My 6-year-old son often refuses to take his pancreatic enzymes with meals. Do you have some tips and advice for him to accept taking them? What exactly do these enzymes do?
When food is ingested, it goes into the stomach where it is reduced into small pieces. These pieces then pass into the small intestine. In a healthy organism, digestion is done with the aid of bile (liver) and enzymes (pancreatic). Essential nutrients are then absorbed by the body and converted into energy used for growth. Undecomposed food (undigested) are excreted from the body in the faeces. In most people with cystic fibrosis (CF), the pancreatic ducts are clogged with the same type of sticky mucus that is found in the lungs. The enzymes secreted by the pancreas are then unable to travel to the small intestine, and the food is not digested properly, resulting in problems of nutrition and growth. This is why people with CF generally must take pancreatic enzyme supplements to promote healthy digestion. The required amount varies depending on age, body weight, and the quantity and quality of the food ingested. It may vary over time, especially with children.
Most children can learn to swallow enzyme capsules between the ages of three and seven. The capsules must not be chewed or crushed and their contents should not be sprinkled on food. When the child starts the enzyme intake, weight gain is a sign that the body digests and absorbs food well. Never increase the amount of enzymes without talking to your healthcare team. Indeed, it can be dangerous to take too much.
It is often difficult to make children take enzymes. The younger, for example, may simply reject it if they feel that it angers the person who shows them how to take them, while school children are sometimes embarrassed to take their enzymes at school. Your child will probably be willing to take their enzymes if, from the start, you show yourself as constant and are frank about the issue. During early childhood, explain why enzymes have to be taken while eating. Explain that they will help them grow and gain weight, that they will prevent flatulence, stomach pain and loose stools, and that by taking them, they will have more energy to play with other children.
School-age children are sometimes embarrassed to take their enzymes in the presence of their friends, which may deter them from taking them at school. To avoid this situation, it is better to adopt an open attitude and to integrate the taking of enzymes in the daily routine at home and at school.
Some foods can be digested without enzyme supplements. Fruits (including dried fruit), juices, soft drinks, hard candy, popsicles and jellies (Jell-O ©) are good examples.
Finally, for mothers who are breastfeeding, it is important to give babies some enzymes with each drink. If your baby is underweight at the diagnosis of CF, you may need, in addition to breastfeeding, to give them enriched breast milk bottles for at least a few weeks. After the weight is returned to normal, you can stick to breastfeeding.
By specialist dietitians for Cystic Fibrosis in Canada