Infancy and childhood are the periods at risk for diseases that need protection the most. The period between the age of zero and one is called “infancy” and the period from infancy to adolescence is called “childhood” (Bayar, 2019).
Progressive developmental changes associated with the growth of organs and maturation of their functions, in short, growth and development are very important in childhood and infancy. In this process, the disease affects the health of children and babies very negatively, which makes hospitalization or outpatient treatment and the use of drugs inevitable. Considering in terms of patient safety, drug administration has an important place during the disease, but drug administration is much more risky in infants and children than in normal adult individuals due to physiological structure differences (Calisir, 2020).
Liver enzymes play a role in converting drugs into harmless metabolites and eliminating toxicity. The activities of these enzymes, which play a role in drug metabolism in children aged 1-6, and especially in newborns, are lower than in adults. Kidney, another organ responsible for drug metabolism, is not sufficiently developed, especially in infants, and can reach adult levels 6-12 months after birth(Bayar,2019). Another factor affecting drug metabolism in infants and children is the low surface area that provides intestinal absorption and the short intestinal transit time, which may indicate that drug absorption is delayed. Gastric pH, which decreases until the age of 2, is one of the gastrointestinal system factors that affect drug metabolism (Calisir, 2020). Newborns have a higher percentage of body fluid and a lower percentage of fat and muscle tissue than children and adults (Bayar,2019). This may lead to differences in drug distribution. All of these affect drug distribution, drug metabolism, and indirectly affect food-drug interaction. In the event of a possible food-drug interaction, infants and children are at greater risk than adults due to these physiological differences. Another risk in this group of patients is that while difficulties in drug administration cause the treatment to decrease, its interaction with food poses a risk for both treatment and nutrient deficiency. The resulting nutrient deficiencies can create different problems. For example, the use of psychiatric drugs such as valproic acid and lithium in adolescents and children changes the bioavailability of nutrients. In addition, the use of antiepileptics such as carbamazepine and phentoin causes a decrease in folic acid level. It is known that folic acid deficiency causes a decrease in verbal memory skills (Çorum,2016).
Physiological differences must be taken into account when calculating drug doses to be administered to infants and children and when examining drug-nutrient interactions (Aksoy, 2016).
In order to fully capture growth and development during the disease, it should be considered how the food-drug interaction can affect growth and development. Body composition, which changes depending on nutritional status and growth, will have an impact on drug action, metabolism and excretion (Aksoy, 2016). Therefore, it is very important to follow the food-drug interaction and how it affects growth in children (Aksoy, 2016).