Experts say that the first 5 to 7 years in the life of a child is the “golden age or critical period”. It is a time of growth and the most rapid development in the human brain. It is a very sensitive period with the brain being bombarded with various inputs from the surrounding environment. The brain is at its plastic best and is open to accepting various kinds of learning and enrichment, both positive and negative. Malnutrition and lack of stimulation can undermine this growth phase.
Yatish was getting to be 7 years and while he had progressed rapidly in terms of his cognition, his physical growth was a big worry. He was scrawny, his eyes were drawn in and he was painfully underweight. I was worried, worried that we were in a catch 22 scenario. If he did not get enough nutrition he would not be in a situation to do the physical exercises, which was so vital for his development. But giving him the right nutrition was a bigger challenge. He was a small eater and his reflux was still a worry. He had a great limitation in the choice of foods and the texture of foods. He could not eat hard foods, as his chewing function was under developed and he could not take in liquids as he would aspirate and choke. He hated pureed foods. Every mealtime was a battle. It tested my patience and skill levels and I dreaded it.
Dysphagia or difficulty in swallowing is a common problem in children with cerebral palsy due to oral motor dysfunction. Poor lip closure, poor jaw control or tongue thrust can affect the child's ability to chew, drink, and swallow. Drooling is also a symptom of poor oral motor skills. Poor posture and weak head and neck control pose great problems in feeding. As also children who have a high degree of spasticity burn a lot of calories during the day by way of their muscle contractions. It was absolutely a no win situation.
http://www.cerebralpalsysource.com/About_CP/malnutrition_cp/index.html
I had to get this right. He had undergone two surgeries in a matter of one year and he was spending at least 3-4 hours in some kind of therapy, apart from school. The key words were consistency, ease of feeding and nutrition. Every weekend was an opportunity to try new foods and arrive at a menu which worked for us and also tweaking recipes to suit his requirement. It was also one way of taking away the monotony of eating the same food everyday.
I am totally against force feeding children. It takes away the joy of eating. Hunger is a basic instinct and every child will eat if he or she is hungry, which I found to be true even in Yatish’s case. When he was really hungry, the incidents of choking, throwing up were much lesser. An important learning is that, every child responds well to a routine in feeding. If the meal times were fixed, you would have less fussy children; this is especially true of a special child.
As we also did a lot of travelling around with Yatish, it meant I had to develop a travelling menu. What foods worked in a moving car, what worked in a flight, what is the best position to feed without causing much agony and spillage? What foods were a safe bet, when you went to somebody else’s house, what food could you give him in a restaurant? Which seat was the best when you travelled in a train?
It is amazing how in country which is not disabled friendly, you have to think laterally and come out with solutions. All this cannot be figured out at one go as it takes a lot of effort, trials and errors to arrive at the winning formula. You have to slow down, look at the problem objectively and arrive at a solution, use your intuition to guide you.
To bring up a child in the way he should go, travel that way yourself once in a while. ~Josh Billings
