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Special diets for those special needs

Sarah Palin brought the condition back into the spotlight during her run for the White House when attention focused on her infant son Trig, who has Down's syndrome. About one in 600 children are born with the genetic disorder in Ireland.

Some of the issues Down's syndrome children can face include difficulties with feeding, gaining excess weight/being underweight, constipation, coeliac disease and thyroid disorders. Children with Down's syndrome also have different growth patterns to those of the general population -- their average height is shorter and their growth rate is slower from three to 36 months.

Feeding and drinking difficulties can be common in babies and children with Down's syndrome as a result of having smaller oral cavities and reduced muscle tone in the face and tongue. Smaller nasal passages can lead to them breathing through their mouths rather than their nose, which can cause difficulties coordinating sucking, swallowing and breathing during feeding.

These factors can impact on how a child develops efficient oral and feeding skills. Babies with increased oral sensitivity can have difficulty accepting new tastes and textures, however the assistance of a speech and language therapist at an early stage can help with oral, motor and feeding skills. Some babies with Dow's syndrome may need the support of a paediatric dietitian to assist with feeding difficulties, poor weight gain, oral sensitivity and to provide weaning advice.

Weaning your baby may be delayed (particularly the introduction of red meat). If this is the case then your baby should stay on baby formula. In addition, their transition to cow's milk should also be delayed until they are 18 months. Follow-on formula is recommended as its iron content is higher than standard baby formula, and this will help to reduce the risk of anaemia and low iron stores, which can be a concern for some people with Down's syndrome.

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Weight gain is a problem for many older children and adults with Down's syndrome, who tend to be shorter than their peers, and have a resting metabolic rate 10 to 15pc lower than the general population. Regular exercise combined with a healthy balanced diet, correct portion sizes and avoidance of foods high in fat and sugar will help prevent excess weight gain.

If your child is underweight then try providing them with more nutrient-rich foods. If you are weaning your baby you can add calories by using baby formula instead of water to mix dried baby food or blending homemade purees, while butter or olive oil can be added to pureed vegetables and potatoes.

Unlike adults, children need small, regular, energy-rich meals every day. You can increase their calorie intake with foods such as oil, butter, cream, grated cheese and sugar. Some children may need a paediatric nutritional supplement but your doctor or dietician will be able to advise you on this.

Children with Down's syndrome have low muscle tone, which can make them more susceptible to constipation. As they begin to walk and their stomach-muscle tone improves, constipation may ease.

It is important to include a variety of fibre-rich foods in your child's diet as well as plenty of fluids, which can help manage constipation. You can increase your child's fluid intake by including foods with a high water content such as fruit, yoghurts, smoothies, custard, jelly, ice cream and ice pops. Ensuring your child is active will also help strengthen their tummy muscles and stimulate the bowel.

Down's Syndrome issues

Here are some other common issues that children with Down’s syndrome may face, and how to address them.

THYROID DISORDERS

Hypothyroidism occurs more frequently in people with Down’s syndrome than in the general population, and this can contribute to weight gain.

Hypothyroidism can be checked with a blood test, which is usually carried out each year for the first five years of your child’s life, and every two years thereafter. If your child shows signs of rapid weight gain it is important to consult your doctor immediately.

COELIAC DISEASE

This requires dietetic guidance to help implement and manage a gluten-free diet.

DIABETES

Like coeliac disease, diabetes is more common in people with Down’s syndrome. Following a healthy and balanced diet is vital in helping to control diabetes and prevent long-term health complications.


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