Nutrition Interventions for Children with Special Health Care Needs

Assessment Intervention Evaluation
Dietary
Nutrient intake is adequate
Recommend adequate energy intake including:
• Increased concentration of infant formula (if urine osmolarity is
maintained below 400mOsm) 3
• Increased energy in food or infant formula by adding
carbohydrate (e.g., Moducal® or Polycose®) or fat (e.g.,
vegetable oil, margarine, MCT oil)+
• Counseling about dietary supplements
• Fortified breast milk (adding formula or modular®)
• Separation of hind milk from fore milk for pumped breast milk;
use hind milk for feedings
• Consideration of tube feeding if a child has documented growth
failure and/or having difficulties with oral feeding
• Consider speech/and or occupational therapy consult if poor oral
intake
Obtain diet history and/or 3 to 7
day food record; assess intake
of energy, protein, vitamins,
minerals, and electrolytes
• Energy needs for infants may
range from 120-180 kcal/kg/
day
• Energy needs for older
children may be significantly
higher than normal, 120-150
kcal/kg/day for toddlers
Section 3 - Condition-Specific Nutrition Interventions
Recommended distribution of
energy:
• 8-10% from protein; protein
should be given at a minimum
of the recommended for age
• 35-65% from carbohydrate
• 35-50% from fat
Nutrition Interventions for Children With Special Health Care Needs 211
*For reference data and guidelines for taking accurate measurements, see Chapter 2
† For more information about products to increase energy see Appendix S and for guidelines to increase energy in formula see Appendix T.