Nutrition Interventions for Children with Special Health Care Needs

Table 7-2: Nutrition Interventions for Acute Diarrhea
Assessment Intervention Evaluation/Outcome
Anthropometric *
Child maintains growth
pattern.
Adjust recommendations for energy
intake based on growth data.
Measure and plot on appropriate growth chart:
• Height or length for age
• Weight for age
• Weight for height (or length) or BMI
• Head circumference (under 3 years)
Compare current measurements to available previous measurements.
If there are recent weights, this can be helpful in assessing amount of
dehydration.
Repeat height/length, weight and OFC measurements at every clinic
visit.
Section 2 - Problem-Based Nutrition Interventions
Clinical
Treatment for medical causes
of acute diarrhea is identified.
Attempt oral rehydration to prevent need
for hospitalization and parenteral fluids.
Oral rehydration therapy with a glucoseelectrolyte
solution is only required if
there is dehydration. 50-100 ml/kg of
body weight of solution is given over a
4-hour period. Ongoing losses can be
estimated at 10 ml/kg for each stool. 5
Obtain information about clinical history. Include child’s age, other
diagnoses (prematurity, congenital disorders, prior surgery),
medications, possible exposures through day care attendance,
camping, or foreign travel. Food record is helpful to evaluate possible
causes of diarrhea.
Nutrition Interventions for Children With Special Health Care Needs 87
Obtain information about stool history, including duration of illness,
stool frequency, consistency, and presence of blood or mucus.
Appropriate medical and
dietary recommendations are
followed. Physical signs of
dehydration should resolve
and diarrhea should gradually
decrease in severity. If
diarrhea does not resolve,
further medical testing
and management may be
indicated.
Treatment depends on the cause of
diarrhea. Provide medical management
and appropriate nutrition intervention for
diagnosed diseases/disorders. Generally
anti-diarrheal medications are not
recommended.
Work with primary care provider or medical consultant.
Medical evaluation may include some of the following when indicated:
• Physical examination especially assessment of hydration status
(see Table 7-1 for clinical description of degrees of dehydration)
• If diarrhea is very frequent, prolonged or bloody, tests may be
indicated including stool culture for bacteria, tests for rotavirus or
parasites, and stool white blood cells.
• Blood tests for electrolytes may be done especially if
hospitalization is required.