Nutrition Interventions for Children with Special Health Care Needs

Complication Possible Cause Intervention
Constipation * Inadequate fiber/bulk or fluid • Try formula with added fiber
• Increase water
• Supplement with prune juice
• Try stool softeners, suppositories or enema, as indicated
• Refer to physician
Delayed gastric emptying • Refer to physician
• Recommend medication to stimulate movement of GI tract
• Elevate child’s head (30-45°) during feeding and for 1 hour after meal
• Check for residuals before feeding
• Try smaller, more frequent bolus feedings or continuous drip feeding
• Consider jejunal feeding
Gastroesophageal
reflux
Large residuals Decreased gastric motility • Elevate child’s head during feeding
• Use gastric stimulant to promote gastric emptying
• Consider continuous feeds
Hyperosmolar formula • Switch to isotonic formula
Medications • Do not add medications to formula; give between feeding with water or juice.
• Refer to physician
• Refer to physician
• Decrease protein
• Increase fluids. Monitor fluid intake and output
Tube feeding
syndrome
(dehydration,
azotemia, and
hypernatremia)
Appendix N
Nutrition Interventions for Children With Special Health Care Needs 365
Excessive protein intake with
inadequate fluid intake
• Refer to physician
• Replace sodium losses
• Restrict fluids
Hyponatremia Inadequate serum sodium
may be related to excessive
water intake, excessive fluid
loss (e.g., vomiting and/
or diarrhea), medications,
tracheostomies, or fluid
retention related to renal or
cardiac problems