From the Guidelines
If a child is losing weight while unwell, I strongly recommend consulting a healthcare provider promptly and focusing on maintaining hydration and nutrition to prevent further complications and promote recovery. This approach is crucial in managing the child's condition, as weight loss during illness can lead to increased morbidity, mortality, and decreased quality of life 1.
When it comes to nutrition, offering small, frequent meals with calorie-dense foods like full-fat yogurt, cheese, avocados, and nut butters (if age-appropriate and no allergies exist) can help mitigate weight loss 1. Some key recommendations for nutrition education include:
- Eating regular meals and snacks
- Reducing portion sizes
- Choosing calorie-free beverages, except for milk
- Limiting juice to 1 cup per day
- Increasing consumption of fruits and vegetables
- Consuming 3 or 4 servings of low-fat dairy products per day
- Limiting intake of high-fat foods
- Limiting frequency and size of snacks
- Reducing calories consumed in fast-food meals
Ensuring adequate fluid intake is also vital, and this can be achieved through water, diluted fruit juices, or oral rehydration solutions like Pedialyte 1. Additionally, nutritional supplement drinks such as PediaSure may be beneficial for children over 2 years. It is essential to continue offering regular meals even if appetite is poor and to make food appealing and easy to consume.
Weight loss during illness often occurs due to increased metabolic demands, decreased appetite, and potential fluid losses from fever, vomiting, or diarrhea. While temporary weight loss during brief illnesses is common, persistent weight loss requires medical evaluation to identify and address underlying causes, which might include infections, digestive issues, or other medical conditions requiring specific treatment 1.
From the Research
Weight Loss in Unwell Children
There are no specific studies that directly address the issue of a child losing weight while unwell. However, some studies provide information on childhood obesity, malnutrition, and nutrition support that may be relevant.
- Childhood obesity is a significant public health problem worldwide, and obese children are at risk for various comorbidities, including dyslipidemia, hypertension, and diabetes mellitus 2.
- Malnutrition is a common problem in hospitalized patients, including children, and is associated with negative clinical outcomes, such as increased mortality and hospital length of stay 3.
- In cases where a child is losing weight while unwell, it is essential to assess their nutritional status and provide appropriate nutrition support. Enteral nutrition (EN) is generally the preferred route, but total parenteral nutrition (TPN) may be considered when EN is not tolerated or there is gut failure 4.
- Dietary modification, therapeutic exercise, and behavioral modification are the fundamentals of treatment for childhood obesity, and pharmacotherapy and/or bariatric surgery may be considered for obese individuals who do not respond to these measures 2.
- Family involvement in healthy lifestyle changes is crucial for weight loss and prevention in children 5, and primary care providers play a key role in conveying messages about healthy eating to children and families 6.