Nutrition / Dietary advice in Pediatric Prescription: Nestle

Speaker: Dr. Subhash Agarwal, M.D., FIAP, Senior Consultant, Pediatrician & Neonatologist Presented at:  Nestlé Nutrition Institute, Delhi

Summary

This video speaks of the evidence and showcases how individual health care costs can be reduced as good nutritional advice may improve the clinical course of diseases. It highlights the importance of good nutritional care and how one needs to look at various aspects of patient well-being. Taking a scenario of a child who is unwell, Dr. Subhash speaks of scenarios like fever and diarrhoea and discusses the social taboos / misconceptions surrounding reactions to ailments like the common practice of stopping food. The video also points out recommendations and advice to parents and medical practitioners. While presenting cases, it showcases situations for parents to follow.

Nutrition advice is important in a sick child. During any ailment, the need of fluids and calories is rather increased. The basal metabolic rate is increased and for each degree centigrade rise of fever, basal metabolic rate rises by approx.10%. The child is usually in a clinical or sub-clinical dehydration state because of excessive loss due to evaporation (fever), more loss due to increased respiratory rate, loss due to diarrhoea or vomiting, more loss due to increased metabolic rate and decreased intake due to toxicity of disease. Another important aspect of reduced intake of fluids and calories in a diseased child is the Social Taboos misunderstandings and Misbelieves in the society. Common practice of stopping food especially solids in a sick child are a huge misconception of society. Fasting and resting helps in improving general condition of the child is also a common belief. Fasting is the key to faster improvement is believed in naturopathy and Ayurveda. In diarrhoea, restricting oral fluids is common. Parents feel it increases frequency actually it is exaggerated gastro-colic reflex. In a vomiting child, ice cubes are given to curb the thirst induced by dehydration.

Breast feeding is truly “Nectar” in present times. No contraindication in any situation. It can be given in any disease even if there is vomiting, diarrhoea, high fever, mild abdominal distention, respiratory distress etc. It provides full and balanced nutrition. It is very easy to digest even by a sick child. It makes the child comfortable in mother’s laps. It imparts very soothing effect to the sick child; Mother too feels relaxed and reassured and it prevents chances of aspiration, vomiting and secondary infection in early infancy.

Micronutrients are very essential for the mother and their infants. Proteins constitute 20% of body weight. They are essential for forming cell protoplasm. Essential amino acids are required for proper growth and regeneration. Carbohydrates are the most important for supplying immediate ready energy to the affected cells. They make bulk of the diet and are easy to digest even in illness. Fats form an integral part of cellular membranes they are efficient stores of energy, they impart palatability to food and serve as vehicle for fat soluble vitamins - A, D, E and K Essential fatty acids are not synthesized in the body. They are necessary for growth, skin and hair integrity, regulation of cholesterol metabolism, lipotropic activity, decreased platelet adhesiveness and reproduction. Minerals and Vitamins also act as catalyst for cell growth.