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Nutrition concerns for children with cerebral palsy fact sheet

Common nutrition concerns for children with cerebral palsy

Good nutrition is essential for children with cerebral palsy (CP) to reach their potential in growth and development. The benefits of good nutrition include:

  • Improved weight and growth
  • Improved immune function
  • Decreased irritability
  • Improved cognitive ability
  • More rapid recovery from surgery and illness
  • General improvement in well being
  • Improved circulation

Children with CP may be at risk of the following nutritional concerns:

Poor weight gain

Some children with CP have difficulty gaining weight and may be underweight for their height and age.
Poor weight gain and growth were once thought to be a usual consequence of having CP; this is no longer the case. Poor weight gain in children with CP can be due to a number of factors which may include:

  • Inadequate nutritional intake
  • Increased energy expenditure

What are the causes of inadequate nutritional intake?

  • Difficulties with eating or drinking
  • Limited variety of food or drinks
  • Taking increased time to finish meals
  • Behavioural/emotional issues affecting mealtimes
  • Poor appetite
  • Difficulty communicating hunger or thirst

What are the common causes of increased energy expenditure?

  • Increased muscle tone
  • Inefficient or involuntary movements
  • Epilepsy or seizures and other common complications such as chest or urinary infections

Swallowing or feeding difficulties

Children with CP may have difficulties eating and drinking.  Problems with muscle strength, movement, coordination or sensation may affect the muscles of the mouth, face and throat. This can cause difficulties with sucking, biting, chewing, controlling and swallowing food, fluid and saliva effectively. Also, children with CP can often take significantly longer than usual to finish their meals.

Reflux

Gastro-oesophageal reflux is seen frequently in children with CP and may contribute to inadequate nutritional intake. It may cause children pain associated with eating and drinking and contribute to refusal behaviours during mealtimes.

Constipation

Constipation is also a common complication of CP and may affect a child’s appetite, behaviour and general wellbeing. It may be a result of:

  • Immobility
  • Incorrect positioning
  • Abnormal gut motility
  • Side effects of medication
  • Insufficient fluid intake
  • Insufficient dietary fibre intake

When should I be concerned about my child’s nutrition or feeding?

If your child has any of the following signs you should seek help and advice from your child’s doctor, dietitian or speech pathologist:

  • Slow growth
  • Weight loss
  • Inadequate weight gain
  • Difficulties eating and drinking, which may include:
    • Coughing, choking or gagging while eating/drinking
    • Multiple swallows to clear food or fluid
    • Wet, gurgly breathing or wet voice both during and after mealtimes
    • Refusal to eat or drink
    • Difficulties with or refusal to eat certain food textures (eg lumpy foods, chewable foods)
    • Difficulty coping with certain foods or fluids (eg increased coughing with thin fluids)
  • Prolonged mealtimes eg longer than 30 minutes
  • Frequent illness, particularly chest infections
  • Frequent vomiting
  • Chronic constipation or diarrhoea

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

Cerebral Palsy League of Queensland (2001). “Help me Grow”. Nutrition for Children with Cerebral Palsy. A guide for parents and carers.

Shaw V, Lawson M, 2007. Clinical Paediatric Dietetics. 3rd Edition, Blackwell Sciences Ltd., London.

Stallings VA, et al. Dev Med Child Neurol, 1993; 25:125–38 | Sullivan PB. Bailliere’s Clin Gastroent, 1997;11:29–546. |   Trougton KEV, Hill AE. Dev Med Child Neurol, 2001;43:187–90 |   Von Konigsmark M. Current Therap, 2000;41:61–4 | Fung EB, et al. J Am Diet Assoc, 2002;102:361–73 | Reily S, et al. J Paeds, 1996;129:877–82 | Sullivan PB, et al. Dev Med Child Neurol, 2000;42:674–80 | Sullivan PB, et al. Dev Med Child Neurol, 2004;44 461–7 | Gisel EG, Patrick J. Lancet, 1988;331:283-6.

Resource No: FS201. Developed by the Queensland Paediatric Rehabilitation Service, Children’s Health Queensland. Updated: October 2015. 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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