Food Supplements For Children

[Dirk_brijs]

My son is 11 years old. He is 155cm tall and weighs 33 kg. As per standard growth curves he is supposed to have a 55Kg target so he is well under that.

The issue now is that he doesn't seem to have any appetite most of the time even not for foods we know he likes alot like Pizza and other junk so don't even want to mention for the regular rice dishes he gets.

Anyway I was wondering if giving him food supplements like a whey proteine shake would be more harmful then beneficial. I am sure they would produce body weight but would there be any more nasty side effects to this with children.

I am not talking about 7 or 8 shakes a day but just one in the morning and one before bed time?

Any ideas and advise welcome as info on the net is spares about food supplements for children.

[Dirk_brijs]

anyone can give any insight on supplements and children?

[robblok]

To be honest with just 2 shakes i doubt it would be bad. He is lacking in food so extra calories would be good and better a protein shake then bad snacks.

Its not like he will get crazy amounts of protein every day because he does not get it from other food sources.

This is my opinion and i am not a Dr.

[AyG]

(1) Have you had your son checked out to make sure there isn't any physiological problem causing his low body weight, or psychological problem causing his reluctance to eat?

(2) Rather than giving a shake, try and increase the calorie content of what he does eat - and that means getting him to eat more fat. Coconut milk-based curries, fatty cuts of meat, deep fried foods, fried rice rather than plain. Don't worry too much about protein. The human body needs surprisingly little. Based upon his weight and age, you son only needs 30 g protein per day.

(3) If he is eating very little, consider giving him a children's multivitamin tablet to make sure that he's getting all the nutrients he needs.

[robblok]

I beg to differ, giving him deep fried foods and other trans fats is not the way to go. If need be give him fat but make sure its the right kind.

Those shakes can help and if you are smart you add some oats to them too and put it all in a blender. It is proven that drinking calories is easier then eating them. I would say proteins are better as fats (unless the ratio's are totally off but proteins are ALWAYS better as deep fried foods and trans fats)

[AyG]

I didn't mention trans fats. Food deep fried in oil or pork fat doesn't contain trans fats. Only food cooked in shortening (hydrogenated animal fat) contains significant amounts of trans fats.

The problem with the OPs child is that he isn't eating very much. Encouraging him to eat energy-dense food is going to up his calorie intake much more effectively than giving him a shake, which contains far fewer calories per unit volume. One risk with giving shakes is that he will eat less normal food, which contains a much wider range of essential nutrients than shakes.

Shakes are also bad for a couple of other reasons: excessive protein intake can cause kidney damage by chronically increasing glomerular pressure; Asians (and I'm assuming the child concerned is part Asian) are very often lactose intolerant, which could lead to gastric upset (likely reducing the amount of food eaten) and/or diarrhea (again, reducing nutritional uptake).

[tfc]

See if you can get away with mixing in a banana, some honey, yoghurt and coconut milk. Delicious.

[robblok]

I didn't mention trans fats. Food deep fried in oil or pork fat doesn't contain trans fats. Only food cooked in shortening (hydrogenated animal fat) contains significant amounts of trans fats.

The problem with the OPs child is that he isn't eating very much. Encouraging him to eat energy-dense food is going to up his calorie intake much more effectively than giving him a shake, which contains far fewer calories per unit volume. One risk with giving shakes is that he will eat less normal food, which contains a much wider range of essential nutrients than shakes.

Shakes are also bad for a couple of other reasons: excessive protein intake can cause kidney damage by chronically increasing glomerular pressure; Asians (and I'm assuming the child concerned is part Asian) are very often lactose intolerant, which could lead to gastric upset (likely reducing the amount of food eaten) and/or diarrhea (again, reducing nutritional uptake).

Fried foods are bad fats especially here in Thailand were fats are used longer and longer. Also tell me how fried food contains more nutrients then a shake with proteins and oatmeal ? I would say not.

Also giving him this food might lead to him eating less of other foods. Shakes or no shakes its easier to take a shake and still eat normal food.

Lactose intolerant is indeed something that has to be checked out. But you can also make a protein shake with soy proteins and water.

Also a shake does not contain excessive proteins, it might contain just as much proteins as your fried food. You should really read up a bit more about this subject.

Edited September 15, 2012 by robblok

[robblok]

Solid whole foods are always better (not fried foods) as shakes. So try that first if that really does not work you can try the following.

1 scoop soy protein powder (if lactose intollerant)

40 grams of oatmeal

table spoon of olive oil

Blend it all together and drink (with water or milk if not lactose intollerant). A great combination of proteins and healthy fats unlike fried foods.

Edited September 15, 2012 by robblok

[Sheryl]

It is not normal for an 11 year old boy to lack appetite and interest in even favorite foods. There is an underlying problem, either medical or psychological (or both), that needs to be identified and addressed and, with a weight as low as this, addressed urgently.

If this seemed to come on suddenly around a time that can more or less be pinpointed, I would tend to suspect that he had some sort of traumatioc experience that he has not felt able to tell you about. Could be any number of things...being bullied at school, sexual assault (it does happen to young boys as well as to girls, and they usually are ashamed and afraid to tell) or something of similiar magnitude.

Get a thorough physical check up by a pediatrician and also have him seen and assessed by a child pyschologist. If you are in Bangkok, Samitivej Srinakarin Children's Hospital is very good.

Please don't delay or put this off, nor try to resolve this by pushing him to eat. While he probably does need a nutritional supplement(s) along the way, more than anything he needs to have the underlying cause identified and treated. Focusing instead on the symptom is likely to worsen matters.

[Dirk_brijs]

Traumatic maybe but it must be from a very very young age then cause he had this forever I even remember him as a baby not wanting to eat at times. The strange thing is at times he does want to eat and seem to be wanting to eat all day long just to have his appetite fall for several days.

The problem is when he is at home we can make him eat not force but make him eat but the time he spends in school he almost for sure never eats. The issue seem to be too when home and he eats he seem to be eating breathtakingly slow and I dont mean good slow eating as I know it could be good to eat also but I am taking over an hour for a single sandwich slow. We try not to force him in eating faster as we rather have he eats it at least.

Another issue is we cant really force him anyway but we do make him eat his palet for sure but you can just tell the days if he really doesnt want to eat he eats his plate and just gets to the toilet and vomits it back out. He gets checked regularly as he is asthmatic so he has alot of hospital visits done and we have been told that the asthma can play a role in this all but again I am talking about days even he has no issues what so ever with his respiration.

When I say he is asthmatic I dont want you to think to he has issues 24/7 the major problem is basically that his lungs are weak so whenev er he gets sick his lungs get attacked straight away with bacterial fluid filling up his lungs resulting in the asthma.

Anyway he is lactose intolerant for sure as one of his favortite dishes is Cereal (Rice Krispies) with milk so I am still leaning to trying the supplemental whey drinks.

or not?

[robblok]

dirk,

I dont understand what you mean with he is lactose intolerant because he eats cereal rice with milk. Do you mean he is lactose intolerant or not because he takes milk or not ?

[Dirk_brijs]

dirk,

I dont understand what you mean with he is lactose intolerant because he eats cereal rice with milk. Do you mean he is lactose intolerant or not because he takes milk or not ?

sorry about that guess fingers moved too fast

he is NOT lactose intolerant for sure

[Sheryl]

If he is on any regular medication for his asthma that may be affecting his appetite.

And/or there may be another physical problem and/or psychological one.

What you describe is outside the range of normal behavior, particularly the vomiting after being made to eat and the drastic shifts between no eating and eating excessively.

He needs to be evaluated by a skilled pediatrician and also a child psychologist. something is significantly wrong and as he enters puberty worse problems are likely to arise if you do not identify and deal with it now.

[Dirk_brijs]

If he is on any regular medication for his asthma that may be affecting his appetite.

And/or there may be another physical problem and/or psychological one.

What you describe is outside the range of normal behavior, particularly the vomiting after being made to eat and the drastic shifts between no eating and eating excessively.

He needs to be evaluated by a skilled pediatrician and also a child psychologist. something is significantly wrong and as he enters puberty worse problems are likely to arise if you do not identify and deal with it now.

He is on Pulmicort on a regular basis.

Again if it would be an underlying psycological problem it must have been from when he was a baby as again even as a baby he didnt want to eat any solid foods.

[Sheryl]

And again, this is simply not normal, and a serach for the cause, be it physiological or psychological, should be undertaken.

Lack of appetite is a known side effect of Pulmicort (as is nausea and vomiting) so that is likely adding to the problem, butt from what you say there is more to it if it has been lifelong. In any case, you need to see a really good pediatrician for a thorough investigation, s/he may also be able to advise on alternatives to pulmicort or ways to deal with thsi side effect.

[thaipod]

I'm going through the same thing with my 9 year old son at the moment he is 30 kilos and is quite thin and is eating only small amounts and also taking up to an hour to finish a small meal . I've also tried to encourage him to eat different food and now only cooking his favorite dishes and desserts to get him to eat.

[bina]

there is a lot on the internet about anorexia pediatric (anorexia just means lack of appetite, although usually people think of it as the teenage girl starving herself syndrome) ; ive know babies to have this; there is treatment...

a thoroufh evaluation has to be made: oral/facial (tongue/palate problems and swallowing breathing problems), enterogastic (it just turns out that my american niece, at age 18 has been diagnosed with some gastric bacteria or soemthing that affects absorbtion , as she has always been small, thin, we thought that, like me, we are just smaller then the rest of our families... i can find the name, but it took my sister four years and a doctor at tufts med. univ. to id the bug, up til now she was just considered a picky and poor eater, with cyclical stomacfh aches that were thought to be stress related, vomiteing suddenly that was thought to be psyochological and funnily enough, she is also asmathic although well controlled)... absorbtion maladies (like celiac; or CF cystic fibrosis which possibly could be the 'asthma' with fluid in lungs ?? (son was a possible CF when at age 8 he had a minor operation and took forever to get out of anesthesia and was in the end i'd' with asthma but we were on follow up for a few years in a lung clinic where they measure weight height and lung function... not all CF presents as a child gasping constantly for breath, but affects digestive etc... but a good lung clinic is needed (the diagnoses is by symptom and sweat check)...

it could be just nothing, although that is a bit too strange... some kids do eat the same thing only for long periods of time... these are phases for the most part and they tend ot grow out of them... but still..

not to say these are the things but sometimes if one asks a doctor 'could it be...' then it helps the doctor give u a list of checkups, without being 'pushy to the doctor ...

definately not just give shakes and additions of food...

good luck

bina

[Dirk_brijs]

there is a lot on the internet about anorexia pediatric (anorexia just means lack of appetite, although usually people think of it as the teenage girl starving herself syndrome) ; ive know babies to have this; there is treatment...

a thoroufh evaluation has to be made: oral/facial (tongue/palate problems and swallowing breathing problems), enterogastic (it just turns out that my american niece, at age 18 has been diagnosed with some gastric bacteria or soemthing that affects absorbtion , as she has always been small, thin, we thought that, like me, we are just smaller then the rest of our families... i can find the name, but it took my sister four years and a doctor at tufts med. univ. to id the bug, up til now she was just considered a picky and poor eater, with cyclical stomacfh aches that were thought to be stress related, vomiteing suddenly that was thought to be psyochological and funnily enough, she is also asmathic although well controlled)... absorbtion maladies (like celiac; or CF cystic fibrosis which possibly could be the 'asthma' with fluid in lungs ?? (son was a possible CF when at age 8 he had a minor operation and took forever to get out of anesthesia and was in the end i'd' with asthma but we were on follow up for a few years in a lung clinic where they measure weight height and lung function... not all CF presents as a child gasping constantly for breath, but affects digestive etc... but a good lung clinic is needed (the diagnoses is by symptom and sweat check)...

it could be just nothing, although that is a bit too strange... some kids do eat the same thing only for long periods of time... these are phases for the most part and they tend ot grow out of them... but still..

not to say these are the things but sometimes if one asks a doctor 'could it be...' then it helps the doctor give u a list of checkups, without being 'pushy to the doctor ...

definately not just give shakes and additions of food..

good luck

bina

Now let that be exactly the problem I face now.

He was just (last week) in Hospital for 4 days at Phayathai (considered a good hospital with a good Pedriatic pulminologist??) but even now they didnt even do any kind of test on him at all. Just treat the symptoms.

She just said we dont really know why it keeps coming back?. Even when we asked to maybe perform a full medical check on him we were told not needed as it is all connected to the asthma?? While I seriously think the underlying factor is actual the reason to the asthma.

Even when I ask her about his weight issue she claims it is not unusual (?????? 31Kg for 157cm????) for Thai Children and also direct effected by the asthma????

It looks like Thai hospitals are not really interested in finding a cause but just treat symptoms......Sure a good way to go for financial reasons but for the patient??????

Would love to bring him to Europe for a check but issue there is as he is not registered there he has no insurance in Belgium.

Anyone know of a better hospital in Bangkok or anywhere where we could go with a reputable pedriatic pulminologist?

[AyG]

Samitivej Srinakarin children's hospital has a good reputation plus a specialist clinic dealing with children's weight problems. (The clinic doesn't appear to be listed on the website, but I noticed it when I was there last week.)

http://www.samitivejhospitals.com/Children_Hospital/en

[Sheryl]

Yes, as sstaed before, Samitivej Srinakrin chuldren's Hiospital is your best bet,. You can fuind all types of pediatric specialists there. Your son's problem probably needs an interdisciplinary approach...the asthma (and side effects of treatment0 are a part of his probklem but there are other things going on. He needs to be throughly assessed for allergies, GI/swallowing issues, depression etc. Odds are there is an interplay of more than one factor causing this.

Try to get docs who trained abroad. there are many there. Appoitnemts at both the weight loss clinic and with a pulmonologist would be a good way to start.

[Dirk_brijs]

Yes, as sstaed before, Samitivej Srinakrin chuldren's Hiospital is your best bet,. You can fuind all types of pediatric specialists there. Your son's problem probably needs an interdisciplinary approach...the asthma (and side effects of treatment0 are a part of his probklem but there are other things going on. He needs to be throughly assessed for allergies, GI/swallowing issues, depression etc. Odds are there is an interplay of more than one factor causing this.

Try to get docs who trained abroad. there are many there. Appoitnemts at both the weight loss clinic and with a pulmonologist would be a good way to start.

thanks for all the advise