Proper Nutrition in Common Childhood Illnesses

During illness, on one hand the daily need for energy increases due to an increase in the body's metabolism (for example, the increased metabolism caused by fever), and on the other hand, due to loss of appetite, food intake is insufficient or the consumed food is not well absorbed (for example, the loss of nutrients caused by diarrhea and vomiting). These changes can threaten the child's health and also delay their growth and development, which is a continuous process. Nutrition plays a role both in controlling some diseases and especially in compensating for the growth delays caused by diseases. Proper nutrition of children after recovery from illnesses can be effective in compensating for the growth delay resulting from the diseases.

 

∴ Feeding a child with diarrhea

In diarrheal diseases, an increased need for food exists for the following reasons: • repairing the damage inflicted (for example, in diarrhea, repairing the damage inflicted on the intestinal epithelium). • meeting the needs of the immune system to confront the invading agent. • compensating for the serum protein lost through the damaged intestinal mucosa.

∴ The causes of reduced food intake and loss of nutrients in diarrheal diseases can also be attributed to the following reasons: 1/ loss of appetite and vomiting 2/ reduction of intestinal villi and rapid passage of food through the intestine 3/ dietary restrictions: the wrong habit that during diarrhea feeding should be reduced leads to a worsening of the diarrhea condition.

This is while, in children with diarrhea: • Eating speeds up the repair of the intestinal mucosa and stimulates the quicker return of pancreatic function and the production of digestive enzymes, which leads to a quicker return of digestion to its normal state. • Breast milk is usually well tolerated during diarrhea, and during diarrhea the stool volume of breastfed children is lower than that of children who are not breastfed, and their illness period is shorter.

∴ In a child with diarrhea, nutrition plays an important role in preventing the occurrence of signs of dehydration and malnutrition; to this end it is recommended:

1/ Give the child more fluids than usual (in addition to ORS, fluids such as plain soup, doogh, and water). 2/ Give the child more food than usual. But the food should be given to the child in more frequent but smaller portions. Infants must be breastfed frequently, and in children deprived of breast milk, feeding with formula must be continued. In children over 6 months, the consumption of foods such as yogurt, eggs, cereals, meat, chicken, and also fruits and vegetables (especially natural fruit juices) is recommended. Of course, the food of these children must be fresh and well cooked, and giving them commercial sweet drinks (such as carbonated beverages) must be avoided, as they may intensify the diarrhea due to their high osmolarity. 3/ If vomiting is observed after consuming ORS or liquid foods, the child should be fed more slowly, in smaller volumes, and more frequently. 4/ The recommended foods should also be continued after the diarrhea stops, and the child should be given 1 extra meal per day for up to 2 weeks after the diarrhea stops. 5/ Increase yogurt consumption, and in children over 2 years, replace milk with yogurt. 6/ Children over 6 months should be fed six meals a day, and meat, fish, chicken, and eggs should be included in the child's diet. 7/ To ensure the intake of vitamins and minerals, it is recommended to use various yellow and green vegetables in preparing soup. Natural carrot juice and apple juice are also good choices for feeding these children. 8/ Greater intake of food sources containing folic acid (green leafy vegetables), iron, and zinc (meats, eggs, and legumes) is recommended. 9/ When diarrhea lasts 14 days or more, it is called persistent diarrhea. This type of diarrhea is seen more in malnourished patients and children deprived of breast milk. One of the causes of persistent diarrhea can be the infant's or nursling's sensitivity to cow's-milk protein. In this case, as diagnosed by the physician, the mother should limit consumption of dairy products and even beef.

 

∴ Feeding a child with an acute respiratory infection In these conditions, due to the child's loss of appetite, increased metabolism, the risk of a negative energy balance and the consequent reduced growth and vulnerability to malnutrition exists. Proper feeding of the child during illness and afterward is effective in controlling the complications of this illness and compensating for the growth delays of the illness period.

A - During illness

• For children younger than 6 months or children for whom complementary food has not been started, the frequency of breastfeeding should be increased. • Children older than 6 months should be given foods that have the highest amount of calories and nutrients relative to their volume. Based on the child's age, these foods should be a mixture of cereals, locally available legumes, or a mixture of cereals and meat and chicken, and to make these foods more nutritious, a little liquid oil or butter can be added to them. Dairy products and eggs are also suitable (egg white should not be given to a child under one year), and the child should be encouraged to eat as much as they wish. • Giving warm liquid foods such as soup to children with colds and coughs helps improve the clinical signs and compensate for water lost through fever. • Increasing the use of food sources containing vitamin C (fresh fruits and vegetables) and zinc (meat and legumes) is recommended to strengthen the child's immune system. • In children over one year, giving some honey with lukewarm tea helps the recovery of a child with a respiratory infection and cough.

B - After illness (convalescence)

When a child is ill, they usually eat less, so after the respiratory infection clears, the child should be given one extra meal per day for two weeks or until the child returns to normal weight. This will help them regain their normal health and prevent them from developing malnutrition. Malnutrition increases the likelihood of respiratory infection and diarrhea recurring in a more severe form.

 

∴ Feeding a child with fever

 

Fever disrupts the child's feeding process by reducing appetite and increasing the body's metabolism.

At this time, the following recommendations are useful: • In children younger than 6 months, continued feeding with breast milk or formula (in nurslings deprived of breast milk) • Continued feeding with breast milk along with liquid foods in children over 6 months • Increasing the number of feedings, even with small volumes, to compensate for the child's reduced appetite • Attention to feeding after the illness to compensate for the possible growth delays

 

∴ Nutritional recommendations for sick children

 

Given the importance of feeding a sick child, practical recommendations for these children are provided below:

• Before feeding the child, wash their hands and face so that the child feels more at ease. • Do not feed the child while they are drowsy. • Continued breastfeeding in infants is emphasized. • Food should be given to the child more frequently and in smaller volumes. • In case of a stuffy nose, first clean the nose and then feed.

∴ In case of nausea:

1/ Stop giving food for 4 to 6 hours, but every 10 minutes give about 10 milliliters of fluids. If the child's vomiting stops after 4 to 6 hours, give the child a little food, for example about 30 milliliters of milk or relatively thin puree. 2/ If the child tolerates 30 milliliters of food, give it again 2 hours later, and gradually increase the amount and concentration of the food. 3/ If the child vomits again, start the child's feeding from the beginning with 10 milliliters of fluids. 4/ If the child vomits after each feeding and signs of dehydration are seen, they may need to receive IV fluids. 5/ If the child's vomiting is caused by the severity of coughing (a cold), after feeding, the child should be kept in a sitting position for a while, and in case of vomiting, the child should be fed again some time later.