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