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What are the nutritional requirements and administration route for children with chronic liver disease? The objective of energy intake should be 1...

What are the nutritional requirements and administration route for children with chronic liver disease?

The objective of energy intake should be 125-130% of the recommended amount, if based on ideal weight, and additional calories may be necessary to allow catch-up growth if there is significant weight deficit.
Carbohydrates are the main source of energy and should constitute 2/3 of non-protein energy.
Lipids should constitute between 30 and 50% of caloric intake, and formulas containing 50-60% lipids in the form of medium-chain triglycerides (MCT) are recommended.
Protein intake in infants should be 2-3 g/kg/day, and in advanced liver disease, protein intake should be reduced and supplemented with 10% branched-chain amino acids.
Vitamins A, D, E, and K are dependent on bile acid secretion in the intestinal lumen for absorption, and their deficiency is associated with cholestasis and the use of chelating agents such as resincolesteramine.
Vitamin E is the most hydrophobic of the fat-soluble vitamins, and its deficiency is common in children with chronic cholestasis, but can be improved with the use of tocoferol polyethylene glycol succinate.
Vitamin K is necessary for the synthesis of prothrombin elements, and its deficiency is associated with low prothrombin activity.
Calcium, selenium, zinc, and phosphorus should be supplemented at double the recommended amounts due to the risk of altered hepatic metabolism.
The administration of growth hormone and IGF-1 has been evaluated in children with cirrhosis, but it does not improve somatometric parameters or body composition.
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