Care & Maintenance of Cerebral Palsy: Bathing, Toilet Training, Dressing, Feeding &
Nutrition, Play, Fitness, Seizures, Sleep, Suctioning, Hearing, Vision and Teeth
Cerebral Palsy
Cerebral Palsy
Cerebral Palsy
Cerebral Palsy
Cerebral Palsy
Cerebral Palsy
Cerebral Palsy
Cerebral Palsy
Cerebral Palsy
Cerebral Palsy
Cerebral Palsy
Cerebral Palsy
Cerebral PalsyFeeding & Nutrition Cerebral Palsy Cerebral Palsy

Children with Cerebral Palsy often have difficulties with eating and therefore, with getting adequate nutrition. It can take up to 15 times longer to feed a child with Cerebral Palsy than it does a child without disabilities. Even when caregivers spend the extra time, the children still often run the risk of not getting enough food to sustain their calorie requirements. Children who have a high degree of spasticity burn a lot of calories during the day by way of their muscle contractions. Depending on the types of problems encountered and the degree of disability, different adaptations will be required.

To asses the particular problems, up to five professionals may be involved. The physiotherapist will concentrate on the best positioning of your child. The dietician can advise on the best kinds of food to give her.

Cerebral Palsy

Cerebral Palsy
The speech and language therapist can advise on the best ways to achieve a good chewing pattern and mouth closure. The occupational therapist can advise appropriate feeding equipment and seating. Ideally, all five professionals would observe the child eating in her "normal" way at the same time and be able to work together to make suggestions so that the recommendations are not conflicting in any way. Obviously, this will be difficult to accomplish because in this setting, the child is unlikely to behave in her "normal" way with this large an audience; as well as the scheduling difficulties with getting all five professionals in the same place at the same time. Ultimately, it will be the responsibility of the caregivers to synthesize the recommendations, in combination with their unique knowledge of the child to come up with a plan which will work for the child and increase the amount of food that they successfully ingest. In one study, a full 20% of children with CP were severely underweight or badly nourished due to eating and drinking problems. This represented half the children who had eating and drinking problems.


It is wise to aware of what kind of feeding problems can be encountered in children with Cerebral Palsy. While the following is certainly not an exhaustive list, it will describe some of the more common difficulties,

No matter which form of CP and related disabilities the child may have such as hearing loss, correct body position and posture will greatly increase the chances for success in feeding. Children with a spastic form of CP need to be positioned so as to minimize their spasms.

Make sure your child can see the plate, the food which is on it and the spoon bringing the food from the plate to her mouth. This is especially important for children with hearing impairment. Talk to her about the process and let her see, feel and smell the food, feel the plate and the spoon and get a sense of their proximity to each other and to her.

All children with or without disabilities go though a stage when they get very messy during feeding. There is a danger that caregivers of children who have disabilities will keep their children extra clean either because it is easier to do so because they are not attempting to feed themselves or because the caregiver feels (though they may not be aware of it) that it accentuates the ‘look’ of disability.

Self feeding should be encouraged depending on the level of impairment of the child as long as it does not adversely affect the number of calories and the nutritional content of the meal. When it is possible, it adds to the feeling of empowerment and independence of the child. If they are able to control their hand and arm well enough to get them near their mouth, assistance can be given in guiding their hand to their mouth until they are able to do it on their own.

It is important that the caregiver is aware of where the food is ending up. If food is left around a child’s mouth throughout a meal it may cause her to lose sensitivity or the ‘feel’ of where the food should be. However, there is no harm in a child with disabilities getting the same opportunity to experience food fully by getting her hands in it, for example.

It is important to ensure that the child can see the spoon coming to her mouth during feeding. There are various techniques to encourage good chewing and mouth closure which a speech and language therapist may be able to advise on. Some children with CP have difficulty keeping their mouths closed and/or have a habit of thrusting out their tongue when trying to eat. It can also take a long time to move from the mouth movements associated with sucking from the breast or bottle to the rounded chew required to break down solid food in the mouth. If the child has difficulties with this, the move from the sucking to chewing may need to be encouraged slowly and patiently by very gradually increasing the density of texture and later on the ‘lumpiness’ of the food offered. Some children with CP have difficulty with their gag reflex. This means that they find it hard to cough up bits of food that go down the wrong way. The danger of food or fluid going into the lungs is the increased risk of infections and pneumonia.

Some children with CP can have a hyper sensitivity to touch in and around the mouth area and some have very little sensitivity in that area. A child who overreacts or under-reacts to touch can improve feeding skills through a careful program of controlled oral motor input – that is, through a program that gradually desensitizes or sensitizes him to touch in and around the mouth. If the child is oversensitive to touch, it is best to begin touching him (with the caregiver's hand or a toy) outside the mouth and slowly work up to touching him inside the mouth. Remember that firm pressure is more acceptable to the child than light touch. If the child will now accept the caregiver's hand, he may want to guide the child's hand to do the stimulation. If the child is under-responsive to touch, the caregiver will want to bombard him with input from different types of touch and texture. An occupational therapist or speech-language pathologist can show the caregivers how to use different food temperatures and textures to increase the child’s awareness of what is in his mouth. Your caregiving team may also find that placing a mirror in front of the child during mealtimes helps her feeding skills.

There are ways to supplement the caloric and nutritional content of the foods being given to children and adults with CP. This can be accomplished through such things as adding powdered skim milk to regular whole milk, adding cheese to dishes, adding wheat germ in food preparation, etc.

Snacks or small meals and desserts are another good opportunity and are often of a texture well tolerated my most individuals. These might include: puddings, custards, rice pudding, thick shakes, ice cream, crackers or bread with peanut butter, raisons ( alone or added to any of the above if lumpy textures are OK and if choking is not a concern), dried apricots, or fruit straps.

Ensure, Ensure Plus, Carnation Instant Breakfast, Sustacal, and Pediasure are liquid nutritional supplements that are available in drugstores and grocery stores without prescription, It would be a good idea to consult your pediatrician or nutritional counselor for other suggestions they might have.

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Care & Maintenance of Cerebral Palsy: Bathing, Toilet Training, Dressing, Feeding &
Nutrition, Play, Fitness, Seizures, Sleep, Suctioning, Hearing, Vision and Teeth