Chapter 11 Toddler and Preschooler Nutrition: Conditions and Interventions
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Transcript of Chapter 11 Toddler and Preschooler Nutrition: Conditions and Interventions
Chapter 11Toddler and Preschooler Nutrition:
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