SB

Chapter 11 Toddler and Preschooler Nutrition- Conditions & Interventions

Chapter 11: Toddler and Preschooler Nutrition: Conditions & Interventions

Introduction

Nutrition plays a crucial role in the development of toddlers and preschoolers. While many children in this age group enjoy healthy growth, a significant percentage may require specialized interventions to ensure their nutritional needs are met effectively.

Icebreaker

Most toddlers and preschoolers develop healthily; however, various factors can impact the nutrition of at-risk children, including their pre-existing health conditions and socioeconomic circumstances.

Special Health-Care Needs

Definition

Children classified as having special health-care needs include those with or at risk for:

  • Physical disabilities

  • Developmental disabilities

  • Chronic medical conditions

Causes

The causes of special health needs can vary widely, but some common contributors include:

  • Genetic or metabolic disorders that affect growth and development.

  • Birth defects that may lead to physical or mental challenges.

  • Premature births, which can lead to various health complications.

  • Trauma or infections that can hinder normal development.

  • Prenatal exposure to drugs or alcohol, which can result in long-term health issues.

Statistics

  • Approximately 19.4% of children in the U.S. have special health-care needs.

  • Up to 90% of these children face nutritional challenges that can impact their growth and development.

Nutrition Services for Children

Services designed to meet medical and nutritional needs should begin early in life, as early identification and intervention are vital for optimal outcomes. Children’s rights under laws such as the Americans with Disabilities Act (ADA), Social Security Disability Act (SSDI), and Supplemental Security Income (SSI) provide a framework for accessing these necessary services.

Eligibility for Early Intervention Services

Early intervention services are available for children under 3 years old and eligibility is determined based on:

  • Cognitive development

  • Physical development

  • Communication development

  • Social/emotional development

  • Adaptive development

Case Examples: Educational vs. Nutritional Needs

  • Example: Bill (18-month-old): Born prematurely at 30 weeks, Bill shows a 25% delay in development and qualifies for early intervention services. His nutritional challenges include a self-restricted intake of pureed foods, necessitating specialized dietary guidance.

  • Example: Sue (4-year-old): Sue has Autism Spectrum Disorder (ASD), resulting in unique nutrition problems such as a preference for sugary snacks and an overall lack of balanced meals. She benefits from tailored nutrition interventions to address her specific needs.

Early Intervention Nutrition Services (Table 11.2)

Nutrition services must align with educational programs to support holistic development. Examples of these services include:

  • Assessing dietary intake through comprehensive dietary analysis.

  • Collaborating with multidisciplinary teams that involve registered dietitians and healthcare professionals.

  • Monitoring growth patterns and addressing any emerging nutritional issues.

Impact of COVID-19

The COVID-19 pandemic has significantly impacted access to nutritional programs, mainly due to school closures affecting food distribution systems. Important questions for future investigation include:

  • Duration of school closures and their long-term effects on children's health.

  • Availability and effectiveness of food assistance programs during and after the pandemic.

Funding for Nutrition Services

Various programs assist in providing necessary nutrition for children with special health needs, including:

  • Americans with Disabilities Act (ADA)

  • Social Security Disability Insurance (SSDI)

  • Supplemental Security Income (SSI)

  • Individuals with Disabilities Education Act (IDEA)

Qualification for Early Intervention Programs

To qualify for early intervention, children must demonstrate developmental delays across several areas of growth and ability.

Nutrition Needs of Toddlers and Preschoolers with Chronic Conditions

Common nutritional risks faced by these children include:

  • Lead poisoning, which can severely impair cognitive development.

  • Iron-deficiency anemia, leading to fatigue and impaired growth.

  • Changes in energy needs, where some children may become underweight or overweight due to fluctuating nutritional requirements.

Specific Nutritional Needs for Chronic Conditions

  • Energy Needs (Table 11.3):

    • Higher energy needs are often seen in conditions like cystic fibrosis, where maintaining weight can be a challenge.

    • Conversely, conditions such as Down syndrome or renal disease may require lower energy intakes.

  • Vitamins and Minerals: Essential, particularly in conditions corresponding with deficiencies like sickle-cell anemia, where specific supplements may be needed to meet health standards.

Feeding Problems

General Feeding Problems

Children with special health needs frequently face various feeding challenges, such as:

  • Low interest in eating and/or selective eating habits.

  • Extended meal times that lead to frustration for both child and caregiver.

  • Preference for liquid nutrition over solid foods, potentially leading to deficiencies.

Feeding Problems Due to Developmental Delays

Behavioral feeding issues may manifest as specific food preferences or aversions in children with developmental delays.

Medical Conditions Linked to Feeding Issues

Certain medical conditions can cause feeding difficulties, including:

  • Gastroesophageal reflux, which can create discomfort during meals.

  • Autism Spectrum Disorder and other behavioral disorders that may result in heightened sensitivities to food textures.

  • In some cases, children may require tube feedings due to severe feeding problems.

Behavioral Feeding Issues

Children with behavioral disorders, such as Attention Deficit Hyperactivity Disorder (ADHD), often exhibit high fluid intakes, which can lead to imbalanced nutritional statuses.

Infant and Toddler Growth Assessment

Regular nutrition assessments are essential in identifying children who may need intensive nutritional interventions. These assessments typically track growth metrics, including weight, length, and head circumference, while considering any medical or nutritional factors affecting growth.

Identifying Feeding Problems

Common signs of potential feeding problems include:

  • Failure to thrive, particularly evident through growth chart analysis.

  • Signs of celiac disease or other medical conditions that affect digestion and absorption of nutrients.

  • Breathing or muscle coordination problems that hinder the effective swallowing of food.

Success Strategies for Feeding

Supporting feeding issues due to neuromuscular problems, such as those seen in cerebral palsy, involves tailoring strategies to individual children. Best practices for feeding include individualizing meal patterns and offering soft, easy-to-chew foods to promote a positive eating experience.

Nutrition-Related Conditions

Indicators of failure to thrive may involve:

  • Measurement of weight for age on growth charts that falls below expected norms.

  • Increased nutritional needs for recovery from health issues or illnesses.

Common Food Allergies

The estimated prevalence of food allergies in children ranges between 2-8%. The most common allergens include milk, eggs, and peanuts, tree nuts, wheat soy, shellfish which require careful management in the diets of affected children.

  • important to avoid cross contamination

Impact of COVID-19 on Nutritional Needs

Long-term implications of the COVID-19 pandemic include an increase in food insecurity, with many families facing challenges in accessing healthy meals for their children.

Dietary Supplements

Caution is advised when considering the use of dietary supplements or herbs in children, and any supplement usage should be discussed with healthcare providers to ensure safety and efficacy.

Sources of Nutrition Services

Professionals such as registered dietitians serve as primary care providers for nutrition. Various programs such as WIC (Women, Infants, and Children), early intervention services, and child care feeding programs are available to support families and children in need.

Conclusion: Key Points

Children with special health needs often require specific interventions and services tailored to their unique nutritional challenges. Addressing these challenges effectively can significantly impact their overall growth and eating behaviors as they develop throughout early childhood.