Caring for a Child With MASH

Metabolic dysfunction-associated steatohepatitis (MASH) is a serious liver condition. While it is typically considered an adult disease, it can affect children too. In fact, rates of MASH are increasing all over the world – for adults and children alike.¹

MASH is a form of metabolic dysfunction-associated steatotic liver disease (MASLD), where the liver becomes inflamed and damaged due to fat buildup. Understanding MASH, its causes and risk factors, and its treatment options helps caregivers better support children with this condition.²

Why do children get MASH?

MASH develops when fat builds up in the liver, leading to inflammation and cell damage. Several risk factors contribute to children’s likelihood of developing MASH:^1,2

• Being overweight or obese
• Insulin resistance or type 2 diabetes
• Certain genetic factors
• Lack of physical activity
• Unhealthy diet

A child with MASH may not have any noticeable symptoms. MASLD and MASH are usually found when routine blood work or other tests come back abnormal.³

What does treatment look like for children with MASH?

In children, early detection of liver problems can stop or even reverse liver damage. Early detection can also prevent long-term health problems down the road. Parents and caregivers must work closely with care teams to develop a treatment plant that involves:^3,4

• Lifestyle changes
• Weight management
• Medicine, if needed
• Ongoing monitoring
• In extreme cases, surgery or other medical procedures

Lifestyle changes

Lifestyle changes are a crucial part of MASH treatment. They include eating a healthy diet and getting plenty of physical activity. A dietitian who specializes in pediatric liver diseases can recommend meal plans and support.^3,4

Weight management

Weight loss is another primary treatment method for MASH. For children with obesity, gradual and sustained weight loss is important. Doctors may advise children to try and stay at their current weight as they grow taller. A pediatrician or a dietitian can help create a safe and effective weight loss plan.^3,4

Medicine

In some cases, doctors may prescribe medicines to manage underlying conditions. Things like insulin resistance or high cholesterol can contribute to MASH. As your child’s caregiver, you will need to be responsible for filling all prescriptions. You will also need to tabs on which medicines they are taking, dosages, and any possible side effects.³

Ongoing monitoring

Children with MASH need regular checkups to monitor liver health. This may include blood tests, imaging studies, and sometimes liver biopsies to check for liver damage.^3,4

Be sure to keep clear and organized medical records for your child. Gather all of their medical history in one place so you can easily send it to any new doctors, schools, and insurance agencies.^3,4

Surgery or other procedures

If MASH has progressed to cirrhosis or liver failure, your child may need a liver transplant. This option is considered when all other treatments have failed and the liver is no longer able to function. Learn how to care for someone after a liver transplant.^2,4

How caregivers can support their child with MASH

Supporting a child with MASH requires understanding, encouragement, and sustainable lifestyle changes. It also requires being a good role model. Here are some ways parents and caregivers can offer support:^3,4

• Educate yourself – Learn as much as you can about MASH, why it occurs, and how it is treated. Understanding the condition can help you make informed decisions and support your child.
• Encourage healthy eating – Stock your home with lots of whole fruits and vegetables. Eat out less, and cook at home more. Limit access to sugary snacks and drinks such as juice or soda. Encourage family meals, and involve your child in meal planning and preparation. Reduce the amount of fast food or processed foods your family eats.
• Exercise more – Make exercise a family activity. Plan fun things that everyone can enjoy, such as hiking, biking, or playing sports together.
• Be encouraging – Positive reinforcement can motivate your child to make healthy choices. Celebrate their successes, no matter how small. Encourage them during challenging times.
• Communicate with healthcare providers – Stay in contact with your child’s healthcare team. Follow their recommendations, and keep them up to date on any changes in your child’s health.