Nutrition in Children with Special Needs: Autism, Down Syndrome, ADHD, Cerebral Palsy.

Raising a child with a special need comes with multiple challenges, usually almost always involving her health and well being. In such situations, medical diet management can achieve plenty in terms of positive results for both the child and her parents.

A Special Child

A child with a special need or a special child is one with a physical, mental, physiological, or developmental disorder, and owing to which has needs which are different from her or his peers.

These needs are termed special as they are essential to help the child lead a (near) normal life e.g. A child born with a dysfunctional heart may have special  medical needs through his life, which another child of the same age may not.

Similarly, a child with ADHD (attention deficit hyperactivity disorder) has a special need for a school environment which caters to his particular challenge.

Image (c) Whizz Kidz, UK

Special Needs is a vast field and includes conditions like autism, Down syndrome, Intellectual Disability (ID), epilepsy, Cerebral palsy (CP), spina bifida, deafness, visual defects, and physical impairments including paralysis.

Medical Dietary Management for Special Needs

A medical diet consulting will not help cure a special need, but will help manage the daily, and seemingly insurmountable dietary challenges which are part of raising a special child. Certain benefits a parent or caregiver can expect out of such a consult include...

• One of the biggest challenges with some special needs children  is to help them get through a meal with minimum fuss, stress (to the child), wastage, and maximum consumption e.g. children with Intellectual Disability (formerly termed mental retardation) or dysphagia (swallowing difficulty). A medical diet consult helps the caregiver tackle this obstacle with  knowledge backed meal management strategies.

• A diet and special need match, which ensures that the child's diet is 100% suitable for her special need is possible only under professional guidance e.g. infants diagnosed with the metabolic disorder phenylketonuria, need a diet which is low in the amino acid phenylalanine and have to be on such a diet for life.

•  It's vital that any child's special need does not interfere with her getting adequate nutrition e.g. children with dysphagia are unable to eat enough to meet the nutrition requirement of their age group, owing to difficulty in swallowing, and a specialized diet consult will help prevent interference of special need with the child's daily nutrition requirement.

• A tailored medical diet can help palliate symptoms of some special needs, reducing dependence on prescription drugs meant for the same e.g. ketogenic diets help manage symptoms of refractive (drug resistant) pediatric epilepsy better. In other words, symptom alleviation.

In my own practice, I've consulted parents of children with dysphagia, ADHD, Down syndrome and cerebral palsy, among others. Seeing these tiny souls feel, act, and grow better, because they are eating better, is a sublime experience.

Oh, and the little girl whose picture I've used in this post is nine year old Robyn, physically disabled owing to achondroplasia, but as sprightly as any child can get. Do read how Robyn and children like her got back their wings with the help of mobility equipment from Whizz Kidz, UK. http://www.whizz-kidz.org.uk/ 

                                                                     

                                                                  

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Raksha Changappa, BSc Honors (Clinical Dietetics), MSc (Nutrition), MBA (Marketing), is an award winning specialist dietitian & nutritionist specialising in rare and challenging disorders. A triple Gold Medalist in nutrition and recipient of prestigious awards including the Padma Bhushan Dr. MC Modi award, Raksha was featured as a Bangalore "Local Hero" by The Times of India (2008), placed #1 in the StyleCraze.com "Top 10 Nutritionists of India" list (2016), and listed as a "Personality of Karnataka State" by Karnataka.Com (2015). Pro nature-ecology-fauna-flora. Art, music, dance, and literature enthusiast. Army daughter. Knowledge seeker. She manages her decade old, Bangalore based private practice and is on board the panels of Doctor NDTV & Dr Raxa.

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Dessert made with artificial sweeteners? Not for indulging.

You know that advertisement? The one for an artificial sweetener where a dessert tries to tempt a man into eating it? As ad makers believe in using the feminine gender in every advertisement (irrespective of the gender`s significance to the product), the dessert is depicted as enticing the man using a lilting feminine voice. In the background is his watchful wife, the barrier between him and the dessert.

Its one of the many sexist ads' floating around. But lets discuss that angle someother day.

To continue... caught in the middle of the wife and the dessert, what`s the man to do? The ad tells you the- WHAT.

Enter a chef who convinces the wife to use the brand of sweetener he endorses. If she does, then her dessert starved husband neednt be dessert starved again.

Next time this commercial is on TV, change the channel. 

Why? ... Because its misleading.

One, a chef is not a dietician. Chefs are culinary experts but its a dietician who is the last word in all matters concerning nutrition and diet. Dieticians have to fulfill certain fixed academic (e.g. obtaining a Bachelor of Science degree in Nutrition and Dietetics, or Dietetics) and training requirements (e.g. predetermined hours of supervised internship in hospitals) and often have to write an exam to obtain a license or registration to practice (varies as per the country they are practicing in). Thus chefs are not in a position by virtue of this difference to speak for or against an artificial sweetener, unless its presented as a personal opinion and not an authoritative one.

Two, a dessert e.g. icecream, pastries, and other similar species, or even traditional Indian sweets made using an artificial sweetener instead of sugar are popularly called `Low Calorie' or `Sugar Free' or 'Diet' when sold commercially. And, these days we have commercials encouraging preparation and consumption of home made Indian sweets, like halwa, kheer and so on, to be made using a Y brand of artificial sweetener. `Eat away, as it has no sugar, so no calories', the advertisements' say.

If you are a diabetic or a weight watcher, who has bought the ad`s sweet lie and gleefully consumes plenty of desserts made with artificial sweeteners, rethink.

For a diabetic, absence of sugar in a sweet is not a green signal to start indulging. Ditto for a weight watcher. Here's why. And, its not the age old (and very incorrect) argument of artificial sweeteners causing cancer. For the entire deal on artificial sweeteners, read my popular article published in Asian Age and Deccan Chronicle in Jan 2010.

Diabetics are always at risk for developing cardio-vascular disorders like high blood cholesterol, so even if a sweet doesnt have sugar it will almost always have plenty of fat (ghee, butter, oil), or milk. Both are excellent sources of cholesterol. For weight watchers, just because a sweet doesnt have sugar, doesnt make it `zero calorie'. A dessert/sweet still has other calorie supplying ingredients like milk, oil/butter/ghee, dried fruits, condensed milk...you get the drift. Thus, no dessert can be a weight watchers friend. Containing sugar or not.

So, while one can always enjoy creative advertisements (I always do) do put some thought before literally buying an advertisements health claim.

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The Nutrition Omnibus and A Fistful of Nutrition © Raksha Changappa. Contents of this blog post (excluding images) are the exclusive copyright and intellectual property (IP) of Raksha Changappa. This post is solely for knowledge and information of the reader and not to be construed as medical advice. If you want to use the post contents, kindly do so by acknowledging the source, namely this blog and the author, via hyperlinks or credits. If not, no content will be copied, reproduced, republished, transmitted or distributed, in any form or means, including print and electronic media. Copyright and IP infringements will be taken seriously. For queries contact nutrewise@gmail.com

Are Fast Food Advertisements Deciding What Your Child Eats?

A television advertisement of a global fast food chain shows a little boy buying a burger for his equally little `girlfriend’. The advertisements basic aim is to show the company's fast food as so affordable, that everyone can buy it. Even kids.

I would love to diss this multinational`s marketing ploy of targeting young children, but many health bodies are already at it. Instead this post focuses on how you can help your child not get swayed by these, and similar advertisements which promote food which is not only expensive but also high in overall calories, fat and sugar and low on health.

While occasional treats are alright, whats not is not alright is if the child begins to think of fast food as-nice, exciting, hip and a mandatory item to consume.


Here is what you can do when an all powerful junk food advertisement comes on TV:

Don`t criticize the food being advertised: Avoid saying that burgers are bad and French fries are terrible. It might make your child want that food more. Instead try giving examples of what it might do to eat lots of burgers or fries.
Example: "If you want to eat a burger every week then you wont be able run very fast in that school race."

Discuss the food commercial with them: Next time a fast food commercial is on, have a fun session with your kid where you can sit and discuss what all went into making the food being advertised.

If its a burger, talk about the mayonnaise, the cutlet, the butter, the lettuce and more. Try telling her the merits and demerits of individual items, and sum up by emphasizing on how the demerits are more in number.

Kids dont get attracted by words like `good health’ so you have to use kidspeak like: "If you eat that fast food you will feel less energetic, do you want to feel tired during your play time?"

Television is not reality: Over time explain to your children that the characters (including child artistes) in a commercial are professionals called actors. And, that its not real. Explain that the aunty who features in the ad and her kiddos, dont really eat instant noodles or huge jars of ice cream daily in their real lives.

Negotiate on the fast food requests: Set a bar on the number of times your child can indulge in fast food at school or with the family. Give reasons why you are setting this bar using kidspeak as discussed above. Remember not make the bar sound as if it were a punishment.

Set a fast food budget: Works for older kids. Its simple. Allot a prefixed amount of money for their fast food expenses. The fast food is ruled out when that month's or week's `fast food money' runs out. You will have to do a little homework prior to doing this. Find out the average expense per person, during one visit to a fast food joint and allot money as per the number of visits you want to restrict your child to.

Everything written above is to be implemented very, very, gradually. Resist the temptation of implementing it in one shot. It may backfire.

Children can wear you out into giving into their demands. Children may also not be cooperative and listen to everything you say. But, what they don't know and that you will know (eventually) is that persistence in incorporating good eating habits pays.

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The Nutrition Omnibus and A Fistful of Nutrition © Raksha Changappa. Contents of this blog post (excluding images) are the exclusive copyright and intellectual property (IP) of Raksha Changappa. This post is solely for knowledge and information of the reader and not to be construed as medical advice. If you want to use the post contents, kindly do so by acknowledging the source, namely this blog and the author, via hyperlinks or credits. If not, no content will be copied, reproduced, republished, transmitted or distributed, in any form or means, including print and electronic media. Copyright and IP infringements will be taken seriously. For queries contact nutrewise@gmail.com