Nutrition Interventions for Children with Special Health Care Needs

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Chapter 14 - Nutrition Interventions for Failure to Thrive tAble 14-1: nutrition interventions For FAilure to thrive Assessment Intervention Evaluation/ Outcome Anthropometric:* Weight gain is appropriate. Measure and plot on appropriate growth chart (for infants born prematurely use corrected age) Normal to accelerated weight gain and linear growth demonstrated. Collaborate with all disciplines to develop and prioritize a comprehensive treatment plan according to the individual needs of each child and family. A regular team meeting can help keep communication clear throughout the course of treatment. 1,2,3 • Height or length for age • Weight for age • Weight for length or BMI • Head circumference (under 3 years) Improved growth parameters: If %IBW ≤ 75%, temporary hospitalization for nutrition support and hydration may be required. 4 • Weight for length or BMI between 25th- 75th%ile • % IBW >85% (mild to normal) • % IBW >100% may be required to reverse linear stunting Determine height-age, weight-age,† and ideal weight for height.‡ Compare current weight to ideal weight for height. Obtain all available previous growth measurements. Compare all current measurements to reference data for chronological age and to previous measurements. 156 Nutrition Interventions for Children With Special Health Care Needs Calculate rate of weight gain and linear and OFC growth. Use percent ideal body weight (%IBW) to determine relative risk for physiologic complications associated with malnutrition. Classification of malnutrition: 16 (% IBW) (Classification) 80-89% Mild 70-79% Moderate
Assessment Intervention Evaluation/ Outcome Upper body muscle and fat stores between 10-90th%. Adjust recommendations for energy and/or protein intake, as appropriate. Measure: • Triceps skinfold • Mid upper arm circumference Calculate: • Arm muscle circumference • Arm fat area Indicators of inadequate stores: • Muscle and fat stores ≤5% may suggest long-term inadequate intake • Normal muscle with fat stores ≤5% often suggests acute energy deficiency Section 3 - Condition-Specific Nutrition Interventions Repeat mid upper arm circumference and triceps skinfold at least every 3 to 6 months Biochemical Biochemical indicators of specific nutrients within normal limits. Nutrition Interventions for Children With Special Health Care Needs 157 Offer nutrient-dense foods, emphasizing specific nutrients identified to be at risk. Monitor for iron deficiency as indicated by CBC, and diet record. Use supplements as needed to augment the child’s diet. Suggest nutrition panel (albumin, prealbumin, vitamins A and E, zinc and retinol binding protein), as appropriate. Refer to physician to treat electrolyte imbalance. Serum electrolyte levels are within normal limits. Check serum electrolyte levels. Assess for metabolic acidosis, indicated by low CO2. Clinical Refer to physician if medical problem is suspected. Medical causes of failure to thrive are addressed. Review medical history for medical reason for growth problems. Acidosis, renal insufficiency, “mild” cystic fibrosis can present as failure to thrive.
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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 8 - Oral-Motor Feeding Prob
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Chapter 9 - Behavior Issues Related
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Chapter 9 - Behavior Issues Related
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Chapter 18 - 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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