Contents

Contributors. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . v Reviewers. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xi Foreword . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xv Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xvii Acknowledgments & Dedication . . . . . . . . . . . . . . . . . . . . . . . xix

7. Water-Soluble Essential Micronutrients. . . . . . . . . . . . . . 56

Winston Koo, MBBS, FACN, CNS Judith Christie, RN, MSN May Saba, PharmD, BCNSP Mirjana Lulic-Botica, BSc, BCPS Letitia Warren, RD, CSP Winston Koo, MBBS, FACN, CNS May Saba, PharmD, BCNSP Mirjana Lulic-Botica, BSc, BCPS Judith Christie, RN, MSN

8. Fat-Soluble Vitamins . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74

PART I INTRODUCTORY AND BASIC PHYSIOLOGY

1. Mechanics of Nutrient Intake. . . . . . . . . . . . . . . . . . . . . . . 3
Mark R. Corkins, MD, CNSP , SPR, FAAP Carol G. McKown, DDS, MS Anna M. Dusick, MD

9. Fluids and Electrolytes. . . . . . . . . . . . . . . . . . . . . . . . . . . 87

Gerald L. Schmidt, PharmD, BCNSP

2. Gross Digestion Principles: Gastric Grinding and Gastrointestinal Motility. . . . . . . . . . . . . . . . . . . . . . 11

Jane P. Balint, MD

PART II AGE-SPECIFIC NUTRITION FOR GROWTH ANDDEVELOPMENT

10. Nutrition and Early Development . . . . . . . . . . . . . . . . . 105
Russell J. Merritt, MD, PhD, FAAP Barbara Marriage, PhD, RD Ricardo Rueda, MD, PhD Jacqueline J. Wessel, RD, CNSD

3. Carbohydrates: Changes with Development. . . . . . . . . . . 17

Seema Mehta, MD Robert J. Shulman, MD Peggy R. Borum, PhD

4. Fats. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 5. Protein Digestion, Absorption, and Metabolism. . . . . . . . 31

Richard A. Helms, PharmD Emma M. Tillman, PharmD Anup J. Patel, MD John A. Kerner, MD

11. Human Milk . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 120 12. Infant Formulas and Complementary Feeding. . . . . . . 129
Kelly Green-Corkins, MS, RD, CNSD Timothy Sentongo, MD Timothy Sentongo, MD

13. Growth Assessment and Monitoring . . . . . . . . . . . . . . 143 14. Obesity and Metabolic Disorders. . . . . . . . . . . . . . . . . 149
Michelle Battista, BS, PhD Candidate Robert Murray, MD Shirley Huang, MD Melanie Katrinak, RD, CSP, LDN

6. Minerals. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45
Winston Koo, MBBS, FACN, CNS Mirjana Lulic-Botica, BSc, BCPS May Saba, PharmD, BCNSP Letitia Warren, RD, CSP

15. Lipid Disorders. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 162

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16. Use of Fad and Popular Diets. . . . . . . . . . . . . . . . . . . . 169

Catherine Christie, PhD, RD Julia A. Watkins, PhD, MPH Judith C. Rodriguez, PhD, RD

30. Oncology, Hematopoietic Transplant, and Survivorship. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 349

Nancy Sacks, MS, RD, LDN Elizabeth Wallace, RD, CNSC, LDN Seema Desai, MS, RD, LDN, CNSD Vinod K Prasad, MD, MRCP (London) David Henry, MS, BCOP Virginia Guzikowski, MSN, CRNP Liesje Nieman Carney, RD, CNSD, LDN Beth Bogucki Wright, MS, RD, CSP, LDN Susan Rheingold, MD Arlet G. Kurkchubasche, MD Arlet G. Kurkchubasche, MD

17. Sports Nutrition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 178

Jackie Buell, PhD, RD, LD, ATC, LAT Diane L. Habash, PhD, RD, LD

PART III DISEASE STATES AND NUTRITION

18. Developmental Delay . . . . . . . . . . . . . . . . . . . . . . . . . . 191
Kathleen J. Motil, MD, PhD

31. Trauma and Burns . . . . . . . . . . . . . . . . . . . . . . . . . . . . 378 32. Surgery. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 387

19. Eating Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 204

Christina Fitzgerald, MS, RD, LDN Betsy Hjelmgren, MS, RD, LDN, CSP

20. Food Allergies. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 213

Mary Beth Feuling, MS, RD, CD, CNSD Michael B. Levy, MD Praveen S. Goday, MBBS, CNSP Diane Olson, RD, CNSD, CSP , LD W. Frederick Schwenk II, MD

PART IV NUTRITION CARE OF THE PEDIATRIC PATIENT

33. Assessment of Nutrition Status by Age and Determining Nutrient Needs . . . . . . . . . . . . . . . . . 409
Liesje Nieman Carney, RD, CNSD, LDN Jennifer Blair, MA, RD, CSP, LDN

21. Diabetes Mellitus and Other Endocrine Disorders. . . . 226

22. Inborn Errors of Metabolism . . . . . . . . . . . . . . . . . . . . 232

Bridget Reineking, MS, RD, CD Sandra van Calcar, PhD, RD, CD

34. Parenteral and Enteral Nutrition Support: Determining the Best Way to Feed. . . . . . . . . . . . . . . . 433
Liesje Nieman Carney, RD, CNSD, LDN Andrea Nepa, MS, RD, CSP, LDN Sherri Shubin Cohen, MD, MPH Amy Dean, MPH, RD, LDN Colleen Yanni, MS, RD, LDN Goldie Markowitz, MSN, CRNP Beth Lyman, RN, MSN Jennifer M. Colombo, MD Jodi L. Gamis, OTR

23. Cardiac Disease. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 247

Anupama Chawla, MD, CNSP , DCH (UK) Janice Antino, RD, MS, CNSD, CSP Mindy Freudenberg, RD, MS, CNSD

24. Renal Disease. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 256

Christina L. Nelms, MS, RD, CSP , CNSC, LD Marisa Juarez, MPH, RD, LD Bradley A. Warady, MD Donald George, MD Elizabeth Bobo, MS, RD, LDN, CNSD

35. Implementation of the Plan. . . . . . . . . . . . . . . . . . . . . 448

25. Gastrointestinal Disease . . . . . . . . . . . . . . . . . . . . . . . 283

36. Evaluation and Monitoring of Pediatric Patients Receiving Specialized Nutrition Support . . . . . . . . . . . 460
Elaina Szeszycki, PharmD, BCNSP Wendy Cruse, MMSc, RD, CNSD Michelle Strup, PharmD Patrick M. Jones, MD, MA Brian Carter, MD

26. Hepatic Disease. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 302

Samuel A. Kocoshis, MD Renee A. Wieman, RD, CSP , LD, CNSD Robert H. Squires, Jr., MD

37. Ethical Issues in the Provision of Nutrition . . . . . . . . . 477

27. Intestinal Failure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 311 28. Pulmonary Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . 323

Allison Mallowe, RD, LDN Suzanne Michel, MPH, RD, LDN Maria Mascarenhas, MBBS Anita Nucci, PhD, RD, LD Sharon Strohm, MBA, RD, LDN Neelam Katyal, MS, RD, LDN Beth Lytle, RD, LDN

Test Your Knowledge Answers . . . . . . . . . . . . . . . . . . . . . . . . 487 Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 495

29. Organ Transplantation . . . . . . . . . . . . . . . . . . . . . . . . . 337

Contributors

Janice Antino, RD, MS, CNSD, CSP Certified Specialist in Pediatric Nutrition, Registered Dietitian Stony Brook University Hospital Stony Brook, NY Jane P. Balint, MD Director, Intestinal Support Service Pediatric Gastroenterology, Hepatology and Nutrition Nationwide Childrens Hospital Columbus, OH Michelle Battista, BS, PhD Candidate The Ohio State University OSUN Interdisciplinary PhD Program Columbus, OH Jennifer Blair, MA, RD, CSP, LDN Clinical Dietitian III The Childrens Hospital of Philadelphia Philadelphia, PA Elizabeth Bobo, MS, RD, LDN, CNSD Clinical Dietitian, Gastroenterology and Nutrition Nemours Childrens Clinic Jacksonville, FL Peggy R. Borum, PhD Professor of Human Nutrition University of Florida Gainesville, FL Jackie Buell, PhD, RD, LD, ATC, LAT Director of Sports Nutrition, Department of Human Nutrition College of Education and Human Ecology Ohio State University Columbus, OH

Brian S. Carter, MD Professor of Pediatrics Vanderbilt University Medical Center Nashville, TN Anupama Chawla, MD, CNSP, DCH (UK) Director of Pediatric Gastroenterology and Nutrition Stony Brook University Hospital Stony Brook, NY Catherine Christie, PhD, RD Chair, Department of Nutrition and Dietetics University of North Florida Jacksonville, FL Judith Christie, RN, MSN Childrens Hospital of Michigan Detroit, MI Sherri Shubin Cohen, MD, MPH Medical Director, Pediatric Feeding and Swallowing Center The Childrens Hospital of Philadelphia Philadelphia, PA Jennifer M. Colombo, MD Pediatric Gastroenterology Fellow Childrens Mercy Hospital Kansas City, MO Mark R. Corkins, MD, CNSP, SPR, FAAP Associate Professor Indiana University School of Medicine, Riley Hospital for Children Indianapolis, IN

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CONTRIBUTORS

Wendy Cruse, MMSc, RD, CNSD Pediatric Dietitian Indianapolis, IN Amy Dean, MPH, RD, LDN Clinical Dietitian The Childrens Hospital of Philadelphia Philadelphia, PA Seema Desai, MS, RD, LDN, CNSD Clinical Dietitian Duke University Medical Center Durham, NC Anna M. Dusick, MD Associate Professor of Clinical Pediatrics Indianapolis University School of Medicine Riley Hospital for Children Indianapolis, IN Mary Beth Feuling, MS, RD, CD, CNSD Clinical Dietitian Specialist Childrens Hospital of Wisconsin Milwaukee, WI Christina Fitzgerald, MS, RD, LDN Owner/President Nourished, Nutrition and Wellness Services Chicago, IL Mindy Freudenberg, RD, MS, CNSD Certified Nutrition Support Dietitian, Registered Dietitian Stony Brook University Hospital Stony Brook, NY Jodi L. Gamis, OTR Occupational Therapist Childrens Mercy Hospital Kansas City, Missouri Donald E. George, MD Division Chief Gastroenterology Nemours Childrens Clinic Jacksonville, FL Praveen S. Goday, MBBS, CNSP Associate Professor Pediatric Gastroenterology, Hepatology and Nutrition Medical College of Wisconsin Milwaukee, WI

Kelly Green-Corkins, MS, RD, CNSD Clinical Dietitian Specialist Clarian Home Care Indianapolis, IN Virginia Guzikowski, MSN, CRNP Nurse Practitioner Division of Oncology The Childrens Hospital of Philadelphia Philadelphia, PA Diane L. Habash, PhD, RD, LD Bionutrition Clinical Research Manager General Clinical Research Center Ohio State University Columbus, OH Richard A. Helms, PharmD Department of Clinical Pharmacy The University of Tennessee Health Science Center Memphis, TN David W. Henry, MS, BCOP Associate Professor, Pharmacy Practice University of Kansas Medical Center Kansas City, KS Betsy Hjelmgren, MS, RD, LD, CSP Founder, Feed to Succeed Chicago, IL Shirley Huang, MD Medical Director, Healthy Weight Program Attending Physician, Division of GI, Hepatology and Nutrition The Childrens Hospital of Philadelphia Philadelphia, PA Patrick M. Jones, MD, MA Clinical Fellow (Neonatology) Vanderbilt Childrens Hospital Nashville, TN Marisa Juarez, MPH, RD, LD Pediatric Renal Dietitian Texas Childrens Hospital Houston, TX Melanie Katrinak, RD, CSP, LDN Clinical Nutritionist The Childrens Hospital of Philadelphia Philadelphia, PA

CONTRIBUTORS

vii

Neelam Katyal, MS, RD, LDN Clinical Dietitian Childrens Hospital of Pittsburgh Pittsburgh, PA 15213 John A. Kerner, MD Pediatric Gastroenterology, Hepatology and Nutrition Stanford University Palo Alto, CA Samuel A. Kocoshis, MD Professor of Pediatrics University of Cincinnati College of Medicine Director, Nutrition and Small Bowel Transplantation Cincinnati Childrens Hospital Medical Center Cincinnati, OH Winston Koo, MBBS, FACN, CNS Clinical Director, NICU Hutzel Womens Hospital Professor of Pediatrics Childrens Hospital of Michigan Carman and Ann Adams Department of Pediatrics Wayne State University Detroit, MI Arlet G. Kurkchubasche, MD Associate Professor of Surgery and Pediatrics Alpert Medical School Brown University Providence, RI Michael B. Levy, MD Associate Professor Allergy-Immunology Medical College of Wisconsin Milwaukee, WI Mirjana Lulic-Botica, BSc, BCPS Hutzel Womens Hospital Detroit, MI Beth Lyman, RN, MSN Senior Program Coordinator for the Nutrition Support Team Childrens Mercy Hospital Kansas City, MO Beth Lytle, RD, LDN Clinical Dietitian Childrens Hospital of Pittsburgh Pittsburgh, PA

Allison Mallowe, RD, LDN Clinical DietitianPediatric The Childrens Hospital of Philadelphia Philadelphia, PA Goldie Markowitz, MSN, CRNP Pediatric Nurse Practitioner The Childrens Hospital of Philadelphia Philadelphia, PA Barbara Marriage, PhD, RD Senior Research Scientist Abbott Nutrition Columbus, OH Maria Mascarenhas, MBBS Section Chief, Nutrition, Division of Gastroenterology andNutrition The Childrens Hospital of Philadelphia Associate Professor of Pediatrics University of Pennsylvania School of Medicine Philadelphia, PA Carol G. McKown, DDS, MS Owner/President Carol G. McKown, M.S., D.D.S., P.C Volunteer Faculty, Riley Hospital Pediatric Dentistry Dept. Carmel, IN Seema Mehta, MD Department of Pediatric Gastroenterology, Hepatology, and Nutrition Baylor College of Medicine Texas Childrens Hospital Houston, TX Russell J. Merritt, MD, PhD, FAAP Director of Medical Affairs Abbott Nutrition Columbus, OH Medical Director, Nutrition Support & Intestinal Rehabilitation Childrens Hospital of Los Angeles Keck School of Medicine University of Southern California Los Angeles, CA Suzanne Michel, MPH, RD, LDN Clinical Dietitian, Pediatric Cystic Fibrosis Center The Childrens Hospital of Philadelphia Philadelphia, PA

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CONTRIBUTORS

Kathleen J. Motil, MD, PhD Associate Professor of Pediatrics USDA/ARS Childrens Nutrition Research Center Baylor College of Medicine Houston, TX Robert Murray, MD Nationwide Childrens Hospital Center for Healthy Weight and Nutrition Columbus, OH Christina L. Nelms, MS, RD, CSP, CNSC, LD Clinical Nutrition Specialist, Pediatric Renal Dietitian Childrens Mercy Hospitals and Clinics Kansas City, KS Andrea Nepa, MS, RD, CSP, LDN The Childrens Hospital of Philadelphia Philadelphia, PA Liesje Nieman Carney, RD, CNSD, LDN Clinical Dietitian IV, Publication Specialist The Childrens Hospital of Philadelphia Philadelphia, PA Anita Nucci, PhD, RD, LD Assistant Professor Georgia State University Division of Nutrition Atlanta, GA Diane L. Olson, RD, CNSD, CSP, LD Assistant Professor of Pediatrics Mayo Clinic College of Medicine Rochester, MN Anup J. Patel, MD Pediatric Gastroenterology, Hepatology and Nutrition Stanford University Palo Alto, CA Vinod K. Prasad, MD, MRCP (London) Attending Physician Pediatric Bone Marrow and Stem Cell Transplant Service Duke University Medical Center Durham, NC Bridget Reineking, MS, RD, CD Clinical Dietitian Specialist Childrens Hospital of WisconsinMilwaukee Milwaukee, WI

Susan R. Rheingold, MD Assistant Professor of Pediatrics Division of Oncology The Childrens Hospital of Philadelphia Philadelphia, PA Judith C. Rodriguez, PhD, RD Professor University of North Florida Jacksonville, FL Ricardo Rueda, MD, PhD Associate Director Discovery Technology Abbott Nutrition Granada, Spain May Saba, PharmD, BCNSP Childrens Hospital of Michigan Department of Pharmacy Practice Detroit, MI Nancy Sacks, MS, RD, LDN Clinical Dietitian/Research Coordinator Division of Oncology The Childrens Hospital of Philadelphia Philadelphia, PA Gerald L. Schmidt, PharmD, BCNSP Nutrition Specialist Shands Jacksonville Jacksonville, FL Clinical Associate Professor University of Florida College of Pharmacy Gainesville, FL W. Frederick Schwenk II, MD Professor of Pediatrics Mayo Clinic College of Medicine Rochester, MN Timothy Sentongo, MD Assistant Professor University of Chicago Chicago, IL Robert J. Shulman, MD Professor of Pediatrics Baylor College of Medicine Texas Childrens Hospital Foundation Chair in Pediatric Gastroenterology Texas Childrens Hospital Childrens Nutrition Research Center Houston, TX

CONTRIBUTORS

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Robert H. Squires, Jr., MD Clinical Director, Pediatric Gastroenterology Childrens Hospital of Pittsburgh Pittsburgh, PA Sharon Strohm, MBA, RD, LDN Dietitian Coordinator Childrens Hospital of Pittsburgh Pittsburgh, PA Michelle Strup, PharmD Home Infusion Pharmacist Clarian Home Care Indianapolis, IN Elaina Szeszycki, PharmD, BCNSP Clinical Pharmacist Nutrition Support and Pediatric Gastroenterology Riley Hospital for Children Indianapolis, IN Emma M. Tillman, PharmD Fellow, Department of Clinical Pharmacy The University of Tennessee Health Science Center Memphis, TN Sandy van Calcar, PhD, RD, CD Metabolic Dietitian Biochemical Genetics Program University of WisconsinMadison Madison, WI Elizabeth Wallace, RD, CNSC, LDN Clinical Dietitian The Childrens Hospital of Philadelphia Philadelphia, PA Bradley A. Warady, MD Professor of Pediatrics University of Missouri-Kansas City School of Medicine Associate Chairman, Department of Pediatrics Chief, Section of Pediatric Nephrology Director, Dialysis and Transplantation The Childrens Mercy Hospital Kansas City, MO

Letitia Warren, RD, CSP Childrens Hospital of Michigan Detroit, MI Julia A. Watkins, PhD, MPH Associate Professor Department of Nutrition and Dietetics University of North Florida Jacksonville, FL Jacqueline J. Wessel, RD, CNSD Neonatal Nutritionist Cincinnati Childrens Hospital Cincinnati, OH Renee A. Wieman, RD, CSP, LD, CNSD Registered Dietician II Liver and Intestinal Transplantation Services and Comprehensive Nutrition Center Cincinnati Childrens Hospital Medical Center Cincinnati, OH Beth Bogucki Wright, MS, RD, CSP, LDN Clinical Dietician IV, Technology Specialist Clinical Nutrition Development The Childrens Hospital of Philadelphia Philadelphia, PA Colleen Yanni, MS, RD, LDN Clinical Dietitian & Education Coordinator (Outpatient) The Childrens Hospital of Philadelphia Philadelphia, PA