FOOD & DIETS FOR THE DOWN SYNDROME
Feeding the child is a challenge for the carers and American based studies suggest that eating problems are common. The most common problems are tongue trust, difficulties in chewing, poor lip seal, choking and gagging on food. The consequences of these problems result in major nutritional problems like Failure to thrive, obesity, dental care and constipation.
Failure to Thrive ( Faltering Growth )
Babies and children not putting on enough weight is a concern to many parents and professionals dietetic advice may be required. Usually there is not enough energy used by the baby or child because of various factors. It is commonly seen in the first two years and can be rectified in most cases by giving additional energy.
According to the UK experts: Weight faltering means that a baby’s weight is not proportional to his / her height and there is low weight for height, or that baby may have been born with low birth weight and is not able to increase his / her weight.
The root cause of faltering growth is attributed to inadequate calorie intake and a number of factors may be associated to this :
- Inadequate content or frequency of meals
- Interaction difficulties between parents / carers and children meal times.
- Oral-motor dysfunction like difficulty chewing or swallowing food or drinks.
- Development difficulties.
- Illness (most parents realize that when a child is ill, his/her weight often goes down).
Failure to thrive (Faltering Growth) can be easily rectified or prevented with the foundation of good nutrition set in the early years of life, especially the firsy year.
Mother’s milk is an excellent source of all nutrients essential for the health, growth and development of a baby for the first six months of life. The next step is to establish sensible eating patterns which will take time in the Down Syndrome’s child but it is encouraging to read that a survey of parents by Van Dyke and colleagues in the USA found that 60% are totally independent in feeding by early childhood. The feeding success was attributed to the regular assessments and feeding programmes.
What is Constipation?
Constipation can be described as the frequent passage of dry, hardened faeces, often accompanied by straining and pain. It is also shown that children with chronic constipation have lower energy intakes and a higher incidence of anorexia.
The first thing to clarify is whether the child is actually constipated. There is a general feeling that bowels have passed every day, which is not necessarily true. For some opening their bowels three times a week is normal where for others it may be twice a day. The important factor is as long as the child is not straining too hard when passing faeces and that no blood is passed, there should not be a problem.
Constipation does not normally occur in breast fed babies where a normal bowel movement may range from one after each feed to once every 10 days and usually soft and yellow color. Bottle fed babies tends to produce a harder and smellier stool and more prone to constipation than breast fed babies so extra fluid as water should be given to relieve the symptoms.
To avoid constipation or relieve the symptoms follow the guidelines:
- Give plenty of water or fruit juice (diluted for younger children).
- Give wholemeal bread instead of white.
- Encourage high fiber cereals.
- Give plenty of vegetables and beans.
- Encourage fresh fruit especially with the skin if edible.
The recommended intake is 20 – 30 grams per day for adults. For children age 3 and above, the formula used in US is a useful guide to adopt, which is age plus 5. For example, the recommended intake for a 4 year old would be 4 plus 5, which gives 9 g a day.
HOW TO MAKE HEALTHY EATING FUN
A good eating environment in your home, childcare centre and kindergarten will encourage positive eating habits among children and helps transmission of family and multi-cultural values. To create this phenomenon you should focus on the following :
- Provide a variety of healthy food choices.
- Staff members should sit with the children and eat the same food.
- Help children increase skills by giving them plenty of practice with child-sized eating utensils.
- Allow children to participate in preparing food.
- Children to choose how much to eat by serving themselves. It is acceptable if to leave 2 to 3 teaspoon behind on the plate if children are full.
- Serve meals in small attractive portions.
- Refer to the Ministry Of Health Food Pyramid.