Feeding children with digestive disorders

When digestive disorders appear in children, we must go immediately to the pediatrician, who is in charge of diagnosing and indicating the correct treatment. At this stage, and especially during the first year of life, infants may suffer from gastroesophageal reflux, acute gastroenteritis, irritable bowel syndrome and constipation, among other conditions. For the treatment and prevention of these diseases, a proper diet is vital.

Gastroesophageal reflux

Gastroesophageal reflux is the passage of gastric contents into the esophagus, caused mainly by inadequate relaxation of the lower esophageal sphincter and poor adaptation to increased intra-abdominal pressure.

Depending on the severity of the symptoms, it is classified into the following two types:

• Physiological gastroesophageal reflux: it is manifested by the involuntary return of ingested food and/or gastric secretions into or out of the mouth; these usually disappear after the age of one year. Most children under one year of age suffer from it.

• Gastroesophageal reflux disease: manifested by symptoms such as intense crying, difficulty eating, or the expulsion of vomit with blood.

Dietary modifications for the treatment of gastroesophageal reflux:

• It is recommended in overweight or obese infants, before making major dietary changes adjust the amounts to be ingested.

• Thicken the formula with cereals, when the infant's age allows it.

• In older children, carbonated drinks and spicy foods should be eliminated.

• Use of antiregurgitation formulas. They should be used only in extreme cases, together with medical treatment and close follow-up.

• The pediatrician will indicate the proper position when feeding the baby.

Acute gastroenteritis.

Acute gastroenteritis is an inflammation of the gastric and intestinal mucosa that manifests clinically as diarrhea. They are usually processes produced by an infection.

This disorder is more frequent in the first years of life, and although most intestinal infections are of short duration, in children under one year of age, complications such as dehydration and malnutrition occur more frequently as a result of this disease.

Dietary modifications for the treatment of acute gastroenteritis:

• Rapid oral rehydration, with oral rehydration solution supplementation, to counteract fluid losses.

• Maintain regular breastfeeding in all cases.

• In case of not breastfeeding, continue to offer undiluted milk or formula, administering it in more frequent feedings of smaller amounts.

• Offer lactose-free milk only to children with symptoms of malabsorption.

• In case of infants, older than four months, who ingest other foods in a complementary way, reintroduce these foods early.

• In case of older children, maintain the usual diet, without indication of astringent diets, limiting only the consumption of foods high in simple sugars, such as sweets, pastries and cakes, among others.

Irritable bowel syndrome (IBS)

Irritable bowel syndrome is a functional digestive disorder, which causes chronic and/or recurrent abdominal pain lasting more than twelve weeks, not necessarily consecutive, during a year. It also causes diarrhea or constipation or alternation of both.

In the pediatric population, pharmacological treatments used in adults are not recommended, due to their lack of safety. For this reason, dietary modification is recommended as a first step to control the disease. Depending on the predominant symptoms, the following dietary modifications are recommended.

Irritable bowel syndrome with constipation or alternating constipation and diarrhea:

• Increased consumption of soluble fibers, contained in fruits and in cereals barley and oats, is recommended. These foods act as prebiotics due to their fermentation in the colon.

• It is not recommended to increase the consumption of insoluble fibers, contained in whole wheat cereals, rye and rice as well as legumes and vegetables, since these fibers are scarcely fermentable in the colon.

Irritable bowel syndrome with diarrhea:

• Increased consumption of soluble fibers, contained in fruits and in barley and oat cereals, is also recommended.

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