritional
requirements according to age:
1. Energy: 108 kcal/kg/day
 108x6=648 kcal/day
Step 1 determine the nutritional
requirements according to age:
1. Energy: 108 kcal/kg/day
 108x6=648 kcal/day
2. Protein: 2.2g/kg/day
2.2x6=13.2g/day
Step 1 determine the nutritional
requirements according to age:
1. Energy: 108 kcal/kg/day
 108x6=648 kcal/day
2. Protein: 2.2g/kg/day
2.2x6=13.2g/day
3. Phe: 47 mg/kg/day 47x6= 282mg
0.282gm0.3 gm/day
Step 1 determine the nutritional
requirements according to age:
1. Energy: 108 kcal/kg/day
 108x6=648 kcal/day
2. Protein: 2.2g/kg/day
2.2x6=13.2g/day
3. Phe: 47 mg/kg/day 47x6= 282mg
0.282gm0.3 gm/day
4. Fluids: 1.5 ml/1kcal 1.5x648=972 ml/day
 Step 2 determine the amount needed from
standard formula according to Phe requirements
1. 100 gms of SF  0.2 gm Phe
 Step 2 determine the amount needed from
standard formula according to Phe requirements
1. 100 gms of SF  0.2 gm Phe
??? Gms of SF  0.3 gm Phe
 Step 2 determine the amount needed from
standard formula according to Phe requirements
1. 100 gms of SF  0.2 gm Phe
??? Gms of SF  0.3 gm Phe
(100x0.3)÷ 0.2= 150 gm
 Step 2 determine the amount needed from
standard formula according to Phe requirements
1. 100 gms of SF  0.2 gm Phe
??? Gms of SF  0.3 gm Phe
(100x0.3)÷ 0.2= 150 gm
So the amount required from SF is 150 gm per
day
 Step 2 determine the amount needed from
standard formula according to Phe requirements
1. 100 gms of SF  0.2 gm Phe
??? Gms of SF  0.3 gm Phe
(100x0.3)÷ 0.2= 150 gm
So the amount required from SF is 150 gm per
day
2. 100 gms of SF  1.2 gm
protein
 Step 2 determine the amount needed from
standard formula according to Phe requirements
1. 100 gms of SF  0.2 gm Phe
??? Gms of SF  0.3 gm Phe
(100x0.3)÷ 0.2= 150 gm
So the amount required from SF is 150 gm per
day
2. 100 gms of SF  1.2 gm
protein 150 Gms of SF  ???
Gm protein
 Step 2 determine the amount needed from
standard formula according to Phe requirements
1. 100 gms of SF  0.2 gm Phe
??? Gms of SF  0.3 gm Phe
(100x0.3)÷ 0.2= 150 gm
So the amount required from SF is 150 gm per
day
2. 100 gms of SF  1.2 gm
protein 150 Gms of SF  ???
Gm protein
(150x1.2)÷ 100= 1.8 gm
Step 3 determine the amount needed from Phe
free formula according to protein requirements
Step 3 determine the amount needed from Phe
free formula according to protein requirements
1.Protein requirement is 13.2 gm/day but Part of this
protein is provided from SF, So first determine the
amount from SF
Step 3 determine the amount needed from Phe
free formula according to protein requirements
1.Protein requirement is 13.2 gm/day but Part of this
protein is provided from SF, So first determine the
amount from SF
2.150 gm of SF provides 1.8gm protein so the rest to
be provided from Phe FF is-
13.2-1.8 =11.4
Step 3 determine the amount needed from Phe
free formula according to protein requirements
1.Protein requirement is 13.2 gm/day but Part of this
protein is provided from SF, So first determine the
amount from SF
2.150 gm of SF provides 1.8gm protein so the rest to
be provided from Phe FF is-
13.2-1.8 =11.4
Step 3 determine the amount needed from Phe
free formula according to protein requirements
1.Protein requirement is 13.2 gm/day but Part of this
protein is provided from SF, So first determine the
amount from SF
2.150 gm of SF provides 1.8gm protein so the rest to
be provided from Phe FF is-
13.2-1.8 =11.4
3. 100 gm of Phe FF 4 gm protein
??? gm of Phe FF  11.4 gm protein
Step 3 determine the amount needed from Phe
free formula according to protein requirements
1.Protein requirement is 13.2 gm/day but Part of this
protein is provided from SF, So first determine the
amount from SF
2.150 gm of SF provides 1.8gm protein so the rest to
be provided from Phe FF is-
13.2-1.8 =11.4
3. 100 gm of Phe FF 4 gm protein
??? gm of Phe FF  11.4 gm protein
(100x11.4)÷4 = 285 gm of Phe FF
Is the amount of energy needed is
ful@illed from both SF and Phe
FF???
 Is the amount of energy needed is
ful@illed from both SF and Phe
• SF FF???
100 gm  250 Kcal
150 gm  ??
(150x200)/100=
375 Kcal
 Is the amount of energy needed is
ful@illed from both SF and Phe
• SF FF??? • Phe FF
100 gm  250 Kcal 100 gm  100 Kcal
150 gm  ?? 285 gm ?? Kcal
(150x200)/100= (285x100)/100
375 Kcal =285 Kcal

• Total caloric intake from both SF and Phe FF is

375 + 285 = 660 Kcal/day so the energy
requirements are covered
(the actual amount needed is 648 kcal/day)
 Is the amount of energy needed is
ful@illed from both SF and Phe
• SF FF??? • Phe FF
100 gm  250 Kcal 100 gm  100 Kcal
150 gm  ?? 285 gm ?? Kcal
(150x200)/100= (285x100)/100
375 Kcal =285 Kcal

• Total caloric intake from both SF and Phe FF is

375 + 285 = 660 Kcal/day so the energy
requirements are covered
(the actual amount needed is 648 kcal/day)
 Last
• Mix 150 gms of step:
SF with 285 gms of Phe FF with
972 ml of water