Nutrition – School-Age

Nutrition is very important for people with chILD. When your child grows, their lungs grow too.  

Children with lung disease can have trouble growing and gaining weight. This is because they may use more energy (calories) to breathe. They usually need to eat more calories than other kids without lung disease. Your medical team may include a dietitian who can help make sure your child is eating what they need to grow.  

What should they eat? 

As your child gets older, your doctor and dietitian will help you choose foods to help your child grow.  

• Keep track of what your child eats each day.  
• Set regular meal and snack times.  
• Offer several balanced, healthy foods. Let your child choose what and how much to eat. 
• Ask to see your child’s growth chart at every visit. If your child loses weight or does not grow well, make sure you work with their medical team to make changes. 

What if they have trouble eating? 

Children with lung disease can also have problems with acid reflux disease (GERD) and gastrointestinal dysmotility (trouble moving the food through the gastrointestinal system). This might cause belly aches and spit-ups or vomiting.  Your child’s care team may have them see a gastroenterologist (stomach doctor) to help with these symptoms.  

When young children are breathing fast, it can be hard to swallow safely. Trouble swallowing is called dysphagia. This can lead to aspiration. Aspiration is when liquid or food goes into the lungs instead of the swallowing tube (esophagus). Your medical team may order a swallowing test to check this. If your child is having trouble swallowing, a speech therapist can help make changes for safe eating. Usually, this problem gets better with feeding therapy, time, and when breathing gets better.  

Will my child need a feeding tube? 

Some children need to use a feeding tube to make sure they grow safely. They might need a feeding tube if… 

• They can’t eat enough food to gain weight 
• They can’t drink enough liquid to stay hydrated 
• They have trouble swallowing (dysphagia or aspiration) 

The decision to have a feeding tube can be hard for parents. There are different types of feeding tubes. The names of the tubes are based on how they enter the body and where the feeds go. Your child’s medical team can help decide the best tube type for your child. 

• Nasogastric tube (NG tube) – this tube is placed through the nose and feeds into the stomach. This is a temporary tube and will need to be changed at times. 
• Nasojejunal tube (NJ tube) – this tube is placed through the nose, but it is guided past the stomach and feeds into one of the upper parts of the small intestine (jejunum). This is a temporary tube and will need to be changed at times.  

• Gastrostomy tube (G tube) – this tube is placed through the abdominal wall and into the stomach.  
• Gastrostomy-Jejunostomy (GJ tube) – this tube is placed through the stomach but it is guided past the stomach and feeds into one of the upper parts of the small intestine (jejunum). With this tube, there are two ports (openings) – one that goes to the stomach and one that goes to the jejunum.  
• Jejunostomy (J-tube) – this tube is placed through the abdominal wall straight into the jejunum.  

How does my child use a feeding tube? 

There are many ways to use feeding tubes. Some children get feeds through the tube all at the same time (like a meal or snack). Other children get feeds through the tube slowly over a longer period (like while sleeping at night).  

The feed (or formula) is poured into a feeding bag, travels through the infusion tubing, and enters the body. You can adjust how quickly or slowly your child gets the feed.  When the feed is finished, your child can go back to their play. Children with tubes can take baths, showers, and swim. Make sure to dry the skin around the tube. If your child uses a dressing and it gets wet, replace it with a new, dry one. 

Your child’s care team will teach you: 

• When and how to change dressings and the tube  
• How to make and store formula 
• How to feed your child and clean the feeding tube 
• What to do if the feeding tube moves , falls out, or other problems arise 
• How to order supplies and formula (doctor’s office, DME vendor, pharmacy, or WIC) 

Keep in mind that as children grow and gain weight, they may need a larger size tube and a new feeding schedule.  

Kids tend to adjust quickly to feeding tubes. With a little practice, you will too! 

Author(s): Nour Akil  Reviewer(s): Katelyn Krivchenia  Version: