Kids with cerebral
palsy (CP) have problems with their muscle tone, movement, and/or motor skills.
This can make mealtimes challenging.
Some kids may not have the coordination to feed themselves or chew and swallow
safely or successfully. Digestive problems like gastroesophageal
reflux and constipation
can make eating uncomfortable. So it can be hard for kids to get enough to eat, and
that can lead to poor growth and/or malnutrition.
But the right diet and feeding techniques can help many kids with CP have
a productive mealtime experience, enjoying the meal while getting the nutrients they
need to thrive.
What Nutrients Does My Child Need?
Kids with CP need good nutrition and healthy foods just like other kids do. But
sometimes, they might need more or fewer calories depending on their activity level
and muscle tone (how "tense" their muscles are at rest). For example, a child with
high muscle tone and a higher physical activity level will use more energy and need
to eat more than a child with low muscle tone and a lower activity level.
Kids who can't walk or who have trouble getting enough nutrients in their diet
due to feeding problems are more likely to have weak bones (low bone density). This
makes their bones more likely to fracture,
To help keep bones
strong, kids with CP need to get enough of these three nutrients:
a mineral that supports bone and tooth structure and function. Best sources of this
include milk, yogurt, cheese, and calcium-fortified juices.
a vitamin that helps the body absorb calcium from food and supplements. It's found
in some fish, such as salmon and tuna, fish liver oil, and fortified products like
milk, orange juice, and cereal. Our bodies also make vitamin D when skin that is not
protected by clothes or sunscreen is exposed to the sun.
Phosphorus, a mineral that plays a role in the formation of bones
and teeth. It's found in dairy products, meat, fish, eggs, poultry, nuts, seeds, and
Other important vitamins and minerals for bone health include vitamin C, vitamin
K, magnesium, copper, zinc, and manganese. These are found in beans, vegetables, and
a variety of other foods. Many kids get enough of these nutrients in their regular
Is My Child Getting Enough Nutrients?
The care team can make sure that your child gets the nutrients needed. The team
The team will ask for a detailed food record of what your child eats, including
any formulas or puréed meals. Then, they can see whether your child is getting
the right amount of calories, protein, vitamins, minerals, and fluids. This depends
on your child's age, height, weight, growth trend, and physical activity level.
They'll make a customized dietary plan from this information. The plan helps you
make sure that your child grows well and maintains a healthy weight.
Your child's growth and diet will be checked at follow-up doctors' visits. If your
child isn't keeping a healthy weight or getting the right nutrition, the feeding plan
will be modified. Kids' nutritional needs change as they get older, so it's important
to follow up with your care team regularly as your child grows.
Sometimes a child with CP can't eat enough by mouth to get all the needed nutrients.
So, doctors and dietitians might recommend a supplement. Supplements might be specific
vitamins or minerals, or calorie or protein boosters. These boosters can be store-bought
(pre-mixed in a pouch or box) or homemade. Several different formulas are available
for different dietary needs. Homemade formula recipes should be created by a dietitian
to ensure they meet nutrition goals.
Some kids might need supplements to get more of individual nutrients, such as calcium
and vitamin D, if they don't get enough from their diet or if they have a nutritional
deficiency. Vitamin and mineral supplements come in different forms, like liquid or
chewable tablets. Your child's doctor or dietitian will suggest the best form for
Children who have problems swallowing may need thickeners added to their food and
beverages to help them swallow safely. A speech-language therapist can see if your
child needs a thickener and, if so, find the right texture and consistency your child
Feeding tubes allow
food to be ingested without having to be chewed or swallowed.
Deciding on a feeding tube can be a hard decision for parents. Parents might want
their child to eat by mouth, like other kids. But it's not safe for some kids with
CP to eat by mouth. Kids who have trouble chewing or swallowing can get food in their
airways or lungs, and this can cause respiratory illness. In this situation, feedings
by mouth would not be allowed and all nutrition would be provided by tube.
Tube feeding also might be a good idea for kids who can eat safely, but can't eat
enough (even with supplements) to maintain a healthy weight. In these cases, tube
feeding might supplement a child's regular mealtime routine.
Tube feeding can make mealtimes easier and happier for kids. Mealtimes are less
tiring and stressful, and more enjoyable for kids who have trouble eating. And caregivers
know that their child is getting the nutrition needed.
A child's tube can be placed:
through the nose to reach the stomach for short-term feeding support
directly through a port on the belly and into the stomach for long-term feeding
Complete, nutritionally balanced formulas or puréed meals are fed through
the tube. These ensure that kids get enough calories and the nutrition needed to grow
and maintain a healthy weight. They also provide fluids to keep kids hydrated.