Nutrition Interventions for Children with Special Health Care Needs

Chapter 16 - Nutrition Interventions for Respiratory Diseases
TaBle 16-2:
aSSeSSmeNT INTeRveNTIoN evaluaTIoN/ouTCome
* †
Anthropometric:
Maintain established growth
pattern for weight and length
for age.
Further assessment is required to determine
potential causes of inadequate growth.
Intervention may be a combination of dietary,
feeding, behavioral and medical interventions.
Measure and plot on appropriate growth chart using corrected
age:
Length for age
• Weight for age
• Weight for length (or height) or BMI
• Head circumference (under 3 years)
For infants and children with mild and moderate BPD these values
should be obtained monthly for the first 4 months after hospital
discharge and every 3 months thereafter for the first year of
life, more often if weight gain is less than 15 g/day. For infants
with severe BPD, measure length bimonthly, weight weekly (use
incremental growth charts11 ), and head circumference monthly. 2
Infants relying on tube feeding should have frequent weight
checks to adjust feeding rates with growth, initially every 1-2
weeks, then monthly.
While some infants and young children with BPD will exhibit
catch-up growth (growth that shows increasing percentiles on
growth charts), those who were very small at birth and those
who have moderate to severe illness may not show catch-up
growth for several years. All infants and children with BPD should
have at least a steady growth pattern that follows established
growth percentiles.
Fat and muscle stores within
normal parameters for
age, gender, and medical
condition.
Very inactive children and those dependent on
steroids or mechanical ventilation may develop
excessive fat stores and energy intake may
need to be reduced.
For older toddlers and children with moderate to severe BPD,
especially those on corticosteroid therapy, assessment of midarm
circumference, mid-arm muscle circumference, and triceps
skinfold every 2 months can be useful to assess fat stores
and protein status. 2,12 Triceps skinfold 85th percentile or arm muscle area