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Manual (168 pgs) Provides practical information that will enable
you to assess nutrient and fluid needs of the school-age child, including
children with developmental disabilities who may require enteral nutrition
support. It will help you:
- educate children and their families regarding sound nutrition practices
- develop nutrition care plans for school-age children
- assess nutrient needs for overweight children
- provide parental interventions for weight management
- evaluate the difference between eating disorders and disordered
eating
- specify nutrient intervention and repletion
- assess fluid and nutrient needs for children participating in physical
activity
- evaluate nutrient needs for children with developmental disabilities
- implement feeding delivery for children receiving enteral nutrition
support
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A
Guide to Pediatric Nutrition
Aurea Thompson, MSH, RD, CSP, LD/N
OVERVIEW AND INTRODUCTION
Welcome to Pediatric Nutrition, a self-directed, accredited learning
program. Pediatric nutrition is specialized medical nutrition therapy
that includes nutrition for infants, children and adolescents. This
program specifically focuses on nutrition for the school-age child and
some of the issues that are particular to this population. With the
childhood obesity epidemic on the rise in the United States, nutrition
professionals must be savvy on what the normal nutrient needs are for
a child, as well as how to properly assess the overweight child. Surprisingly,
school-age children are also vulnerable to the aspects of eating disorders.
It is also the age when some children get involved in sports activities
through school or in their community for the first time. Therefore,
it is during these school-age years that some parents and even the children
themselves begin to ask questions about proper nutrition and seek out
various resources for the answers. Today, being able to educate children
and their families and develop nutrition care plans while incorporating
evidenced-based nutritional practices is what distinguishes the nutrition
professional as an expert.
This self-directed, accredited learning program will provide you with
detailed information that will enable you to assess nutrient needs for
children and adolescents, including:
- Assessing nutrient needs for the school-age child.
- Assessing nutrient needs for the overweight child and parental interventions
for weight management.
- Evaluating the difference between eating disorders and disordered
eating, and assessing nutrient intervention and repletion.
- Assessing fluid and nutrient needs for the child participating in
physical activity.
- Assessing nutrient needs for the child with developmental disabilities.
- Assessing nutrient needs and method of feeding delivery for children
receiving enteral nutrition support.
This learning program is designed to help you earn 10 continuing professional
education units (CPEUs). It is a category 2 Continuing Professional
Education (CPE) program, meaning that the reader has general knowledge
of the literature and professional experience within the area covered.
The focus of the program is to enhance knowledge and application.
To get the most out of this program, it is suggested that you follow
these four steps:
Step 1: Read the material presented in each of the chapters.
Step 2: When you come to an example, stop for a moment and work out
the answers using pen and paper.
Step 3: Assess what you have learned by completing the self-assessment
instrument contained at the end of the learning program.
Step 4: Compare your answers to the answer key contained at the end
of the learning program. If you score at least 80% correct, you have
completed this program and are ready to transfer your answers to the
CONTINUING PROFESSIONAL EDUCATION REPORTING FORM. If you scored less
than 80% correct, re-read the learning program until you score at least
80% correct.
After you have successfully completed the program, complete the CPE
CONTINUING PROFESSIONAL EDUCATION REPORTING FORM and
Mail to: Wolf Rinke Associates, 721 Valley Forge Road #486, Valley Forge, PA 19481,
Or Fax to: (410) 531-9282,
Or submit On-line at www.easyCPEcredits.com
Once we receive your successfully completed CONTINUING PROFESSIONAL
EDUCATION REPORTING FORM we will send you a certificate of completion.
Happy Learning!
GOAL AND OBJECTIVES
Goal
To provide you with practical information that will enable you to properly
assess nutrient and fluid needs of the school-age child, including children
with developmental disabilities that may require enteral nutrition support.
Objectives
Upon the completion of this accredited, self-directed learning program
you should be able to:
Assess energy, protein and fluid needs for children ages 5 through 12
years.
Explain the role of the School Breakfast Program and the National School
Lunch Program in the diet of the school-age child.
Assess energy, protein and fluid needs for the overweight child.
Calculate Body Mass Index and interpret the information for a child
in this school-age population.
Explain the importance of lifestyle and dietary modifications in the
therapy of childhood weight management.
Explain how parental behaviors and attitudes can influence children's
eating habits.
Assess nutrient needs and apply medical nutrition therapy in developing
a care plan for children with eating disorders.
Evaluate energy and hydration requirements for children participating
in physical activity.
Assess energy, protein and fluid needs for children with developmental
disabilities.
Apply anthropometric measurements of children with developmental disabilities
utilizing the appropriate growth charts for their population.
Evaluate different routes of enteral nutrition therapy for children
requiring short- or long-term nutrition support.
Evaluate different types of pediatric oral and/or enteral formulas by
analyzing their compositions.
TABLE OF CONTENTS
Chapter 1 Nutrition for the School-Age Child 1
Childhood Independence and Food Selection 2
Assessing Growth Parameters in the School-Age Child 3
Assessing Nutrient Needs in the School-Age Child 3
Calculating Energy Needs 4
Calculating Protein Needs 6
Calculating Fluid Needs 8
Vitamins and Minerals for the School-Age Child 8
Iron 9
Calcium 9
Vitamin D 9
Medical Nutrition Therapy (MNT) for the School-Age Child 10
Case Study #1 10
Summary 13
Chapter 2 Childhood Obesity 15
School Nutrition Dietary Assessment 17
School Nutrition Policy Initiative 19
Assessment of Obesity 19
Pediatric Multi-Component Weight Management Programs 21
Parental Recognition of Obesity 23
Parental Behaviors to Prevent Obesity 24
Parenting Styles and the Impact on Childhood Obesity 25
Case Study #2 26
Assessing Energy Needs for the Overweight Child/Adolescent 28
Case Study #3 part A 28
Medical Nutrition Therapy for Pediatric Weight Management 29
Case Study #3 part B 30
Summary 31
Chapter 3 Eating Disorders and Disordered Eating 33
Disordered Eating 34
Eating Disorders 34
Treatment Options 35
Medical Nutrition Therapy Goals 38
Case Study #4, part A 40
Case Study #4, part B 41
Summary 43
Chapter 4 Physical Activity for the School-Age Child 45
Hydration 45
Pre-Exercise and Post-Exercise Meals 47
Case Study #5 48
Summary 48
Chapter 5 Developmental Disabilities 51
Anthropometric Measurements in Children with Special Health Care Needs
52
Goals of Medical Nutrition Therapy 53
Down Syndrome 53
Case Study #6 54
Cerebral Palsy 55
Case Study #7 56
Spina Bifida 57
Prader-Willi Syndrome 58
Physical Activity 59
Summary 59
Chapter 6 Pediatric Enteral Nutrition Support 61
Pediatric Enteral Formulas 62
Polymeric Formulas 62
Semi-Elemental Formulas 63
Elemental Formulas 64
Blenderized Formulas 64
Enteral Feeding Delivery 64
Use of Oral Feedings with Tube Feedings 65
Tube Feeding Complications 65
Mechanical 66
Gastrointestinal 66
Metabolic 66
Monitoring Enteral Feedings 66
Pediatric Enteral Nutrition Therapy Goals 68
Summary 68
References 71
Appendix A. MyPyramid for Kids 6 to 11 Years 79
Appendix B. A Guide to Daily Food Choices for Children 83
Appendix C. National Center for Health Statistics 2000 CDC Growth Charts
85
Appendix D. Dietary Reference Intakes for Nutrition Categorized by Age
and Gender 91
Appendix E. Growth Charts for Children with Down Syndrome 97
Appendix F. Cerebral Palsy Growth Charts 105
Appendix G. Pediatric Formulas 137
List of Abbreviations 139
Glossary 141
Nutrition Information Resources 145
Self-Assessment Questions 147
Answer Key 159
Explanation to Questions 161
About the Author 167
About Wolf Rinke Associates, Inc. 168
ABOUT THE AUTHOR
Aurea R. Thompson is a registered dietitian and member of the American
Dietetic Association. She obtained her Board Certification as a Pediatric
Specialist in Nutrition in November 2007. An Ohio native, she holds
a B.S. in Dietetics from Eastern Michigan University, Ypsilanti, MI,
where she completed a coordinated undergraduate program including an
internship rotation through the University of Michigan hospital system.
She then went on to complete her master's degree at the University of
North Florida, Jacksonville, FL.
Aurea has more than 16 years of experience as a registered dietitian.
She started her career as a public health nutritionist for the Nassau
County Department of Health working in the WIC program. She went on
to become the WIC Director for both Nassau and Baker County. In 1999,
she left community dietetics to begin her clinical career as a dietitian
at St Vincent's Medical Center in Jacksonville, FL. During this time,
she authored two publications for Ronald Watson's series Nutrition and
AIDS and AIDS and Heart Disease. In 2000, she was named "Young
Dietitian of the Year" by the Jacksonville Dietetic Association
and was recognized by the Florida Dietetic Association. In 2003 she
took the position of pediatric dietitian at Wolfson Children's Hospital
in Jacksonville, FL, where she currently specializes in critical care
nutrition. In addition to her hospital work, she writes a monthly nutrition
article for Jax4kids, a publication that features local community topics
and information with a focus on children and adolescents.
She lives with her husband and two children.
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