Nutrition Interventions for Children with Special Health Care Needs

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