Intestinal infections are represented by a large group of diseases with a fecal-oral mechanism of infection caused by various pathogens (salmonella, clostridia, shigella, company-, adeno-, enteroviruses, amoeba dysentery, lamblia, proteins and others), the unifying feature of which is the presence diarrhea (diarrhea). In the structure of infectious diseases of childhood, intestinal infections occupy a leading place.
An important component of the complex treatment of intestinal infections is properly organized therapeutic nutrition. The diet for intestinal infection in children is aimed at reducing the inflammatory process in the gastrointestinal system, reducing intoxication, restoring water-salt metabolism, eliminating gastrointestinal dysfunction, normalizing the intestinal biocenosis.
Modern approaches to the organization of nutrition for children with acute intestinal infection at any severity of the disease presuppose the abandonment of the previously widely practiced hungry water-tea pause on the first day of the disease, since its purpose contributes to the disruption of nutrition and the development of a deficiency of the protein component, slowing down the repair of the gastrointestinal mucosa and a decrease in the protective function of the body.
Diet with intestinal infection for children of the first year of life
With intestinal infection in infants of the first year of life who are naturally breastfed, breast milk is an optimal food because it contains anti-infective factors such as interferon, immunoglobulin A, lactoferrin, lysozyme. Lactation allows to minimize the nutrient deficiency in the child’s body, in particular protein, electrolytes, liquid and helps restore the mucous membrane of the gastrointestinal tract. A free feeding schedule during the phase of the phase is unacceptable, since applying the baby to the breast systematically leads to the emergence / intensification of regurgitation, vomiting, diarrhea.
It is important at 8-10-fold feeding of the child to have a night break in feeding at least 6 hours. The milk volume per one feeding with an 8-fold chart (every 2 hour) should be 40-50 ml and 60-80 ml when fed through 2,5 hours. at 6-fold feeding (in 3,5 hours) – 120-160 ml. For mild forms of the disease in children up to a year in the first 3-4 days from the onset of the disease, the diet is reduced by 15-20%. The missing volume to the physiological nutritional level is compensated by the liquid.
When there is a lack of breast milk, use adapted infant milk / sour-milk mixtures. It is forbidden to include in the diet of infants with intestinal infection unadapted formula, kefir and whole milk due to a high risk of strengthening osmotic diarrhea and sensitization to the cow’s milk protein.
Children under six months with mixed feeding with positive dynamics on the part of the gastrointestinal tract can be introduced complementary foods on the third day. Most often for this purpose it is recommended 5% rice, buckwheat and semolina porridge, which with good portability replace 10%, cooked on whole milk. The amount of complementary foods varies depending on the age of the child. After a few days 10-20 grams of cottage cheese, vegetable purees, fruit and jelly based on berries and fruits in the amount of 50-150 ml, juices are added to the porridges. Then the diet is expanded by minced meat and other kinds of complementary foods.
Children with mild forms of intestinal infection who are fed on an artificial diet in the diet include adapted sour-milk mixtures. Nutrition of children of this age is more diverse – cereals with the addition of butter, cottage cheese, vegetable purees, 1 / 2 yolk of chicken eggs, not concentrated broth, vegetable soup and minced meat.
If the intestinal infection is accompanied by the phenomena of fermental dyspepsia of flatulence from the diet, it is necessary to exclude sweet milk mixtures, juices, replacing them with low-lactose / lactose-free infant formulas and food products, as well as mixtures made on the basis of soy protein. It is recommended to give the child porridge on the water (vegetable broth) without sugar, baked apples (up to 100 g per day), kefir three-day.
It should be taken into account that in severe forms of intestinal infections, in the acute period, especially in premature infants and with the presence of hypotrophy, as well as in cases of invasive diarrhea, protein deficiency can occur due to impaired absorption and loss of amino acids through the intestine. To such children, starting from the 3 day of the disease, milk adapted mixtures enriched with protein, intended for feeding premature babies, and curd are prescribed.
Diet in children after the year and older age groups (from 3-x and more years).
Nutrition for children of this age group is built on the same principles. On the first day off, kefir is administered through 3-3,5 hours per 150-200 ml, depending on the age. It is important to take into account that the duration of the discharge period should not exceed 3-5 days, after which the one-time food volume and the diet as a whole should be increased, and provide physiologically adequate nutrition, taking into account the age and functional status of the gastrointestinal tract with the exclusion of prohibited foods from the diet .
The child’s diet should include unconcentrated soups, kefir, diet meat and nonfat fish, cottage cheese, butter, cream, chicken eggs, potatoes, boiled vegetables. Croup and vegetables for porridge and garnish are well boiled to a state of softness. Very useful rice porridge in a semi-liquid form, prepared on water without salt, butter and sugar, has a good fastening and enveloping mucous membrane action. In an acute period of the disease, all dishes should be steamed / boiled and mashed or in the form of mashed potatoes (mashed porridge, soup-mashed potatoes, omelettes).
Useful compotes of dried fruits, jelly from berries, especially blueberries, lemons, watermelons. From the diet exclude foods that enhance peristalsis, promoting the development of fermentation processes, and also containing coarse fiber (rye bread, legumes, cucumbers, all kinds of cabbage, beets, pasta, turnips, bananas, grapes).
To reduce the vomiting, food and liquid should be given at a small interval in small portions. Restrictions are prescribed until the frequency and nature of the stool is normalized, after which the product set is gradually expanded. In the absence of appetite, the child is forbidden to feed the child on the first day. In this period it is important to provide the body with a sufficient amount of liquid for age.
As a free liquid, you can use herbal teas based on sage, chamomile, lime, pure boiled water, light green tea, broth
The volume of free fluid that must be drunk during intestinal infection is determined from the ratio of 80-100 ml of fluid after each episode of diarrhea / vomiting for children younger than 2-x and 150-200 ml of fluid / rehydration solution for older children. In this case, the entire volume of the solution should be used fractionally, in small sips of 50-100 ml every 5-10 minutes.
Nutrition of the child after an acute period of intestinal infection expands. You can include boiled fish, meatballs, eggs, milk porridge, steamed burgers, soups on low-fat diluted broth, bananas, fresh apples without skin, white rusks, dry biscuits, biscuits. It is mandatory to include in the diet of enriched fermented milk products (with the addition of pro- и prebiotics). It should be borne in mind that during the period of the disease there is an intensified breakdown of the protein, therefore, in the diet, foods containing animal protein (chicken, beef, fish, cheese, cottage cheese, eggs) should be present in sufficient quantities.
Excluded from the diet are fat red meat (pork, lamb), animal fats, salmon fish, waterfowl (ducks / geese), which contains poorly digestible and difficult to digest fats. Easily digestible fats (vegetable oils, including) should be consumed in small amounts. It is necessary to limit the intake of easily assimilated carbohydrates in the form of sweets, sugar, cakes, cakes, ice cream, canned juices, as they strengthen the processes of fermentation in the intestine.
At the stage of recovery, a diet for children after intestinal infection should last at least 3-4 weeks, and in severe forms of the disease and up to 2-3 months. Ignoring the diet during this period can lead to the resumption of intestinal disorders and the formation of chronic enteritis or colitis. Especially relevant is the diet after the transferred dysentery, rotavirus gastroenteritis, salmonellosis, in which the insufficiency of motor, evacuation and digestive function of the intestine persists for a long period.
Therefore, feeding the baby after intestinal infections should exclude abundant meals, fatty and hard-to-digest products, as well as containing coarse vegetable fiber and food additives (dyes, flavor enhancers, preservatives). The nutrition menu for both younger and relatively older children should be moderately sparing with the exception of aggressive food products – smoked products, fatty meat and fish, fried, acidic foods, legumes, marinades, confectionery, ice cream, drinks containing alcohol and carbon dioxide , products that contain a large content of essential oils (onions, garlic, spices, radish, radish, coffee, chocolate). Just as with intestinal infection in adults, it is necessary to take tablets of vitamin-mineral complex intended for children.
Acute intestinal infections in adults and children.
Diet for intestinal infection involves the inclusion in the diet of dried wheat bread or white breadcrumbs, low-fat chicken and non-concentrated vegetable broths, and mucous soups based on carefully digested rice or buckwheat and vegetables.
Recommended inclusion in the diet of low-fat varieties of red meat and meat of chicken, turkey, rabbit, from which cooked boiled pieces of meat, which are then crushed, as well as pate, steam cutlets or meatballs. Low-fat species of sea and river fish are useful.
In the diet can include dairy products (curdled milk, yogurt without additives, kefir), steam omelette and chicken eggs, soft grated cheese, grated cheese, butter and vegetable oil in small quantities.
For the garnish carefully digested cereals (rice, buckwheat) and boiled vegetables (beets, potatoes, pumpkin, cauliflower, carrots) and various greens are used, from which caviar, stew, mashed potatoes are prepared. In the diet can be present marmalade, jam, honey.
As a free liquid, it is recommended to drink broth of wild rose, not carbonated table water, weak green tea, diluted water with freshly prepared juices, teas based on chamomile, lime, thyme, sage, cranberry / cranberry juice, raspberry / currant tea, dried fruit compotes, boiled water with the addition of honey, infusion of dried cornel and blueberries.