Nutrition Interventions for Children with Special Health Care Needs

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Chapter 20 - Nutrition Interventions for Short Bowel Syndrome Table 20-1: Nutrition Interventions for Short Bowel Syndrome Assessment Intervention Evaluation/Outcome Anthropometric * Weight for height (length) is between 10th and 90th percentiles. If poor weight gain, evaluate need to: Measure and plot on appropriate growth chart (for infants born prematurely, use corrected age until 2 years old): • increase energy and protein intake • alter intake to decrease stool or ostomy output. Child is gaining weight and growing at a normal rate for age (or corrected age). 8 If weight gain is excessive, evaluate need to decrease energy intake (this is most often an issue with patients on parenteral nutrition). • Height (length) for age • Weight for age • Weight for height (length) or BMI • Head circumference (
Assessment Intervention Evaluation/Outcome Biochemical Child’s micronutrient needs are met and biochemical indicators are within normal limits. If intestinal loss is in ileum, give a water soluble form of fat soluble vitamins (e.g., ADEK’s ® multivitamin;1mL liquid/day for infants < 1 year; 2 mL liquid/day for children 1-3 years; 1 chewable tablet per day for children 3-10 years; 1-2 chewable tablets per day for children >10 years) If receiving parenteral nutrition, see Chapter 11 and Appendix O. After parenteral nutrition is discontinued and enteral or oral feedings are sole source of nutrition, monitor serum levels up to once every 4 weeks until levels are within normal limits. Once stable, measure every 6 to 12 months. Dosages for specific vitamin and mineral supplements will vary depending on a child’s age, size, and degree of deficiency; consult the child’s physician and pharmacist for appropriate dosage of vitamin and/or mineral to treat deficiency. Section 3 - Condition-Specific Nutrition Interventions Indicators of vitamin A status are within normal limits. Vitamin A If deficiency, give additional vitamin A in watersoluble form. Monitor levels every 1-2 weeks while giving high doses of vitamin A to avoid toxicity. Indicators of vitamin E status are within normal limits. Vitamin E If deficiency, give additional vitamin E in watersoluble form. Monitor levels every 2-4 weeks to avoid vitamin E excess. Indicators of vitamin D, calcium, phosphorus, and alkaline phosphatase are within normal limits. Vitamin D, calcium, phosphorus, alkaline phosphatase If vitamin D deficiency, give high dose vitamin D. Make sure child is receiving at least DRI of calcium and phosphorus. Check serum calcium at least 1 month after high dose vitamin D is started and monthly thereafter to monitor for vitamin D toxicity. Recheck serum vitamin D three months after high dose supplement is started. Once serum vitamin D is within normal limits (32 to 80ng/ mL); give maintenance vitamin D of 18 IU/kg/day. Continue to monitor serum 25(OH)D every 3 to 6 10, 11, 12 months. If serum calcium or phosphorus are low, and vitamin D levels are normal, give supplements of calcium and/or phosphorus. Nutrition Interventions for Children With Special Health Care Needs 233
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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 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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