Nutrition Interventions for Children with Special Health Care Needs

aSSeSSmeNT INTeRveNTIoN evaluaTIoN/ouTCome
Dietary
Growth is adequate. Intakes
of vitamins and minerals
are at DRI/RDA levels. For
infants, iron intakes are
those recommended by
the American Academy of
Pediatrics.
For infants with mild BPD, appropriate growth,
and good feeding skills, provide standard infant
formula.
For infants: assess intake of energy, protein, carbohydrate,
vitamins, minerals.
For infants with moderate or severe BPD,
ongoing fluid restriction, or feeding problems
that interfere with adequate intakes, a 22
kcal/oz formula may be used or formula may
be concentrated to 24-30 kcal/oz following
guidelines in Appendix T.
In infancy, protein intake may be compromised if intake of infant
cereal, high carbohydrate baby food, or glucose polymers are
excessive. Protein should provide 8-12% of energy for infants.
Excessive protein and high renal solute load may result if formula
is concentrated to greater than 24 kcal/oz without the use of
modular products.
Guidelines for infants receiving tube feedings
are found in Chapter 10.
Section 3 - Condition-Specific Nutrition Interventions
Small infants with limited energy needs may
require additional supplements to meet DRI/
RDA requirements for vitamins and minerals if
sufficient formula is not taken.
Attention should be paid to iron, calcium and
phosphorous intakes of all VLBW infants (see
Chapter 15).
Foods are introduced to the
child when developmentally
appropriate.
Nutrition Interventions for Children With Special Health Care Needs 185
Foods should be introduced as the infant is
developmentally ready. See Chapter 8.
Assess introduction of non-milk feedings (solids).
Foods are sometimes introduced to the infant with BPD according
to chronological age since birth. This is not nutritionally or
developmentally appropriate. Infants with growth and feeding
difficulties should begin the transition to solid foods using high
nutrient dense foods. This can be accomplished by reading labels
for jar baby foods, using infant cereal mixed with breast milk
or formula, and when appropriate making baby food from table
foods.