Nutrition Interventions for Children with Special Health Care Needs

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.