In what percentage of TBSA burns do children usually require nutrition support?

• A. Greater than 20% TBSA
• B. Up to 20% TBSA
• C. 10-20% TBSA
• D. All burns require nutrition support

Answer: (A)

In children, the need for nutrition support rises with the size of the burn because larger injuries provoke a strong hypermetabolic and catabolic state. When TBSA burns exceed about 20%, energy and protein demands become high enough that without nutrition support there’s a real risk of lean body mass loss, impaired wound healing, and infection. Starting nutrition early, ideally via enteral feeding within the first 24–48 hours, helps meet these needs and preserve gut integrity; if enteral feeding isn’t possible, parenteral nutrition is considered. Smaller burns don’t usually drive enough metabolic stress to require routine nutrition support, so the threshold is greater than 20% TBSA.