3.4 Anticipatory Guidance
Nutrition
Feeding and eating problems—the inability or refusal to eat certain
foods because of neuromotor dysfunction, obstructive lesions, or psychological
factors—are more common in children with special health care needs
than in the general pediatric population.
Some contributors to nutritional problems that are common among
children with special health care needs include the following:
- Children with neurological impairment may require prolonged feeding time to obtain adequate energy, which extends the opportunity for an acidic environment to develop in the mouth.
- Children with asthma often use a bronchodilator that can reduce saliva flow. Other medications that cause dry mouth are antihistamines, antidepressants, antibiotics, and anti-gastroesophageal reflux agents. Obtaining adequate fluid intake is a common concern for children with special health care needs; inadequate fluid intake can lead to dehydration, resulting in reduced saliva flow.
- Children with neurologic problems (e.g., cerebral palsy) may have feeding difficulties caused by a hyperactive gag reflex or ineffective sucking and swallowing. Gastroesophageal reflux can cause dental enamel erosion as gastric contents are regurgitated into the mouth, eroding surface enamel and exposing the dentin. Children may then experience sensitivity to hot and cold foods and, eventually, severe pain. Poor muscle tone may also impair a child’s ability to chew and swallow.
Continued on the next page.
|
