Nutrition Interventions for Children with Special Health Care Needs

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Chapter 17 - Nutrition Interventions for Cystic Fibrosis Assessment Intervention Evaluation/Outcome All CF centers have patient education materials (written, video) for increasing energy density If patient cannot orally consume adequate energy to maintain weight and nutritional status, consider enteral feedings (i.e., gastrostomy or nasogastric tube). 12,13 Intake provides an adequate amount of protein for growth. Provide recommendations for an adequate intake of protein. Estimate individual protein needs. 5 Protein needs may be as high as 150-200% RDA for age for ideal body weight. Infants (less than 12 months): 4.0 g/kg/d Children (1-10 years): 3.0 g/kg/d Males (11 years and older): 2.5 g/kg/d Females (11 years and older): 2.0 g/kg/d Intake provides an adequate amount of fat for growth. Encourage use of foods containing essential fatty acids (e.g., safflower, corn, sunflower, and sesame oils). Evaluate fat intake. Fat may supply 30-50% of total energy. Fat intake will vary according to weight gain, pulmonary status, and fat tolerance. (There is no limit on dietary fat 198 Nutrition Interventions for Children With Special Health Care Needs intake.) Intake of vitamins and minerals is adequate. Provide conventional vitamin/mineral supplements daily (dosage based on DRI/RDA for age). Evaluate intake of vitamins and minerals. 5 (Specific vitamins and minerals are recommended by CF center RD.) Specific brands are: Sourcecf, Aquadeks and Vitamax. Caregiver demonstrates appropriate use of vitamin/ mineral supplements. When indicated by lab test results, dietary data, or clinical data, use CF-specific vitamins (Sourcecf, Aquadek, or Vitamax) 14 Intake of sodium chloride is adequate. No episodes of heat exhaustion or dehydration. 4 Evaluate intake of sodium chloride. 4 Provide salt adequate to meet individual needs. Infants will require supplementation with sodium chloride (table salt). An appropriate and safe dose is 2-4mEq/kg/d. This amount can be provided as ⅛ teaspoon table salt per day.
Assessment Intervention Evaluation/Outcome Enzymes are provided in an appropriate dose and are used consistently. Instruct caregivers to Evaluate consistency and appropriate use of enteric-coated pancreatic enzymes. 7 • Give enzymes with all foods and drinks (exception: some children may be able to eat simple carbohydrates without symptoms of malabsorption). • Give an adequate number of enzyme capsules. Adequate replacement varies from patient to patient. The required number of capsules may vary, depending upon: Enzyme dosage is the responsibility of the patient’s CF center. Recommendations are to use 2000 to 3000 IU lipase/ kg/meal as the upper limit of dosage, although the patients’ needs vary. a) amount of food eaten The most commonly used products include Ultrase, Ultrase MT12, MT18, MT20; Pancrease MT4, MT10, MT16, MT 20; Creon 6, Creon 24, Creon 24., Pancrecarb MS4, Pancrecarb MS8 & Pancrecarb MS16. b) protein, fat, and carbohydrate content of foods Section 3 - Condition-Specific Nutrition Interventions c) stool size, frequency, and consistency • Carry enzymes at all times for convenient use. Keep enzymes at child’s bedside when in hospital, if approved by the hospital. • Check enzymes for freshness. When out-ofdate or exposed to temperature extremes, enzyme beads may shrivel and turn a darker beige color. Nutrition Interventions for Children With Special Health Care Needs 199 For infants, instruct caregivers: • Open capsules to be taken and place in small amount (1/4 tsp) strained fruit or yogurt. • Give enzymes by spoon at the start of each feeding. • Enzymes are effective for approximately 1 ½ hours. • Check baby’s mouth to see that no beads remain under tongue or between gums and cheeks. Beads may cause tissue breakdown and discomfort if left in mouth.
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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 12 - Accommodating Special
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Chapter 13 - Nutrition Intervention
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Page 164 and 165: Chapter 13 - 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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Nutrition Interventions for Children with Special Health Care Needs

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