A nurse is providing dietary teaching to a parent of a 10-month-old infant who has phenylketonuria. Which of the following responses by the parent indicates an understanding of the teaching?

Phenylketonuria (PKU) is an inborn error of metabolism caused by a deficiency of the enzyme phenylalanine hydroxylase, leading to accumulation of phenylalanine in the blood. High levels are toxic to the developing brain and can result in intellectual disability and neurologic damage if not managed. Dietary management is the cornerstone of treatment and involves strict restriction of high-protein foods while ensuring adequate nutrition for growth and development in infants and children. Rationale: A. Orange juice restriction is not required in PKU because fruits and juices are generally low in phenylalanine. The main concern is limiting high-protein foods such as meat, dairy, eggs, and certain grains rather than fruit-based products. Therefore, this statement does not reflect correct understanding. B. Switching to whole milk is incorrect because milk contains high levels of phenylalanine and is strictly restricted in children with PKU. Infants and children with PKU require specialized medical formulas that provide nutrients without phenylalanine. Regular dairy products would worsen metabolic control and risk neurotoxicity. C. Ensuring the child eats 1 ounce of meat daily is incorrect because meat is high in protein and phenylalanine and must be avoided in PKU management. Even small amounts can lead to harmful accumulation of phenylalanine. Protein intake is carefully controlled using special medical formulas rather than regular animal proteins. D. Steaming carrots and cutting them into small pieces is appropriate because vegetables like carrots are low in phenylalanine and can be included in a controlled PKU diet. Proper preparation supports safe feeding for a 10-month-old while maintaining dietary restrictions. This demonstrates understanding of appropriate food selection in PKU management.