Can children with burns covering > 20% TBSA have nutrition support by oral intake?

• A. No, they generally cannot meet their nutrient needs by oral intake alone
• B. Yes, they can meet all needs by oral intake
• C. Only if they are with minor burns
• D. Only with supplements

Answer: (A)

Severe burns trigger a hypermetabolic, highly catabolic state in children, so their energy and protein needs rise much more than usual. When burns cover more than about 20% of TBSA, the body’s demand for calories and amino acids to support wound healing, immune function, and lean tissue preservation often cannot be met by oral intake alone. Pain, fatigue, medications, and gut tolerance further reduce how much a child can eat, making it unlikely that oral feeding by itself will cover the nutritional requirements. Because early, adequate nutrition supports healing and reduces complications, nutrition support is typically started early, with enteral feeding preferred for most cases. Supplements can help, but they usually aren’t sufficient to meet the needs if oral intake is the sole source in large burns.