Nutrition Interventions for Children with Special Health Care Needs

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Chapter 10 - Enteral Feeding References 1. A.S.P.E.N. Guidelines for the use of parenteral and enteral nutrition in adult and pediatric patients. J Parenter Enteral Nutr. 2002; (26):1SA-138SA. NOTE – A process was described for updates of these guidelines in J Parenter Enteral Nutr. 2009; 33:255-259. Future updated guidelines will be published as separate chapters and will be available at the A.S.P.E.N. website (www.nutritioncare.org) with access to all. 2. A.S.P.E.N. Enteral nutrition practice recommendations. J Parenter Enteral Nutr. Mar-Apr 2009; 33(2):122-67. 3. Axelrod D. Pediatric enteral nutrition. J Parenter Enteral Nutr. 2006; 30(1s): S21-S26. 4. Charney P, Ainsley M. ADA Pocket Guide to Enteral Nutrition. Chicago, IL: American Dietetic Association; 2006. 5. Rolandelli RH, Bankhead R, Boullata J, Compher C. Clinical Nutrition: Enteral and Tube Feeding, 4th Edition. Philadelphia: WB Saunders Company; 2004. 6. Davis A. Rehabilitating a malnourished infant: A case presentation. PNPG Post. Pediatric Nutrition Practice Group of the American Dietetic Association; Summer 2002. 128 Nutrition Interventions for Children With Special Health Care Needs
Chapter 11 Section 2 - Problem-Based Nutrition Interventions Community Monitoring of the patient on home parenteral Nutrition Kathryn L. Hunt, RD, CD Parenteral nutrition (PN) is needed when the patient’s gastrointestinal tract will not sustain life or when a child is unable to tolerate enteral feedings for a significant period of time. PN may be administered for weeks or months, as may be required for children with nutritional depletion from certain diseases, or for years, as may be required for children with severe short bowel syndrome (1). However severe or significant the need, PN is now an accepted form of therapy with life-saving capacities for pediatric patients. Indications for home parenteral nutrition for pediatric patients are listed below. • Short bowel syndrome • Intestinal motility disorders (e.g., pseudo-obstruction) • Inflammatory bowel disease (e.g., Crohn’s disease, ulcerative colitis) • Hypermetabolic states (e.g., severe burns and trauma) • Acute and chronic pancreatitis • Special circumstances (e.g., hepatic failure, cancer, congenital villous atrophy) • Unexplained intestinal malabsorption syndromes The goal of the health care team in managing the pediatric patient on PN is to provide a solution of carbohydrate, protein, and fat that will achieve a positive nitrogen balance for growth, increase the patient’s weight, and improve clinical outcome. The solution should also contain appropriate amounts of electrolytes, vitamins, minerals, and trace elements to maintain balance within the patient’s body and prevent nutrient deficiencies (2). Despite its life-saving capacities, PN has risks and potential consequences, including liver damage from overfeeding, biliary sludge from absence of enteral nutrition, and catheter-related sepsis (3). To minimize these risks and to prevent other complications, the patient receiving PN should be transitioned to enteral feeding at the earliest opportunity (4). This requires close monitoring and regular re-evaluation by the health care team. In general, PN regimens (including solution composition) are established in the hospital, where the patient’s metabolic response and tolerance can be monitored closely (5). After discharge, it is important to continue to monitor response to PN Nutrition Interventions for Children With Special Health Care Needs 129
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Nutrition Interventions for Childre
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Kay Kopp, OTR/L Occupational Therap
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Appendices Appendix A Sample Screen
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ii Nutrition Interventions for Chil
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Population “Children with special
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vi Nutrition Interventions for Chil
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Chapter 1 - Nutrition Screening and
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Chapter 2 - Anthropometricss needs,
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Chapter 2 - Anthropometricss Statur
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Chapter 2 - Anthropometricss Techni
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Chapter 2 - Anthropometricss paraly
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Chapter 2 - Anthropometricss time a
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Chapter 2 - Anthropometricss measur
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Chapter 2 - Anthropometricss Mild m
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Chapter 2 - Anthropometricss 9. Re-
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Chapter 2 - Anthropometricss 5. Per
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Chapter 2 - Anthropometrics Table 2
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Chapter 2 - Anthropometricss Refere
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Chapter 2 - Anthropometricss 26. Kr
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Chapter 3 - Physical Activity for C
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Chapter 4 - Breastfeeding recommend
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Chapter 4 - Breastfeeding Table 4-1
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Chapter 4 - Breastfeeding Assessmen
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Chapter 4 - Breastfeeding 58 Nutrit
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Chapter 5 - Medication-Nutrient Int
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Chapter 6 - Nutrition Interventions
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Chapter 16 - Nutrition Intervention
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Chapter 22 - Ketogenic Diet for Sei
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Appendix A Please list any other nu
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Appendix A Baby formula What kind o
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Appendix B Manufacturer Description
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Appendix C 282 Nutrition Interventi
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Appendix D 284 Nutrition Interventi
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Appendix E 292 Nutrition Interventi
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Appendix E Table 3: Parent-Specific
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Appendix F Percentiles of Upper Arm
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Appendix F 302 Nutrition Interventi
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Appendix G 304 Nutrition Interventi
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Appendix H 312 Nutrition Interventi
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Appendix I 320 Nutrition Interventi
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Appendix J 328 Nutrition Interventi
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Appendix K 336 Nutrition Interventi
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Appendix K 338 Nutrition Interventi
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Appendix L 340 Nutrition Interventi
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Appendix M 342 Nutrition Interventi
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Appendix M 344 Nutrition Interventi
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Appendix N Gastrostomy Tube Feeding
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Appendix N activities. When feeding
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Appendix N Feeding Sets/Extensions
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Appendix N Fluid and Electrolytes W
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Appendix N osmolality of full-stren
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Appendix N Modular Products Modular
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Appendix N his family, and the home
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Appendix N • The feeding tube may
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Appendix N equipment. The Special S
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Appendix N Table N-2: Common Compli
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Appendix N Complication Possible Ca
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Appendix N 368 Nutrition Interventi
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Appendix O Some conditions increase
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Appendix O Table O-3: Recommended P
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Appendix O 374 Nutrition Interventi
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Appendix P Diet Prescription for Me
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Appendix Q Goals Considerations for
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Appendix R Condition Description Nu
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Appendix R Condition Description Nu
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Appendix R References 1. Ekvall SW
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Appendix S Table S-1: Infant Formul
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Appendix S Comments Osmolality (mOs
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Appendix S Table S-2: Pediatric For
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Appendix S Table S-3: Modular Produ
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Appendix S Comments Energy (kcal) P
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Appendix S Contact Information Abbo
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Appendix T Powdered Formulas Accura
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Appendix T Table T-1: Liquid Concen
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Appendix T 402 Nutrition Interventi
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Appendix U Nutrition Strategies for
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Appendix U ADA Pocket Guide to Nutr
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Glossary Autism Spectrum Disorders
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Glossary Early intervention service
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Glossary Length (recumbent length)
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Glossary Stadiometer moveable headb
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Index specialist 98 target 108 Bink
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Index elemental formula 348 elimina
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Index I ICF. See International Clas
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Index risk indicators 4 screening 1
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Index suppositories 72, 77 Surmonti
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Nutrition Interventions for Children with Special Health Care Needs

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