Nutrition Interventions for Children with Special Health Care Needs

Chapter 16
Section 3 - Condition-Specific Nutrition Interventions
Nutrition Interventions for respiratory
Disease
Donna Johnson, RD, PhD
Updated by Joan Zerzan, MS, RD, CD
Causes of abnormal respiratory function in infancy are shown in Table 16-1.
Nutritional implications are dependent on the nature of the disorder, clinical
manifestations, treatment modalities, compensatory mechanisms, and the presence
of other underlying conditions. Compensatory mechanisms are designed to maintain
normal ventilation and include: increased respiratory rate, increased work of
breathing, grunting, and nasal flaring. The consequences of these mechanisms
include increased effort, increased energy expenditure, and exhaustion. Normal
infant activities such as feeding and growth may be impaired.
Table 16-1: Causes of Respiratory Disease in Infancy1 Cause Example
Infections Viral (respiratory syncytial virus-RSV, parainfluenza),
bacterial
Bronchopulmonary dysplasia
(BPD), Chronic Lung Disease
(CLD)
Congenital anomalies of heart
and lung
prematurity, aspiration, meconium aspiration, infection
Tracheomalacia, laryngomalacia, congenital heart
disease (CHD), diaphragmatic hernia, hypoplastic lung,
congenital cysts or tumors
Congenital Syndromes Beckwith-Wiedeman, CHARGE association, Pierre Robin,
Treacher Collins, Trisomy 18, deLange, Mobius sequence,
cleft lip and palate
Bronchopulmonary dysplasia (BPD) has been described as a “chronic pulmonary
disorder that is the consequence of unresolved or abnormally repaired lung damage”
(2). BPD is seen primarily in preterm infants requiring respiratory support in the
first 2 weeks of life. However, chronic lung dysfunction can occur in full term infants
with respiratory distress syndrome, meconium aspiration, congenital heart disease,
congenital neuromuscular disease, or respiratory infections (3). Although advances
in clinical practices may be associated with reductions in the incidence and severity
Nutrition Interventions for Children With Special Health Care Needs 177