Children with cerebral palsy can suffer from both nutritional problems and physical difficulties with swallowing and choking which make them worse. In extreme cases of "failure to thrive", surgery may be used to set up food delivery to the throat (tube feeding) or straight into the stomach (gastrostomy). Liquidised food, positioning techniques, long feeding sessions, and encouragement to learn to eat normally after being tube fed, are techniques that can be used at home.
Association for Rehabilitation of Communication and Oral Skills (ARCOS), tel: 0845 1228697, www.arcos.org.uk. Services include assessment and equipment loan. Information and advice to parents whose babies and children have feeding difficulties, given by speech therapists, physiotherapists and occupational therapists.
Health visitors should be able to help find and choose special feeding equipment for babies and small children who have difficulties with sucking and swallowing. The Cleft Lip and Palate Association (CLAPA) sell a range of this equipment, tel: 0207 833 4883, www.clapa.com.
Half PINNT, network of regional support groups for parents of children on tube, nasogastric feeding or intravenous feeding, PO Box 3126, Christchurch, Dorset BH23 2XS, tel: 01582 765238, www.pinnt.com/halfpinnt_main.htm.
Kapitex Healthcare Ltd. sell a range of special cups, spoons and ‘chewy tubes’, tel: 01937 580 211, www.kapitex.com.
Worster-Drought Syndrome Support Group, tel: 01473 240761, www.wdssg.org.uk. This condition is related to cerebral palsy and particularly affects movements of the mouth and throat.
Gisel EG et al. Feeding management of children with severe cerebral palsy and eating impairment: an exploratory study. Physical and Occupational Therapy in Pediatrics 2003;23(2):19-44.
Orenstein SR. Oral, pharyngeal, and oesophagal motor disorders in infants and children. GI Motility online (2006) doi:10.1038/gimo38. Published 16 May 2006. www.nature.com/gimo/contents/pt1/full/gimo38.html
See also Nutritional approaches and Speech and language therapy
