The severity of a child’s burn determines her nutritional needs. In some instances, the child may need more than two times the number of calories and protein than he normally would, according to registered dietitian Angelyn Vaughan, a member of the burn care team at Doctors Hospital.
“The difference between treating adult and pediatric burn patients is that there is not much research on the nutritional needs of children who have been severely burned,” says Vaughan. “There still is a greater level of uncertainty in children than in adults.”
When coming off tube feeding, unlike adults who still may have a period of not eating well, children generally bounce back quickly and are ready to eat whole foods again. “That’s the fun part of my job,” Vaughan said. “Instead of seeing the patient languishing post tube feeding, we get to order a normal pediatric diet for them. It’s common to see a patient eating a regular diet within hours of having his feeding tube removed.”
Vaughan explains that the dietitian consults with the child’s parent or guardian about what she usually likes to eat, and design the child’s meals around those favorite foods whenever possible. If the child is old enough to talk, she can tell the dietitian herself. In any case, the recommended diets usually are high in calories and protein with meat, milk eggs and cheese. Parents are encouraged to offer these foods in place of or in conjunction with the typical high carbohydrate snacks kids like such as crackers, Cheetos, Cheerios and the like. Fluid intake is especially important to prevent dehydration in the burn patient.
Burns to the child’s face present a particular problem when significant swelling might make it difficult for him to move his mouth to eat. The child may have to remain on tube feeding a bit longer. Vaughan says once he is on regular food, it is important for the occupational or speech therapist to work with the child to preserve what skills he has since a two- or three-year-old who goes for months without eating may have to relearn the ability to feed themselves.
Regardless of the burn, the nutritional needs of children are different than adults. The child’s needs also change as he or she grows and matures. Having that understanding of the physical needs as they relate to nutrition and motor skills, from infancy to the teenage years, is critical to promoting recovery and fostering healthy development in the pediatric burn patient.