Feeding the child with liver disease: A review and practical clinical guide

Smart, Kathryn; Alex, George; Hardikar, Winita

doi:10.1111/j.1440-1746.2011.06687.x

Cited by 26 publications

(19 citation statements)

References 34 publications

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“…Chronic liver disease is due to biliary atresia, other cholestatic liver diseases, inborn errors of metabolism, and α‐antitrypsin deficiency. Biliary atresia accounts for 60% of children younger than 2 years 49 . Growth failure in CLD is due to increased energy expenditure, anorexia, reduced intake, malabsorption and impaired hepatic protein synthesis, pubertal delay, adrenal insufficiency, and euthyroid syndrome 50 , 51 …”

Section: Chronic Liver Diseasementioning

confidence: 99%

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Growth Failure and Nutrition Considerations in Chronic Childhood Wasting Diseases

2014

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Growth failure is a common problem in many children with chronic diseases. This article is an overview of the most common causes of growth failure/growth retardation that affect children with a number of chronic diseases. We also briefly review the nutrition considerations and treatment goals. Growth failure is multifactorial in children with chronic conditions, including patients with cystic fibrosis, chronic kidney disease, chronic liver disease, congenital heart disease, human immunodeficiency virus, inflammatory bowel disease, short bowel syndrome, and muscular dystrophies. Important contributory factors to growth failure include increased energy needs, increased energy loss, malabsorption, decreased energy intake, anorexia, pain, vomiting, intestinal obstruction, and inflammatory cytokines. Various metabolic and pathologic abnormalities that are characteristic of chronic diseases further lead to significant malnutrition and growth failure. In addition to treating disease-specific abnormalities, treatment should address the energy and protein deficits, including vitamin and mineral supplements to correct deficiencies, correct metabolic and endocrinologic abnormalities, and include long-term monitoring of weight and growth. Individualized, age-appropriate nutrition intervention will minimize the malnutrition and growth failure seen in children with chronic diseases.

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Section: Chronic Liver Diseasementioning

confidence: 99%

“…Vitamin D deficiency can contribute to growth failure in liver disease 51 . Portal hypertension, organomegaly, and ascites contribute to enteral feeding intolerance 49 . Improved growth can be achieved with supplemental feeding in patients with biliary atresia 59 …”

Section: Chronic Liver Diseasementioning

confidence: 99%

Growth Failure and Nutrition Considerations in Chronic Childhood Wasting Diseases

2014

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“…Appropriate feeding practice was determined when the score was greater than 60% of the possible score, and inappropriate feeding practice was de ned as ICFI < 14. In addition, given the unique nutrient requirements of children with chronic cholestatic liver diseases [8,20] , two ad-hoc questions were added to the survey to identify the intake of dairy products and medium chain triglycerides.…”

Section: Data Collectionmentioning

confidence: 99%

Feeding practices in 6-24-month-old children with chronic cholestatic liver diseases: A mixed-method study

Chen

Wang

et al. 2020

Preprint

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Background: Children with chronic cholestatic liver diseases have a high risk of malnutrition. However, nutritional management in China has received little attention, and there has been limited evidence regarding improving these practices. This study aimed to evaluate the feeding status of chronic cholestatic children aged 6-24 months and to explore their parents’ experiences with feeding practices. Methods: A mixed-method study was conducted among parents of 74 children with chronic cholestatic liver diseases. The Infant and Young Child Feeding Index (ICFI) was used to collect quantitative data of feeding practices. In-depth interviews with parents were performed to generate qualitative data. Multivariate analysis was conducted to identify predictors of inappropriate feeding practices. Qualitative data were analyzed using thematic analysis.Results: Only 16.2% of the children had appropriate feeding practices. In terms of dairy products, the rate of breastfeeding, medium-chain triglyceride formula feeding, and regular formula feeding were 25.7%, 39.2% and 44.6% respectively. The complementary feeding rate was 68.8%, and the age of adding complementary foods was 6.9±1.7 months. Consumption of foods from animal sources was suboptimal, 66.7% of the children aged 6-8 months and 45.5% of the children aged 9-11 months had carbohydrates as a single source of complementary foods and had no intake of meat, eggs or bean products, while in the age group 12-24 months, 52.0% of the children had eggs less than 2 days/week, 60.0% had meat less than 2 days/week, and 60.0% had no intake of bean products. Low literacy of the primary care provider was significantly related to inappropriate feeding practices (adjusted OR 5.52; 95% CI 1.29, 23.66). The result of the interviews indicated that parents generally lacked the scientific knowledge of feeding and thought that the intake of animal source foods and oils would be a burden to the liver and cause damage to the liver functions.Conclusion: Parents generally lacked science-based feeding knowledge and the feeding practices in 6-24-month-old children diagnosed with chronic cholestatic liver diseases fell short of the recommendations in current nutritional guidelines. Appropriate interventions targeting social and cultural family circumstances should therefore be included in supporting parents in feeding practices to improve children’s clinical outcomes.

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“…[60][61][62][63] Debe evitarse el ayuno o el hipoaporte del PPAC, ya que, por el bajo contenido de glucógeno, rápidamente se produce catabolismo proteico, y aprovecharse al máximo la ventana de suficiencia hepática para que el apoyo nutricional, además, permita su crecimiento. Si bien esto puede generar una ingesta sódica mayor a la recomendada, debe primar el aporte nutricional y administrar diuréticos al aparecer la ascitis.…”

Section: Manejo Nutricionalunclassified

Manejo de la ascitis secundaria a cirrosis en el paciente pediátrico. Revisión y recomendaciones. Parte 1: Fisiopatología, evaluación diagnóstica, criterios de hospitalización, tratamiento, manejo nutricional

et al. 2017

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Manejo de la ascitis secundaria a cirrosis en el paciente pediátrico. Revisión y recomendaciones INTRODUCCIÓN L a a s c i t i s s e d e f i n e c o m o l a acumulación patológica de líquido en la cavidad peritoneal.1-3 Es la complicación más frecuente de la cirrosis; su presencia marca un hito en la progresión de la enfermedad y está asociada a mala evolución. 4,5 El trasplante hepático es la opción terapéutica curativa para pacientes cirróticos con ascitis. 6,7 Un tratamiento exitoso de la ascitis puede mejorar la evolución y aliviar los síntomas del paciente cirrótico.8 Existen numerosos artículos y guías de práctica clínica basadas en evidencias para pacientes adultos, pero poco ha sido publicado en la población pediátrica. 2,3,5,6,[8][9][10][11][12][13] Además, consideraciones propias de esta edad dificultan a los pediatras basarse en recomendaciones extrapoladas de la población adulta.2,14 Entre las diferencias, se encuentran las etiologías de la cirrosis, la función renal en relación con la superficie corporal, la distribución corporal del agua, los requerimientos hídricos y nutricionales que deben contemplar el crecimiento, los niveles séricos de creatinina que definen la insuficiencia renal y el tipo de dieta con mayor contenido de sodio y agua libre de solutos.12,15-17 Asimismo, dadas las actuales recomendaciones de las concentraciones de cloruro de sodio (NaCI) en las soluciones de mantenimiento endovenoso, los aportes de sodio por kg también son mayores y pueden alcanzar 15 mEq/ kg/día en lactantes ≤ 10 kg. [18][19][20][21][22][23] Los objetivos de este consenso de expertos son revisar la fisiopatología de la ascitis secundaria a cirrosis y

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Feeding the child with liver disease: A review and practical clinical guide

Cited by 26 publications

References 34 publications

Growth Failure and Nutrition Considerations in Chronic Childhood Wasting Diseases

Growth Failure and Nutrition Considerations in Chronic Childhood Wasting Diseases

Feeding practices in 6-24-month-old children with chronic cholestatic liver diseases: A mixed-method study

Manejo de la ascitis secundaria a cirrosis en el paciente pediátrico. Revisión y recomendaciones. Parte 1: Fisiopatología, evaluación diagnóstica, criterios de hospitalización, tratamiento, manejo nutricional

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