As pediatricians in a busy tertiary-care government hospital, we had the
opportunity to closely observe the quirky dietary habits of hospitalized
children, over last few years. Pediatric wards are not dissimilar to
some school canteens if the contents of the daily morning sweeping are
analyzed. One can find all sorts of colorful, empty packs, providing a
fair insight into the eating habits of our little mates.
A few instances come alive even today: A 2-year-old
boy, with subcutaneous emphysema till neck and bilateral chest tubes,
was spotted eating potato chips; another child having grade four
tonsillitis with throat pain demanded a pack too and munched them
effortlessly (he was hospitalized because of poor oral acceptance due to
odynophagia); and there was this 9-year-old chap who agreed to undergo
pleural tap only if he would get chholey-bhature after the
procedure. Another time, a mother was noted convincing her 6-year-old
girl by telling her that intravenous fluid containing multivitamin
injection (MVI) was a soft-drink called Mountain Dew that was going
through her cannula! Another girl whose heart failure was not being
controlled despite maximum pharmacotherapy was seen devouring aloo
bhujia (a high salt Indian snack) on morning rounds, explaining her
failure of response to diuretics.
Return of appetite characterized by asking for foods
is a reliable sign of clinical improvement. During an epidemic of dengue
fever in Delhi, while struggling with increased patient load, scarcity
of beds and long duty hours, it was always heartening to hear that
sentence: "Doctor, my child is asking for something to eat, can I?" When
passing by the same bed a few minutes later, the child was already
enjoying a buffet of Magic Masala, Fun Flips, and Bikaneri bhujiya,
samosa, and dhokla – gulping them merrily with Frooti or
Limca. Invariably, the appetite for fried stuff returns earlier than
that for other foods! The day a child asks for chips, could be well
relied upon as a sign of recovery.
Tea is the most favorite hot drink in Northern India.
As milk is considered ‘heavy’ for sick children, parents prefer tea as
the first drink to break a nil-per-orally regimen. An otherwise
improving child on ventilator developed brownish aspirates, courtesy an
overenthu-siastic caregiver who fed the child tea by nasogastric tube.
And all the time, we kept on investigating the child for a
gastrointestinal bleed! Even newborns are not spared the onslaught of
tea; thanks to their ‘loving’ grannies.
Outpatient areas have similar scenarios. Children are
brought in with a bag of munchies or a tetra-pack of mango drink, as
bribe for allowing the doctor to auscultate them or for getting that
painful jab without creating a ruckus. Some kids get Parle-G as the sole
form of complementary feeding. Ready-to-eat noodles is the latest
addition to the list of preferred complementary foods. A mother
confessed that she has started Maggi for her daughter as a complementary
food, as she does not like anything else. Another child easily swallowed
the spiciest snacks, while at home her mother had to cook veggies
for her separately to avoid the spicy family servings.
Parents often complain that the kid does not eat
anything and seek that magical tonic to put on weight. They want some
medicine that would make their child eat more of home-made food. Sorry
parents, we pediatricians cannot do much other than counseling you. And
for fellow pediatricians, our hard work to achieve healthy diet
practices is here to continue longer.
