Nutrition Interventions for Children with Special Health Care Needs

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Chapter 16 - Nutrition Interventions for Respiratory Diseases aSSeSSmeNT INTeRveNTIoN evaluaTIoN/ouTCome Young children are growing adequately and achieving DRI/RDA levels of vitamin and mineral intake. If energy needs remain high past early infancy, foods should be chosen to provide optimal energy and nutrients. Suggestions include yogurt, pudding, cottage cheese, pancakes, hot cereals, tuna or meat salad, scrambled egg, cheese, and mashed avocado. High fat foods such as butter, margarine, mayonnaise, cream cheese, and cream can be added to other foods to increase energy content. Assess intake of energy, protein, vitamins, and minerals of young children. Homemade milkshakes, fruit slushies, and instant breakfast products can be used as an energy-dense snack or bedtime beverage. Commercial pediatric enteral feeding products may also be used for this purpose. Meals and snacks should be offered at regular times 5-6 times each day in a pleasant, noncoercive environment. Tube feedings are sometimes required for infants with BPD, especially those who continue to depend on mechanical ventilators. The type of enteral feeding is usually changed at about 1 year of age. (See Chapter 10). Tube-fed infants should continue to receive oral stimulation and to have social interactions at feeding times. A team approach to feeding problems and referral for additional assessment and therapy may be indicated. (See Chapter 8) Feeding skills: Feeding problems are common in infants with BPD. Feeding should be assessed by a feeding observation and careful questioning of caregivers. 186 Nutrition Interventions for Children With Special Health Care Needs Problems with feeding are addressed.
aSSeSSmeNT INTeRveNTIoN evaluaTIoN/ouTCome Child ingests adequate energy to support growth. Family is able to enjoy feeding interactions with child. Check with primary care provider about provision of additional oxygen at feeding times and/or use of bronchodilators before feedings. Fatigue: Consider fatigue as a feeding issue if the infant stops feeding before ingesting adequate energy. Family may be spending several hours each day feeding infant and may feel inadequate in light of meeting energy requirements. Increase energy concentration of formula or other foods. (See Appendix T) Manipulate the feeding schedule to increase efficiency. Shorten feeding times and end when feeding becomes less efficient. Try smaller, more frequent feedings. Consider gastrostomy tube placement. (See Chapter 10) Section 3 - Condition-Specific Nutrition Interventions Infant feeds without distress and demonstrates coordination of suckswallow-breathe. See Chapter 8. Help infant to “pace” feeding. poor coordination of swallowing: Feeding observation may show abnormal sucking patterns with short irregular sucking bursts with long pauses and rapid breathing. Nutrition Interventions for Children With Special Health Care Needs 187 Consider interventions listed in fatigue section (above). Refer for feeding therapy. Feeding is not associated with adverse pulmonary consequences. Dependent on findings of specialist. May include changes in texture or temperature of foods and beverages. In severe cases it may not be safe to feed orally. Swallowing dysfunction due to aspiration: Infants with BPD are at risk of aspiration due to airway damage caused by intubation as well as reduced ability to use pulmonary air to clear the larynx. Suspect aspiration with episodes of respiratory deterioration or wheezing with feedings, and refer for testing and intervention. Aspiration can be assessed with videofluoroscopic swallowing study (VFSS)
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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 10 - Enteral Feeding Other
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Chapter 10 - Enteral Feeding Table
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Chapter 10 - Enteral Feeding Table
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Chapter 10 - Enteral Feeding Refere
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Chapter 11 - Community Monitoring o
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Chapter 20 - 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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