Spina bifida Feeding your child (1445)

The nutrition issues below are common in children with spina bifida. They may or may not be a concern for your child. 

Feeding Difficulties

Some infants and children with spina bifida have feeding problems. These feeding problems are often caused by Chiari II malformation. 

• It is not normal for your child to gag, choke, vomit or have a hard time swallowing.  Talk to your child’s health care provider if you see these problems.
• Helpful teaching sheets about how best to feed babies and children:
  –Feeding your baby for the first 12 months #1593
  –Feeding your toddler #1590
  –Feeding your school-aged child #1596

Weight Gain

Overweight is a common problem for people with spina bifida. People with spina bifida can be less active and have less muscle mass. This can lead to lower energy needs. There are things you can do to help your child not gain too much weight:

• Offer a variety of healthy choices from the time your child first starts eating solid food.
• Limit or avoid foods with extra fat and added sugars, like chips, sweet treats, soda and juice (even 100% fruit juice). 
• Plan to give healthy meals and snacks at set times throughout the day.
• Encourage physical activity as much as you are able.

Weaker Bones

Children with spina bifida may have weaker bones. This can lead to bone breaks. Calcium and vitamin D are important for bone strength. 

• Most children can meet their calcium and vitamin D needs with three servings of dairy per day. If your child cannot eat dairy, you can use fortified soy milk products instead.
• If your child is not getting that much, they may need a calcium and vitamin D supplement.
• Helpful teaching sheet: Calcium and Vitamin D in Your Diet #1993
• Weight-bearing activity, like walking and running, also helps to keep bones strong. Encourage physical activity as your child is able. 

Constipation

Constipation is common in children with spina bifida. Talk to your health care provider about the right plan to treat constipation for your child.  Your health care team may recommend medications for constipation. It is also important to make sure your child gets enough fiber and fluid. 

• The amount of fiber a child needs is based on their age. Your child should get their age + 5 grams of fiber per day.
  - For example: if your child is 5 years old, they need 5 + 5 = 10 grams of fiber per day
• Increase fiber slowly. Adding fiber to the diet too quickly can cause stomach pain.
• Helpful teaching sheet: 
  – High Fiber Recipes #1553
• It is important to drink more fluid when you eat more fiber. More fiber without enough fluid can make constipation worse.
• The right amount of fluid for your child will depend on his or her weight.
  – Water is the best choice
  – If your child does not like plain water, you can use sugar-free drinks like Crystal Light
  – Avoid sweetened drinks, like soda and juice

– Weight – Fluids per day 
– 10 pounds – 16 ounces (2 cups) 
– 20 pounds – 30 ounces (3-3/4 cups) 
– 30 pounds – 40 ounces (5 cups) 
– 40 pounds – 48 ounces (6 cups) 
– 50 pounds – 52 ounces (6 ½ cups) 
– 60 pounds – 55 ounces (7 cups) 
– 80 pounds – 61 ounces (7 ½ cups) 
– 100 pounds – 67 ounces (8 ¼ cups) 
– 120 pounds – 73 ounces (9 cups) 
– 140 pounds – ounces (10 cups)