Nutrition in Children with Liver Disease: Evaluation and Management

The liver is the major organ for maintaining normal homeostasis of both macronutrients (proteins, carbohydrates, and fat including essential fatty acids) and micronutrients (vitamins and minerals). Therefore, children with significant liver disease, especially those with chronic cholestasis, cirrhosis, or end-stage liver disease, often demonstrate impaired nutrient metabolism as well as possible malabsorption or maldigestion of nutrients. Routine assessments of nutritional status, appropriate supplementations, and nutritional intervention or rehabilitation (if needed) are crucial in managing these children. The roles of various diets in children who suffer from end-stage liver disease and complications from hepatic dysfunction such as hepatic encephalopathy or ascites have been widely studied. During the past two decades, many children with chronic end-stage or life-threatening liver disease have undergone liver transplantation as a therapeutic option. Nutritional support also plays an essential role in managing these children both before and after the transplantation.