Practical Tips
There are also some practical things you could do to help your child to cope on a daily basis. Many children worry about having an ‘accident’ outside the house. It may help them to carry a small ‘emergency kit’ containing wipes, disposal bags, and spare underwear. If you are a member of Crohn’s and Colitis UK on behalf of your child, they will be sent a membership card which is also a ‘Can’t Wait’ card. This can help when asking to use toilet facilities when out and about. You can also get a key from RADAR (www.radar.org.uk) which will allow your child to use disabled toilets.
How Can I Get My Child To Eat?
Children with IBD are often thin and even underweight. During flare-ups they may not be very interested in food, or they may feel that eating makes their symptoms worse. Even with treatment it can be difficult for a child with IBD to eat enough to reach their ideal weight, especially during the growth spurt that occurs during puberty. This lack of interest in food can be both worrying and frustrating for parents. You may like to try
the following approach.
- Keep calm and avoid insisting that your child eats, or ‘finishes everything on the plate’.
- Remember, it is the condition that is making them unable to eat, not your cooking.
- Relax your rules about unhealthy food and allow your child to eat snacks and calorie rich ‘fast’ foods, at least some of the time. If you are worried about lost nutrients, check with your child’s IBD team for advice.
- Try offering smaller meals more often during the day, or encouraging an older child to make their own small meals and snacks to eat when they feel like it.
Although children with IBD may grow more slowly than other children, four out of five should reach their full adult height. However, if you are concerned, for example, because puberty is delayed, talk to your child’s doctor. Growth charts and bone age (this can be shown by a wrist x-ray) can indicate how much growth time is left. Your specialist may refer you to an endocrinologist (growth specialist) if they feel your child may benefit from growth hormone.
What can I say to other people about my child’s IBD?
It is up to you and your child whether and how much you tell friends, neighbours and relatives outside the immediate family. You may fear that some people will react badly to the news that your child has a chronic bowel disease. Negative reactions are most likely when people are afraid of, or don’t understand the condition. If you can be open and honest, this is usually the best way to combat any confusion or misunderstandings. It can be particularly worthwhile talking to the parents of your child’s friends, after checking with your child that they are happy about this. Other parents may, for example, be worried that your child’s condition is infectious, or that your child needs a special diet, but be reluctant to mention it until you do. You will probably find that most people are supportive once they know how they can help.
Can we go on holiday with a child with IBD?
There is no reason why you shouldn’t be able to take regular family holidays, although sometimes with a child with IBD these can take extra planning. For holidays abroad in particular you will probably feel more secure if you do plan ahead and, once there, take the usual sensible precautions. You may find some of the following suggestions helpful:
• Choose destinations where you know they will have clean water and familiar food in order to cut the risk of tummy bugs. Avoid shellfish and salads you have not prepared yourself, dairy products unless you know they have been pasteurised, and ice cream from unreliable sources, such as kiosks. Drink bottled water instead of tap water. Carrying a kit of water, wipes and anti-bacterial gel can be useful.
• Ensure you have adequate supplies of any medicines your child will need. Keep drugs in the original packaging, and if you are flying, put them in your hand luggage. (You may need to check with the airline about rules relating to liquids). It is usually a good idea to carry a copy of a letter from your GP or hospital explaining your child’s condition, and why the medication is necessary. This can also be useful to show a doctor abroad, should you need to see one. You may also want to take the contact details of your child’s IBD team with you.
• Discuss with your doctor whether it would be a good idea to take some antibiotics with you on holiday in case a tummy bug strikes.
• Some travel immunisations may not be advisable for children with IBD, so check with your doctor which immunisations would be sensible, ideally before deciding on a destination.
“We have been to Crete and Florida with her UC, gastrostomy, feed, pump
and various meds – we are not letting it stop us living life to the full.”
(Mum of a 14 year old girl with UC)
For more tips and suggestions on managing holidays, see our information sheet, Travel and IBD. You may also need to think about taking out holiday health insurance before you travel. You will need to tell the insurance company about your child’s IBD, and it may be more expensive because your child has a pre-existing medical condition. However, as a flare-up can happen at any time, it may be worth taking out cancellation insurance even for holidays in the UK. If you are holidaying abroad, additional insurance cover for medical expenses can be useful. Although UK travellers in Europe are covered for some of their treatment by the European Health Insurance Card (EHIC) this will not cover all the costs you may incur. Full details are on the NHS website, www.nhs.uk/nhsengland/Healthcareabroad. Our information sheet, Insurance and IBD, includes a list of sympathetic insurance companies suggested by people with IBD.
Coming up in Part 5 - Kids, IBD and School
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