Eating Well for Young Children

Transcription

1 Living and Eating Well Eating Well for Young Children We have many children to feed, Ma. But some are HIV+ve and others HIV-ve. Do they need to eat different food? No, Ma. All children need a good, balanced diet to grow well and stay healthy. It is very important that the kids who are HIV+ve eat well, though. We must make sure they eat enough of the right things, and we need to check their weight and health often. We have to help them to eat when they are sick. We also need to keep ourselves as healthy as we can so that we can care for them. It s our responsibility to keep them well, isn t it? But mostly we need to stop them from getting sick. We need to do everything we can to make sure that germs are kept away and their bodies are strong enough to fight infections. It is. We can try and encourage them to be responsible too. This booklet will give you important information about how to help children in your family to eat better. It gives special advice on good nutrition for HIV+ve children. This booklet is a supplement to CINDI s Living and Eating Well publication. It is available from the CINDI offices (55 Jabu Ndlovu/Loop St, Pietermaritzburg) or from You should read CINDI s Living and Eating Well with this booklet. This publication was made possible through funding from Irish Aid.

2 Good food for young children All children need a good, well balanced diet to grow well and stay healthy. Like adults, they need to eat lots of different kinds of food every day. From 1 year, children should be eating what the rest of the family eats. The only difference is that children have smaller stomachs, so they need to eat smaller amounts of food, more often, than adults. Babies also need similar kinds of food, but it needs to be softer at the beginning. You can read lots of information about good nutrition in CINDI s other nutrition publications, like Living and Eating Well. What should children be eating? Starchy Food Starchy food should be eaten at each meal. It is important to give energy and to help children grow. Mealie meal porridge Rice Potato Bread Fruit and Vegetables Children should eat fruit and vegetables every day. Try to give them different colour fruit and vegetables. For example: dark orange pumpkin or butternut dark green leafy spinach Red tomatoes Add 1 teaspoon of margarine or oil to your starchy food and 2 teaspoons of sugar to porridge to help children grow well. Food from animals or dried beans, peas, lentils or soya Children should eat meat, chicken, fish, eggs, milk or maas at least once a day, if possible. You can give dried beans or soya if no animal foods are available. Fats, oil and sugar These are very important foods to help children gain weight. They can be added to each meal. If your child is not gaining enough weight you will need to feed more food, and add extra sugar, oil or margarine to the food they are eating. If a child is gaining weight too quickly you should stop adding extra margarine or oil. Weigh your children at the clinic often. This will give you important information about how well they are growing.

3 How much and how often should my children be eating? Children need to eat smaller amounts, more often than adults. Some children have bigger appetites than others and will eat a bigger portion of food. Children who are HIV-ve should be eating 5 small meals every day. They should have three meals with other members of the family, and two snacks in between. HIV+ve children need to eat more they should have an extra meal each day. The important things to remember are: If your child is gaining weight well, they are getting enough food. Children need more nutrients in each portion of food, because they eat less, and need more to grow well. HIV+ve children need more food for energy and to grow well. How can I get my children to eat well? Children often get too distracted to eat well and finish their meal. It is also difficult to get them to eat if they have a poor appetite or are feeling ill, even though this is when it is most important that they eat as much as they can. This is especially a problem with HIV+ve children. Good snack foods Children need snacks in between meals. Good snack foods are: Bread, especially with peanut butter Fruit Children also need one to two cups of milk or maas a day. The best way to get children to eat well is to sit with them and encourage them to finish their food. Young children need assistance when they eat. Give each child their own food, in their own bowl. Get older children, and children who are well, to encourage younger children and those who are sick. Mealtimes should be enjoyable and relaxed. Never force a child to eat. Rather offer food again a bit later, and give extra meals once they are feeling better.

4 What about HIV+ve children? Feeding HIV+ve children a good diet will help to prevent illnesses. Children who are HIV+ve are often underweight and are shorter than uninfected children of the same age. This is because HIV+ve children are often sick, and they tend to eat less because they don t have a good appetite. In many families there are some children who are HIV+ve, and others who are not. The HIV+ve children don t need to eat different food. It is important though that they are always encouraged to eat, that the food they eat is as full of energy and nutrients as possible, and that care is taken to only provide safely prepared and stored, fresh food. Ways to add more energy to food You can add: oil or margarine to porridge sugar peanut butter pure dairy milk powder It is very important to give HIV+ve children a good diet. They need: To eat more than uninfected children do. This is because they need to eat as much as they can when they are well, and they need more energy to fight infections. Food from animals, or other foods with lots of protein, every day. Plenty of fresh fruit and vegetables. Give one white vegetable, one yellow vegetable and one green vegetable with the main meal each day. As many different kinds of food as possible. Food that is stored and prepared safely to prevent unnecessary illness. How often should I take my child to the clinic? Children, especially those who are HIV+ve, should go to the clinic often for check-ups and immunisations. Go once a month for weighing and growth monitoring. HIV+ve children should get a multivitamin supplement from the clinic every month. Every 6 months, until they are 5, children need Vitamin A. These supplements are very important to help children develop a good immune system and to stay well. The clinic will also give worm treatment every 6 months. If you are HIV+ve, your baby should be tested when they are 6 weeks old when you visit the clinic for immunisations.

5 How should I feed a sick child? Sick children usually have poor appetites and can lose a lot of weight when they are sick, especially if they have vomiting or diarrhoea. Nausea, vomiting and diarrhoea, and sores in the mouth are common problems in children who have HIV. These can all affect how much food the child will eat. Vomiting and diarrhoea stop the body from using the nutrients in food which goes in, but comes out too quickly. This can make the child lose weight which will affect their immune system. A child who is too thin will get infections easily. It is important to encourage your child to eat when they are sick and even more so, as soon as they are feeling better. While they are sick: The sick child may prefer liquids so try to give maas, yoghurt or a soup made by boiling meat or bones and vegetables together until they are soft enough to mash. Try to tempt them to eat by offering them their favourite foods. Offer small amounts often through the day. When they are feeling better: It is very important to give extra meals when they are over their illness, and feel like eating again. Feed them 6 times a day so that they can catch up on growth. It is so important to feed your child well after she has been sick, especially if she has lost weight. If you don t, she may get sick again which means more weight loss and even more chance of illness. Know the status of the children in your family. The sooner you know if a child is positive or not, the sooner you can start to make sure he or she stays healthy for as long as possible. Feeding the child a good diet from the beginning will give a good start!

6 What should I do if a child has vomiting or diarrhoea? Vomiting and diarrhoea can be very dangerous for young children. They can lose too much fluid very easily. It is very important to make sure that the sick child is given enough to drink. You can give water, soups, juice, colddrinks and jelly. You can also make up a sugar salt drink at home. Remember, good hygiene and using clean, safe water can help prevent diarrhoea. Diarrhoea If a child has diarrhoea you should: Give extra fluids until the diarrhoea has stopped. You can also try soft porridge and maas. Give Sugar Salt Solution after each loose stool. (Children under 2 years should drink ml. Children over 2 years should have ml). How to make up a Sugar Salt Solution Mix together: 1 litre boiled, clean water, 8 level teaspoons sugar 1/2 teaspoon salt You must take the child to the clinic or hospital if she has been vomiting for more than 12 hours, or if she has had diarrhoea for 3 days. If she does not pass urine as often as usual, or if she has a dry mouth and her eyes look like they are sinking into her head you should go to get help as soon as possible. What about mouth problems? Children who are HIV+ve often get sores in their mouth. This is called oral thrush. If your child has a sore mouth: Feed soft, smooth and wet foods like soft porridge, mashed potato and vegetables. Add gravy or margarine or oil so it is not too dry. Avoid sticky foods like peanut butter and dry rough food like popcorn or hard, raw vegetables. Avoid sour foods like tomatoes, oranges and pineapple, also spicy or salty foods. Give food at room temperature. Food or drinks that are too hot or cold can be more painful to eat. It may be helpful to give liquids with a straw.

7 How can I make sure that my children don t get sick? Good hygiene is always important to stop germs from making us sick. It is especially important for HIV+ve children. Keep your home clean Clean the area where you prepare food well. Store rubbish away from the house. Make sure that your toilet is working well, and that children don t go near human waste (urine and stools). Keep rats, flies and cockroaches away from your home. One of the ways you can do this is to make sure that no food or rubbish is left lying around. Keep yourselves clean Wash your hands and your child's hands with soap before preparing and eating food. Wash your hands, and your child s hands after going to the toilet, and after you have changed a nappy. Be safe with food It is very important to prepare and store food safely. Germs from food can cause diarrhoea. Serve food immediately after it has been prepared. Store left over food covered, in a fridge. If you don't have a fridge, try to only cook enough for one meal. Use clean knives, spoons and plates to prepare food, and clean cups, bowls and spoons to feed children. Looking after your children s teeth is important Germs can get into the body through the gums. As soon as a child gets teeth, it is important to: Brush teeth gently at least twice a day, especially before going to sleep at night. You should use a soft toothbrush and toothpaste. Help your child to brush their teeth to make sure it is done properly. Rinse the mouth with clean water after the child has had something to eat or drink. See a dental hygienist at the hospital when the child is 2 years old. She will check for oral thrush and any teeth or gum problems. This advice is very important for HIV+ve children. Good mouth health will help to keep infections and illnesses away.

8 Living and Eating Well Children and Anti-retrovirals Children who are taking ARVs will feel hungry more often, and need more food. Give bigger portions, and an extra meal a day. Improving the taste It is difficult to get children to take ARVs well. Some of the medicines don t taste good, and they can make your child feel unwell at first. The doctor, nurse or pharmacist at the ARV clinic will tell you how much medicine to give your child and when they should have it. Some of the medicine needs to be taken with food. It is very important that you follow these instructions because some medicines only work well if the stomach is empty, and others might cause nausea or other problems if taken without food. When she starts taking ARVs your child might have nausea, vomiting and diarrhoea. This should get better after a few weeks. She should not stop taking the medicines. Talk to the ARV clinic about any problems she has. If a child is underweight, and taking ARVs, they should get food supplements from the clinic. Ask about these. If your local clinic doesn t have any, ask your health worker where you can get them, or contact the Department of Health District Office. You can read more about ARVs in CINDI s Eating Well on ARVs publication. Some ARVs are very bitter tasting. If you give your child some peanut butter, honey, syrup or jam to hold in the mouth while they take the medicine, it might help with the taste. Don t mix the medicine with food in case the child does not finish the food. Remember that the adult taking care of the child is responsible for making sure that he or she takes the medicines every day at the same time, for the rest of their lives. You will have to find ways to help make it easier for the child to take the medicines well. This publication was developed in April 2007 for CINDI by Landmark Media, illustrated by Kathy Arbuckle and designed by Tangerine Design. Thanks to Dr Neil McKerrow, Chief Specialist and Head: Pediatric and Child Health, Western KZN, for professional input. The publication was made possible through funding from Irish Aid. This publication can be duplicated and distributed and is available on the CINDI website in English and isizulu.