Friday, 6 June 2014

Severe Digestive Disorders: How to Help Your Child Get the Nutrition He Needs

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By Marianne Wait
WebMD Feature

Getting any child to eat healthy foods is a challenge. When your child has a severe digestive disorder or gastrointestinal (GI) problem, it can feel like Mission: Impossible. But you don't have to go it alone. Here’s how to help your child or teen get the nutrition he needs to grow and develop. 

Work With Your Child's Medical Team

Each kind of digestive disorder creates a unique set of dietary needs. Once your child is diagnosed, it's likely that a team of people – doctors, nurses, a nutritionist, and others – will figure out if she’s getting enough calories or certain nutrients from foods. They’ll work together to create a treatment plan with a focus on getting good nutrition. It may include:

  • A special diet
  • Supplements
  • Medications
  • Feeding by IV or a feeding tube placed in her body

Each team member plays a different role. "It's important to form a good alliance first with your primary care physician," says Vincent Mukkada, MD. This doctor can be the "team quarterback," Mukkada says. "It’s very important to have a primary care person who can take all of that information and synthesize it."

One of the team members will track how your child is developing on a growth chart. If her growth or weight falls off a lot, it can be a concern, says dietitian Julia Driggers, RD. In that case, your child's doctor may alter her treatment plan.

Get Your Child the Right Nutrition

If your child has trouble gaining weight, the goal, Mukkada says, is "not to get more nutrients in, it’s to get the right nutrients in." The trick is not only to get calories, vitamins, and minerals. It's also to make sure he gets macronutrients – those needed in large amounts, especially protein.

These tips can also help keep your child's weight and growth on track:

  • Stick with the treatment plan. Treatment will help your child eat better. Take children who are diagnosed with Crohn's disease, says Asim Maqbool, MD. "They’ll come in not feeling well, not eating well, and as soon as they start to get medication to treat the underlying diagnosis, you’ll find they’re able to eat more food and can gain weight.”
  • Pick a dietitian or nutritionist who specializes in kids. It’s one thing to tell an adult what to eat. “It’s another thing to tell a picky 4-year-old,” Mukkada says.
  • Ask what supplements your child needs. Different digestive problems can cause different gaps in your child's nutrition. For example, if your child has chronic diarrhea, he may need extra zinc. Or if his condition causes blood loss, like Crohn’s disease or ulcerative colitis, he may need more iron.
  • Shun empty calories. Potato chips taste great, but junk food isn’t the way to help your child gain weight. Healthy fats like avocados and olive oil will do him more good. A carbohydrate or protein powder or supplement drink can also help. Ask the nutritionist or doctor about what's right for your child.  
  • Nix the added sugar. Sugar is another easy source of calories, but sugar isn’t nutritious. And too much sugar, especially from fruit juice, can cause diarrhea, especially in young children.
  • Factor in fiber. Your child's doctor may advise you to offer him a low-fiber diet, especially when his disease flares. "This is not intended to be for life," Maqbool says. Most likely, your child needs fiber when his disease isn't flaring. To find out how much he needs, add 5 to your child’s age, Driggers says. That's the number of grams of fiber he should get a day. Ask his doctor or nutritionist which kinds of fiber are best.
  • Keep mealtimes structured. It may help your child to eat smaller, more frequent meals instead of three big ones. Make sure some meals are family events, so eating is more fun. “Set mealtimes and try to emphasize having the family eat those meals together, so it’s both a nutritional and social event,” Mukkada says.

One of the best things you can do for your child is not to make growth a big issue for him. Avoid comparing his growth to that of other kids in his class. What’s important is that his height and weight are in the normal range -- and that he keeps growing. 



source : Severe Digestive Disorders: How to Help Your Child Get the Nutrition He Needs

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