Down syndrome calorie requirements of a person are set individually and depend on the degree of mental retardation and level of development. In children with mental retardation, an increase in muscle mass is observed due to physical exercise, which leads to a higher calorie consumption. In special cases, additional calories are required due to disturbances in metabolism.
Caring for a loved one with Down syndrome is challenging, like at any age. Knowing how to feed them properly in order to help them grow and remain healthy is something new parents often struggle with. Information on proper nutrition for those with Down syndrome can be difficult to find. Parents want to do their best for those they love, but all the conflicting information can sometimes make things worse.
Down Syndrome Calorie Requirements
2013 study compared calorie needs in children with Down syndrome versus their
siblings without Down Syndrome
–28 individuals with Down Syndrome vs. 35 siblings
– Ages 3 – 10
– Individuals with DS use 78 calories less per day (~5-10%)
• Probably not the main reason for higher BMIs
All ages of people with Down syndrome may have issues swallowing, eating, or drinking. Through maturity and therapy, these problems might become better or disappear. Certain problems, though, can linger for the rest of one’s life. People with Down syndrome frequently have narrow palates or small mouths at birth, which causes their tongues to appear larger. Chewing, swallowing, and speaking may become more challenging as a result. A feeding therapy team can offer advice on how to change nutrient-dense food to make it simple and secure to eat. Textures and abilities may develop gradually to a regular texture diet or they may change over the course of a lifetime.
Feeding and drinking issues can occur in infants and kids with Down syndrome. A smaller mouth cavity and low muscle tone in the face muscles can be contributing causes. A high arched palate, a smaller oral cavity, and decreased tongue muscular tone can also make the tongue appear larger. Teeth typically develop later in life. Due to their smaller nasal passages, many kids mouth breathe and may struggle to coordinate their breathing, sucking, and swallowing when eating. Each of these variables may have an effect on how successfully a toddler learns to eat and speak.
While some moms may prefer to bottle-feed their kid, mothers of newborns with Down syndrome may have no trouble breastfeeding. Some infants easily transition to solid meals and successfully complete the typical weaning process. Depending on their child’s ability to feed himself, parents may choose to prolong the weaning process.
With early intervention from a speech and language therapist, oral motor and feeding skills can be encouraged in infants who have increased oral sensitivity. Babies with enhanced oral sensitivity frequently struggle to tolerate new tastes and textures. A paediatric dietitian may be needed to assist some newborns with Down syndrome with their feeding issues, poor weight gain, weaning guidance, and oral sensitivity.
Down Syndrome and Diet-Related Issues
Heart Defects: 40-50% of babies with Down Syndrome have congenital heart defects ranging from a heart murmur to more severe conditions requiring cardiac surgery. Infants requiring cardiac surgery will benefit from the intervention of a Paediatric Dietitian to provide nutrition support prior to and post corrective cardiac surgery.
Thyroid Disorder: Thyroid disorder (usually hypothyroidism) occurs more frequently in people with Down Syndrome than in the general population. Blood testing to check thyroid function is normally carried out annually up to five years of age, and at least once every two years thereafter throughout life. Weight gain is a feature of hypothyroidism. Thyroid function should always be checked in those with rapid weight gain.
Coeliac disease: Coeliac disease is more common in people with Down Syndrome. Dietary intervention is required to manage coeliac disease with the implementation of a gluten-free diet for life. For more information on coeliac disease, see our fact sheet “Coeliac disease and a gluten-free diet.”
Diabetes: Diabetes is more common in people with Down Syndrome. A healthy balanced diet is important to help control diabetes and prevent long term complications.
Constipation: Children with Down Syndrome have generalised low muscle tone, which predisposes them to constipation. The onset of walking and improvement in abdominal muscle tone can help to alleviate difficulties with constipation. Ensuring an adequate fluid intake and eating a variety of fibre rich foods can help manage constipation. In addition laxative medication may be required.
Structural Problems of the Gut: Structural problems of the gut are more common in infants and children with Down Syndrome and generally require surgical intervention and support from a specialist dietitian.
Infection: Infants and children with Down Syndrome can be more vulnerable to infection, in particular chest, ear, nose, throat a nd eye infections. Repeated infections requiring antibiotics can impact on a child’s appetite. Inclusion of a daily probiotic yoghurt or probiotic yoghurt drink may promote the growth of healthy bacteria in the gut following antibiotics. Loss of appetite and food refusal because of illness can impact on a child’s nutritional status, growth and well-being.
Food Intolerances and Allergies:
Due to symptoms including a blocked or runny nose, wheezing, irritability, colic, and sobbing, some parents of children with Down syndrome frequently want to omit cow’s milk from their child’s diet.
Contrary to prevalent assumption, cow’s milk has not been clinically demonstrated to stimulate mucus production. Unless a child has a confirmed allergy to cow’s milk, there is no justification for removing it from their diet. Rice milk and goat milk are not suggested for kids. Goat milk protein may not be as nutrient-dense as cow milk protein. Rice milk should not be consumed by kids under the age of 4 1/2. Soya infant formula should not be given to babies younger than six months old, and it is rarely suggested for kids younger than one year old. For kids under two, soy milk substitute is not advised as a major beverage.
A child’s growth and bone health may be harmed by unsupervised food restrictions, which can result in nutritional deficiencies and failure to flourish. Before removing milk from a child’s diet, it is recommended that you consult a dietician or your general practitioner for professional guidance.
Vitamins and Minerals: There is no conclusive evidence to support the addition of vitamin and mineral supplements in the diet of an individual with Down Syndrome. Additional vitamins and minerals in the diet do not improve health status or intellectual functioning. It can be dangerous to exceed any recommended dose of vitamins or minerals.
What Can I Do?
Weaning: As for the general population solids should be introduced to a baby’s diet between 17 and 26 weeks. If weaning is delayed beyond 26 weeks, in particular the introduction of iron rich foods, there may be a risk of iron deficiency anaemia. To provide additional iron, some infants continue to drink infant formula and delay the transition to cow’s milk until eighteen months of age. Achieving the daily nutritional requirement for iron will reduce the risk of iron deficiency anaemia and low iron stores. You should consult with your Public Health Nurse, GP or Dietitian if for any reason weaning is delayed.
Underweight: For infants and children whose weight is faltering, providing more nutrient-rich food can improve their nutritional intake. For infants who are weaning, extra calories can be added to food by using breast milk or infant formula, in place of water, to blend home made pureed meals or to mix into dried baby food. Butter, full fat spread or oils such as olive oil, sunflower oil or rapeseed oil can be added to pureed vegetable and potato.
Youngsters require frequent, calorie-dense little meals. Adding calorie-dense common components to food, such as oil, butter, full-fat spreads, cream, cream cheese, shredded cheese, and sugar, will result in an increase in caloric intake. Some kids might need the assistance of a good pediatric nutritional supplement. For kids, a variety of specialized supplements are offered.
Constipation: To prevent and alleviate constipation:
- Offer regular drinks to ensure an adequate fluid in take. Some infants and younger children with Down Syndrome often have difficulty achieving their daily fluid requirement.
- If necessary, a thickening agent can be added to fluids. This changes the consistency to a semi-solid, which can be offered from a spoon to improve fluid intake.
- Aim to incorporate plenty of fluid into your child’s diet by including foods with a high water content such as fruit, yoghurt, yoghurt drinks, smoothie drinks, custard, milk pudding, jelly, ice cream and frozen ice lollies.
- Include a range of fibre-rich foods in the diet such as fruit, vegetables, pulses, wholegrain cereals and wholemeal bread.
- Encourage regular activity where possible to stimulate the bowel and strengthen the stomach muscles. Constipation often improves when younger children start walking.
- Some children with Down Syndrome may require prescribed laxative medication to alleviate their difficulties with constipation.
A healthy lifestyle will be encouraged and weight gain in childhood and later life will be prevented with a smart eating plan and regular exercise. It will be easier to maintain a healthy weight if you use the Food Pyramid as a guide when making meal selections, choose sensible serving sizes, and stay away from foods with excessive quantities of fat and sugar. For assistance with weight loss, a referral for dietary intervention may be necessary.
Healthy Eating Tips for Children with Down Syndrome
The health epidemic of childhood and adolescent obesity is getting worse. More than 15% of children in America are overweight, which puts them at risk for a variety of health issues.
Down syndrome in children is not an exception. In fact, compared to their classmates without Down syndrome, they are even more likely to be overweight. According to research, between the ages of one month and 18 years, up to 50% of children with Down syndrome are overweight. Although the precise cause is unknown, there are a number of contributing factors, such as:
- Lower basal metabolic rate. Studies have shown that people with Down syndrome burn fewer calories while resting than individuals without Down syndrome.
- Hypothyroidism. Individuals with Down syndrome have a higher likelihood of having thyroid disorders that can cause weight gain.
- Hypotonia (poor muscle tone) and heart defects. These may cause a delay in achievement of motor milestones and limited physical activity. Later there may be medically imposed limitations on sports activities or organized play, which reduces opportunities to burn calories.
- Short stature. Children with Down syndrome are shorter in stature than their peers without Down syndrome, and because of this they need less food intake. Consumption of even a small amount of excess calories can result in weight gain.
Strangely, a lot of infants with Down syndrome have trouble gaining weight. Food intake is frequently decreased by difficulties sucking and swallowing brought on by hypotonia or weakness from heart issues. Eventually, issues with tongue thrust and a delay in tooth eruption may impede the transition from milk to solid foods.
While it’s not a given that children with Down syndrome will become obese, parents who have spent months trying to help their child gain weight may find it difficult to learn the proper prevention techniques, according to Catherine Conway, MS, RD, CDN, CDE, the director of nutritional services at the YAI/National Institute for People with Disabilities in New York. The issue extends to the child, who must be cautious while making food choices. They want to eat like everyone else in the society we live in, according to Conway.
How can you ensure that your Down syndrome child stays at a healthy weight? Here are a few concepts:
When given a variety of healthful meals at each meal and snack, young children can develop appropriate eating habits. Lean meats or meat substitutes like tofu or peanut butter, colorful fruits and vegetables, whole grain breads, cereals, and pastas, as well as milk or milk products like yogurt and cheese, should all be included in your child’s diet. Like all children, children with Down syndrome will make the right meal choices throughout the day provided they are given a good selection. Most health professionals advise taking a daily multivitamin to make up for any vitamin and mineral deficiencies.
Conway suggests involving your child in the planning and preparation of meals. Children who prepare their own meals and snacks get the chance to practice fine motor skills, color recognition, and counting in addition to learning about healthful foods. Even very small children can assist with stirring the muffin batter or picking up salad toppings.
Another expert who has a private business in Oregon and is the mother of a kid with Down syndrome is Joan Medlen, RD, LD. She advises people not to undervalue the importance of a family meal. According to Medlen, “the family supper is a fantastic teaching period.” It’s an opportunity to socialize while learning about food over a thoughtfully prepared dinner.
Parents are crucial role models for healthy eating habits, therefore it’s important to consider your personal eating habits as well. Keep soda and potato chips outside the house, even if you enjoy them. Save sweets, pies, and other high-calorie, low-nutrient meals like cakes and pies to special occasions. If you want to provide dessert, choose something healthy that kids will like. Conway says, “Make lovely fruit cups.”
Children with Down syndrome can maintain a healthy weight by increasing their physical activity rather than restricting their food intake, which may result in nutritional deficiencies in kids under the age of 18, according to Medlen. This can entail making little, everyday adjustments like taking the stairs instead of the elevator or bringing your child along while you drive or drive yourself to a close destination. Make an effort to locate and schedule family activities that require mobility, such as biking, hiking, or games of tag or catch.
Older Children and Adolescents
Down syndrome youngsters who are older can set their own dietary and weight objectives. Also, they can start to understand that shorter people require less food than taller people, according to Conway.
Finding “the hook” is a helpful motivator for obtaining or maintaining a healthy weight, according to Conway. That is, decide what the healthy body size will enable, such as fitting into a favorite wardrobe or having the energy to perform a sport.
Even older kids can participate more actively in the planning and preparation of meals. Even if there are more pictures than words in the recipes, youngsters can assist with shopping and follow easy instructions. Conway utilizes digital images of foods to help with buying and cooking since “one picture is worth a thousand words,” she claims.
Medlen concurs. She advocates using color-coded measuring cups and spoons when cooking and restricting recipes to no more than five ingredients. Another suggestion is to prepare just enough food for the meal. We eat any leftovers, according to Medlen.
Exercise is still crucial for older children with Down syndrome to maintain a healthy weight. Youngsters can now participate more in team sports or sign up for a gym. Also, they can assist with physical tasks like raking leaves, working in the garden, or mowing the grass.
To ensure that your kid with Down syndrome gets the most out of each nutritious meal, it’s critical to recognize and treat feeding and swallowing problems as soon as they arise.
Due to physical, physiological, or behavioral challenges related to their condition, children with Down syndrome may have trouble eating or swallowing. Eating can be challenging for certain people due to poor muscle tone, sensory concerns, food refusal, limited endurance, or difficulty with oral motor skill development. This causes stress for both parents and children, which may ultimately hinder a child’s capacity to develop and flourish.
Paying attention to your child’s cues and fostering where he or she is developmentally is the first step to a safe and happy dinner.
BUILDING UP BABY
Both breast and bottle feeding promote a baby’s growth and oral motor skill development. It’s important to pay attention to your baby’s breathing, swallowing, degree of alertness, and developing postural control in addition to the mouth. Latching works best for babies when they are awake and alert. Talk to newborns, stroke their feet, or change their diapers to keep them awake.
The award-winning Down Syndrome WorldTM magazine ran this piece.
Join today to read all the articles and have new issues sent straight to your door!
A pediatrician may suggest working with specialists, such as those at the Feeding Clinic at the Anna and John J. Sie Center for Down Syndrome at Children’s Hospital Colorado, to develop a safe and effective feeding plan that can be adapted to babies who breast-feed, bottle-feed, or both.
A parent’s ability to observe is essential for spotting problems with swallowing and eating. Keep a watch out for symptoms of swallowing issues include red, watery eyes, coughing, choking, congestion, and a persistent respiratory or pulmonary ailment. Any of these symptoms could point to dysphagia, or trouble swallowing, which need additional medical testing.
Feeding issues can manifest throughout meals as excessive or nonexistent chewing, stuffing the mouth, and pocketing food. Food rejection, difficulty to sit at the table, reluctance to try new meals, purposeful gagging and vomiting, among other behavioral indicators of feeding problems, can occur.
Place two or three bites of food on a plate at a time if your child is filling their mouths too much, and keep giving them tiny portions. When given a full plate of food, children frequently struggle to resist the urge to stuff their mouths.
Children’s ability to sit and actively participate in feeding themselves is also impacted by poor postural stability. Eating securely is more difficult if they are unable to independently hold their heads up or have trouble sitting down. If your child is sitting in a high chair, consider holding them more upright on your lap or laying little towel rolls on either side of their trunks. This may provide sufficient support to allow the youngster to explore food and self-feed.
SETTING THE TABLE
If your child appears to have behavioral or sensory issues with food, try these tips to set him or her up for success:
- Lay the groundwork for fun and exploration before mealtime. Let children have a voice in what they want to eat and allow them to help with meal preparation — make a smoothie together, for example. Allow them to experience the sensory side of preparing food by touching, smelling, and of course, tasting the ingredients.
- Eat at their eye level. Children learn eating skills by watching you, so it’s important that you model these skills at their eye level.
- Listen — even when your child isn’t saying anything. Young children with Down syndrome may take longer to chew and swallow food than typical children. Don’t rush them. Understand that nonverbal cues, such as pushing a spoon away or turning the head to the side, are your child’s way of saying, “I’m not ready for another bite yet.” Respecting these signs builds trust, which is the foundation of a successful feeding relationship.
Finally, keep in mind that every child is unique and that treating feeding and swallowing difficulties with a one-size-fits-all strategy may not be effective. Pediatricians and specialists may be incredibly helpful in helping parents create evidence-based, tailored feeding programs that will help kids succeed at mealtime.
- What is Down syndrome? Down syndrome is a genetic condition caused by the presence of an extra copy of chromosome 21. This extra genetic material can cause developmental delays and physical characteristics associated with the condition.
- How common is Down syndrome? Down syndrome is one of the most common genetic conditions, occurring in approximately 1 in 700 births.
- What are the physical characteristics of Down syndrome? Individuals with Down syndrome may have a range of physical characteristics, including almond-shaped eyes, a small nose and mouth, short stature, and a small head.
- What are some common health concerns for individuals with Down syndrome? Individuals with Down syndrome may be at increased risk for certain health concerns, including heart defects, vision and hearing problems, and thyroid disorders.
- Can individuals with Down syndrome live independently? Many individuals with Down syndrome are capable of living independently, depending on the severity of their condition and the level of support they receive. Supportive services and accommodations, such as employment assistance, specialized education, and medical care, can help individuals with Down syndrome live fulfilling and independent lives.