The website promotes quality, community-based nutrition and feeding team services for children with special health care needs and their families in Washington State. Information about nutrition professionals, nutrition needs of children with special health care needs, and nutrition resources can be found here.
Children and adolescents with special health care needs are those who have congenital or acquired conditions that affect physical, behavioral and /or cognitive growth and development and who require more than the usual pediatric health care. The term refers to children who have developmental disabilities, chronic conditions, or health-related problems as well as those who are at risk for these conditions. These children may have medical diagnoses such as Down syndrome, cystic fibrosis, cerebral palsy, pediatric HIV/AIDS, spina bifida, muscular dystrophy, autism, Prader-Willi syndrome, and others.
Good nutrition is essential for all children to achieve their physical and developmental potential. Children with special health care needs are at increased risk for nutrition-related problems because of:
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- Physical disorders or disabilities that may affect their ability to consume, digest, or absorb nutrients
- Biochemical imbalances caused by long-term medications or internal metabolic disturbances
- Psychological stress from a chronic condition or physical disorder that may affect a child’s appetite and food intake
- Environmental factors that may influence a child’s access to and acceptance of food
- Delayed growth, underweight and overweight
- Feeding delays, oral-motor problems, or altered feeding interactions
- Inadequate or excessive diet quantity or quality
- Medication/nutrient interactions
- Elimination problems, i.e. constipation, diarrhea
- Altered energy and nutrients needs, i.e. inborn errors of metabolism
- Dental caries including early childhood caries (ECC) that may be related to inappropriate breastfeeding or bottle-feeding
- Poor or excessive appetite
It has been estimated that up to 40% of children with special health care needs have nutrition risk factors that could be helped by referral to a registered dietitian (RD). Preventive nutrition services, as well as intervention for identified problems, can help assure a well-nourished child who is healthy, can participate in education and therapy programs, and is better able to function in all activities of daily life.
Dietetics is the science of applying food and nutrition to health. Registered dietitian nutritionists (RDNs) are food and nutrition experts who have met specific education, training, examination, and continuing education requirements. RDNs use the credential letters “RDN” after their name to indicate they have met the requirements. RDNs, such as those in the Washington State CYSHCN Nutrition Network, can provide nutrition services for children with special health care needs. Additional information about RDNs can be reviewed at the Academy of Nutrition and Dietetics (AND) web site, along with the AND position statement about nutrition services for individuals with intellectual disabilities and special health care needs (2015).
RDNs who work with children with special health care needs often have additional training in the area of pediatrics and special health care needs. They provide nutrition assessment and intervention regarding feeding and food intake. RDNs work closely with the family and child. The RDN may consult with the primary care provider and others who also work with an individual child and his/her family.
Some RDN’s use the job title Nutritionist. All nutritionists do not necessarily have specific training and education requirements, so look for the RDN after the individual’s name. In the state of Washington the RDN can choose to be a Certified Dietitian (CD). A CD in Washington can receive payment for nutrition services for children with special health care needs if a referral has come from the primary medical provider and the child is covered by Medicaid.
