Nutrition support in paediatrics

Abstract

Summary In this chapter, undernutrition is used as the over-arching term for both faltering growth and malnutrition as defined by the World Health Organization (WHO). The causes for undernutrition in children with chronic disease are multifactorial and linked to increased macronutrient and micronutrient requirements, altered metabolism, increased nutrient losses through stool and urine, reduced dietary intake and disordered feeding. To identify a child with undernutrition, it is important to review their growth record, considering the trend of growth. Nutritional screening tools may be more appropriate to identify nutritional risk and could be utilised by nursing staff to screen for undernutrition that is then subsequently diagnosed by a dietitian following a detailed nutritional assessment. Nutrition intervention for infants and children with faltering growth focuses on the use of oral nutrition support and enteral nutrition. If growth remains suboptimal, the placement of a nasogastric tube (NGT) may be required for short-term nutrition support.