Nutritional Challenges in Children

Nutritional issues are addressed at almost every visit to a pediatrician or child health specialist, whether for health maintenance or acute care. Adding to the challenge of assessing the nutritional status of any child is getting an accurate impression of their developmental status, environment, and social support structure. Medication management, ongoing chronic medical conditions, and the demands of a growing body all play a role as well.

This issue of Pediatric Annals provides several interesting and unique cases in childhood nutrition that illustrate challenges faced in the clinical setting on a daily basis. After reviewing these articles, the reader will be better prepared to serve as a guide and problem-solver for families with vexing nutritional issues.

Table of Contents

A 16-Year-Old Boy with Anemia, Pica
Linda S. Nield, MD ; Stacey Gillespie, RN, MSN, CPNP; and Brian D. Riedel, MD

An 18-Month-Old Boy with Severe Dermatitis, Edema, Muscle Wasting
Vineeta S. Mittal, MD; Meghana Sathe, MD; David Troendle, MD; and Matthew Cox, MD

A 15-Year-Old Girl with Dysphagia, Failure to Thrive
Christina Ryan, MD, PhD; Muhammad Khan, MD; Eva Delgado, MD; William Berquist, MD; and Christopher Longhurst, MD

A 9-Year-Old Girl with Stabbing Stomach Pain, Low-Grade Fever
Samuel Bitton, MD; Toba A. Weinstein, MD; Jeremiah J. Levine, MD; and Michael J. Pettei, MD, PhD

Pre-Term Neonate with Intestinal Failure, Feeding Issues
Daniel T. Robinson, MD; and Robin H. Steinhorn, MD

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Faculty, reviewer and staff disclosures:
Susan Donlevy, RN, MSN, CPNP, has disclosed no relevant financial relationships.
Deepak Kamat, MD, PhD, has disclosed no relevant financial relationships.
Leonard R. Krilov, MD, PhD, has disclosed the following relevant financial relationships: Medimmune and Merck: Consultant; GlaxoSmithKline, Medimmune, and Novartis: Grant recipient; and GSK, Medimmune, and Merck: Member of speakers’ bureau..

Faculty members report the following financial relationships:
Robert Listernick, MD, has disclosed no relevant financial relationships.
Thomas J. Selva, MD, has disclosed no relevant financial relationships.
Stanford T. Shulman, MD, has disclosed no relevant financial relationships.
Robert R. Tanz, MD, has disclosed no relevant financial relationships.

The staff of Pediatric Annals have disclosed no relevant financial relationships.

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This CME activity is primarily targeted to pediatricians, osteopathic physicians, pediatric nurse practitioners, and others allied to the field. There are no specific background requirements for participants taking this activity. Learning objectives are found at the beginning of each CME article.

Vindico Medical Education designates this Journal-based CME activity for a maximum of 3 AMA PRA Category 1 Credits™ by successfully completing the quiz at PediatricSuperSite.com. Complete instructions are given at PediatricSuperSite.com. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Educational objectives can be found at the beginning of each article.

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