À la Carte -- 8. Children With HIV/AIDS

Thanks to better testing of pregnant women for HIV and more effective anti-HIV treatment, fewer HIV-positive infants are born in Canada than in the time before HAART. And many children who were born with HIV are now reaching their teenage years and adulthood.

Children with HIV are like other children -- their bodies are especially sensitive to nutrition. All children must eat well to grow properly. On top of the normal demands of growth, HIV-positive children must cope with the extra demands that the virus places on their body.

Meeting these demands can sometimes be hard because children living with a chronic disease such as HIV can have a poor appetite and little interest in food and can feel full quickly. They often eat very slowly and tend to be picky eaters. Like HIV-positive adults, they experience problems such as diarrhea and nausea, which make it harder to eat. They can also have metabolic problems with blood lipids and fat redistribution.

As a parent or guardian of a child with HIV, it is easy to worry about your child's nutritional needs. This can sometimes make meals very difficult. Not being able to get enough good food can make it even harder.

As children grow into their teenage years, the challenges continue. They gain independence but also must begin to take responsibility for their chronic condition. Good nutrition and even adhering to their HAART regimen may become less important to teens as they grapple with all the complexities of living with a chronic disease like HIV -- and being a teenager.

Children living with HIV need ongoing nutrition care and support.

HIV-positive children should have ongoing nutritional care at a pediatric centre to make sure they stay healthy and grow properly. If growth is slow, boosting nutrition will be an integral part of the treatment plan. The first step will be to change the child's diet to increase calories and protein.

In more severe cases where the child still doesn't gain weight or grow quickly enough or even loses weight, a feeding tube may be required. A PEG (percutaneous endoscopic gastrostomy) is the preferred method because children often need extra help for a long time.