Eating and drinking well

Eating and drinking is a complex activity involving lots of different nerves and muscles. Our breathing control is very important too. In order to feel healthy it is important to drink enough fluids and have a diet that contains enough nutrients.

If you have recently had a diagnosis of COVID-19, you may have trouble with eating and drinking due to:

General fatigue and weakness which can impact greatly on your chewing and swallowing.
Spending time in ITU and requiring a breathing tube/ventilation to help you breathe, which can result in swelling and discomfort in your throat.
Weak swallowing muscles – When we eat and drink we use lots of nerves and muscles which can become weaker over time if they are not being used. If you did not eat and drink for a period of time in hospital, your swallowing muscles may have become weaker.
Reduced appetite.

If you have been assessed by a Speech and Language Therapist during your hospital admission you may have been given advice about how to make eating and drinking easier, such as having softer foods or thickening your drinks. If needed, you may have been given a program of exercises to help strengthen your swallow.

Please contact your GP should you experience ongoing difficulties with eating and drinking or have any of the following symptoms

Coughing during or after eating and drinking
New and frequent chest infections
Wet or gurgling voice after eating or drinking
Food sticking in your throat

Symptoms of COVID-19

Symptoms of COVID-19 can vary greatly; you may not experience any or all of the symptoms listed on the next few pages. This information is intended to give some practical tips for maintaining good nutrition while you recover from your illness and support your immune system.

Mealtime fatigue or shortness of breath

If you are finding mealtimes challenging because you feel tired or breathless try these techniques:

Try having 6-8 smaller snacks throughout the day, rather than three larger meals. This may help give you energy throughout your day and reduce the risk of you feeling excessively tired after your meal. If you don’t feel up to eating food then consider a milky drink instead.
Soft and moist meals and snacks can be easier to manage when you are feeling tired. If you are having something dry, consider adding a sauce or chutney to make it easier to manage.
Eat slowly, ideally sitting upright and keeping your breathing even. If you are struggling then stop, rest and try again a short while later.
Ask friends and family members to help with meal preparation.
Keep a flask or drinks bottle nearby containing drinks.

Cough

If your cough is persistent:

Make sure you are drinking regularly, aim for 6-8 glasses per day. You will need more if you have a fever, diarrhoea or vomiting.
It is an “Old Wives’ Tale” that dairy foods should be avoided – THIS IS NOT TRUE, unless you have a known allergy to Cow’s Milk Protein.
If you have a bout of coughing during a mealtime, stop and rest and then try again when you are ready.

Looking after your mouth

This is very important if you are having difficulty eating and drinking and also if you have had any help with your breathing in hospital. The use of breathing masks and tubes can cause your mouth to become very dry which can encourage more bacteria to develop.

Regular mouth care is important to help prevent infections and dryness.

Dry/sore mouth

Some people get a dry mouth when they use oxygen, nebulisers or some inhalers. If this is the case it can affect your appetite. Some things you can do to help yourself are:

Choose soft and moist foods.
Take small frequent drinks.
Ice lollies made with fruit juice or squash, sugar-free gum and boiled fruit sweets may help.
Drinking plenty. Fruit juice may sting so try less acidic options such as squash, milk or milk based drinks.
Cold food and drinks may be soothing, but if not try adjusting the temperature of your drinks to see if it helps; room temperature may be most comfortable.
Salty or spicy food may also sting if your mouth is sore.
Soft, moist food is less likely to scrape at sore areas.

Tell your doctor if you have a persistent dry or sore mouth as they may be able to prescribe something to help. You may also need painkillers before mealtimes if your mouth is very sore.

Taste changes

Changes in your sense of taste can occur for many reasons but can impact upon your appetite and desire for food. Some things you can do to help yourself are:

Sharp, spicy and sweet foods have a stronger taste. Keep trying different seasonings and sauces to find what suits you.
Taste changes may not last long so if you go off a particular food, try it again regularly.

Reduced interest in food or low mood

If you are finding that you are not feeling hungry or don’t feel like eating, you could:

Eat with other people within your household.
Think about how the food is presented, for example do you have a preferred plate or cup?
Choose meals based on what you feel like eating that day.

Weight loss

If you have lost weight, it is important to eat and drink enough. Some things to try are:

Have three meals a day and some snacks between meals.
Have at least two nutritious drinks a day, such as milkshake, smoothies, hot milk drinks.
Drink 6-8 glasses of liquid every day - tea, coffee, water.

You can add “toppers” to enrich foods to help you gain weight and have more energy. You could try:

Grated cheese
Mayonnaise
Evaporated milk
Cream
Butter
Dried milk powder

Enriched milk: Add four heaped tablespoons of milk powder to every pint of full cream milk and use at least one pint of this milk on cereal, in drinks and puddings each day.

What can I do if I find making meals difficult?

Consider using ready meals and convenience foods.
Have food or frozen meals delivered to your door by companies such as Wiltshire Farm Foods, Oakhouse Foods, supermarkets or local shops.
Allow family and friends to help with shopping and cooking when possible.
Your local council may offer support if you are self-isolating and don’t have any family or friends to help with shopping.

If you continue to lose weight after trying these suggestions or if you are still not eating and drinking well, please tell your doctor or another healthcare professional.