Nutritional Needs for Special Health Care Children

Child and Preadolescent Nutrition

• This presentation discusses nutrition for children and preadolescents.
• It highlights the importance of modified nutrition services for children with chronic conditions.

Children with Special Health Care Needs

• Nutrition services are tailored to meet the unique needs of children with chronic conditions.
• Examples of chronic conditions include cystic fibrosis, diabetes mellitus, cerebral palsy, phenylketonuria, and behavioral disorders.
• "People-first language" is emphasized, such as "a girl with Down's syndrome" instead of "the Down's girl."

Nutritional Requirements of Children with Special Health Care Needs - Energy Needs

• Children's nutritional needs vary greatly depending on their specific health condition.
• Some conditions require fewer calories due to slower growth or decreased muscle mass (e.g., Prader-Willi syndrome).
• Others may require increased calories due to higher activity levels (e.g., ADHD or ASD).

Nutritional Requirements of Children with Special Health Care Needs - Protein Needs

• Protein needs also vary based on the specific condition.
• Recovery from burns can increase protein needs up to 150% of the recommended daily intake (DRI).
• Some inborn errors of metabolism (e.g., PKU) require lowered protein.
• In some cases, hydrolyzed proteins or specific amino acids are necessary.

Nutritional Requirements of Children with Special Health Care Needs - Other Nutrients

• The presentation notes that some conditions can impair nutrient intake.
• Eating disorders or feeding issues can compromise nutrient intake.
• Side effects of medications can also affect nutrient intake.
• Some conditions require restricted intake of specific foods, affecting calcium levels, which can be lower for children with special needs than for the general population.

Growth Assessment

• Growth charts are a critical tool in assessing a child's growth.
• In-depth growth assessments are necessary to interpret results within the context of each child's condition.
• Warning signs for assessing growth include plateaus in weight, patterns of weight gain and loss, unexplained weight gain or loss, and failure to regain weight lost during illness.
• Evaluation of growth also requires consideration of factors like age of onset of the condition, secondary conditions, activity level, and body composition.

Growth Assessment - Body Composition and Growth

• Health conditions may influence growth parameters like muscle mass, bone structure, and fat stores.
• Conditions like Down's syndrome, cerebral palsy, and spina bifida can impact body composition and growth.
• Assessing body composition becomes necessary for accurate growth monitoring in specialized cases.
• Specialized growth charts are needed for children with variable disease severity.

Growth Assessment - Specialized Growth Charts

• Specialized growth charts are specifically designed for children with particular conditions.
• Conditions like juvenile rheumatoid arthritis, cystic fibrosis, Rett syndrome, spina bifida, seizures, and diabetes have specific growth patterns.

Nutrition Recommendations

• Parents' role is crucial in deciding the method of meeting their child's nutritional needs.
• Oral nutritional supplements, gastrostomy feeding, and other specialized feeding methods may be necessary for specialized needs.
• These methods can be temporarily required or are permanent depending on the child’s specific needs.

Nutrition Recommendations - Other Nutrients

• Vitamin and mineral supplements can be beneficial to ensure adequate intake
• Excessive intake can happen unintentionally, so special attention to calcium and vitamin D is important.
• For some conditions, fluids are critical but are also affected.
• Conditions such as excessive drooling can influence hydration and nutrient intake.

Eating and Feeding Problems in Children with Special Health Care Needs

• Feeding challenges can stem from underlying health or neurological conditions. These challenges can be further influenced by low self-feeding skills , issues related to meal length or food loss , required adjustment in timing of meals or snacks , families’ coping strategies , and individual circumstances.

Eating and Feeding Problems in Children with Special Health Care Needs - Case Studies

• Cystic fibrosis impacts nutrient absorption.
• Inadequate pancreatic enzymes lead to malabsorption.
• Increased energy requirements often exist due to infections and chronic lung diseases. This needs to be addressed with nutrient-dense meals,
• Diabetes mellitus affects insulin regulation impacting glucose metabolism.
• Timing and composition of meals/snacks, and insulin injections play crucial roles.
• Seizures involve uncontrolled electrical disturbances in the brain leading to various outcomes, including mild or severe jerking.
• Postictal periods create a need for careful feeding plans around food choking.
• Ketogenic diets can help with uncontrollable seizures.

Eating and Feeding Problems in Children with Special Health Care Needs - Case Studies (continued)

• Cerebral palsy results from brain damage, often leading to slow growth and feeding difficulties.
• Athetosis increases energy expenditure due to uncontrolled movement, necessitating higher calorie intake.
• Inborn metabolic errors necessitate dietary and treatment interventions to regulate abnormal breakdown products from foods and beverages.

Eating and Feeding Problems in Children with Special Health Care Needs - Case Studies (continued)

• Phenylketonuria (PKU) necessitates low-protein diets to avoid complications.
• Attention deficit hyperactivity disorder (ADHD) can affect appetite and create erratic meal and snack patterns.
• Pediatric HIV infections raise specific nutritional needs for HIV management in children which requires tailored plans that manage special circumstances and unique situations.
• Childhood celiac disease requires avoiding gluten for life.

Eating and Feeding Problems in Children with Special Health Care Needs-Case Studies (continued)

• Food allergies may involve reactions to specific foods and trigger life-threatening reactions.
• Strategies focus on minimizing allergen exposure in school settings and training staff to respond to reactions.
• Dietary supplements and herbal remedies are not recommended for all chronic conditions and dietary strategies should be established by experienced practitioners for successful management.

This quiz explores the unique nutritional requirements and challenges faced by children with special health care needs. Topics include growth charts, dietary interventions, and considerations for conditions like cystic fibrosis and celiac disease. Test your knowledge on how to support these children's nutritional health effectively.