Undoubtedly, It is children’s world and we are just living in it! But to create that colourful world for children with Kidney disease is no easy task!
Children with kidney disease face unique challenges when it comes to nutrition. Proper nutrition plays a crucial role in managing the health and supporting growth of these children. As parents, guardians, caregivers, healthcare professionals, we are regularly pushed to the edge in managing these issues -
- The dietary restrictions in view of kidney disease (mainly pertaining to salt, potassium, phosphorus and fluid intake) often pose challenges in meeting the calorie, protein and other nutritional requirements of these kids.
- Poor appetite due to kidney disease or dialysis often poses a challenge to feeding these children. Certain medications given to treat kidney disease may at times compound this problem in children.
- Finding reliable sources of information regarding the right kind of diet tailor-made to the child’s special requirement is challenging.
- Parents and caregivers also need to cope with the children’s food aversions, picky eating, vomiting, adjusting to the new diet, treatment modality, etc.
In this blog, we will discuss seven practical tips to help parents and caregivers navigate nutrition challenges and ensure children with kidney disease receive adequate nutrition while maintaining overall well-being.
Monitor Fluid Intake:
Not all types of kidney disease warrant fluid restriction. However, at certain stages it may be important to restrict the total fluid allowance to prevent excessive fluid build-up in the body. Parents/ care-givers will need to monitor the child's fluid intake and work with the healthcare team to establish appropriate limits. Encourage the child to consume fluids in small, measured amounts throughout the day. Avoid bottled beverages, such as sodas, juices, electrolyte or sports drinks. Be mindful of foods with high water content, such as soups and fruits, as they contribute to overall fluid intake.
Control Sodium and Potassium Intake:
Depending on the stage of kidney disease, sodium and potassium levels in the diet may have to be regulated. Excessive sodium can lead to fluid retention, while elevated potassium levels can pose risks to heart health. It is better to rely on home cooked food to effectively manage the electrolytes. However, if you have to include packaged food, read food labels carefully, choose low-sodium options, and avoid adding salt during cooking or at the table. Additionally, limit potassium-rich foods like fruits, green leafy vegetables, and juices. Ensure your child's diet includes suitable alternatives to maintain a well-balanced nutrition profile. For more clarity on the do(s) and don’t(s) in the child’s diet, and for a list of potassium content in various foods, please utilize the services of a renal dietician.
Optimize Protein Intake:
Protein is an essential nutrient for growth and repair, but excessive protein intake can strain the kidneys. Work with a kidney dietitian to determine the appropriate amount of protein your child needs based on their age, weight, and kidney function. High-quality protein sources like lean meats, eggs, and dairy products are preferred in recommended portion sizes. Consider the use of low-protein supplements or medical foods as recommended by the healthcare team to supplement protein intake without overburdening the kidneys. Do not opt for over the counter supplements and proprietary energy drinks
Address Micronutrient Deficiencies:
Children with kidney disease may be at risk of certain micronutrient deficiencies. Your pediatric nephrologist will monitor your child’s vitamin and mineral levels through regular blood tests and address any deficiencies with appropriate dietary adjustments or supplements.
For instance, iron and vitamin D deficiencies are common and can impact growth and overall health. Sun exposure and vitamin D-fortified foods can help meet their vitamin D needs. Any requirement for supplementation will be addressed by the pediatric nephrologist. Do not given nutritional supplements without checking with your health care team.
Individualize Phosphorus Management:
Phosphorus control is vital for children with kidney disease as excess phosphorus can weaken bones and negatively affect kidney function. Limit phosphorus-rich foods like dairy products and meat. Avoid all processed food like chocolate and carbonated beverages. Utilize phosphate binders as prescribed by the healthcare team to reduce phosphorus absorption. Choose low-phosphorus alternatives and prioritize whole foods over processed options. Regular monitoring of phosphorus levels is crucial to maintaining a balance that supports bone health without causing additional strain on the kidneys.
Consult a Pediatric Kidney Dietitian:
One of the first steps in managing nutrition challenges is seeking guidance from a pediatric renal dietitian. These specialized professionals can create personalized meal plans that consider the child's specific kidney condition, growth stage, and individual nutritional requirements. They can help develop a diet that optimizes kidney function while ensuring adequate intake of essential nutrients like protein, vitamins, and minerals. Regular consultations with a kidney dietitian will enable ongoing adjustments to the child's dietary plan as their needs evolve.
Encourage a Supportive Environment:
Creating a supportive environment for your child is key to overcoming nutritional challenges. Hence, reach out to various online communities or with small groups in your locality and connect with different people. However, stick to the treatment plan recommended by your nephrologist and renal dietitian. Do not follow the information available on social media as they may not be relevant for your child.
- For infants, breast milk is encouraged to be provided whenever possible as it is naturally low in phosphorus, potassium etc.
- Also, a right kind of rice milk, infant formula can also be used after consultation with the pediatric nephrologist and dietitian.
- Rely on fresh rather than processed foods.
- Avoid or limit the use of salt in cooking.
- Read food labels to ascertain the sodium content.
It can be extremely taxing when you have to manage nutritional adequacies in a child with kidney disease. As the burden of care, affection, and emotions reach an all-time high, it is important to lean onto your friends and families. Meanwhile, we need to constantly remind ourselves that each child is unique, and so are the requirements of diet.