Impact of acute illness on nutritional status of infants and young children with sickle cell disease

Objective To evaluate changes in growth, nutritional status, body compositi on, and energy and nutrient intakes during illness and usual state of healt h in infants and young children with sickle cell disease. Design Sixteen children, aged 0.4 to 5.6 years, vith SS type sickle cell di sease (SCD-SS) were assessed at the time of hospital admission for an acute illness episode and during an 18-hour overnight follow-up visit 2 to 6 wee ks after the acute illness episode when in a state of usual health. Main ou tcome measures included growth in height and weight compared with reference standards, body composition determined by the skinfold thickness technique and total body electrical conductivity, and dietary intake determined by 2 4-hour recall during hospital admission and at follow-up. Results Height, weight, and weight-for-height z scores did not differ from national reference data; triceps skinfold thickness and arm fat area z scor es were less. Mean standard error body fat was 15.6 +/- 2.1% at the time of hospital admission, as measured by total body electrical conductivity, and was not significantly different from the follow-up value (16.2 +/- 2.2%). Mean energy intake was 44 +/- 9% of Recommended Dietary Allowances at the t ime of admission and differed significantly from the follow-up value of 90 +/- 9% (P < .05). Applications Infants and children with sickle cell disease appear to be at nutritional risk during an acute illness episode, as indicated by body fat measures and inadequate intakes of energy and macronutrients. Energy intake may be suboptimal for several days surrounding an admission for an acute i llness in children with sickle cell disease. Physicians and other health pr actitioners should be alert to inadequate nutrient intakes of their patient s during this time period and may consider supplemental energy to avoid a p otential net negative energy balance.