Children with acquired brain injury (ABI) who are nonambulatory are often at high risk for feeding problems, abnormal activity, altered weight and growth patterns. They present a challenge in calculating their energy needs to prevent excessive weight gain. A retrospective chart review was conducted to look at the trends in nutritional intervention provided for 15 children (4 girls, 11 boys) age 5-17 years during the first year of their rehabilitation program. We examined energy intake, progression of feeds, changes in growth and body composition. Estimated energy needs were calculated using the Basal Metabolic Rate (BMR) x calorie adjustment factor for activity level, this total was same as actual intake. This was compared to the Recommended Dietary Allowances (RDA). Data on anthropometrics was assessed using software and serially plotted on growth charts of the Sunny Hill Anthropometric Pediatric Evaluation System (S.H.A.P.E.S). Children ranged in level of consciousness from vegetative state to fully conscious. The majority of the children (13) were fully dependent and nonambulatory while 2 boys were ambulatory with mild physical impairments. All the children were initially on total enteral nutrition support and 7 progressed to oral feeds. For 13 children the calculated/ actual energy intakes were less than the RDA with an intake range of 40-90% of the RDA. The S.H.A.P.E.S. results showed that the children continued to grow in length along the same or higher percentile curve. The fully dependent nonambulatory children gained weight easily, but the weight was usually reflected as an increase in fat tissue development while muscle development decreased; this presented a challenge for energy calculations. Nutritional intervention is essential for children with ABI during rehabilitation to help the child have reasonable weight gain, optimal growth, development and quality of life.