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When Your Child Has Cystic Fibrosis: Maintaining Good Nutrition

Cystic fibrosis can cause problems with the pancreas, liver, and other digestive organs. These problems can affect your child’s ability to absorb nutrients and fats. Good nutrition can help with some of these problems. It can also improve your child’s immune system, decreasing the risk of infection. This all helps your child stay active. You’ll likely meet with a nutritionist 1 or more times a year to assess your child’s needs and make any changes. Your child’s doctor will do regular follow-up tests to make sure your child is progressing with weight, height, and lung function.

Boy drinking milk.

Eating a Healthy Diet

Work with a nutritionist to determine your child’s nutritional needs. Have your child eat as normal a diet as possible, but one that is varied and rich in protein and calories. Your child should eat foods that decrease inflammation and help with lung function. Here are examples of foods to provide:

  • Fresh fruits and vegetables

  • Foods high in calcium, such as dairy products or fortified juice

  • Foods high in iron, such as fortified cereal, meat, and deep-green vegetables

  • Salty meals and snacks (Avoid processed snacks.)

  • Foods high in zinc, such as meats, liver, eggs, and seafood

  • Foods high in fat (Avoid products listing trans fat on labels. Trans fat can increase airway inflammation.)

Adding Calories

To maintain weight and slow the decline in lung function, your child will need to consume more calories than a child without cystic fibrosis. This is about 30–50% more than the daily recommended allowance. The amount of calories needed is even higher than this when your child is ill or has an infection. Try for 3 meals plus 2–3 snacks a day. Here are examples of high-calorie foods to add to your child’s diet:

  • Butter

  • Cheese

  • Nuts

  • Eggs

  • Whole milk (full-fat)

  • Peanut butter

If your child doesn’t gain weight or is behind on height, special liquid supplements may help add calories. If weight is still a problem, nighttime tube feeding may be needed.

Replacing Pancreatic Enzymes 

Your child’s pancreas may not produce certain enzymes. This can cause intestinal problems, such as greasy, foul-smelling stools, urgency, frequency, cramping, and diarrhea. If not treated, it can lead to serious problems such as a bowel obstruction, which can require surgery. For this reason, most children with cystic fibrosis need replacement pancreatic enzymes. These help the body absorb nutrients, especially fats and soluble vitamins. The doctor prescribes these enzymes, which come in capsule form. Here are some general guidelines for giving your child enzymes:

  • For younger children, open capsules and sprinkle the contents on an acidic food, such as applesauce. These enzymes don’t taste bad. Ask your child not to chew the sprinkles. To be sure your child takes them all, put the sprinkles on a small amount of food and watch your child eat them.

  • Older children can choose to swallow the capsules whole.

  • Have your child take the capsules with every meal and snack. Depending on how well your child’s pancreas functions, your child may take up to 6–8 capsules with every meal.

  • Make sure your child brings the enzymes to school and takes them with lunch and snacks.

  • Your child must take enzymes with liquid nutritional supplements, too.

Supplementing with Vitamins

It is harder for a child with CF to get needed nutrition from foods alone. Your child will need to take vitamins once or twice a day, as directed by the doctor. These include fat-soluble vitamins, such as vitamins A, D, E, and K. Vitamins are available in drops or as chewable tablets. Ask your child’s healthcare provider how much to give your child and to suggest brands that are easy to absorb.

How to Help Your Child

Putting too much emphasis on food can be overwhelming for your child. To avoid turning eating into a power struggle, try these tips:

  • Make food as appealing as possible.

  • Encourage your child to eat what he or she can comfortably.

  • Don’t force your child to eat. Big portions can be hard to eat at one sitting. Try for smaller meals more often.

  • Keep to a schedule, but don’t make your child stay at the table for more than about 15 minutes at a time.

  • Give younger children a few simple food choices.

Call your child’s doctor if your child has any of the following:

  • Constipation, abdominal pain, or other signs of an intestinal obstruction

  • Difficulty gaining weight

  • 2–3 loose stools a day, or a change in the size or consistency of stools

 

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