Nutrition Interventions for Children with Special Health Care Needs

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Chapter 18 - Nutrition Interventions for Congenital Heart Disease Table 18-1: CongeniTal CardiaC anomalies Defect Description Symptoms Treatment Growth/Developmental Implications See specfic anomaly below. Tend to be more severely growth retarded overall; generally work within their internal limits of oxygen availability; more developmental delays compared to children with acyanotic defects R to L shunts See specfic anomaly below. Cyanotic/ Hypoxic Cyanosis; dyspnea Primary repair Moderate growth failure, especially with regards to weight R ventricular outflow obstruction; ventricular septal defect (VSD); narrowed pulmonary valve; thickened R ventricular wall; displaced aorta Tetralogy of Fallot Arterial switch Growth retardation in 30-50% of patients. Cardiomegaly; cyanosis Two parallel and separate circulatory systems exist, one pulmonary and one systemic Transposition of the Great Arteries (TGA) 206 Nutrition Interventions for Children With Special Health Care Needs Poor feeding and growth Systemic to pulmonary shunt; may also have a pulmonary valvulotomy or pulmonary outflow patch (later in childhood) Murmur; CHF; not compatible with life unless there is an inter-atrial communication and pathway for entry of blood into pulmonary circulation (ie, patent ductus arteriosus (PDA) Complete obstruction of pulmonary artery resulting in total diversion of blood from R ventricle to aorta Pulmonary Atresia
Defect Description Symptoms Treatment Growth/Developmental Implications 40% of children have marked weight and height growth retardation Staged surgical repair: Slightly increased heart size Stage 1: Cavo-Pulmonary Shunt or “Glenn”. Connects superior vena cava (SVC) to R pulmonary artery to direct blood from upper circulation to lung w/o return to heart Stage 2: Fontan (later in childhood). SVC and inferior vena cava (IVC) are connected to pulmonary artery so that lung circulation operates w/o separate ventricle (which is too small to do its job) Tricuspid Atresia Absence of any communication between R atrium and R ventricle; blood from R atrium passes through atrial septal defect (ASD) into L atrium, mixes with oxygenated blood returning from lungs, flows into L ventricle, and is sent into circulation; VSD usually present. Section 3 - Condition-Specific Nutrition Interventions Poor feeding, growth, and failure to thrive after surgery; nutritional status deteriorates post-op Staged surgery - mortality high even with surgical intervention: CHF; heart murmur in 2/3 of patients L side of heart poorly formed and cannot support main circulation; • Hypoplastic Left Heart L ventricle and aorta are small; syndrome including severe coarctation, severe aortic valve stenosis or atresia, and severe mitral valve stenosis or atresia Nutrition Interventions for Children With Special Health Care Needs 207 Stage 1: Shunt from R arm artery to R pulmonary artery for blood flow to lungs Stage 2: Cavo-Pulmonary Shunt or “Glenn” (see above). Previous shunt removed Stage 3: Fontan (if needed-see above) L to R shunts Dyspnea See specific anomaly below Poor feeding; typically affects weight rather than length (except for Coarctation of the Aorta and Pulmonary Stenosis) Acyanotic Weight negatively affected prior to duct closure; growth acceleration following closure Heart murmur Fluid restriction; pharmacologic closure (Indocin or Ibuprofen); surgical ligation Failure to close the fetal communication between the pulmonary artery and aorta PDA (Patent Ductus Arteriosis)
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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 172 and 173: Chapter 14 - Nutrition Intervention
Page 264 and 265: Chapter 22 - Ketogenic Diet for Sei
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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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