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Nutrition Interventions for Children with Special Health Care Needs

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Chapter 4 - Breastfeeding<br />

Assessment Intervention Evaluation/Outcome<br />

Infant will show growth in all parameters<br />

at an appropriate rate<br />

If <strong>for</strong>tification is needed, try to rely on breastfeeding<br />

and/or breast milk as much as possible:<br />

Is <strong>for</strong>tification needed?<br />

• During pumping, separate hind milk, and use<br />

this as a supplement.<br />

• Add energy enhancement to expressed breast<br />

milk<br />

• Balance feedings at the breast <strong>with</strong> energy<br />

enriched bottle feedings<br />

• Breast feed using a energy enriched breast milk<br />

through a tube feeding device (i.e. supplemental<br />

nursing system)<br />

Babies may require <strong>for</strong>tification to provide extra<br />

calories <strong>for</strong> growth if:<br />

• The baby is not able to take adequate volume<br />

at the breast, or <strong>with</strong> breast + supplement<br />

• There are additional caloric or nutritional<br />

requirements specific to the baby’s medical<br />

condition.<br />

56 <strong>Nutrition</strong> <strong>Interventions</strong> <strong>for</strong> <strong>Children</strong> With <strong>Special</strong> <strong>Health</strong> <strong>Care</strong> <strong>Needs</strong>

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