Salt
People with CF lose large amounts of salt in their sweat. Infants with CF are more prone to salt losses due to rapid rates of growth, large body surface area and low salt content of breastmilk, infant formula and first foods. Some parents even report that their baby’s skin tastes salty when they kiss them, or they may have salt crystals on their skin when it’s hot. Salt losses are even higher in hot weather and if your baby has a fever because of increased sweating.
Loss of salt can increase the risk of dehydration which can be serious, especially in babies and young children. To prevent dehydration, the salt lost through sweat needs to be replaced and so salt supplementation is required, usually from birth.
Salt Dosages
Each baby will have individual salt requirements based on factors such as CF symptoms, weight, and the climate you are living in. The PCH dietitian will calculate your baby’s salt requirements and adjust the dose over time based on those factors. In WA, salt supplementation is usually required all year round.
Signs that your baby may need more salt include:
- Concentrated or strong-smelling urine
- Salt crystals on the skin/hair line
- Lethargy
- Irritability
Administering Salt
A salt solution is recommended for infants and is available on prescription. It is a liquid which can be added to expressed breast milk or formula or can be mixed with a small amount of water and syringed straight into their mouth.
It is recommended to spread the required dosage out over the day by administering a small amount at each feed. Salt is best given at the beginning of a feed as it may cause vomiting in some infants. As they get older, salt will need to be added to their food as well.
Signs of Dehydration
If your baby is showing signs of dehydration, try giving them smaller amounts of milk feeds more frequently. You should also ring the CF clinic for further assessment and advice.
Signs of dehydration in babies include:
- Fewer/lighter wet nappies than usual
- Salt crystals on the skin
- More concentrated/darker urine in nappies
- Dry skin or lips
- Dark sunken eyes
- Tearless crying
- Lethargy and drowsiness
- Loss of appetite
Vitamins
Babies with CF often have deficiencies in ‘fat-soluble’ vitamins A, D, E and K due to their limited or total inability to absorb these vitamins, particularly those who are pancreatic insufficient.
Vitamins are essential for normal growth and function and to fight infection. Vitamin levels should be checked at least once a year at your child’s annual review and more frequently if required.
These vitamins are important for:
VitABDECK
Vitamin supplements are required for CF babies.
VitABDECK is a CF-specific multivitamin that is generally prescribed for people with CF, including infants.
Vitamin Dosages
VitABDECK is usually taken once daily. It comes in a capsule form, and infants up to three years should have approximately half a capsule daily.
If you forget to give a dose, give the missed dose as soon as you remember, then give the next dose at the time it is normally due. If it is almost time for the next dose, skip the dose you missed and take your next dose when you are meant to.
Administering Vitamins
The VitABDECK capsule should be opened and required amount should be mixed in with apple or pear puree and spoon fed to your baby. If using apple puree doesn’t work, it can also be dissolved with sterilised water and given orally via a baby syringe. VitABDECK does not have a pleasant taste so avoid mixing it into breast milk or formula.
To enhance absorption, the mixture should be taken with enzymes and followed by a fat containing food or drink (breast milk or formula for your infant).
If VitABDECK is not well tolerated, separate supplements may be considered. This is something to discuss with your child’s CF team.