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gagging. Also  ask  how  long  it  takes  the  child  to   complete  a  meal  or  snack.  Determine  if  there   are  any  foods  the  child  avoids  or  used  to  be   able  to  eat,  but  has  trouble  eating  now3   o Inquire  about  stooling  –  how  often  the  child   stools,  and  if  he  or  she  has  any  trouble  passing   stools.  When  children  become  constipated,   they  can  get  full  easily  and  may  not  want  to  eat   or  may  have  trouble  tolerating  tube  feedings   • It  is  important  to  analyze  adequacy  of  intake,  and   make  recommendations  accordingly,  in  order  to   prevent  under-­‐  or  overnutrition   o Children  with  SMA  Type  I  and  severe  Type  II   tend  to  be  prone  to  undernutrition;  children   with  less  severe  Type  II  and  Type  III  may   struggle  with  overnutrition7     o As  children  with  SMA  get  older,  their  lean   body  mass  decreases.  This  may  result  in  over-­‐ nutrition  if  energy  intake  is  not  adjusted4     **For  more  information  regarding  how  to  prevent  under-­‐   or  overnutrition,  please  follow  this  link:   http://muscle.ca/wp-­‐ content/uploads/2012/11/fsma_nutrition_brochure_web .pdf.  Refer  to  pages  25  -­‐  26.         8  

Nutritional Management of Children with SMA: A Toolkit  
Nutritional Management of Children with SMA: A Toolkit  
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