A Guide to Pediatric Nutrition for the School-Aged Child, 2nd Edition
Aurea Thompson, MSH, RDN, CSP
Manual with 1 Reporting Form (176 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
- specify nutrient intervention and repletion
- assess fluid and nutrient needs for children participating in physical
- evaluate nutrient needs for children with developmental disabilities
- implement feeding delivery for children receiving enteral nutrition
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A Guide to Pediatric Nutrition for the School-Aged Child, 2nd Edition
Aurea Thompson, MSH, RDN, CSP
OVERVIEW AND INTRODUCTION
Welcome to Pediatric Nutrition, a self-directed, accredited CPE program. Pediatric Nutrition is specialized medical nutrition therapy (MNT) that focuses on nutrition intervention over the spectrum from infancy to adolescence. This CPE program specifically focuses on nutrition therapy for the school-age child (ages 5 to 12 years) and some of the nutritional/medical issues that are particular to this population. With the childhood obesity epidemic on the rise in the United States, nutrition professionals must be savvy regarding normal pediatric nutrient needs, as well as how to properly assess the overweight child. Surprisingly, school-age children are also vulnerable to eating disorders. It is also the age when many 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. 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 the expert.
This is a level 2 Continuing Professional Education (CPE) program approved for ten continuing professional education units (CPEUs). That means that the reader has general knowledge of the literature and professional practice in the area covered. The focus of this CPE program is to enhance knowledge and application.
To get the most benefit from this program, we suggest you adhere to the following four steps:
Step 1: Review the objectives.
Step 2: Study each chapter. As you read, think of patients from your own practice that fit the situation described.
Step 3: Assess what you have learned by completing the self-assessment instrument at the end of this CPE program.
Step 4: Compare your answers to the answer key that has been provided. If you score at least 80% (40 questions) correct, you are ready to transfer your answers to the CONTINUING PROFESSIONAL EDUCATION REPORTING FORM. If you scored less than 80% correct, re-read this CPE program until you score at least 80% correct.
After you have successfully completed this program, complete the CPE REPORTING FORM and:
Submit on-line at www.easyCPEcredits.com,
Or fax to: (410) 531-9282,
Or mail to: Wolf Rinke Associates, Inc., 13621 Gilbride Lane, Clarksville, MD 21029.
We will email your Certificate of Completion.
When you submit your CPE Reporting Form to us via www.easyCPEcredits.com. fax or mail, be sure to write your correct email address in the space provided on the CPE Reporting Form. If writing by hand, be sure to print your email address clearly.
To ensure that our emails are delivered to your inbox (instead of your junk/spam folders), please add email@example.com to your Address Book or Safe List of allowed email senders. Also, be sure to allow attachments from this email address.
GOAL AND OBJECTIVES
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.
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 MyPlate has in family meal planning and food selection.
- 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 be able to interpret growth parameters for a child in this school-age population.
- Explain the importance of portion distortion, food insecurity and the role that dietary and lifestyle modifications have 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 activities.
- 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
New Plate, New Ideas
Customize Your Plate
Dietary Guidelines 2015-2020
Healthy People 2020 Objectives
Childhood Independence and Food Selection
Assessing Growth Parameters in the School-Age Child
Assessing Nutrient Needs in the School-Age Child
Calculating Energy Needs
Calculating Protein Needs
Calculating Fluid Needs
Vitamins and Minerals for the School-Age Child
Medical Nutrition Therapy (MNT) for the School-Age Child
Case Study #1
Chapter 2: Childhood Obesity
Food Insecurity and Obesity
School Nutrition Dietary Assessment
Ethnicity and School Breakfast/Lunch Participation
School Nutrition Policy Initiative
Assessment of Obesity
Pediatric Multi-Component Weight Management Programs
Parental Recognition of Obesity
Parental Behaviors to Prevent Obesity
Parenting Styles and the Impact on Childhood Obesity
Case Study #2
Assessing Energy Needs for the Overweight Child/Adolescent
Case Study #3 part A
MNT for Pediatric Weight Management
Case Study #3 part B
Chapter 3: Eating Disorders and Disordered Eating (DS)
Nutrition Education Principles for Eating Disorder Recovery
Case Study #4, part A
Case Study #4, part B
Chapter 4: Physical Activity for the School-Age Child
Pre-Exercise and Post-Exercise Meals
Case Study #5
Chapter 5: Developmental Disabilities
Anthropometric Measurements in Children with Special Health Care Needs
Goals of MNT
Case Study #6
Case Study #7
Prader-Willi Syndrome (PWS)
Feeding the Child with Very Low Energy Needs
Physical Activity in the Child with Developmental Delay
Chapter 6: Pediatric Enteral Nutrition Support
Pediatric Enteral Formulas
Enteral Feeding Delivery
Use of Oral Feedings with Tube Feedings
Tube Feeding Complications
Monitoring Enteral Feedings
Pediatric Enteral Nutrition Therapy Goals
Pediatric Inflammatory Bowel Disease
List of Abbreviations
Nutrition Information Resources
Appendix A: Comparison of MyPyramid with MyPlate for Children 6 to 11 years
Appendix B: Tips to Help Families Incorporate MyPlate Messages
Appendix C: National Center for Health Statistics 2000 CDC Growth Charts
Appendix D: Dietary Reference Intakes for Nutrition Categorized by Age and Gender
Appendix E: Curve Comparisons for Children with Down Syndrome
Appendix F: New Cerebral Palsy Growth Charts
Appendix G: Pediatric Formulas
Explanation to Questions
About the Author
About the Editor
ABOUT THE AUTHOR
Aurea R. Thompson is a registered dietitian and member of the Academy of Nutrition and Dietetics. 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.
ABOUT THE EDITOR
Aurea has more than 20 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 pediatric and neonatal critical care nutrition. She has earned her Certification as a Specialist in Pediatric Nutrition from the Academy of Nutrition and Dietetics. In addition to her hospital work, she writes a monthly nutrition article and blog for Jax4kids, a publication that features local community topics and information with a focus on children and adolescents. She resides with her husband, son and daughter in Florida.
Wolf J. Rinke, PhD, RDN, CSP is the president and founder of Wolf Rinke Associates, Inc., a company that has provided high quality CPE programs to nutrition professionals since 1990.
He earned a Bachelor of Science degree at Drexel University, a Master of Science at Iowa State University, a PhD in Continuing and Vocational Education (Adult Ed) at the University of Wisconsin, and interned at Walter Reed Army Medical Center. He participated in a test item writer workshop sponsored by the Commission on Dietetic Registration (CDR).
Wolf is a past Adjunct Associate Professor, Graduate School of Management & Technology, University of Maryland, and a former Adjunct Faculty Member, School of Continuing Studies, The Johns Hopkins University.
He is the past president of the DC Dietetic Association and has been honored by the Academy with the Award for Excellence in the Practice of Management; the Outstanding Dietitian of the Year Award; the Outstanding Service Award; and has delivered the Lenna Frances Cooper Lecture.
At the Academy he has served in numerous leadership roles including Chair, Scholarship Committee, DBC; Chair, Communication Committee, CDR; Chair, Area Coordinating Committee, COE; Chair, COE, and member of Resource for Education Programs Committee; Honors Committee; CDR, Licensure Panel and Ethical Practices Task Force; CDR; House of Delegates and Board of Directors.
He is the author of more than 500 articles, numerous CPE home-study programs, several popular books, and the free monthly eNewsletter "Read and Grow Rich" written specifically for savvy Nutrition Professionals like YOU!
Subscribe now at www.easyCPEcredits.com–you'll be glad you did!
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