The use of oral protein calorie supplements in children with chronic disease

A lack of growth and poor nutrition are common in children with chronic diseases like cystic fibrosis and kidney disease. This may be due to reduced appetite, food not being absorbed properly and the need for extra calories caused by their disease. Oral protein calorie supplements are widely used to improve nutritional status and weight gain. These can take the form of whole protein milk or juice drinks. Adverse effects include the risk that the protein and calories in the supplement may replace those from normal food intake. This may have a negative effect on eating behaviours. It can also cause bloating, vomiting and diarrhoea due to potential for rapid ingestion of high calorie liquid. The review includes three studies with 135 children, all of whom had cystic fibrosis. We found insufficient evidence to support the use of these supplements. Until further data are available, we suggest these products are used with caution.