Factors contributing to poor nutrition for a child with cerebral palsy:
(1) poor suck
(2) hypotonia
(3) problems with tongue movements (persistent tongue thrust, limited lateralization, etc)
(4) poor lip closure
(5) problems chewing and swallowing
(6) tonic bite
(7) hyperactive gag reflex
(8) severe regurgitation (vomiting, gastroesophageal reflux, etc)
(9) poor appetite
(10) difficulty in communicating needs and wants (thirst, hunger, food preferences, fullness, etc)
(11) adverse effects of medications affecting appetite or the gastrointestinal tract
(12) inadequate trunk support
(13) problems with sitting
(14) need for assistance to eat and drink
(15) suboptimal care by caregivers (associated with frustration, depression, exhaustion, etc)
Evaluation of a child with cerebral palsy should include subjective questions about food intake and objective measures of growth and development.
Identifying the contributory causes for poor nutrition can help to guide interventions to improve the child's nutritional status.
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