Assuring Pediatric Nutrition in the Community |
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FREQUENTLY
USED GUIDELINES:
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HOW DO I ASSESS A CHILD WHEN I SUSPECT GROWTH FAILURE? A comprehensive nutrition assessment is recommended when growth failure is suspected. This assessment typically includes a physical history and examination, laboratory tests, feeding and diet assessment, evaluation of anthropometrics and growth velocity, and psychosocial evaluation. The most comprehensive evaluation is done by an interdisciplinary team, with specialists from pediatrics, nursing, speech pathology, occupational therapy, nutrition, and social work. Physical
history and exam What
should be included in the physical history and examination when growth
failure is suspected? What
should I include in evaluation of anthropometrics when growth failure
is suspected? Weight is more sensitive to nutritional insults than height, and it is generally affected first. Changes (decreases in percentiles) in a child’s stature or head circumference are generally symptoms of chronic undernutrition. At this point, a child’s weight for height or length can appear appropriate; this is called stunting. What
laboratory tests should be considered when growth failure is suspected? What
should be included in a feeding and diet assessment when growth failure
is suspected? When physical barriers to effective feeding are suspected, consult with a feeding specialist. Speech, physical, and occupational therapists can provide assessments of motor-related feeding problems. A diet record or history will help to determine whether or not a child is receiving adequate nutrition. If an infant is breastfed, determine the frequency and duration of feedings, and ask questions about maternal intake and psychosocial and environmental influences. A lactation consultant is a useful team member when problems with breastfeeding are suspected. If an infant is formula-fed, review formula preparation methods. Estimates of food intake should be as detailed as possible and should reflect the actual intake of the child, rather than the amount of food offered or prepared. Assess overall energy intake and intakes of macronutrients (protein, carbohydrate, and fat) and micronutrients (vitamins and minerals). Ask about the child’s pattern of intake, including when foods are offered and what types of foods are offered. Determine whether or not foods offered are developmentally appropriate. What
psychosocial issues should be examined when growth failure is suspected? |
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This page was last updated 02/16/2001 | ||
Copyright 2001, University of Washington, CHDD |