Nutrition Interventions for Children with Special Health Care Needs

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Chapter 15 - Nutrition Interventions for Premature Infant After Discharge gestational age and size. Morbidity associated with the late preterm infant includes temperature instability, hypoglycemia, respiratory distress, feeding difficulties and growth failure in the immediate post discharge period (3). Complications that may affect nutritional needs and growth outcome are listed in Table 15-2. Table 15-2: Complications That may Affect nutritional needs & Growth Physiological System Affected Possible Complications Reference in this volume Respiratory Bronchopulmonary dysplasia (BPD) Reactive airway disease (RAD) Cardiac Congenital heart disease (CHD) Patent ductus arteriosus (PDA) Cor Pulmonale Chapter 16 Chapter 18 Renal Nephrocalcinosis Chapter 19 Gastrointestinal Gastroesophageal reflux (GER) TPN-induced cholestasis Short bowel syndrome (SBS) Neurodevelopmental Developmental delays Cerebral palsy Hematological Anemia Learning disabilities Vision and hearing Immunological Susceptibility to repeat infections, illnesses, and rehospitalizations Nutrition Alteration in growth Osteopenia Feeding difficulties Growth Expectations and Assessment Chapter 8 Chapter 11 Chapter 20 Chapter 8 Chapter 8 Appendix R Chapter 2 Chapter 5 Chapter 8 During hospitalization, it is common practice to strive for “in utero” rates of growth (15 g/kg/day weight gain, 0.5-1.0 cm/week increase in length). After hospital discharge, it is unclear what represents optimal growth for the preterm infant. Growth data should be plotted according to the infant’s age corrected for prematurity. See example below for calculating corrected age: Corrected age (CA) = Chronological age (CH) – number of weeks premature 166 Nutrition Interventions for Children With Special Health Care Needs
Section 3 - Condition-Specific Nutrition Interventions Example: An infant is born at 28 weeks gestation and is now 6 months past his date of birth: Step 1: 40 – 28 = 12 weeks or 3 months premature Step 2: 6 months – 3 months = 3 months CA A number of growth charts have been developed for monitoring growth in preterm infants. See Appendix D for copies of these growth charts. The CDC growth charts developed for term infants are also used for monitoring growth of preterm infants after hospitalization. When using the CDC growth charts, growth should be plotted according to corrected age until approximately 2 years of age (4). See Table 15-3 for weight gain expectations for the first year of life. Table 15-3: Weight Gain expectations Using Age as a Guide 14 Age Population Percentile Weight Gain: Male Birth-6 mos (using CA)* Weight Gain: Female Premature infant 20-30 g/day 20-30 g/day Birth-6 mos Term infant† 10 th percentile 6-12 mos (using CA for preterm infants)* >12 mos (using CA for preterm infants)* Preterm and term infants† Preterm and term infants† 50 th percentile 90 th %ile 10 th percentile 50 th percentile 90 th percentile 10 th percentile 50 th percentile 90 th percentile 22 g/day 23 g/day 28 g/day 12 g/day 13 g/day 15 g/day 7 g/day 8 g/day 9 g/day * CA = corrected age † Calculated from CDC growth charts (10th-90th percentile) 19 g/day 21 g/day 23 g/day 12 g/day 13 g/day 14 g/day 7 g/day 8 g/day 9 g/day Follow-up studies suggest that when growth parameters are plotted according to corrected age (CA), VLBW and ELBW infants may not achieve percentiles comparable to term infants of similar age; they remain smaller and lighter (4-8). Most studies demonstrate little “catch-up growth” for the VLBW infant between 1-3 years of age. Infants with chronic medical conditions may not experience “catch-up growth” until school age (7,8). It is important to note that the term “catch-up growth” is often used in a non-traditional sense, to identify infants who achieve > 10th percentile on growth charts. More correctly, “catch-up growth” describes an infant who demonstrates accelerated rates of growth following a period of growth failure. The infant who continues to gain 20-30 g/day after 6 months of age, or the SGA infant Nutrition Interventions for Children With Special Health Care Needs 167
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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 19 - 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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