Nutrition Interventions for Children with Special Health Care Needs

Chapter 7 - Nutrition Interventions for Diarrhea
Treatment
Treatment of chronic diarrhea depends on the cause of the diarrhea and the results
of a total assessment. Malnourished infants with diarrhea present a significant
challenge for successful treatment and need energy replacement in addition to
rehydration. Energy requirements of infants or children with chronic diarrhea may
be as high as 200 kcal/kg/day (2). Enteral feedings may be attempted orally or by
slow continuous nasogastric tube feeds. For children who are severely malnourished
or who have poor gastrointestinal function for other causes (e.g., short bowel
syndrome), parenteral nutrition may be required. Medications may have some role in
treating chronic diarrhea. Pancreatic enzyme replacement is required in cystic fibrosis
and other pancreatic disorders. Sulfasalazine and corticosteroids may be used in
inflammatory bowel disease. If there is a specific protein or carbohydrate intolerance
or enzyme deficiency, avoidance of the offending foods is the treatment of choice.
Many children affected by chronic diarrheal conditions may require nutrition
evaluations and follow-up throughout infancy and childhood. Special formulas and
dietary supplements may be needed.
Diarrhea is a very common occurrence in childhood. Frequency of the stools and
duration are two variables used to determine what, if any, evaluation is needed. The
remainder of this section presents guidelines for nutrition assessment, intervention,
and evaluation/outcome for children with acute (Table 5-2) and chronic (Table 5-3)
diarrhea.
86 Nutrition Interventions for Children With Special Health Care Needs