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High Risk Nutrition Care Plan Guidelines 9
Prenatal exposure to alcohol can damage the developing fetus and is the leading preventable cause of birth defects and intellectual and neurodevelopmental disabilities. Effects of FASD include physical, mental, behavioral, and/or learning disabilities with possible lifelong implications. A person with FASD might have any or a combination of the following: • Facial abnormalities, such as a smooth ridge between the nose and upper lip • Small head size, short stature, low body weight • Sleep and sucking problems as an infant • Hyperactive behavior, difficulty with attention, poor memory, difficulty in school, learning disabilities, poor reasoning and judgement skills • Poor coordination, speech and language delays, intellectual disability • Problems with heart, kidneys, bones, vision, or hearing The severity of the alcohol’s effects on a fetus primarily depends on the following: • Quantity – the amount of alcohol consumed by a pregnant woman per occasion • Frequency – the rate at which alcohol is consumed or is repeatedly consumed by the pregnant woman • Timing – the specific gestational age of the fetus when alcohol is consumed by the pregnant woman
Research indicates children with FASD are often “picky eaters” and may not meet the recommended intakes for several nutrients. They are also more likely to have a past diagnosis of underweight which may be due to abnormal eating patterns and nutritional inadequacies. Children and infants with FASD may be delayed in acquiring age-appropriate feeding skills which may impact introduction of solid foods and self-feeding skills.
Assessment, counseling, and referral guidelines: • Complete nutritional assessment according to WIC protocol. • Assess diet and feeding skills. • Counsel based on assessment findings. • Make referrals, as appropriate, according to Section 3.5 of the WIC Procedure Manual.
Documentation: • Check “High Risk Education” on the Nutrition Education screen under Nutrition Education Topics and enter “Fetal Alcohol Spectrum Disorders” under Topic Status. • Document the specific details regarding the nutritional assessment and nutrition care plan in the Nutrition Assessment field on the Care Plan Summary in Crossroads.
Recommendations for the WIC CPA: • Learn about and reinforce the health care team’s plan of care and encourage participants/caregivers to keep all appointments and take any prescribed supplements or medications as directed. • Work to build a rapport with the mother/caregiver for expression of concerns related to the child’s health and the demands of parenting a child with FASD.