Page 216 - MHF-FeedingMinds-final.indd

7.3
Nutrition for Children with Chronic
Diseases and Syndromes
Summary
●● V●a riouSsummemdiacrayl cBounlldeitteiodnLsisrtequire dietary ●● Children with coeliac disease need to eat a
modification and a paediatric dietitian can
advise on how to make these while ensuring
nutritional adequacy to support health and
normal growth.
●● Nutritional support is required for several
conditions and may be delivered using higher
energy family foods or prescribable sterile
nutritional supplements.
●● Some or all of a child’s nutritional requirements
may be provided by tube feeding when they
are unable to consume their energy and
nutrient requirements orally.
●● Pumps and plastics for home enteral tube
feeding can be delivered directly to the home
or a holiday destination.
Medical Conditions Requiring
Dietary Modifications
Several medical conditions in infants and children
require a modified nutritional intake to treat or
ameliorate either the condition itself or the
consequences of some medical treatments. Table
7.3.1 lists the dietary modifications required for
several medical conditions, the more common of
which are discussed in further detail in the rest of
this chapter. For a comprehensive guide to the
treatment for all paediatric conditions requiring
dietary modification, students and practitioners
should use the 4th edition of Clinical Paediatric
Dietetics edited by Vanessa Shaw and published by
Wiley (Shaw 2013).
gluten-free diet and are entitled to a monthly
allowance of gluten-free products on
prescription.
●● Children with cystic fibrosis usually need a diet
higher in energy and certain nutrients and
usually take pancreatic enzymes with each
meal and snack.
●● Children with cancer may need nutritional
support when their appetite is decreased.
●● Children with insulin-dependent diabetes need
to control the carbohydrate content of their
diet and the distribution of the carbohydrate
throughout each day.
Considerations when Advising
and Supporting Parents and
Carers
When an infant or child is diagnosed with a medical
condition, it can be very traumatic for the family and
they may need time to come to terms with the
diagnosis before they can embark on a programme of
learning about the extra responsibility of following
the dietary modifications required of them. Parents
may have to deal with guilt feelings, particularly if
their child’s condition was genetically inherited.
Individualized advice from a paediatric dietitian
with experience of the medical condition is needed
for any dietary modification. The aims of dietary
treatment are to meet the nutritional and energy