Neurologic impairments, whether associated with a congenital disorder or due to a traumatic event, can influence the nutritional requirements of children with special health care needs. In some cases the nutrition issues are present due to medical complications and severe disabilities, including seizures, gastrointestinal disturbances such as gastroesophageal reflux (GER), vomiting, or constipation; oral-motor dysfunction, severe intellectual disabilities, hypotonia, minimal physical movement, poor head control, and developmental delays.
Some children, such as those with athetoid cerebral palsy, or those with pulmonary and cardiac conditions, require a very high intake of energy (kilocalories) due to increased muscle tone and respiratory rates and a high level of involuntary movements. Many resources are available to aid in the nutrition management for children with high energy needs. For other children, metabolic rate and activity level are very low compared to children of a comparable age and size. Thus, their energy needs are reduced, but there is little documented information available for assessing children with low energy requirements.
For any child with special health needs a coordinated team approach provides for communication and the most effective care. This team includes parents or caregivers and other professionals who work with the individual child. The team should include a registered dietitian (RD), who has experience working with families who have children with special needs. The RD assesses the unique requirements of a child with very low energy requirements.
This NUTRITION FOCUS edition will review issues related to energy and nutrient needs for children requiring a very low level of kilocalories. Two case studies will be presented to illustrate the discussion.
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Feeding the Child with Very Low Energy Needs
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