Children with cerebral palsy often have difficulties with feeding and swallowing. These can cause children to become underweight and undernourished, with consequences for growth and development1,2. A new tool can help parents screen for risk of feeding/swallowing difficulties and undernutrition quickly and easily, so they know when to seek medical help.
Cerebral palsy is a group of disorders that affects a person’s movement, posture, and balance. Cerebral palsy is one of the most common childhood disabilities, affecting 2–3 out of every 1000 babies born worldwide3.
Cerebral palsy is caused by damage to the brain before, during, or shortly after birth. The damage may occur for many different reasons – for example, an infection in either mother or baby, or complications during birth resulting in reduced blood and oxygen supply to the baby’s brain3.
Cerebral palsy is typically detected in infants aged between 12 and 24 months. Early signs may include infants being slower to learn skills such as rolling over, sitting up, standing, and walking. If symptoms are mild, cerebral palsy may not be discovered until later in childhood3.
Cerebral palsy causes lifelong problems with movement, posture, and balance. Typical symptoms of cerebral palsy include poor muscle co-ordination, exaggerated reflexes, stiffness, weakness, and difficulties when speaking, eating and swallowing3.
The severity of these symptoms varies from person to person. Some children with cerebral palsy can walk independently and manage daily activities without help; others will need a wheelchair, tube-feeding, and lifelong specialist care3.
For parents, learning that your child has been diagnosed with cerebral palsy can be daunting and hard to process. Your child may have complex medical issues that will need ongoing specialist care. You will also need to learn how to support your child at home. Ensuring that your child eats and drinks enough is a daily task for all parents – but for children with cerebral palsy, this can present multiple challenges.
Feeding and swallowing difficulties are very common in cerebral palsy4. This is because children with cerebral palsy frequently have damage to the parts of the brain that control eating and swallowing5.
Children with cerebral palsy may experience reflux, vomiting, and drooling4,5. They may also develop aspiration, whereby food or liquid enters the airways, potentially leading to lung infections4. Some children may be unable to swallow safely and require tube-feeding4.
Feeding and swallowing difficulties can make for long and stressful mealtimes4. The resulting reduction in macro- and micronutrient intake can negatively affect children’s growth and development, with consequences for long-term health4.
A child who is unable to get enough of the right nutrients (for example, some children with cerebral palsy), may become underweight and undernourished4. This can adversely affect their physical and mental development and increase their risk for other health problems, such as infections and a slower recovery following illness.
To avoid these negative consequences and help children with cerebral palsy to reach their full potential, it is important to identify feeding difficulties early. This will allow children to be evaluated by specialists and to receive support, such as medical nutrition, if needed4. However nutritional support may be overlooked. You may find that your healthcare professional is focussed on other important areas of your child’s health and so may not have the time to discuss their nutritional needs.
Growth charts are widely used to check whether a child’s height and weight are normal for their age. When completed over a period of time, weight and height charts also show whether a child’s growth is on track or whether there are signs for concern6. Growth charts are typically completed during medical checkups.
Recently, a new tool was created for parents of children and young people with cerebral palsy7. Developed by experts and tested with children with cerebral palsy, the Feeding and Nutrition Screening Tool (FNST) comprises 4 simple questions that can be answered by parents, without any specialist medical knowledge7. Based on their answers, the FNST can identify, with a high level of accuracy, children at risk of feeding/swallowing difficulties and undernutrition.
If you have concerns about your child’s feeding, nutritional intake or weight, it is important to consult your doctor. Your child may benefit from being seen by a dietician or feeding professional for a full assessment and support, including medical nutrition.
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Breastfeeding is the best form of nutrition for babies and provides many benefits to babies and mothers. The decision not to breastfeed can be difficult to reverse and the financial implications must be considered. All preparation and feeding instructions for the products must be carefully followed, because improper use or preparation could cause health risks to those who consume it. Always consult your healthcare professional for advice and make an informed decision about feeding your baby and/or child. Always use products under the recommendation and supervision of a health professional.
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