Nutrition Interventions for Children with Special Health Care Needs

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Chapter 19 - Nutrition Interventions for Chronic Renal Failure 226 Nutrition Interventions for Children With Special Health Care Needs
Chapter 20 Section 3 - Condition-Specific Nutrition Interventions Nutrition Interventions for Short Bowel Syndrome Lori Brizee, MS, RD, CSP, LD Definition of Short Bowel Syndrome Short Bowel Syndrome (SBS) is defined as malabsorption resulting from anatomical or functional loss of a significant length of the small intestine. This occurs most commonly after bowel resection in the newborn period (e.g., secondary to necrotizing enterocolitis, mid-gut volvulus, gastroschisis, or intussusception). SBS can also result from trauma to the bowel (e.g., with an auto accident or fall, or with severe nonaccidental trauma). The amount of bowel that must be lost to produce malabsorption is variable and depends on which sections are lost and whether or not the ileocecal valve is preserved. The normal length of small intestine is approximately 300-850 cm for an adult, 200-250 cm for an infant over 35 weeks gestation, and approximately 100-120 cm for a premature infant less than 30 weeks gestation. Loss of greater than 80% of the small bowel is associated with increased requirement for parenteral nutrition support and decreased overall survival. When the ileocecal valve is lost, the resulting risk for bacterial contamination of the small intestine from the colon mandates more small intestine for tolerance of oral/enteral feeding (1,2,3). The small intestine consists of the duodenum, jejunum, and ileum. (See Figure 1) The majority of carbohydrate and protein absorption takes place in the duodenum and jejunum. Fats and fat-soluble vitamins are absorbed in the ileum. Bile salts are excreted from the liver into the duodenum and are required for the absorption of long chain fatty acids and fat-soluble vitamins in the ileum. Vitamin B12 binds to intrinsic factor (produced in the stomach) and is absorbed in the terminal ileum. Fluids and electrolytes are predominantly absorbed in the ileum and in the colon. When the duodenum and/or jejunum are resected, the ileum can largely adapt to perform their absorptive functions. The duodenum and jejunum, however, cannot adapt to perform the functions of the ileum. Thus, resection of the duodenum or jejunum is generally much better tolerated than resection of the ileum. The ileocecal valve is the main barrier between the small and large intestine. It helps regulate the exit of fluid and malabsorbed nutrients in small bowel. It also helps Nutrition Interventions for Children With Special Health Care Needs 227
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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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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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