Caloric Intake for Children with Cystic Fibrosis

CF Child

For today’s Conversations with Clinicians, Gina Salvatori, a registered dietitian (RD) and licensed dietitian/nutritionist (LDN) with CHC Solutions, Inc., answered our questions on overcoming nutritional challenges for children with cystic fibrosis.

What is Cystic Fibrosis?

Cystic fibrosis (CF) is a genetic disease that causes persistent lung infections and limits a person’s ability to breathe. The gene mutations inhibit an important protein’s ability to work properly. This causes the mucus in various organs to be sticky and thick.

How Does Cystic Fibrosis Affect Nutrition?

The buildup of this sticky and thick mucus prevents the release of digestive enzymes. These enzymes help the body absorb food and key nutrients. This can result in malnutrition and poor growth.

It is especially important for children to get the right amount of nutrients they need. Proper nutrition in a child with cystic fibrosis allows the child to grow, and good growth helps with better lung function. So, it is important that children with CF grow and gain weight at the rate they are needed to. However, this is difficult for them because they need to take in 1.5 to 2 times more calories than a peer.

How Can A Child with Cystic Fibrosis Get their Necessary Nutrients?

Children with CF require more calories to grow and gain weight at the same rate as a peer. It is much harder for a child with CF to get the right amount of calories because they are only going to eat a normal volume of food for their age. This makes it necessary to come up with ways to increase their caloric intake from what they eat.

Enzyme replacement pills can be very beneficial. They help the body absorb food and necessary nutrients. Children can take them before every meal and snack so they can obtain all possible nutrients.

The pill is specific to each patient with CF. Their team of doctors and dietitians can help them come up with the correct enzyme base on several factors:

  • Their weight
  • What they are eating
  • Their bowel movements
  • The rate they are growing
  • The increase they need in growth

Fat-soluble (and possibly water-soluble) vitamins can help with the poor absorption of nutrients. Children with CF are most likely going to need a supplement for vitamins A, D, E and K. Vitamins are specific to each patient similar to the enzyme replacement pills.

A feeding tube may also be necessary. For instance, a two-year-old that needs double the nutrients may struggle since kids can tend to be picky eaters at times. Pushing the extra volume and calories is sometimes not possible.

A dietician is a great resource for families who have children with CF. Every person is different, so having a professional who can interpret your child’s lab values and tests can be very helpful in guiding the family toward healthy outcomes.  

What is Calorie Boosting?

To calorie boost means to take the food a child likes and add extra calories to it. Also, any time there is full fat option, choose the higher caloric option. For instance, choose whole milk opposed to skim. Typical foods enjoyed by children can have calories added. For instance, butter and oil can be added to pasta before adding the sauce.

To learn more about healthy, high calorie eating visit the Cystic Fibrosis Foundation’s page at,chocolate%20syrup%2C%20or%20chopped%20nuts.

Send us questions you would like to have answered or topic suggestions for our next Conversations with Clinicians to or email our RD and LDN, Gina Salvatori, at Check back next month for our next segment!

*Disclaimer: Any health and wellness content presented is for general informational purposes only. Such content is not intended to replace or serve as a substitute for professional medical advice, diagnosis or treatment.