Question

Case Scenario: A one-year old child is brought into the clinic for a high fever (greater than 101.4) chills, and a cough lasting five days. The child is lethargic, not eating or drinking. The mother states there was a flu bug in the home, so she thought the symptoms would be resolved but became concerned when the child was so lethargic that he would not eat or drink.

Question: What effect does age have on someone experiencing the same symptoms as the child?

Answer 1

A child who is sick will have little or no appetite or anorexia can contribute to a vicious cycle of illness and malnutrition that can be dangerous for a child below two years.

It is seen that, during illness a child may be too weak to eat, have trouble swallowing, or find it difficult to breastfeed because of a cough or blocked nose. Inefficient absorption of nutrients, loss of energy stores, and dehydration due to vomiting or diarrhea must be overcome. Even during a short illness, child growth often falters.

Repeated bouts of common illnesses such as diarrhea, respiratory infections, malaria, or measles undermine the overall nutritional status of infants and young children, which in turn undermines their immunity.

• Deficiencies in key micronutrients such as vitamin A and zinc weaken the body’s protective mechanisms against infection. .
• Appropriate feeding both during and after illness is critical.
• Continue feeding and increase fluids
• For a child under 6 months old: Breastfeed more frequently and longer at each feed
• Breastfeed more frequently and longer at each feed, increase fluid intake, and offer food.
• Give frequent, small feeds.
• Give nutrient-dense foods that are soft, varied, and the child’s favorite foods.
• Give mashed or soft foods if the child has trouble swallowing (do not dilute foods or milk)
• Feed the child slowly and patiently encourage the child to eat but do not force.
• During illness continue feeding. Sick children frequently reject or eat only small quantities of food offered to them. Do not withhold foods or liquids.
• During recuperation, children often have hearty appetites and will be eager to eat more food than usual.
• Children should be encouraged to eat more at every meal, and given an extra “meal” each day (or extra snacks in between meals) for at least two weeks.

Some tips to be remembered are :-

• During illness Give frequent small feeds
• If a breastfeeding infant is too weak to suckle, the mother can express her milk and feed it from a spoon or cup
• Coax the older child to eat; be patient but persistent offer foods the child likes, to overcome lack of appetite.
• Hold the child on your lap or keep him or her sitting up; (Do not feed a child lying down this can cause choking).
• If a child vomits, wait for ten minutes and continue offering fluids or food.
• Do not force a child to eat.

Older infants and young children continue to need high quality food such as meat, fish,liver, eggs, milk, and oil to meet the requirements for catch-up growth. Extra food is needed until the child has regained any weight lost and is growing well again. One rule of thumb is to give a child an extra meal every day for at least 2 weeks.