1) Children with special health care needs often have nutrition problems due to their conditions. Their specific nutrient and calorie needs must be determined through a nutrition assessment and may require customized recommendations.
2) Feeding problems are common in toddlers and preschoolers with special needs, such as low appetite, long mealtimes, or preferring liquids over solids. Conditions like autism, ADHD, cerebral palsy and pulmonary issues can impact eating.
3) Nutrition services for these children are available through various state and federal programs like early intervention, Head Start, and WIC to help address their unique nutrition needs.
1) Children with special health care needs often have nutrition problems due to their conditions. Their specific nutrient and calorie needs must be determined through a nutrition assessment and may require customized recommendations.
2) Feeding problems are common in toddlers and preschoolers with special needs, such as low appetite, long mealtimes, or preferring liquids over solids. Conditions like autism, ADHD, cerebral palsy and pulmonary issues can impact eating.
3) Nutrition services for these children are available through various state and federal programs like early intervention, Head Start, and WIC to help address their unique nutrition needs.
1) Children with special health care needs often have nutrition problems due to their conditions. Their specific nutrient and calorie needs must be determined through a nutrition assessment and may require customized recommendations.
2) Feeding problems are common in toddlers and preschoolers with special needs, such as low appetite, long mealtimes, or preferring liquids over solids. Conditions like autism, ADHD, cerebral palsy and pulmonary issues can impact eating.
3) Nutrition services for these children are available through various state and federal programs like early intervention, Head Start, and WIC to help address their unique nutrition needs.
1) Children with special health care needs often have nutrition problems due to their conditions. Their specific nutrient and calorie needs must be determined through a nutrition assessment and may require customized recommendations.
2) Feeding problems are common in toddlers and preschoolers with special needs, such as low appetite, long mealtimes, or preferring liquids over solids. Conditions like autism, ADHD, cerebral palsy and pulmonary issues can impact eating.
3) Nutrition services for these children are available through various state and federal programs like early intervention, Head Start, and WIC to help address their unique nutrition needs.
Conditions and Interventions Nutrition Through the Life Cycle Judith E. Brown Who Are Children with Special Health Care Needs? • Criteria for “chronic condition” or “disability” varies from state to state • Estimates range from 5% to 31% of children • ~90% of children with disabilities have a nutrition problem Eligibility for Early Intervention Services are Based on: • Developmental delays: – Cognitive, physical, language & speech, psychological, or self-help skills • Physical or mental condition with a high probability of delay • At risk medically or environmentally for substantial delay without services Nutrition Needs of Toddlers & Preschoolers with Chronic Conditions • DRIs are a starting point for setting protein, vitamin and mineral needs • Specific conditions need adjustments • May cause poor appetite & increased caloric needs • May lead to over- or under-weight • Caloric & nutrient recommendations should be customized for each child Nutrition Needs of Toddlers & Preschoolers with Chronic Conditions Growth Assessment • Nutrition assessment should be first step to determine if nutrition services are needed • Assessment answers the following: – Is child’s growth on track? – Is child’s diet adequate? – Are feeding or eating skills age appropriate? – Does diagnosis affect nutritional needs? Growth Assessment • Interpretation of growth charts should consider special health condition • Growth charts specific to some conditions include: – LBW or VLBW – Special head growth chart Nellhaus Head Circumference Growth Chart Plotted for Girl with Rett Syndrome Feeding Problems • Special health care needs cause feeding problems in young children combined with typical feeding issues of the average toddler or preschooler • Examples include: – Low interest in eating – Long mealtimes – Preferring liquids over solids – Food refusals Behavioral Feeding Problems • Mealtime feeding problems are common with toddlers & preschoolers with behavioral & attention disorders • Behavioral disorders that affect nutritional status – Autism – Attention deficit hyperactivity disorder (ADHD) • May be suspected in preschool years but usually treated in the school years Other Feeding Problems • Excessive fluid intake – Child would rather drink than eat • Feeding problems & food safety – Mashed or pureed foods and tubing or devices for feeding may be contaminated or spoilage may occur • Feeding problems from disabilities involving neuro-muscular control Nutrition-Related Conditions • Failure to thrive (FTT) • Toddler diarrhea & celiac disease • Autism • Muscle coordination problems & cerebral palsy • Pulmonary problems • Developmental delay & evaluations Failure to Thrive (FTT)
• What is FTT? Inadequate wt or ht gain with
growth declines more than 2 growth percentiles • May result from: – Digestive problems – Asthma or breathing problems – Neurological conditions – Pediatric AIDS Failure to Thrive (FTT) Toddler Diarrhea and Celiac Disease • “Toddler diarrhea” typically caused by sucrose & sorbitol content of fruit juices • Celiac disease results in diarrhea & caused by sensitivity to the protein gluten found in wheat & other grains Autism • No scientifically proven diet is recommended for prevention or treatment • Gluten-free & casein-free diets have been recommended via Internet and support groups but not scientifically shown beneficial Muscle Coordination Problems & Cerebral Palsy • Cerebral palsy – Group of disorders characterized by impaired muscle activity & coordination present at birth or developed during early childhood – Spastic quadriplegia: a form of cerebral palsy – Reduced dietary intake results from child easily becoming tired while eating Meal Pattern & Recommended Foods • Meal pattern may be changed to provide small, frequent meals, and snacks to prevent tiredness at meals
• Foods recommended are easy to chew and
small Meal Pattern & Recommended Foods Pulmonary Problems • Examples of pulmonary (breathing) problems are brochopulmonary dysplasia & asthma • Breathing problems increase nutrient needs, lower interest in eating & can slow growth • Preterm infants at high risk of breathing problems Developmental Delay & Evaluation • Developmental delay may be suspected when: – Specific nutrients are inadequately or excessively consumed – May result from iron deficiency or lead toxicity • Physical growth may be impacted Food Allergies and Intolerance
• True food allergies seen in ~2% to 8% of children
• Common food allergies include: – Milk – Eggs – Wheat – Peanuts – Walnuts – Soy – Fish Dietary Supplements and Herbal Remedies
• Parents should be cautioned about use of
supplements and/or herbs to treat various conditions • Often unproven recommendations come from support groups or the Internet Sources of Nutrition Services • State programs • Early intervention programs • Early childhood education programs (IDEA) • Head Start • Early Head Start • WIC • Low birthweight follow up • Child care feeding programs