|Nutrition for children with Cerebral Palsy|
The time it takes to make sure that a child with cerebral palsy has proper nutrition can be far longer than a child that does not have these difficulties. Excerpts and links below go into detail on the specific techniques available to enhance mealtime and the specific foods most appropriate for the child for whom basic nutrition is a challenge.
“Because children with cerebral palsy often have difficulty gaining weight, caregivers may need to find ways of supplementing their child’s food intake. As long as your child can tolerate them, you can add any of the following foods to your child’s diet to increase his or her intake of calories:
1. corn oil or canola oil margarine on bread, vegetables, rice, pasta, hot cereals
Ensure, Ensure Plus, Carnation Instant Breakfast, Sustacal, and Pediasure are liquid nutritional supplements that are available in drugstores and grocery stores. They are available without prescription, but we recommend that you consult your child’s pediatrician before using them. If he or she thinks that it would benefit your child, he or she may prescribe a nutritional supplement such as Jevity, Osmolite, Osmolite HN, Promote, Two Cal HN, or Vital, all of which are available only with a doctor’s prescription.” (Cerebral Palsy: A Complete Guide for Caregiving: 324)
“Many children with CP are likely to have difficulties with eating certain foods because of chewing and/or swallowing problems. If you need practical help your consultant or GP may be able to refer you to a dietician who can advise on the kind of diet your child needs and a speech and language therapist can advise on the actual method of feeding.
Try to ensure that you separate out the different tastes as your child grows. If she has problems with developing the ability to chew there are techniques you can use to help the development of chewing such as offering dried apricots or fruit straps in between meals. For children who would find these difficult you can still encourage the chewing reflex by allowing them to chew on (but not swallow) a piece of fruit securely wrapped in a piece of muslin which you can control so that they do not need to deal with the swallowing of solid food. If you are able, try to vary the texture of different foods given to your child. For example, I have found that I can give Danny a grainier texture to his meat by putting it through a coffee grinder rather than pureeing it. All attempts at varying texture will add to a child’s eating development and enjoyment of food.
Make sure that your child has a good balanced diet with proteins (found in meat, cheese or beans) carbohydrates (found in potatoes and bread), roughage (found in oats, wheatgerm and green vegetables), fats (found in butter and oil), vitamins and minerals (found in fruit and vegetables), and plenty of fluids. You should be advised by a health visitor or dietician about the amount of calories your child should received for his or his weight. If it is difficult to provide enough in the normal way you could consider adding food supplements or fortified drinks to their diets. You can also mix normal foods in a way which increase protein, carbohydrate or fat content without adding too much bulk. For example, banana, honey, cream and/or egg can be added to a simple breakfast cereal to enhance its calorie content considerably.” (The Cerebral Palsy Handbook: p. 102-103)
“Because of feeding problems, many children with cerebral palsy have problems gaining weight. In addition, children with high muscle tone burn calories at a higher rate than other do. As a result, you may need to find ways to supplement your child’s diet and improve his growth rate. If your child has low tone, he may have a tendency to gain weight more easily. If this case, you will need to carefully monitor his caloric intake.
The goal in supplementing his diets is to add calories without adding bulk (roughage) or empty calories in the diet. Supplemental calories should come from protein, fats, and unrefined carbohydrates. For example, you can add nutrients and calories to your child’s diet with sprinklings of powdered milk, ground nuts, and cheese. There are also many infant formulas designed to give a high caloric, balanced diet, as well as supplements to increase calories. In addition, underweight children with cerebral palsy sometimes benefit from more frequent mini-meals rather than the usual three meals a day. Your child’s pediatrician, speech-language pathologist, and nutritionist can advise you on these and other ways of increasing or enhancing your child’s nutition.” (Children with Cerebral Palsy: p. 130)
“Many children with eating and drinking difficulties do not receive an adequate or balance diet. It is common for children with CP to suffer from constipation, and to be both short and underweight for their age.
To some extent, poor weight gain may be minimized by providing as many calories as possible in the texture that the child can eat the most efficiently. For example, some children are able to drink thickened liquids from a cup more easily than taking solid foods in other forms. In these cases, it would be beneficial to provide as many calories in a liquid texture as possible.
Poor fluid intake often contributes to the tendency of may children with CP to be constipated. Increasing fluid intake often requires development of drinking skills as outlined earlier, and the introduction of drinking thickened liquids. It is particularly important to try to increase the amount of water intake in cases of constipation.
Looking after a child with eating and drinking difficulties may cause considerable stress and anxiety to carers. In many instances, carers spend excessive amounts of time trying to give sufficient food to the children in their care. It may often be found that after 30 – 40 minutes of eating and drinking, children become so fatigued that beyond this time negligible amounts of food are consumed. For many children, it is advisable to take a rest from the mealtime at this point, and to consider introducing an additional snack to the daily routine to provide further nutrition. In this way, an overall reduction in the amount of feeding time can be made, without reducing the quantity of food or fluid that is consumed. (Children with Cerebral Palsy: p. 180 – 181)
“If there is evidence of weight loss, then a food intake and weight diary should be kept to monitor nutritional status.”
“Maintenance and documentation by the primary care physician or dietitian of appropriate weight for height (length) ratio, per National Center for Health Statistics (NCHS) growth grids.”
“5th Annual Nutrition Conference for Children with Developmental Disabilities”
“To make swallowing easier, the caregiver may want to prepare semisolid food, such as strained vegetables and fruits. Proper position, such as sitting up while eating or drinking and extending the individual's neck away from the body to reduce the risk of choking…”
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