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Nutrition for Children with Special Health Care Needs, Washington State
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Frequently Asked Questions (FAQ)

Who are children with special health care needs?
Why are children with special health care needs at increased risk for nutrition problems?
What are some common nutrition problems seen in children with special needs?
Why should nutrition services be available for children with special health care needs?
How can registered dietitians help children with special health care needs?
Is there a difference between registered dietitians and nutritionists?

Who are children with special health care needs?

Children and adolescents with special health care needs are those who have congenital or acquired conditions that affect physical, behavioral and /or cognitive growth and development and who require more than the usual pediatric health care. The term refers to children who have developmental disabilities, chronic conditions, or health-related problems as well as those who are at risk for these conditions. These children may have medical diagnoses such as Down syndrome, cystic fibrosis, cerebral palsy, pediatric HIV/AIDS, spina bifida, muscular dystrophy, autism, Prader-Willi syndrome, and others.

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Why are children with special health care needs at increased risk for nutrition problems?

Good nutrition is essential for all children to achieve their physical and developmental potential. Children with special health care needs are at increased risk for nutrition-related problems because of:

  • Physical disorders or disabilities that may affect their ability to consume, digest, or absorb nutrients
  • Biochemical imbalances caused by long-term medications or internal metabolic disturbances
  • Psychological stress from a chronic condition or physical disorder that may affect a child's appetite and food intake
  • Environmental factors that may influence a child's access to and acceptance of food

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What are some common nutrition problems seen in children with special needs?

    • Delayed growth, underweight and overweight
    • Feeding delays, oral-motor problems, or altered feeding interactions
    • Inadequate or excessive diet quantity or quality
    • Medication/nutrient interactions
    • Elimination problems, i.e. constipation, diarrhea
    • Altered energy and nutrients needs, i.e. inborn errors of metabolism
    • Dental caries including early childhood caries (ECC) that may be related to inappropriate breastfeeding or bottle-feeding
    • Poor or excessive appetite

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Why should nutrition services be available for children with special health care needs?

It has been estimated that up to 40% of children with special health care needs have nutrition risk factors that could be helped by referral to a registered dietitian (RD). Preventive nutrition services, as well as intervention for identified problems, can help assure a well-nourished child who is healthy, can participate in education and therapy programs, and is better able to function in all activities of daily life.

The Children with Special Health Care Needs Program, Washington Department of Health, has a 2-page flyer available – Getting Connected: Prevention and Primary Care for Young Children with Special Health Care Needs. The publication outlines nutrition risks, screening, and referral for children with special health care needs

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How can registered dietitians help children with special health care needs?

Dietetics is the science of applying food and nutrition to health. Registered dietitians (RDs) are food and nutrition experts who have met specific education, training, examination, and continuing education requirements.  RDs use the credential letters “RD” after their name to indicate they have met the requirements.  RDs, such as those in the Washington State CSHCN Nutrition Network, can provide nutrition services for children with special health care needs. Additional information about RDs can be reviewed at the American Dietetic Association (ADA) web site, along with the ADA position statement about nutrition services for infants, children and adults with developmental disabilities and special health care needs (2010).

RDs who work with children with special health care needs often have additional training in the area of pediatrics and special health care needs. They provide nutrition assessment and intervention regarding feeding and food intake. RDs work closely with the family and child. The RD may consult with the primary care provider and others who also work with an individual child and his/her family.

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Is there a difference between registered dietitians and nutritionists?

Some RD's use the job title Nutritionist. All nutritionists do not necessarily have specific training and education requirements, so look for the RD after the individual's name. In the state of Washington the RD can choose to be a Certified Dietitian (CD). A CD in Washington can receive payment for nutrition services for children with special health care needs if a referral has come from the primary medical provider and the child is covered by Medicaid.

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