Approximately 20 per cent of children on the autism spectrum disorders have a higher chance of having gastrointestinal disturbances like constipation, diarrhoea, gastroesophageal reflux, heartburn, bloating.
By Dr Himani Narula
Feeding difficulties are common in children with autism spectrum disorders (ASD) and it can be very stressful for the child and the family. Helping your child overcome feeding issues can be a long, slow journey, but it is well worth earning good health for your child and better meal flexibility.
Language delays can limit a child’s ability to report pain and discomfort that might be interfering with feeding. Researchers found that 69 percent of children with ASD were unwilling to try new foods and another 46 percent had rituals surrounding their eating habits. This poor feeding can lead to malnutrition, nutritional deficiencies in children.
How to manage these feeding difficulties
Approximately 20 per cent of children on the autism spectrum disorders have a higher chance of having gastrointestinal disturbances like constipation, diarrhoea, gastroesophageal reflux, heartburn, bloating as compared to their typically developing peers. Identifying and treating medical conditions like constipation, gastrointestinal disturbances like reflux, stomach cramps causing food refusal can be helpful in improving the appetite and reducing the feeding difficulty. If a child has any intolerance or allergy to any specific food item, that must be withdrawn from the diet in consultation with the paediatrician and dietician. Tooth problems and swallowing issues must also be ruled out and managed. Hence it’s important to always screen the child for various medical causes leading to feeding difficulties and manage them appropriately with the help of a medical professional like your paediatrician, gastroenterologist, developmental paediatrician and dietician.
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In children with autism, behavioural problems, inattention, difficulty in communicating, difficulty in understanding and sensory issues can also interfere with the feeding, leading to difficulties. Here are some tips that can make feeding a little easier. Each child is different, hence families will need to be creative.
Have a feeding schedule or routine. Have your child eat at the same place and at the same time everyday. This way, they will know what will happen at mealtime.
Avoid all-day eating as snacking can reduce appetite at mealtime.
Provide a comfortable seating, making the child sit on a high-chair, or a child-size table and chair.
Limit mealtimes; it is known that even picky eaters do most of the eating in the first 30 minutes.
Minimise distractions, especially the need to avoid TV, mobile watching as it can take the focus off the meal.
Get your child involved in selection and creation of meals.
Practice pleasant and healthy eating behaviours, especially parents modelling healthy eating habits.
Reward positive behaviours by praising, blowing bubbles, or giving a smiley or a sticker; this will encourage the positive mealtime behaviour.
Ignore negative behaviour like spitting, throwing or refusing food.
Present food in fun and familiar ways to make it more likely that the child will eat it.
Caregivers must not feel discouraged if the progress is slow. Small, subtle, consistent changes are most likely to result in long-term, lasting changes in your child’s eating habits. It is very common for children to improve and then fall back into old eating habits from time to time. These ups and downs can be discouraging for parents but remember to celebrate the small successes.
(The writer is Developmental Paediatrician & Co-Founder of Continua Kids)
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