Feeding Dysfunction Down Syndrome Abstracts

Journal of the American Dietetic Association 98 (7): 790-794 (1998 Jul)

Eating Habits of Young Children with Down Syndrome in The Netherlands: Adequate Nutrient Intakes but Delayed Introduction of Solid Food

Hopman E, Csizmadia CG, Bastiani WF, Engels QM, de Graaf EA, le Cessie S, Mearin ML
Department of Dietetics and Nutrition, Leiden University Medical Centre, The Netherlands

OBJECTIVES: To investigate nutritional status, pattern of being breast-fed, age at introduction of solid food, and adequacy of energy and nutrient intakes in children with Down syndrome in The Netherlands. DESIGN: Nutritional status was assessed by height and weight measurements. The dietary history method was used to collect information on the diet. Data obtained from children with Down syndrome were compared with data from control subjects and from the general population of Dutch children. Adequacy of energy and nutrient intakes was assessed by comparison to US recommendations. SUBJECTS: Forty-four Dutch children with Down syndrome (newborns to 4-year-olds) and 37 healthy control subjects without this syndrome. STATISTICAL ANALYSES: The prevalence of breast-feeding of children with and without Down syndrome was compared using the chi 2 test. To compare ages at which solid food was introduced, the log-rank test and Kaplan-Meier curves were used. Anthropometric data and mean dietary intake were compared between the groups using 2-way analysis of variance. Comparison to recommended levels of dietary intake was performed using 95% confidence intervals. RESULTS: Heights and weights of the children with Down syndrome were in the normal range. Down syndrome does not affect the prevalence of breast-feeding of children or the adequacy of their energy and nutrient intakes, but it does significantly delay the age at which solid food is introduced, which can be deleterious to oral-motor development. APPLICATION: If late introduction of solid food is observed in children with Down syndrome, pre-speech therapy should be considered.
Dev Med Child Neurol 38 (8): 695-703 (1996 Aug)

Swallow function in children with Down syndrome: a retrospective study

Frazier JB, Friedman B
The Children's Hospital, 1056 E. 19th Avenue, Denver, CO 80218 USA

The swallow behavior of 19 children with Down syndrome was reviewed. Findings suggest their oral phase may be impacted by oral hypersensitivity which can interfere with their acceptance of textured foods. A disordered pharyngeal phase was identified in 16 of the children, with aspiration occurring in 10 of the 19 children studied. Aspiration identified was silent for eight of these 10 children with cough data and did not correlate with the severity of their oral phase. Aspiration was, therefore, felt to warrant consideration as a factor in the respiratory illness so often seen in this population.
Dev Med Child Neurol 38 (8): 681-694 (1996 Aug)

An exploration of feeding difficulties in children with Down syndrome

Spender Q, Stein A, Dennis J, Reilly S, Percy E, Cave D

Detailed examination of several aspects of feeding was carried out on a representative sample of a defined geographical population of children with Down syndrome. The examination included standardised assessments both of oral-motor function and of parent-child interaction. The findings suggest that the development of oral-motor function in children with Down syndrome not only lags behind intellectual development, but also follows an aberrant pathway. In particular, specific aspects of tongue and jaw function were impaired together with problems initiating and maintaining a smooth sequence of feeding actions. Also, parent-child interactions, as in studies on play, tended to be more controlling. Parents of children with Down syndrome do not spontaneously report the extent of their child's feeding problems unless specific enquiry is made, preferably accompanied by observation of feeding.
American Journal of Mental Retardation 95 (2): 228-23 (1990)

Metabolitic Rate: A Factor in Developing Obesity in Children with Down Syndrome?

Chad, Karen; Jobling, Anne; Frail, Holly
University of Queensland

Resting metabolic rate and its relation with selected anthropometric measures was determined in 11 male and 7 female noninstitutionalized children with Down syndrome. Dietary analysis was performed to determine the nutritional status of the children and whether poor nutritional habits may be influencing factors in the development of obesity in this population. Resting metabolic rate for the total group was 170.4±38.65 ml.min-1 (0.17±0.04 ml.kg-1.min-1). Body weight, height, and surface area were moderately correlated with this rate, with height having the strongest relation. Daily caloric intake was 1,433.84±255.2 calories, comprising of 16.01±2.20% protein, 42.18±7.40% fat, and 40.60±8.83% carbohydrate. Calcium, potassium, and vitamin C were above and iron and thiamine below the recommended daily allowance.
American Journal of Mental Deficiency 85 (4): 410-415 (1981)

Social Development and Feeding Milestones of Young Down Syndrome Children

Cullen, SM, Cronk, CE, Pueschel, SM, Schnell, RR, Reed, RB
Child Developmental Center, 593 Eddy Street, Providence, RI 02902

During an interdisciplinary longitudinal study, the social development and mastery of feeding skills of 89 young Down syndrome children were investigated. Sex, cardiac status, and muscle tone of subjects and parental follow-through data were examined for potential influence on Vineland Social Maturity Scale scores and on a selected subset of feeding milestones. The data revealed that young Down syndrome children attained significantly higher scores on the Vineland and achieved most feeding milestones much earlier if they had no or only mild congenital heart disease, if their parents followed-through appropriately with furnished guidance, and if they had "good" muscle tone.
Journal of the American Dietetic Association 77 (5): 277-82 (1980 Sep)

Feeding Children with Down's Syndrome

Pipes, PL, Holm, VA
Child Development and Mental Retardation Center, Clinical Training Unit, University of Washington, Seattle, USA

A retrospective chart review of forty-nine children with Down's syndrome between the ages of six months and six and a half years seen before 1970 showed that 80 per cent had problems related to food or feeding. An interdisciplinary intervention program utilizing group sessions introduced in 1970 is described. In twenty-one children, most of the nutritional, behavioral, and environmental problems surrounding food previously encountered in children with Down's syndrome were successfully prevented or remedied. The incidence of obesity in Down's syndrome was reduced but not eliminated. Except for paternal susceptibility to food faddism, most professional concerns regarding food and eating were non-existent in sixteen of the children re-evaluated in a follow-up six years after the intervention program.
Journal of the American Dietetic Association 69: 152-156 (1976 Aug)

Dietary Adequacy, Feeding Practices, and Eating Behavior of Children with Down's Syndrome

Calvert, SD, Vivian, VM, Calvert, GP
Ross Laboratories, Division of Abbott Laboratories

A study was conducted to evaluate the dietary intake and identify the eating behavior, feeding practices, and growth pattern of children with Down's syndrome. Data from forty families with a Down's syndrome child one to twelve years of age were obtained by interviews with both parents. Height and weight measurements of the child were taken, and a two-day food record prepared by the mother was evaluated. Approximately half of the children ate foods providing less than the recommended allowances for food energy, calcium, iron, vitamin A, and thiamine. Three-fourths exceeded the allowances for protein and ascorbic acid. Approximately half of the children received daily vitamin-mineral preparations. Eating a limited variety of food; consuming too few fruits and vegetables; and difficulties in using eating utensils, eating foods served to the family, and chewing foods were the eating habits and problems most frequently identified by parents. Food was seldom used to reward, pacify, or discipline the child, and parents were not classified as permissive in relation to food intake of their children. Regardless of age, the children were between the 10th and 50th percentiles for height and for weight. However, weight percentile levels were appropriate for height. Dietitians should be available to counsel parents of children with Down's syndrome and to assist in providing foods of high nutritional value compatible with energy needs of such children. Suggestions of ways to introduce new foods into the diet, to incorporate foods in family meals, and information on feeding-skills training should be provided. Positive re-inforcement regarding the monitoring of the child's food intake should be given to parents. Further research identifying nutrient intake behavior of children with handicapping conditions living in the home environment needs to be conducted so as to provide better guidelines for assisting professional personnel.