Nutrition Interventions for Children with Special Health Care Needs

Chapter 14 - Nutrition Interventions for Failure to Thrive
Assessment Intervention Evaluation/
Outcome
Intake of protein is
adequate.
Enhance energy density of foods offered:
Estimate protein requirement by using RDA for age.
Estimate fluid requirement (adjust with weight gain):
Intake of energy is
adequate.
• Identify and encourage energy-dense foods/beverages
enjoyed by the child
• Increase the energy density of foods/beverages by
adding whole milk, powdered milk, cream, half and
half, instant breakfast powders, avocados, sour cream,
soy powders, peanut butter, margarine, oils, and
yogurt
• Avoid frequent intake of foods with low energy density
(e.g., broth, Jell-O®, popsicles, rice cakes, etc.)
• For 0-10 kg: 100cc/kg
• For 10-20 kg: 1000cc + 50cc/kg (over 10 kg)
• For 20 kg: 1500cc + 20cc/kg (over 20 kg)
Offer a multiple vitamin and/or other supplement to avoid
nutrient deficiencies.
Manipulate fluids to improve appetite and satiety in
children ≥1 year of age: 10
• Encourage a gradual change in fluid consumption to
approximate 16-24 oz whole milk or other calcium
fortified, nutrient dense beverage
• Together, juice, fruit drinks, and soda should be limited
to ≤6-8 oz/day
160 Nutrition Interventions for Children With Special Health Care Needs
For thirst between meals and snacks, offer water.
Feeding
Parents are connected to
an appropriate support system
and /or individual to
help separate their needs
from the child’s needs and
prioritize adequately.
Incorporate recommendations from feeding specialist and
psychosocial professionals into intervention plan.
Refer to findings from parent-child feeding evaluation
from feeding specialist (OT/PT, or speech pathologist)
and psychosocial professionals to gain insight on all factors
effecting a child’s feeding. 7 Note:
Non-threatening feeding
techniques and feeding environment
is provided for
the child consistently.
• Threatening and non-threatening aspects of feeding
techniques and environment for both the child and
parent
• Parent-child interactions
• Child’s feeding skills and other obstacles in the past
or present