Chapter 11: Toddler and Preschooler Nutrition: Conditions and Interventions

Standard nutritional requirements and dietary guidelines frequently need modification based on individual medical diagnoses and functional abilities. Growth assessment in this population requires simultaneous evaluation using both standard growth reference charts from the WHO and CDC alongside specialized growth charts designed for specific conditions, with adjustments for gestational age corrections in premature children and condition-specific factors such as the reduced head circumference growth observed in Rett syndrome that signals neurological decline. The chapter examines common nutritional complications including elevated fluid consumption that displaces nutrient-rich foods, and severe difficulties with oral feeding and swallowing related to neuromuscular conditions such as cerebral palsy, circumstances that may necessitate alternative feeding routes including gastrostomy tube placement for nutritional support. Specific medical conditions demand tailored dietary interventions, exemplified by celiac disease requiring complete elimination of gluten-containing foods. Chronic respiratory conditions increase the physiological work required for breathing, thereby elevating total energy requirements and creating heightened nutritional demands. Access to nutrition services for these children occurs through coordinated multidisciplinary early intervention programs, particularly those funded under the Individuals with Disabilities Education Act Part C, which incorporate registered dietitian nutritionists as essential members of the Individualized Education Plan development and implementation. The chapter emphasizes evidence-based nutritional practice and cautions against the promotion and use of unproven nutritional supplements and complementary therapies marketed toward specific diagnoses such as Down syndrome without rigorous scientific validation.