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Feeding Your Child with Cystic Fibrosis

How many calories does my child need?

Children with cystic fibrosis (CF) often have trouble consuming enough calories to grow or gain weight. Infections, breathing problems, and malabsorption can all contribute to increased calorie needs. The diet for children with CF should be high in calories. If your child consumes the extra calories he or she needs then he or she should grow and develop normally. Children should eat three meals and two to three snacks a day to help meet their calorie needs. It can help to add extra fat to meals and snacks to meet your child's calorie needs. Pancreatic enzymes will usually be needed to help digest this diet.

How can extra calories be added?

  • 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 two to four tablespoons of powdered milk to one 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, Carnation Instant Breakfast, Scandishakes, Pediasure, Boost, Boost Plus, Ensure, Ensure Plus, etc.

Does my child need extra vitamins?

Vitamins A, D, E, and K are known as fat-soluble vitamins. Vitamins are important for proper growth and development. Many children with CF do not get enough of these vitamins from the foods they eat, because they have difficulty digesting and absorbing fat. When this happens, your child may need to take extra vitamins. Your child's doctor can recommend the type and amount of vitamins you should give to your child. There are vitamins specifically made for children with CF. Consult your child's doctor for more information.

Does my child need extra salt?

Children with CF need extra salt in their diets 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 (for example, chips, pretzels, fast foods, french fries, pickles, nuts, and luncheon meats). Extra salt intake is important in the hot weather when children are playing outside and sweating.

What if my child is not gaining weight?

Sometimes, children with CF do not grow or gain weight despite a high-calorie diet. This can occur if your child's appetite is poor, he or she has frequent infections, or he or she has malabsorption. If your child is unable to eat enough food to promote appropriate growth and development, then supplemental oral or tube feedings may be needed, as directed by your child's doctor. This involves placing a small tube through the nose which ends in the stomach. This is referred to as a nasogastric tube, or NG tube. A high-calorie formula or supplement can be given to your child though this tube to help promote appropriate growth and development. Some patients with CF require long-term calorie supplementation by placement of a feeding tube (gastrostomy or "G-tube") through the stomach wall, or by giving intravenous fat solutions (intralipids). Consult your child's doctor for more information.