During the paroxysmal stage of pertussis, which intervention supports hydration and energy?

• A. Provide small, frequent meals.
• B. Increase protein intake.
• C. Maintain a liquid diet.
• D. Offer the child a regular diet.

Answer: (A)

In the paroxysmal stage of pertussis, keeping the child’s energy up while staying hydrated is best achieved by offering small, frequent meals. The intense coughing spells of this stage exhaust the child and increase the effort required to eat, which can quickly lead to fatigue and inadequate intake if meals are large or infrequent. Small portions are easier to handle during each bout of coughing, helping to maintain caloric intake without overwhelming the respiratory effort. They also make it easier to take fluids between feeds, supporting hydration without risking choking or vomiting during a paroxysm. A regular or large meal can be too demanding during fits, and while a liquid diet helps with hydration, it may not supply sufficient energy on its own. Therefore, frequent, smaller meals best support both energy and hydration during this phase.