Excessive hunger and thirst

From ShortGut - Wiki

Some short gut kids struggle with oral aversions, rarely expressing an interest in eating or drinking. But some kids have the opposite problem. All these kids want to do is eat and/or drink all the time. However, oral intakes may need to be strictly limited to keep ostomy outputs in check. Here are some suggestions for coping with the thirst and hunger:

• Ensure your child is not getting thirsty or irritable due to low blood sugars. You can request to check your child's blood sugars (particularly when off TPN) at home with a glucometer. If low blood sugars are to blame, you can increase the hours of TPN per day or ask about running D-5 or D-10 when off TPN.
• Ensure that your child is getting sufficient fluid. You may want to weight diapers to get a 24 hour total of urine output. Use a food scale available at Walmart or Target to weight the diapers. Subtract the weight of a dry diaper to get the amount of urine. For AustinRath, Boston told us that the appropriate urine range is between 1-5 ml/hour/kilo; however, due to high ostomy outputs, he should be on the higher end of the scale, which means 72-120 ml. per kilo per day. Even though his urine output was acceptable, we started giving him additional replacement fluid (LR) when he is off TPN and it has greatly improved his thirst and irritability.
• Ensure that your child is getting the right kind of Fluids -- water by itself can end up sucking water out of the intestine.
• Allow you child to suck on a wash cloth soaked in pedialyte or water. Freezing it works well too. Lasts longer than a quick drink.
• Put a piece of a pedialyte popcicle in a mesh feeding bag (available at Walmart or BabiesRUs) [[1]] or in a sippy cup to eat. It takes a long time to eat, but keeps your child content.
• We made "icecream" with the following recipe: mix 25 ml formula (we use Peptamin Jr) with 25 ml heavy cream. Add 1/2 teaspoon of orange or berry metamucil (make sure your child can tolerate this). Mix and freeze. It actually tastes really good. You can make it into a little popcicle too.
• Have your child on a regular routine for eating and drinking so the child knows when they will get to eat or drink.
• With AustinRath, we also have some behavioral guidelines in place. To normalize his life, we want him to learn to tolerate seeing other people eating and drinking. So we eat and drink in front of him. We never give him our food or drinks, because we don't encourage him to beg or expect that he can always have what everyone else has. We distract him to play with a toy if he starts asking to have what we have. We also always give him everything he's going to get for a meal on his tray at the same time. We don't want to think that if he whines for more, we will give him extra food. He is on a strict schedule for meals and drinks. We don't give him food or drinks at unscheduled times, again to help prevent constant begging for food or drinks.