Nutritional support of children with chronic liver disease

Show simple item record Nel, E.D. Terblanche, Alta J. 2015-09-10T11:10:18Z 2015-09-10T11:10:18Z 2015-07
dc.description.abstract Anorexia, malabsorption and metabolic derangements contribute to the malnutrition that occurs in most children with chronic liver disease. Nutritional support should be started early in the management of these children with the co-operation of a paediatric dietitian to improve quality of life and decrease post-transplant mortality. Nutritional assessment entails a detailed dietary history, physical examination and anthropometry. Weight-based anthropometric measures are unreliable while mid-upper-arm circumference and skinfold thickness provide more reliable estimates of nutritional status. Special investigations such as serum vitamin levels and skeletal X-rays further guide management. High energy (130 - 150% of recommended daily intake (RDI)) and protein (3 - 4 g/kg/day) intakes are recommended. Diets are usually enriched with medium-chain fatty acids because of their better absorption in cholestatic liver disease. High-dose fat-soluble vitamin supplements are given while care is taken to avoid toxicity. Initial doses are two to three times the RDI and then adjusted according to serum levels or international normalised ratio (INR) in the case of vitamin K. Children with good appetites are fed orally. Feeds should be more regular than for other children to avoid prolonged periods of fasting and improve energy intake. Some children require supplementary nasogastric feeds to increase energy intake and avoid overnight fasting. en_ZA
dc.description.librarian am2015 en_ZA
dc.description.uri en_ZA
dc.identifier.citation Nel, ED & Terblanche, AJ 2015, 'Nutritional support of children with chronic liver disease', South African Medical Journal, vol. 105, no. 7, pp. 9-13. en_ZA
dc.identifier.issn 0256-9574 (print)
dc.identifier.issn 2078-5135 (online)
dc.identifier.other 10.7196/SAMJnew.7783
dc.language.iso en en_ZA
dc.publisher Health and Medical Publishing Group en_ZA
dc.rights © 2015 Health & Medical Publishing Group. This work is licensed under a Creative Commons Attribution-NonCommercial Works License (CC BY-NC 3.0). en_ZA
dc.subject Malnutrition en_ZA
dc.subject Children en_ZA
dc.subject Chronic liver disease en_ZA
dc.subject Energy en_ZA
dc.title Nutritional support of children with chronic liver disease en_ZA
dc.type Article en_ZA

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