Nutrition Interventions for Children with Special Health Care Needs

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Chapter 6 - Nutrition Interventions for Constipation of aspiration or swallowing difficulties. Alternatives suggested for infants are sorbitol, naturally found in pear, apple, and prune juices, glycerin suppositories, and lactulose. Corn Syrup Corn syrup has been commonly used to treat constipation, on the theory that its high osmolarity will draw more water into the intestinal tract by osmosis. Although this seems to work in some cases, high osmolarity liquids have not been shown to be effective in treating constipation (2). The remainder of this section (Table 6-1 and 6-2) presents guidelines for nutrition assessment, intervention, and evaluation/outcome for children with constipation. 74 Nutrition Interventions for Children With Special Health Care Needs
Table 6-1: Laxatives Instructions on packages should be followed. Contact physician if age-appropriate instructions are not available. Encourage families to report additions or changes in routines and medications so this information may be considered in prescribing medications and monitoring progress. Brand/Common Name Action Comments Site of Action Onset of Action (hours) Laxative Type small 0.5-3 • May alter fluid and electrolyte and Attracts/retains water in balance Epsom salts large intestinal lumen, increasing • Sulfate salts are considered the Milk of magnesia intestine intraluminal pressure; most potent • May decrease tetracycline cholecystokinin release 0.03-0.25 colon absorption Fleets enema ® Saline Magnesium Sulfate Magnesium Hydroxide Magnesium Citrate Sodium Phosphate Sodium Phosphate/ Biphosphate enema Section 2 - Problem-Based Nutrition Interventions Cascara Senokot ® Ex-Lax ® Dulcolax ® Fletcher’s Castoria ® • Cascara and senna may cause yellow-brown urine; alkaline urine may turn pink-red or red-violet • Bile must be present for phenolphthalein to have effect • Do not give Biscodyl tablets within 1 hour of antacids or milk products • May prefer castor oil when complete evacuation is required 6-10 Direct action on intestinal mucosa; stimulates myenteric plexus; alters water and electrolyte colon Irritant/Stimulant Cascara Danthron Senna Phenolphthalein Casanthranol Nutrition Interventions for Children With Special Health Care Needs 75 Bisacodyl Tablets 0.25-1 2-6 Bisacodyl Suppository Castor Oil Safest and most physiological Citrucel® Hydrocil® Metamucil® Chronulac® Malt supex® Do not give with salicylates, digitalis, or cardiac glycosides Holds water in stool; mechanical distention; malt soup extract reduces fecal pH. small and large intestine 12-24 (up to 72 hr) Bulk-Producing Methylcellulose Psyllium Polycarbophil May cause obstruction if passage is stopped Not for infants less than 1 year of age or children with history of aspiration. Mineral oil Lubricates intestine; retards colonic absorption of fecal water; softens stool 6-8 colon Administer on empty stomach Lubricant Mineral oil (1-2 tsp/ day) Oil enema (1-4 oz) Colace® Doss® Beneficial when feces are hard or dry, or in anorectal conditions where passage of a firm stool is painful Detergent activity; facilitates admixture of fat and water to soften stool. small and large intestine 24-72 Surfactants Docusate sodium (do not use if mineral oil given)
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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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Page 54 and 55: Chapter 3 - Physical Activity for C
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Page 110 and 111: Chapter 8 - Oral-Motor Feeding Prob
Page 118 and 119: Chapter 9 - Behavior Issues Related
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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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Chapter 22 - Ketogenic Diet for Sei
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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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