Feeding Children With Heart Conditions

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The aim of this fact sheet is to explain why many children with heart conditions have eating problems and what you as a parent can do to help overcome them.

Reasons for eating problems
There are a number of reasons why children with heart conditions can find it difficult to feed. These include the following.

  • The child may have an enlarged heart and liver (a symptom of heart failure). If these organs are enlarged, there is less room for the stomach to expand to hold food.
  • The child is too tired to eat. Children with heart conditions often become tired very easily.
  • The child has not learnt to feed through their mouth. Children who are at first fed with a nasogastric tube will have little or no experience of using their mouths to eat. Once the tube is removed, they may have difficulty learning to eat normally.
  • The child may feel discomfort while feeding due to nasogastric tubes. (These can sometimes make a child ’gag’.) Children who have experienced this may continue to associate feeding with discomfort.
  • The child may suffer from reflux (food coming back from the stomach) or allergies. These health problems are common in children with heart conditions.
  • The child may not like the type of food that the consultant or dietician has recommended.
  • The child may lose their appetite or notice changes in taste after surgery.

Calories are what counts!
Eating enough calories is often essential for the health of children with heart conditions, especially if they are preparing for an operation.

Nowadays, there is a lot of pressure on parents to make sure that children have a healthy, well-balanced diet. However, it is more important for children with heart conditions to get enough calories than for them to have a healthy diet. Often this means that you have to feed your child whatever they like to eat, even if it is not very healthy.

The only real problem with a diet that includes lots of sugary food is the risk of tooth decay. Make sure that your child brushes their teeth well and often and goes to the dentist regularly.

Tips for increasing how many calories your child eats

  • Milk
    Whisk or liquidise three to four heaped tablespoons of dried milk powder into whole milk. Try to use at least one pint of this ‘fortified milk’ each day. This seems a lot to take but you can be keep it chilled and they can sip it through the day. You can also use it in drinks (for example, hot chocolate), sauces, custard, soups, puddings, on cereals and in milkshakes.
  • Cream
    Add cream to cereals, porridge, sauces, soups, mashed potato and puddings.
  • Condensed milk
    Add condensed milk to hot and cold puddings.
  • Evaporated milk
    Add evaporated milk to sauces, custards, jelly, puddings and coffee.
  • Cheese
    You can add grated cheese to sauces, potatoes, scrambled egg and vegetables or as a topping to soup and lots of savoury dishes.
  • Eggs
    You can use eggs to make baked custard, beat them into hot puddings, mix them into potatoes for savoury pies or (using chopped hard-boiled eggs) sprinkle them over vegetables or salad.
  • Butter and margarine
    Add butter or margarine to potatoes, melt it on top of vegetables and pasta and spread it thickly on bread.
  • Mayonnaise
    Use in sandwiches, with fish and on savoury biscuits.
  • Sugar
    Add sugar to drinks, cereals and puddings.
  • Jams and spreads
    Use on bread and add to puddings.

Getting help from other people
If you are having problems getting your child to eat, try asking your cardiac liaison nurse for advice. You can also ask for an appointment with the hospital dietician.

Health visitors are another source of good advice and tips for getting children to eat. However, they are used to advising parents on how healthy children should eat. This means that their suggestions may be unrealistic for your child. If you think this is the case, you may want to show them this fact sheet or suggest they talk to your cardiac liaison nurse.

Many parents find that their children eat better when offered food by someone else. Other people (relatives, neighbours, friends and so on) will often be happy to help feed your child.

Practical tips

  • When introducing children to solid food, start with smooth puree or yoghurts. Work towards small bite sized foods that dissolve easily such as sponge fingers.
  • Get your child to help choose and prepare their food. You could let them choose things in the supermarket, look at cookery books together or try baking together.
  • When you are cooking food, get your child involved and encourage lots of touching, tasting and licking of spoons!
  • Make mealtimes fun. Look for children’s food that comes in funny shapes like alphabet spaghetti. You can cut food into funny shapes or arrange it to look like a funny face.
  • Children are more likely to eat when they are sitting at a table with other people. If eating with your family is not working, try asking one of their friends round. Once your child sees a friend tucking in, they may join in too.
  • If your child needs a special diet, make up plenty at a time and freeze it in individual portions. This will mean you do not have to make individual meals every day.
  • If you are filling in a form to claim Disability Living Allowance (DLA), remember that preparing food and feeding time counts towards the extra care your child needs.
  • Sometimes it will work if you tell your child that you do not think they will enjoy food so perhaps they had better not try it.
  • Allow your child to help themselves from the fridge or have a cupboard or tin where they can get snacks and biscuits.
  • Try not to let your child see you becoming distressed or annoyed if they do not eat. If children think that not eating will result in them getting lots of attention, they may continue to refuse food.

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