Growth rates and nutritional needs in people with cerebral palsy will vary according to the individual. Some individuals with CP may grow more slowly than their peers. This may relate to the need for additional nutritional support or or they may catch up later with their peers. Determining the source of growth variations can ensure the child or adolescent receives the support they need. When it comes to general nutrition and CP, these needs will vary across the lifespan, but people with CP generally benefit from nutritional support that promotes healthy bone density and prevents constipation.
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Cerebral Palsy Growth & Development
When there are concerns about growth in children with cerebral palsy there may also be difficulties with feeding or severe motor impairment, or both. Children who have difficulty with eating may get less nutrition than their body needs.
Children who have severe motor impairments move much less and have less opportunities for play and exercise that support muscle and bone growth. Growth problems in children who have cerebral palsy may also be due to genetic differences or prenatal factors.
For children with cerebral palsy, especially as they get older, getting correct measurements of height and weight can be hard to get. If they are not standing by the age of 2 or 3, they will be too big the use the standard scales used for younger children, and need specialized equipment to weigh and measure them.
Cerebral Palsy and Feeding
Feeding, eating, drinking and swallowing are complicated. Every swallowed bite of food or drink goes over the airway. Eating and swallowing must be coordinated so that pieces of food or drink are not taken into the lungs when taking in air. Children with cerebral palsy may have many challenges that alter with this process.
Some of the challenges are decreased coordination of the mouth, tongue and throat (oral motor dysfunction or “dysphagia”) to manage different foods and liquids, not being able to hold their head up, difficulty lining up the head with the neck and trunk to sit up, and trouble reaching for food or drink with their hands.
Some children with CP have other medical diagnoses that complicate learning how to eat. These could be chronic lung disease, congenital heart disease, short gut, gastroesophageal reflux, and constipation.
If your child has feeding problems, feeding specialists can help you evaluate them. Parents are usually the first to see feeding problems. The most common signs in children who have difficulty feeding are longer feeding times, eating small amounts, and slow weight gain.
- Pediatricians: A doctor for infants through to adult age.
- Speech pathologists: A specialist to help with speech and swallowing challenges.
- Occupational therapists: Can help find adaptive equipment to help support the child, or adult, with cerebral palsy to meet independent needs, or safe feeding practices with a caregiver.
- Nurses: In-home health nurses, clinic practitioners or other nurse providers can help with diet recommendations, feeding assistance, referrals and screening for those with cerebral palsy.
- Dieticians: Dieticians may help with nutrition support suggestions, dietary recommendations, referrals and screening to ensure all nutritional needs are being met.
- Gastroenterologists: A specialist that may help with intestinal challenges, like constipation, or recommend surgical options to help the person with cerebral palsy get their nutritional needs met.
- Ear/Nose/Throat doctors: A specialist who can help with hearing, breathing and swallowing challenges that the child or adult with cerebral palsy may have.
- Others: Referrals may be recommended to other specialists to assist the child with cerebral palsy or adult with cerebral palsy.
Management of Cerebral Palsy Growth, Nutrition & Feeding Challenges
Most management skills for problems with feeding, growth and nutrition are non-invasive and practical. Management is based on an assessment of the child’s growth and nutritional status. Then deciding whether feeding is efficient and safe.
Depending on age and feeding abilities the following strategies may be used:
- Mashing, pureeing, thinning or thickening of foods
- Pacing of feeding
- Calorie boosts to foods
- Supplements (e.g. Pediasure, Ensure)
- Eating aides
- Special chairs
Even with these management options, some children are not able to safely take in the needed calories for health and growth. When this happens your medical team will discuss a gastrostomy (also known as a feeding tube or a g-tube).
A gastrostomy is a tool to allow children and families to manage safe feeding and ensure the right nutrition. Most children with a gastrostomy are able to keep eating a little bit by mouth (e.g. their favorite treats). For some children the gastrostomy can be used just for liquids (which are often hard to manage safely), medications, and to serve as “back up” for when children are ill.
The information from this page appears in our free and downloadable cerebral palsy tool kit.