Parents of children infected with viral hepatitis often wonder if there are nutritional restrictions, supplements or changes they should know about.
The liver plays a key role in metabolizing foods, beverages and most medications. It’s clear that children chronically infected with viral hepatitis, like all children, need to eat a well-balanced diet and receive adequate exercise and rest.
What’s less clear is whether any nutritional intervention is needed when children are in the relatively asymptomatic stages of viral hepatitis, when no signs of liver damage are apparent.
Children with advanced end-stage liver disease may need to follow specific nutritional guidelines issued by their pediatric gastroenterologist or a registered dietitian who works closely with the child’s specialist, but the vast majority of children and adolescents with viral hepatitis are not in this category. For most children, no special diet is currently recommended, but there are some issues worth considering.
Many of the issues in the following section apply to adults, because there is very little evidence-based data about nutrition for children with chronic viral hepatitis. Consultation with a pediatric gastroenterologist and a registered dietitian is the best way to ensure proper nutrition.
Weight has a direct impact on the health of children and adults with chronic viral hepatitis. Children with liver disease, like all children, should maintain a healthy weight. Too much or too little body mass can invite a multitude of health risks.
Extremely overweight or obese children with chronic viral hepatitis can add new complications to their liver, such as fatty deposits in the liver, and accompanying liver inflammation, called non-alcoholic steatohepatitis.
Some adult studies have found that an increasing body mass index as it relates to a marker of obesity and advanced age at infection can play a role in the pathogenesis of steatosis in chronic hepatitis C and that steatosis may contribute to fibrosis of the liver and more rapid disease progression, suggesting that measures aimed at weight reduction may play a significant role in hepatitis C management. Parents should consult with their pediatric gastroenterologist and a registered dietitian before ever placing a child with viral hepatitis on a weight loss program.
Some children with chronic viral hepatitis experience a loss of appetite. Parents can try to encourage eating by serving several small meals during the day, which are more easily tolerated than three large meals.
An adequate amount of complex carbohydrates (e.g. pasta, rice, wholemeal breads potatoes and whole grain cereals) can provide calories and help maintain weight for those children who have difficulty maintaining body mass. Adequate rest and moderate exercise can also help.
There are several age-appropriate oral supplements available for those children who may require additional calories to gain or maintain weight above what they are able to consume in a normal diet. Consult with your gastroenterologist and a registered dietitian for recommendations.