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Chapter 11 Toddler and Preschooler Nutrition: Conditions and Interventions

Chapter 11 Toddler 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

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Chapter 11 Toddler and Preschooler Nutrition: Conditions and Interventions

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  1. Chapter 11Toddler and Preschooler Nutrition:Conditions and Interventions Nutrition Through the Life Cycle Judith E. Brown

  2. 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

  3. 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

  4. 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

  5. Nutrition Needs of Toddlers & Preschoolers with Chronic Conditions

  6. 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?

  7. 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

  8. Nellhaus Head Circumference Growth Chart Plotted for Girl with Rett Syndrome

  9. 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

  10. 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

  11. 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

  12. Nutrition-Related Conditions • Failure to thrive (FTT) • Toddler diarrhea & celiac disease • Autism • Muscle coordination problems & cerebral palsy • Pulmonary problems • Developmental delay & evaluations

  13. 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

  14. Failure to Thrive (FTT)

  15. 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

  16. 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

  17. 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

  18. 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

  19. Meal Pattern & Recommended Foods

  20. 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

  21. 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

  22. 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

  23. 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

  24. 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

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