31(2) Increasing Energy Concentration in Infant Feedings

Energy is required by each individual’s body to sustain functions including respiration, circulation, physical work, metabolism, and protein synthesis. In children, energy is also needed for overall growth. Energy needs depend on intake and expenditure. Energy requirements and expenditure are affected by age, gender, body composition, and physical activity levels. Health conditions can also affect energy requirements; this is often seen in children with special health care needs.

While most infants are able to support their growth by drinking breast milk or standard infant formula, some require extra support due to individual feeding issues and/or special health care needs. This edition of Nutrition Focus will review indications for use of calorically dense breast milk and/or infant formula and discuss how to formulate a fortification recipe that is appropriate and safe for use in young infants.

Read more….
Increasing Energy Concentration in Infant Feedings

Subscription required to view the full newsletter

 

Posted in General Topics Related to CSHCN, Nutrition-related Issues | Tagged , , , , , , , , , | Comments Off on 31(2) Increasing Energy Concentration in Infant Feedings

31(1) Milk alternatives

Purchase and consumption of milk alternatives is steadily growing in the US. More than 209 milk and milk alternative products were launched in the US market between  December 2010 and November 2011.1 Whether consumers are choosing milk alternatives  for personal or health reasons, registered dietitian nutritionists (RDNs) need to understand the implications of these beverages on nutrition.

Children with special health care needs (CSHCN) may be receiving milk alternatives as part of their daily food intake. This edition of the Nutrition Focus newsletter will review milk alternatives and provide information to the health care provider to assist families in choosing an appropriate alternative to cow’s milk if it supports their child’s nutrition plan.

Read more….
Milk Alternatives

Subscription required to view the full newsletter

 

Posted in General Topics Related to CSHCN, Nutrition-related Issues | Tagged , , , , , , , , , , , | Comments Off on 31(1) Milk alternatives

30(6) Food Allergies

Food allergies in children present many challenges:

  • ensuring appropriate nutrient intake for growth and development while avoiding offending foods and ingredients
  • maintaining positive social interactions
  • maintaining quality of life

This issue of Nutrition Focus examines food allergies – including diagnosis, symptoms, and management
Read more….
Food Allergies

Subscription required to view the full newsletter

 

Posted in Nutrition-related Issues, Specific Conditions | Tagged , , , , , , | Comments Off on 30(6) Food Allergies

30(5) Pediatric Malnutrition – A look at the new guidelines

Globally, pediatric malnutrition contributes to about half of child deaths. Historically, pediatric malnutrition has been associated with starvation only and was considered primarily to be a problem of the developing world. Identification of malnutrition has focused on the effects of malnutrition (e.g., protein-energy malnutrition, kwashiorkor, and marasmus), but failed to investigate the etiology of malnutrition. Lack of a standardized definition has hampered early identification of malnutrition, understanding of the prevalence

Read more….
Pediatric Malnutrition

Subscription required to view the full newsletter

 

Posted in General Topics Related to CSHCN, Nutrition-related Issues | Tagged , , , , , , , , | Comments Off on 30(5) Pediatric Malnutrition – A look at the new guidelines

30(4) Tube Feeding Basics

Enteral or tube feeding refers to the delivery of liquid feedings through a tube. Tube feedings are used for the infant or child with a functioning gastrointestinal tract who is unable to meet nutrition needs or safely consume food by mouth. The role of tube feeding may range from supportive therapy where only part of the child’s nutrition is provided by tube plus oral food intake, to a primary therapy where all of the nutrition needs are provided via the feeding tube. Feeding tubes may be used to provide medication, hydration, or to release air or stomach contents. Most children who receive tube feedings can continue to receive oral feedings to fulfill pleasurable and social aspects of eating. If children are totally fed via a tube feeding, offering some feedings at the same time the family is eating meals will engage these children in the social aspects of feeding.

Read more….
Tube Feeding Basics

Subscription required to view the full newsletter

 

Posted in General Topics Related to CSHCN, Nutrition-related Issues | Tagged , , , , , , , , , , , , , | Comments Off on 30(4) Tube Feeding Basics

30(3) Practical Tips for Tube Feeding

The goal of this newsletter is to share ideas for successful use of a feeding tube to meet the nutrition needs of a child in a family-friendly manner. Most of the practical tips shared are those from parents who have a variety of experiences
with their children who have used a tube feeding. The suggestions provided are designed for day to day life including school and vacations. The use of the tips and information should be evaluated for each individual child based on their tube feeding experiences and family needs. Table 1, on page 2, describes some items a mother has now learned, but would have appreciated knowing earlier in her child’s tube feeding experience.

Read more….
Practical Tips for Tube Feeding

Subscription required to view the full newsletter

 

Posted in General Topics Related to CSHCN, Nutrition-related Issues | Tagged , , , , , , , , , , | Comments Off on 30(3) Practical Tips for Tube Feeding

30(2) Nutrition Issues for Children with Down Syndrome

Within the community, many health care professionals who work with children with special health care needs have seen families with children who have Down syndrome (DS). Over the last 5 decades individuals with DS have moved out of institutions and benefitted from services beginning within the early intervention system, and continuing with educational and community programs with an emphasis on healthy activities in the school years. Adults with DS have moved into employment/vocations and living arrangements in group or individual settings. From an early age, physical activity and a healthy weight are encouraged, with appropriate consideration given to each child’s health and developmental capabilities.

As the National Down Syndrome Society (NDSS) web site notes, “The NDSS envisions a world in which all people with Down syndrome have the opportunity to enhance their quality of life, realize their life aspirations, and become valued members of welcoming communities”

This issue of NUTRITION FOCUS will update the reader about DS and discuss concerns related to growth, nutrient adequacy, and feeding that often occur in children with DS. The article will also describe how the Registered Dietitian Nutritionist (RDN) works in collaboration with the family, health care providers, educators, and others to provide information and support to families who have a child with DS. Lastly, the article will review the scientific evidence behind the use of supplements and other complementary therapies.

Read more….
Nutrition Issues for Children with Down Syndrome

Subscription required to view the full newsletter

 

Posted in General Topics Related to CSHCN, Nutrition-related Issues, Specific Conditions | Tagged , , , , , , , , , , , , , , , | Comments Off on 30(2) Nutrition Issues for Children with Down Syndrome

30(1) Assessing Fluid Requirements in Infants and Children

Assessment of fluid requirements is an important component of pediatric nutrition care. Fluid intake provides the water that is necessary as a transportation network throughout our bodies and also provides structural integrity to our cells. Accurate assessment of fluid needs is especially important for children as they are at a greater risk of dehydration than adults. This is because the bodies of children contain proportionately more water and therefore require more fluid intake each day to maintain balance. Although we often think of fluid requirements as a goal volume for water consumption, children may meet their fluid requirements through intake of breastmilk, formula, milk, other beverages and even foods. Children with special health care needs require close monitoring of fluid status because their needs may be greater or less than expected and these children may not be able to compensate for inadequate or excessive fluid intake.

This issue of Nutrition Focus will discuss the issue of fluid in children, especially those with special health care needs. The assessment of fluid status will be reviewed. Several cases provide illustrations of fluid assessment and intervention.

Read more….
Assessing Fluid Requirements in Infants and Children

Subscription required to view the full newsletter

 

Posted in General Topics Related to CSHCN, Nutrition-related Issues | Tagged , , , , , , , , , , , | Comments Off on 30(1) Assessing Fluid Requirements in Infants and Children

29(6) Fetal Alcohol Spectrum Disorders

Fetal alcohol syndrome (FAS) is a permanent birth defect caused by maternal alcohol consumption during pregnancy. In the United States, prenatal alcohol exposure is one of the leading known preventable causes of intellectual disabilities. Not all individuals with prenatal alcohol exposure have the birth defect known as FAS. Most present with lifelong neurocognitive and behavioral problems, without the facial features of FAS. This occurs because the window of vulnerability for alcohol to cause the unique facial features is very narrow, perhaps as narrow as the second and third weeks of pregnancy. The window of vulnerability for neurocognitive problems, in contrast, extends throughout pregnancy. The damage caused by prenatal alcohol exposure presents along a continuum. This continuum is called Fetal Alcohol Spectrum Disorders (FASD).

Read more….
Fetal Alcohol Spectrum Disorders

Subscription required to view the full newsletter

 

Posted in Specific Conditions, Uncategorized | Tagged , , , , , , , , , , , , , , , , , | Comments Off on 29(6) Fetal Alcohol Spectrum Disorders

29(5) – A Focus on Family-Centered Care from the Parent’s Perspective

The term “family-centered care” (FCC) was coined in the 1980’s to describe a philosophy of care for children with special health care needs and their families. It was a radical paradigm shift from the previous philosophies of “system-centered care” in which the needs of, or benefit to, the system drive the delivery of services and “child-centered care” in which the strengths and needs of the child, apart from the family, drive the delivery of services. The definition of FCC has since evolved from a philosophy of care to a philosophy of care and a standard of practice.

This issue provides the perspectives of three parents of children with special health care needs and includes a discussion of family-centered care.

Read more….
A Focus on Family-Centered Care from the Parent’s Perspective

Subscription required to view the full newsletter

 

Posted in General Topics Related to CSHCN, Nutrition-related Issues, Uncategorized | Tagged , , , , , , , , , , , , , , | Comments Off on 29(5) – A Focus on Family-Centered Care from the Parent’s Perspective