Current MNT Approach
Intervention Strategies
Medical nutrition therapy (MNT) for children with cerebral palsy (CP) takes into account many facets of their disease. Just like any other child, their caloric needs need to be estimated, but like other special conditions, it requires a different calculation (Table 44-3). Pediatric Growth Charts and Percentile Interpretations can be used to alter the equation to each individual child's measurements.
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Due to the difficulties chewing and swallowing that many children experience tube feeding may be required. However, in addition to tube feeding, other alternative techniques should also be considered. Thickening beverages, altering macronutrient content to increase volume, special utensils, and using customized seating to keep them in the right position may help the child to eat. When it is possible, supporting oral intake with positioning and physical support should be the first choice.
There are several nutritional concerns that need to be addressed in children with cerebral palsy. The most important thing to address is ensuring that the child is consuming the right amount of food and fluids. Micronutrient deficiencies need to be corrected as well, specifically calcium, phosphorus, magnesium, and vitamin D.
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1
1
5
3
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Table 44-3
1(pg 917)
Power Packing
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Power packing is a technique to increase the caloric density of food and beverages without increasing the amount, making it ideal for children that have problems eating and getting enough nutrients. The simplest way to power pack foods and beverages is by adding fats and carbohydrates and incorporating more high-protein foods. Some things typically used include powdered milk, vegetable oil, butter, mayonnaise, cheese, peanut butter, and wheat germ. Another option is ready-to-use supplements like PediaSure, Kindercal, Boost, Ensure, and Resource.
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