Page 224 - MHF-FeedingMinds-final.indd

Common Medical Conditions Requiring Dietary Modifications 215

Table 7.3.3 Entitlement of age groups to gluten-free foods on prescription

Age (years) Units of gluten- Example of monthly prescription
1–3 free food per
4–6 month 6 × 400 g bread (or 3 × 500 g mix suitable for making bread)
2 × 500 g pasta
7–10 10 6 × 400 g bread (or 3 × 500 g mix suitable for making bread)
11 2 × 500 g pasta
11–14 1 (2 × 110–180 g) pizza bases
13 8 × 400 g bread (or 4 × 500 g mix suitable for making bread)
15–18 2 × 500 g pasta
15 1 (2 × 110–180 g) pizza bases
8 × 400 g bread (or 4 × 500 g mix suitable for making bread)
18 3 × 500 g pasta
1 (2 × 110–180 g) pizza bases
8 × 400 g bread (or 4 × 500 g mix suitable for making bread)
4 × 500 g pasta
2 (2 × 110–180 g) pizza bases

The number of prescribable units children are mineral supplement is also prescribed as the
entitled to increases with their age, as shown in fat-soluble vitamins A, D, E and K are usually
Table 7.3.3. poorly absorbed.

Cystic fibrosis Infants and children with cystic fibrosis
generally need a higher energy intake than
Cystic fibrosis is a genetic disorder which is normal healthy children. To achieve this,
inherited from both parents. It is relatively children with cystic fibrosis need to eat more
common in white populations and less so in Asian, food with a higher energy content. They are
African and Middle Eastern families. Several of the encouraged to eat foods containing high
glands in the body do not function very well and amounts of fat and sugar in addition to a
this causes lung disease, malabsorption of food and balanced diet of foods from the four main foods
very salty sweat. Cystic fibrosis is usually diagnosed groups described in Chapter 1.2.
by measuring the amount of salt in a child’s sweat.
Unfortunately cystic fibrosis infants and
Symptoms of the disease vary considerably children often have a poor appetite, especially if
between children and some may have more they are often ill with respiratory illnesses. Some
respiratory problems while others have more may have reflux which can cause pain on eating.
problems with malabsorption of food, particularly Poor appetites often cause considerable stress for
the fat in food. parents, who are very keen for their children to eat
well to prevent more illness. Parents of toddlers
The problems of malabsorption are due to a with cystic fibrosis report more feeding problems
poor production of enzymes from the pancreas than do parents of healthy toddlers.
which are needed to digest foods in the small
intestine so that they can be absorbed into the Parents and older children usually plan the
body. To improve the absorption of their food, child’s diet with a dietitian and he or she will advise
about 90 per cent of children with cystic fibrosis are on how many capsules of pancreatic enzymes to
prescribed pancreatic enzyme supplements to be take with each meal and snack.
swallowed along with meals and snacks. The
amount recommended varies from child to child Children whose growth is inadequate may be
depending on their symptoms. A vitamin and prescribed high-calorie drinks as supplements.
From time to time their calorie intake may be