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Toddler and Preschooler Nutrition: Conditions and Interventions

1) Nutrition problems for toddlers and preschoolers with special health care needs include underweight, overweight, feeding difficulties, and higher nutrient needs due to chronic health conditions. 2) Feeding problems can include food refusals, picky eating habits, and concerns about growth. Nutrition services are provided in schools, early intervention programs, and specialty clinics. 3) A nutrition assessment should include evaluating growth charts, dietary intake, and feeding skills to determine if extra nutrition support is needed based on a child's specific diagnosis and condition.

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92 views28 pages

Toddler and Preschooler Nutrition: Conditions and Interventions

1) Nutrition problems for toddlers and preschoolers with special health care needs include underweight, overweight, feeding difficulties, and higher nutrient needs due to chronic health conditions. 2) Feeding problems can include food refusals, picky eating habits, and concerns about growth. Nutrition services are provided in schools, early intervention programs, and specialty clinics. 3) A nutrition assessment should include evaluating growth charts, dietary intake, and feeding skills to determine if extra nutrition support is needed based on a child's specific diagnosis and condition.

Uploaded by

Ronaldo
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Chapter 11

Toddler and Preschooler


Nutrition:
Conditions and Interventions
Key Nutrition Concepts
• Nutrition problems in young
children with special health care
needs are underweight,
overweight, feeding difficulties,
and higher nutrient needs as a
result of chronic health problems.
Key Nutrition Concepts
• Feeding difficulties in preschoolers
and toddlers appear as food
refusals, picky appetites, and
concerns about growth.
• Nutrition services for toddlers and
preschoolers with chronic health
problems are provided in various
settings, including schools and
other educational programs and
specialty clinics.
Key Nutrition Concepts
• Toddlers and preschoolers at risk
for chronic conditions have the
same nutritional problems,
concerns and needs as other
children.
Key Terms
• Children with Special Health Care
Needs—Infants & children with, or at risk
for, physical or developmental disabilities,
or chronic medical conditions from genetic
or metabolic disorders, birth defects,
premature births, trauma, infection, or
prenatal exposure to drugs.

• Chronic Condition (or disability)—


disorder of health or development that is
unlikely to change.
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
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
Nutrition Needs of Toddlers &
Preschoolers with Chronic Conditions
• Many DRIs apply, but specific
conditions require adjustments
• May cause poor appetite & increased
caloric needs
• May cause overweight or underweight
• Caloric & nutrient recommendations
should be customized for each child
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?
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
Nellhaus Head Circumference Growth Chart
Plotted for Girl with Rett Syndrome
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
Examples of Likes & Dislikes of a 2.5
y/o Child with Developmental Delay
Behavioral Feeding
Problems
• Mealtime feeding problems are common
with toddlers & preschoolers with
behavioral & attention disorders
• Autism—deficits in communication &
social interactions with onset generally
< 3 y/o
• Attention deficit hyperactivity disorder
(ADHA)—low impulse control & short
attention span with & without a high
level of overall activity
Dietary Intake of a 2 y/o
with Suspected Autism
Other Feeding Problems
• Excessive fluid intake
• Feeding problems & food safety
• Feeding problems from disabilities
involving neuro-muscular control
Nutrition-Related
Conditions
• Failure to thrive (FTT)
• Toddler diarrhea & celiac disease
• Autism
• Muscle coordination problems &
cerebral palsy
• Pulmonary problems
• Developmental delay & evaluations
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
Growth Chart
for Child with
FTT Before and
After
Intervention
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
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
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
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
Developmental Delay &
Evaluation
• Child is considered to be
developmentally delayed when there
is at least a 25% delay in one or
more areas of development
• May result from iron deficiency or
lead toxicity
• Physical growth may be impacted
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
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

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