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Cerebral palsy – preparing for surgery fact sheet

Preparing your child with cerebral palsy for surgery

While good nutrition is always important for your health, it is especially important before and after surgery to help the body heal and keep strong to aid recovery.

Why is good nutrition important before surgery?

Good nutrition before surgery is important to ensure that the body is best able to cope with the procedure and decrease the chance of complications. Children who are well nourished have been shown to have better outcomes following surgery.

What should my child eat leading up to surgery?

Prior to surgery ensure your child is eating a healthy diet. General healthy eating guidelines include:

  • Following a balanced diet including protein, fat, carbohydrate, fibre, vitamins and minerals
  • Eating a variety of foods
  • Maintaining a healthy weight for height

What if my child is slow to gain weight or has lost weight?

Help your child gain weight by increasing their protein and energy intake. If your child has a feeding tube (e.g. gastrostomy) please discuss any changes that may need to be made with your dietitian or doctor.

Some examples of foods high in protein and energy that can be included in everyday eating are listed below.

High-protein foods include

  • Dairy products such as milk, cheese, yoghurt, custard, ice-cream, dairy desserts
  • Meat, fish, chicken, eggs
  • Beans, legumes, nuts and seeds

To increase protein

  • Include high protein foods at each meal
  • Add grated cheese to sauces, soups, vegetables, omelettes, pasta
  • Add eggs to dishes such as macaroni and cheese, soups and desserts
  • Use high protein sandwich fillings:
    • Cheese
    • Egg with mayonnaise
    • Peanut butter
    • Baked beans
    • Salmon or tuna with salad and mayonnaise
    • Hummus
  • Choose desserts made on milk or yoghurt
  • Add milk powder to soups, cereals, desserts, scrambled eggs and mashed vegetables
  • Choose drinks made with milk, such as milk shakes, and commercial supplements (in preference to water)

High-energy foods include:

  • Margarine, butter and oils
  • Cream, coconut cream
  • Nuts, seeds and their pastes e.g. peanut butter

Popular high-energy and protein snacks:

  • Dairy desserts/yoghurt/custard
  • Cheese sticks/cheese dips
  • Hard-boiled egg
  • Cheese on toast
  • Ice-cream with topping
  • Fish fingers/chicken nuggets
  • Hot potato chips/potato gems
  • Peanut butter sandwiches
  • Sausage rolls/cheerios
  • Cold meats
  • Macaroni cheese
  • Baked beans
  • Milk shakes/smoothies
  • Dried fruit and nuts

To increase energy:

  • Add margarine, butter, oils and mayonnaise on bread and to vegetables, rice, pasta and soups
  • Use oil based dressings where possible
  • Use oil and butter in cooking where possible
  • Add cream to drinks, fruit, cakes, cereals, desserts, omelettes, soups, mashed vegetables etc
  • Add avocado to sandwiches, on toast/crackers and in salads
  • Use cream based sauces
  • Add sugar and honey to cereal and fruit

What is recommended after surgery?

After surgery, the body needs more protein and energy to recover. These nutrients are needed to:

  • Rebuild and repair damaged muscles, bones and tissues
  • Fight infections
  • Provide energy to participate in therapy
  • Prevent weight loss

Following surgery it may be difficult to meet these increased nutritional needs particularly if nausea or lack of appetite is a problem. As a result your child may have lost weight following surgery. It is important to re-gain this weight and prevent further weight loss. In these cases protein and energy dense foods as listed above can be very helpful.

What do I do if my child has a poor appetite and nausea?

Here are some ways to combat poor appetite and nausea:

  • Encourage small frequent meals over the day rather than 3 main meals
  • Encourage sips of nutritious fluids e.g. milkshakes regularly throughout the day
  • Offer drinks and foods separately so children don’t fill up too quickly
    eg drink fluids after and between meals
  • Make every mouthful count by using high energy and high protein foods for meals and snacks
  • Milk drinks can make good snacks if appetite is low

What if my child is constipated?

Children often experience constipation following surgery. A diet that is high in fibre may help relieve constipation. Foods that are high in fibre include:

  • Wholegrain and wholemeal breads
  • Wholegrain cereals (porridge, wheat biscuits, muesli)
  • Wholemeal pasta and rice
  • Fresh fruit (leave skin on), canned or dried fruit
  • Cooked or raw vegetables (leave skin on)
  • Nuts, seeds, peanut butter
  • Baked beans, lentils, dried peas

Fruit juices do not contain fibre but they can help manage constipation. Prune juice and pear juice in particular may be beneficial. It is also important to ensure your child has enough fluid to drink each day.

Important

If you are concerned about your child’s nutrition leading up to and after surgery please talk to your child’s doctor or dietitian. Remember if your child has swallowing problems and needs modified food textures or thickened fluid please ensure staff at the hospital are aware of this when you are admitted.

Tips

  • Keep lots of ready-to-eat snacks handy
  • Take advantage of times when your child feels hungry
  • To make fortified milk add 1 heaped tablespoon of full cream or skim milk powder to a cup of milk (250ml) and whisk until dissolved.

Use fortified milk in desserts, mashed potato, cereal and whenever else you would normally use milk

Contact us

Queensland Paediatric Rehabilitation Service
Queensland Children’s Hospital
Level 6, 501 Stanley Street, South Brisbane 4101
t: 07 3068 2950
t: 07 3068 1111 (general enquiries)
f: 07 3068 3909
e: qprs@health.qld.gov.au

In an emergency, always call 000.

If it’s not an emergency but you have any concerns, contact 13 Health (13 43 2584). Qualified staff will give you advice on who to talk to and how quickly you should do it. You can phone 24 hours a day, seven days a week.

References

Jevsevar DS, Karlin LI. J Bone Joint Surg Am. 1993;75:880-4
Samson-Fang LJ, Stevenson RD. Dev Med Child Neurol. 2000;42:162-8
Queensland Health (2009) Tips to Increase Protein and Energy Diet Sheet, Nutrition Education Materials Online.

Resource No: FS203. Developed by the Queensland Paediatric Rehabilitation Service, Children’s Health Queensland. Updated: February 2016. All information contained in this sheet has been supplied by qualified professionals as a guideline for care only. Seek medical advice, as appropriate, for concerns regarding your child’s health.

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