Nutrition, HIV and Your Child

Good Nutrition is essential to helping children grow and develop. It is especially important for children with human immunodeficiency virus (HIV). Eating the right food, the amount and types of foods will give these children the energy, protein and other nutrients they need for proper growth and development. Good nutrition can also help these children maintain strength, fight infections and prevent weight loss.

As a parent or guardian of a child with HIV you play an important role in assuring that your child is well nourished. Following are some of the basics for nutritional management of the child who is HIV+.

How does HIV affect my child's appetite?

HIV, along with other infections and medications may decrease your child's appetite. By eating less, your child may lose weight or stop gaining weight. Weight loss is one of the most common and challenging health problems facing children with HIV+. On the other hand, with successful antiviral therapy your child may be gaining weight, sometimes too much.

What type of diet is best for my child?

A diet containing a variety of foods will help meet you child's nutritional needs. A varied diet includes lots of different foods from each category: meats, fruits, vegetables, carbohydrates, milk and other dairy products.

A multivitamin with mineral supplement should always be part of your child's daily regimen. This way you cover all the micronutrients basics because most children, HIV+ or HIV - are picky eaters. That is the nature of children. But, bear in mind that vitamins and mineral supplements do not provide the calories and protein your child needs for growth and development.

Facts about weight gain.

Fat contains more than twice as many calories as carbohydrates( breads, cereals etc) and protein( meat, chicken, fish, dairy, etc.) Make every bite full count if you can. To increase your child's intake try the following sources of calories and protein:

1. Use half and half, evaporated milk or heavy cream in place of milk in cereals or recipes calling for milk.
2. Serve pudding, custards, whipped cream, ice cream, milk shakes or instant breakfasts, commercial nutritional supplements like Ensure or Sustacal
3. Peanut butter and jelly, tuna or egg salad, cheese sandwiches
4. Pizza and casseroles with extra cheese, rice and beans, omelets, etc.

Too add extra calories to food use butter, gravies, sauces, cheese, mayonnaise

NOTE: If your child is normal weight and past two years old, I suggest you go easy on the saturated fats. Heart disease is a new danger for PLWHIV because of effective viral suppression with HAART. New findings of high blood lipids and blood sugar are risk factors. Healthier fats are canola and olive oil, peanut and other nut butters, avocado, and fish oils.

What if my child refuses to eat fruits and vegetables?

If your child doesn't usually eat fruits and vegetables, try novel ways of introducing new and colorful foods. Sometimes kids like them better when they are raw. Try the following:

1. Spread small amounts of peanut butter on fruits like apples or pears
2. Add fruits and vegetables to Jell-O
3. Make fruit shakes with ice cream and milk
4. Freeze bananas on a stick
5. Freeze grapes- use them as ice cubes to cool beverages(this is for older kids, not the toddlers)
6. Pizza and spaghetti- tomatoes are fruit
7. Sweet potatoes are vegetables
8. Baby carrots

Give yourself credit for all that you do for your child everyday.

Donna Tinnerello, MS, RD, CD/N. December 6, 1999

Donna Tinnerello MS, RD,, CD/N is registered dietician with more than 10 years experience in HIV and nutrition. She works at Cabrini Medical Center in lower Manhattan,in private practice and the community.Her subspecialties are cardiovascular, renal, and gastrointestinal disease, diabetes and weight loss. Donna is available for private consultation by referral only.