Nutritional concerns for children with chronic kidney disease (CKD)

Everyone needs energy to grow and be active. Taking in too little energy may lead to decrease activity, poor growth and also decreased resistance to infections or diseases. Energy needs will change depending on the age, height and weight. For kids with CKD, parents should work together with the healthcare professionals to determine their kid’s daily calorie needs. If the child is not growing normally, the healthcare professionals can suggest the suitable ways to increase or add in calories in the child’s diets.

Protein is a necessary nutrient of any diet. It helps in building and maintaining muscle, bone, organs and blood. Some will help to fight disease and heal wounds. Sometimes, doctors or dietitians will suggest patients with CKD to consume moderate or less quantity of protein. However, restricting protein in some patients could cause malnutrition. For children with kidney disease, the objective is to consume sufficient amount of protein for growth but avoid too high protein intake. If the kid is on hemodialysis, the kid’s protein needs will increase, but this will have to base on the type and regularity of dialysis because this process will removes protein from the child’s blood. However, peritoneal dialysis removes even more protein than hemodialysis. Therefore, they will need more protein intake and parents must take note of this and keep their children diet with sufficient protein. Protein sources from animal are eggs, milk, cheese, chicken and fish include more of the essential amino acids our body needs. Moreover, a well-balanced vegetarian meal plan is also applicable.

Sodium is also important for many body functions. Usually, one teaspoon of table salt contains 2,300 milligrams of sodium. Most of the canned foods, processed foods and some frozen foods and some snacks like chips contain a lot of salt. Too high intake of sodium will increase thirst, raise blood pressure and cause water retention that may lead to excess weight gain or fluid buildup in the lungs. In contrast, too little sodium in some patients may cause dehydration and poor weight gain. Healthcare professionals may ask parents to limit or add sodium to their kid’s diet based on their kid’s body needs. Parents should buy “sodium-free” or “low-sodium” food products if their child needs to lessen sodium in their diet. It is recommended that nearly all fresh vegetables and fresh, unprocessed meats are more preferable.

Potassium is found in many fruits and vegetables such as bananas, potatoes, melons and so on. It keeps the heart beating regularly and muscles working right. Healthcare professionals should regularly check on kid’s blood tests to make sure that the potassium level stays in the normal range. If the child’s potassium level rising, parents can try limiting the amount of potassium in their child’s diet. Parents and healthcare experts also have to make sure that the child consume sufficient amount of fluids or water to prevent dehydration, swelling or high blood pressure.

Children with chronic kidney disease (CKD)

Every kid requires good nutrition. If your child has been identified with kidney disease, knowledge about nutrition is very important because the diet of your child can influence the performance of the kidneys. Kidneys help to maintain our health, when blood flows through the kidneys, waste products and extra water are removed from the blood and sent to the bladder as urine. In addition, the kidneys also regulate blood pressure, balance sodium, potassium, calcium, and phosphorus and also control the release of hormones that help bones grow and make red blood cells.

In the early stages of chronic kidney disease (CKD), the kidneys continue to function. They just do not function as well as normal kidneys do. As the kidney function decline slowly, a child’s body may get used to it and sometimes parents may not be aware of the changes in the way their child feels or looks. As the kidney disease getting worse till stages 4 and 5, children will have more symptoms of kidney disease. As kidney disease progresses, nutritional needs change as well. When the kidneys do not function properly, healthcare professionals might suggest a change in the kid’s diet to protect the kidneys. Health problems from CKD can be prevented or delayed by eating the right foods as kidney disease can bound a child’s growth.

Parents can work closely with healthcare professionals to ensure that their kid’s growth is normal. The nutritional needs of children may change as they grow. Parents should work with healthcare professionals to make sure that their child obtains the correct quantity of all nutrients that are necessary. From time to time, the healthcare experts may recommend changes in both the quantity and the types of food the child’s diet to ensure that the kids achieve the nutrition requirement. Some knowledge on food choices may help parents to know what changes need to be made to make sure that their kid is healthy. Healthy eating patterns are also important for children with CKD in order to maintain their nutrition requirements.

Other than changes in nutritional needs, children with CKD may also experience feelings such as depression, anger, fear, and denial related to the medical condition. Moreover, CKD can also cause the increase of fatigue, mental status changes, confusion and also poor memory. Furthermore, CKD may also delays in psychomotor development and oral aversion especially children born with CKD. Therefore, parents and the medical team or healthcare professionals must provide emotional support to children when such difficulties occur and also may need to consider changes in the medical and dietary management in order to maximize the growth potential of the child.

Growing Up

Nutrition requirements for children over 2 years old are a little bit different from adults. Nevertheless, the recommendations for children are intended to encourage optimal growth and development and therefore may not be as restraining as for adults. A variety of foods loaded with essential nutrients is necessary for growing bodies.

As showed in food guidance pyramid, parents should provide their child with foods rich in carbohydrate such as grains, fruits and vegetables which is a must to provide vitamins, minerals, fiber, and energy to the body in their diets. Moreover, mother also asked to give their kids sufficient amounts of dairy products like milk, yogurt and cheese, lean meats, fish, poultry, eggs and beans in their kids’ diet which will provide nutrients for proper growth and development. Normally, children will grow about 2 inches and increase weight from about 4 to 7 pounds a year. Between the ages of 6 and 12, young people will grow with a standard of 1 to 2 feet and almost double in weight. A decreased in weight-for-height might show a keen under-nutrition whereas a decreased in height-for-age may imply a chronic under-nutrition. Such conditions may be due to malnutrition, eating disorders, underlying chronic disease or infection.

Children definitely have food that they like and dislike, therefore, most nutrition experts suggested that parents should make availability of a wide range of foods and encourage them to taste new foods in small amounts without forcing their kids’ in their diets. In addition, nutrition experts often advise parents not to be firm to their children to finish everything on their plate. This is because children will get advantage by choosing their own portion size, with the given food is healthy and nutritious. Lastly, parents are should never use food as a reward for their child.

As children grow older, when they becoming a teenager or adolescence, their calories and nutrition needs will differ relying on their growth rate, the level of their physical maturation, body composition, and physical activity level. Nevertheless, extra nutrients are needed in their diets for them to hold up their growth. As well to other nutrients, parents should provide them with sufficient quantity of iron and calcium which are very important as their body is experiencing a rigorous growth. From 9 to 18 years old, both males and females are encouraged to take in a calcium-rich diet to make sure that there are enough calcium deposits in the bones and this will aid in reducing the risk of getting osteoporosis in their older years. Calcium intake can be reached by consuming at least 3 cups of fat-free or low-fat milk everyday or the some low-fat yogurt or low-fat cheese. There are also many other sources of calcium available other than milk, such as dark green, leafy vegetables and other calcium-fortified foods and beverages.

How Do You Know Your Baby is ready to Begin Solid Foods?

It is a big step for a baby to start eating solid foods in their diets and parents are so excited to help their baby to experience new flavors and food textures. Experts suggested that parents should wait for their baby at least 6 months old before they can introduce any solid foods to them because before a baby reaches 6 months or older, solid foods are not nutritionally required for their growth and development.

In addition to age, there are some signs that show a baby is ready to begin solid foods:

• When the baby is able to sit with help or support.
• When on its stomach, the baby can push up on arms with straight elbows.
• The baby is interested in food when others eat.
• Loss of tongue-thrust reflex - This will let the baby to drink and ingest liquids more easier because with the tongue-thrust reflex present, baby possibly will just drink in liquid purees or thrust the food back out where it protects the baby against choking.
• Doubling on birth weight.

This gives them the opportunity to get adapted to new tastes and textures and enables parents to identify unpleasant reactions to specific foods in their child’s diet. If a certain food stimulates a reaction such as allergy, diarrhea, bloating or gas, then it should be taken out from the baby’s diet for 1 to 3 months before giving the same food to the child again.

Research suggested that a baby at 1 year old, most of them can stand foods which caused a reaction to them earlier. Bring in many different type of foods and flavors to babies in the first two years of life will enhance their possibility to try new foods. Babies should be always sit up when they are eating or drinking, and placed so that they can see their parent’s face when feeding them. Mealtimes offer significant chances for babies and parents to enjoy eating together and enhance the relationship between the mother and child or father and child or both. Additionally, parents should not feed their babies when they are in a rush. Moreover, appetites of babies’ many change from day to day, and they will let their parents know that when they are full by turning their heads away from the spoon or holding their lips closed. Parents also should not force their babies should to eat after they are full. For children under 2 years old, dietary fats are needed in their diets as it is important for the formation of nerves and brain tissues. Health experts do not advise parents to feed reduced-fat foods to children in their diets during this age. On the other hand, to prevent the developing of nursing bottle dental caries in your baby, parents should never put their babies to bed with a bottle of milk or other liquids.

Infant Nutrition

It has been long known that it is important to establish healthful nutrition practices and habits during childhood year and early adolescence. Diet and physical activities are important for these development years which will later set the stage for life-long habits like the difference between strength of health and illness during later years.

For and infant, the optimal growth, health and behavioral development period will be from birth to 2 years but it is also a peak age for their growth to flatter for example, deficiencies in a certain micronutrient and some common childhood illness like diarrhea. In addition, nutrition insufficiencies occurred during this age will have direct and long-term costs which include delayed motor and metal development and also associated with impairments and academic performance, work capability, reproductive outcomes and overall health during their adolescence and adulthood years. Therefore, sufficient nutrition is needed to achieve for a child’s to have full human potential.

There are studies supported that exclusive breast-feeding for the first 6 months of life and the continuation of breast feeding together with suitable complementary feeding up to 2 years old or more. Breast feeding is known to be a nutritional diet as well as has immunologic benefits for an infant. Moreover, nowadays the scientific evidence showed that breast feeding may also have a protective effect against childhood obesity. Hence, breast feeding is highly encouraged all over the world. While breast feeding is encouraged, iron-fortified formulas for infants are also acceptable if the mother cannot breast feed her baby.

In addition, complementary feeding is suitable when breast feeding alone is not enough to provide sufficient nutrients in the infant’s diet and when other solids and liquids are required other than breast milk and take it in along with breast milk but the developmental of the readiness for complementary foods varies among infants. There are some experts suggested that parents should introduce the first complementary foods in the baby’s diet between 4 and 6 months of age. According to them, parents should feed their baby with simple, fundamental foods first. For instance, a single-grain and iron-fortified baby cereal will do. Semi-liquid ground rice cereal is normally suggested due to the gluten-free property and seldom related to the allergic response where gluten is a protein that can sometimes cause allergic reactions in infants.

The iron in fortified baby cereal can aids in preventing iron-deficiency anemia which is a common nutritional disorder during infancy. Once infants can handle that, then they can slowly move up to mashed foods. When they reach the age around 7 to 10 months, thinly chopped foods is applicable.