Feeding Your Child with Cystic Fibrosis

How many calories does my child need?

Children with cystic fibrosis (CF) are often challenged by failure to thrive or poor weight gain despite getting enough calories. Infections, breathing problems, and malabsorption can all contribute to the need for extra calories. Children with CF should have a diet high in calories. With extra calories, he or she should grow and develop normally.

Children with CF should eat three meals and two to three snacks a day to help meet their calorie needs. It can help to add extra fat to meals and snacks to meet these needs. Pancreatic enzymes will usually be needed to help digest this food. 

How can extra calories be added?

You can add extra calories to your child's meals and snacks by trying the following:

• Add butter, margarine, or vegetable oil to:

  • Breads, toast, crackers, or sandwiches

  • Potatoes, hot cereals, rice, noodles, soups, or casseroles

• Add sour cream to:

  • Potatoes, rice, pasta, or vegetables

  • Use as a dip for vegetables, or chips

• Add mayonnaise to:

  • Sandwiches or crackers

  • Dips, salad dressing, or sauces

  • Meat, fish, eggs, or vegetable salads

• Add cream cheese to:

  • Fruit slices, raw vegetables, bread, toast, or crackers

• Use heavy creams in:

  • Soups, sauces, batters, custards, puddings, shakes, mashed potatoes, or cooked cereals

• Use whipping cream on:

  • Pancakes, waffles, fruit, ice cream, pudding, hot chocolate, or other desserts

  • Mix in cream soups, hot cereals, mashed potatoes, pudding, and custards

• Add brown sugar, maple syrup, or syrup to:

  • Hot cereals, cold cereals, fruits, ice cream, or puddings

  • Use as a glaze on meats, or vegetables

• Add powdered milk to:

  • Cereals, potatoes, cream soups, eggs, puddings, gravy, and casseroles

  • Add two to four tablespoons of powdered milk to one cup of whole milk to make "super milk"

• Add cheese to:

  • Sandwiches, burgers, toast, crackers, eggs, potatoes, noodles, and snacks

• Add peanut butter to:

  • Sandwiches, crackers, toast, fruit slices, vegetables, ice cream, or milkshakes

• Use high-calorie drinks such as:

  • Homemade milkshakes, Carnation Instant Breakfast, Scandishakes, Pediasure, Boost, Boost Plus, Ensure, or Ensure Plus

Does my child need extra vitamins?

Vitamins A, D, E, and K are known as fat-soluble vitamins. Vitamins are important for proper growth and development. Many children with CF do not get enough of these vitamins from the foods they eat, because they have difficulty digesting and absorbing fat. When this happens, your child may need to take extra vitamins. Your child's doctor can recommend the type and amount of vitamins you should give to your child. There are vitamins specifically made for children with CF. Consult your child's doctor for more information.

Does my child need extra salt?

Children with CF need extra salt in their diets because they lose more salt in their sweat than other children. Add extra salt by using the saltshaker at meals and including salty foods and snacks -- for example, chips, pretzels, fast foods, french fries, pickles, nuts, and luncheon meats. Extra salt intake is important in the hot weather, when children are playing outside and sweating.

What if my child is not gaining weight?

Sometimes, children with CF don't grow or gain weight despite a high-calorie diet. This can happen if your child's appetite is poor, he or she has frequent infections, or he or she has malabsorption. Symptoms of malabsorption include bloating, flatulence, foul-smelling stools, abdominal pain, and watery diarrhea.

If your child can't eat enough food for normal growth and development, then he or she might need supplemental oral or tube feedings, as directed by your child's doctor. This involves placing a small tube through the nose and into the stomach. The tube is called a nasogastric tube, or NG tube. You can then give your child a high-calorie formula or supplement through this tube.

Some children with CF need calorie supplements over a long period of time. In this case, a feeding tube (gastrostomy or "G-tube") is placed through the stomach wall, or the child is given intravenous fat solutions (intralipids). Consult your child's doctor for more information.