Pediatric Nutrition Assessment Research Articles

Pediatric Nutritional Assessment

Background: Pediatric nutrition plays a vital role in the growth and development of children. It not only meets the daily nutritional needs of healthy children but also supports their normal growth. In contrast, for unhealthy children, it aims to prevent growth delays and developmental issues, especially in cognitive functions. The situation in Indonesia presents a unique challenge with the coexistence of undernutrition and overnutrition, both having significant short-term and long-term health impacts. Discussion: In the realm of pediatric nutrition, malnutrition manifests in various forms. Nutritional deficiencies such as wasting, stunting, and being underweight arise from inadequate dietary intake. Additionally, there are concerns about micronutrient malnutrition, which includes both deficiencies and excesses of vital nutrients. Overnutrition, leading to obesity and associated chronic diseases, is also a significant problem. The approach to pediatric nutritional care is multi-faceted, involving the assessment of nutritional status, determination of individual caloric needs, and selecting the appropriate method for nutrition delivery, whether it be oral, enteral, or parenteral. Monitoring and evaluating the effectiveness of these interventions is a critical ongoing process. An important aspect of preventive care includes educating parents about proper feeding techniques, such as establishing regular meal times and understanding the child's hunger and satiety signals, to avoid feeding difficulties. For cases like Failure to Thrive (FTT), where children do not meet standard growth metrics, careful management is necessary to ensure adequate nutrition and to prevent complications like refeeding syndrome. Conclusion: Effective pediatric nutrition requires a holistic and personalized approach. It is crucial in addressing the dual burden of undernutrition and overnutrition in Indonesia. By implementing proper nutritional care and structured feeding practices, children's health outcomes can be significantly improved, supporting their growth and developmental processes.

Effects of parent- and child-related behavioral feeding problems in early childhood on malnutrition

ObjectiveChildren's responses to food and their caregivers during normal developmental periods are known as feeding behavior. For the healthy development of these behaviors, parent and child relationships must also be healthy. Therefore, we aimed to investigate the effect of behavioral feeding problems on primary malnutrition (PM). MethodThe Behavioral Pediatric Nutrition Assessment Scale (BPFAS) was administered to 300 malnourished and 300 control pediatric patients aged from 9 months to 4 years who were referred to our pediatric gastroenterology outpatient clinic. Pre- and posttreatment data were compared between the two groups. ResultsThere was no statistically significant difference between patients with and without malnutrition in terms of gender and age (p = 0.191, p = 0.128, respectively). Total behavioral frequency (TBF) and total behavioral problem (TBP) scores were significantly higher in the malnutrition group (p < 0.001). In the logistic regression analysis of risk factors that may affect malnutrition we found that a total TBF score of ≥85 increases the risk of developing malnutrition 3.731 times, a child TBF score of ≥62 increases it 2.644 times, and a parental TBF score of ≥21 increases it 4.82 times (p < 0.001). When anthropometric measurements and BPFAS scores of 127 PM patients who received behavioral therapy with enteral products and who attended follow-up were compared with their pretreatment data, there was a significant improvement (p < 0.05). ConclusionOur study showed that behavioral feeding problems may increase the risk of PM and that behavioral therapy together with enteral products has a positive effect on treatment. Therefore, in addition to nutritional support in patients with PM, offering behavioral feeding therapy to parents will positively affect both the child's physical development and the relationship between the parents and their child.

Undergraduate Medical Students' Perceptions of Nutrition Education at the Northern Ontario School of Medicine.

The objective of this evaluation was to determine Northern Ontario School of Medicine (NOSM) undergraduate medical education (UME) students' perceptions of the curriculum related to their nutrition knowledge, attitudes, and counseling self-efficacy/confidence. A 16-item electronic survey (Qualtrics©) was developed, and it included nutrition competency statements, adult and pediatric nutrition assessment and counseling confidence, and nutrition curriculum satisfaction. Students in Years 2, 3, and 4 (n = 192, 66%-73% female) were invited to answer the survey. Of the 61 respondents, 50.8% were Year 2, 34.9% Year 3, and 10.6% Year 4. Overall, 72.1% of the respondents were dissatisfied. Respondents perceived they were least competent in strategies to prevent and treat disease (72.1%), in applying basic dietary strategies (65.6%), and in ethics and nutrition management (62.3%), whereas 52.5% felt competent in the team approach to nutrition care. Respondents reported lowest confidence (less than 10%-15%) in specialized nutrition support, cancer care, renal nutrition, and mental health/eating disorders for both populations. NOSM medical learners reported curriculum dissatisfaction, nutrition incompetence, and poor levels of perceived confidence in nutrition management. Results will be used to inform nutrition curriculum enhancements and future outcome evaluations. Current and future physicians with enhanced nutrition knowledge, awareness of the Registered Dietitian (RD) roles, and an understanding of when to refer patients to an RD can provide better patient-centred care.

Pediatric Nutrition Assessment.

Pediatric patients with chronic illnesses or diseases or who require long-term nutrition support are most vulnerable to nutrition-related issues. Malnutrition in a pediatric patient may negatively affect long-term growth and development. Children also become malnourished much more quickly than adults. A comprehensive nutrition assessment that includes food and nutrition-related history, anthropometric measurements, biochemical data, medical tests and procedures, nutrition-focused physical findings, and patient history should be completed on these patients as no one parameter is a comprehensive indicator of nutrition status. Anthropometric measurements provide important information on the growth and nutrition status of a child, yet many times it is difficult to get accurate and valid measurements due to physical limitations of the child or improper technique. Inaccurate measurements may result in a missed diagnosis of malnutrition or may lead to an incorrect diagnosis of a healthy child. Knowledge of appropriate anthropometric measurements and alternatives is crucial when assessing growth in all children and essential for those who are physically handicapped or critically ill. The purpose of this review is to present key components of a pediatric nutrition assessment so proper nutrition-related diagnosis, including malnutrition, can be accomplished, a nutrition care plan established, and expected outcomes documented.

Screening and analysis of nutritional risk in hospitalized children

Objective To know the status of nutritional risk and the distributing characteristics of high nutritional risk, and provide references for clinical nutrition support. Methods Totally 4 728 hospitalized children that accorded with the assessment standard of nutritional risk in Children′s Hospital of Soocow University from March 2015 to April 2015 were screened out by pediatric nutrition assessment screening tool as the research object. The occurrence of high nutritional risk of hospitalized children and the scores were analyzed by SPSS 19.0 according to different sex, age and departments. Results Among 4 728 hospitalized children, the occurrence rate of high nutritional risk was 18.21%; the medical department accounted for 22.74% and the surgical department accounted for 9.22%. The top three occurrence rate of high nutritional risk were digestive department (40.10%), kidney & rheumatism immunity department (32.13%) and vasculocardiology deparment (26.06%). The occurrence rate of high nutritional risk in female children was higher than the male children (19.99% vs 17.27%) (P<0.05). The occurrence rate of high nutritional risk in hospitalized children who were more than 7 years old was the highest(24.91%). The differences of occurrence rate of high nutritional risk in hospitalized children with different age were significant (χ2=64.844, P<0.05). The total score of nutritional risk in hospitalized children aged 4-7 was the highest and was (4.76±1.13), secondary, it was the score of hospitalized children that above 7 years old and was (4.71±1.27). The total score of nutritional risk in hospitalized children with high nutritional risk and different age was significantly different (P<0.05). Conclusions Hospitalized children have high nutritional risk and there is distributing difference. Children within 1 year old with digestive disorders or operation and children above 3 years old with chronic disease are the priority of clinical nutrition intervention. Key words: Child, hospitalized; Nutritional risk; Screening

PP143-MON: Pediatric Nutritional Assessment Web Application, A Novel Tool for the Professional of Nutrition

PP143-MON: Pediatric Nutritional Assessment Web Application, A Novel Tool for the Professional of Nutrition

Pediatric Nutrition Assessment: Identifying Children at Risk

Nutrition services are important in the prevention of disabilities as well as in the treatment and/or habilitation of children with chronic illness. Level 1 nutrition care requires some basic knowledge of nutrition to screen for nutritional risk factors, knowledge of and access to referral systems for children identified to be at risk, and ability to use general nutrition education materials. Level 2 involves individualized nutrition assessment and intervention for problems such as anemia, chronic constipation, low- or high-calorie diets, feeding problems, and growth monitoring. Level 3 nutrition services are for children with identified disabilities such as cystic fibrosis, diabetes, and metabolic disorders that require specific complex nutrition interventions. The five major components of assessment of nutritional status in children are: anthropometric, clinical, biochemical, dietary, and feeding skill development. J Am Diet Assoc. 1997; 97(suppl 2):S107–S115.

Pediatric Nutritional Assessment

Nutritional assessment is an important facet of the medical care of infants and children. An accurate assessment allows for the early detection and treatment of nutrient deficiencies. The traditional nutritional assessment includes anthropometric measurements, biochemical evaluation, clinical examination, and dietary evaluation. Newer techniques include the assessment of body composition using total body electrical conductivity or bioelectrical impedance. The sophistication of nutritional support makes it necessary to identify more sensitive methods for accurate nutritional assessment.

662 A MANUAL AND SCORING SHEET FOR NUTRITIONAL ASSESSMENT OF THE PEDIATRIC PATIENT

A manual and scoring sheet for nutritional assessment of the pediatric patient has been developed. The manual includes a list of appropriate dietary and medical historical questions to aid in identifying the pediatric patient at risk for nutritional deficiencies; a system oriented nutritional physical examination to identify physical findings of nutritional deficits; and a list of specific nutritional deficits associated with pediatric disease processes. Guidelines are included for obtaining, 1) additional blood studies such as serum vitamin and mineral levels, 2) x-ray studies, such as chest x-ray, bone age, and CT scan of the brain, 3) EKG, 4) and collections of urine and feces. The scoring sheet includes consideration of percent ideal body weight, percent weight change, weight for height, triceps and subscapular skin fold thickness, arm muscle circumference, albumin, transferrin, skin testing, and absolute lymphocyte counts that have been adapted for use in the various age groups within pediatrics. A numerical score is assigned to each item indicating degree of deficit and a total nutrition score is calculated. A score of 0 to 5 indicates normal nutritional status, 6 to 10 mild, 11 to 15 moderate, and > 15, severe nutritional deficits. This type of manual and scoring sheet provides a means to teach concepts of pediatric nutritional assessment.