Children with cystic fibrosis (CF) often have poor weight gain. This can happen even when they get enough calories. Infections, breathing problems, and the body's inability to take in certain nutrients (malabsorption) can all help lead to the need for extra calories. Children with CF should have a diet high in calories. With extra calories, most children with CF are able to grow and develop normally.
Children with CF should eat 3 meals and 2 to 3 snacks a day to help meet their calorie needs. It can help to add extra fat to meals and snacks to meet these needs. Pancreatic enzymes will often be needed to help digest this food.
You can add extra calories to your child's meals and snacks by trying the following:
Add butter, margarine, or vegetable oil to:
Breads, toast, crackers, or sandwiches
Potatoes, hot cereals, rice, noodles, soups, or casseroles
Add sour cream to:
Potatoes, rice, pasta, or vegetables
Use as a dip for vegetables, or chips
Add mayonnaise to:
Sandwiches or crackers
Dips, salad dressing, or sauces
Meat, fish, eggs, or vegetable salads
Add cream cheese to:
Fruit slices, raw vegetables, bread, toast, or crackers
Use heavy creams in:
Soups, sauces, batters, custards, puddings, shakes, mashed potatoes, or cooked cereals
Use whipping cream on:
Pancakes, waffles, fruit, ice cream, pudding, hot chocolate, or other desserts
Mix in cream soups, hot cereals, mashed potatoes, pudding, and custards
Add brown sugar, maple syrup, or syrup to:
Hot cereals, cold cereals, fruits, ice cream, or puddings
Use as a glaze on meats, or vegetables
Add powdered milk to:
Cereals, potatoes, cream soups, eggs, puddings, gravy, and casseroles
Add 2 to 4 tablespoons of powdered milk to 1 cup of whole milk to make super milk
Add cheese to:
Sandwiches, burgers, toast, crackers, eggs, potatoes, noodles, and snacks
Add peanut butter to:
Sandwiches, crackers, toast, fruit slices, vegetables, ice cream, or milkshakes
Use high-calorie drinks such as:
Homemade milkshakes or commercial liquid nutrition supplements
Vitamins A, D, E, and K are known as fat-soluble vitamins. Vitamins are important for proper growth and development. Many children with CF don’t get enough of these vitamins from the foods they eat. That’s because they have trouble digesting and absorbing fat. When this happens, your child may need to take extra vitamins. Your child's healthcare provider can advise you about the type and amount of vitamins to give to your child. There are vitamins specifically made for children with CF. Ask your child's healthcare provider for more information.
Your child will need additional iron and calcium during puberty and when their bones are growing. Zinc is also important to your child's growth and wound healing ability. It also helps the immune system work correctly. Discuss your child's vitamin and nutritional supplement plans with the healthcare provider and CF dietitian.
Children with CF need extra salt in their diets. This is because they lose more salt in their sweat than other children. Add extra salt by using the salt shaker at meals and including salty foods and snacks. These include chips, pretzels, fast foods, French fries, pickles, nuts, and lunch meats. Extra salt intake is important in the hot weather, when children are playing outside and sweating.
Sometimes children with CF don't grow or gain weight even with a high-calorie diet. This can happen if your child's appetite is poor, he or she has frequent infections, or your child has malabsorption.
Symptoms of malabsorption include:
Passing gas (flatulence)
If your child can't eat enough food for normal growth and development, then he or she might need supplemental oral or tube feedings, as directed by your child's healthcare provider. For short-term feedings, your child may have a small tube inserted through the nose and into the stomach. The tube is called a nasogastric (NG) tube. You can then give your child a high-calorie formula or supplement through this tube.
Some children with CF need calorie supplements over a long period of time. In this case, a feeding tube (gastrostomy or G-tube) is placed through the stomach wall. Talk with your child's healthcare provider for more information.