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Nutrition challenges in children with special needs

Ms.Shruti Kelkar

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We will be addressing some of the commonly prevalent nutritional concerns and discuss effective ways to ensure the nutritional well-being of children with special needs.

Some of the queries and concerns given below, have been collected and presented through parent mediated and expert facilitated suggestions.

Disclaimer: Please note that this guide is for information purposes only. Please consult a qualified health practitioner for safe management.

To understand ways to enrich food through supplement and balanced diet you may listen to this audio clip with Nutritionist Shruti Kelkar.

Some kids experience unpredictable bowel movement with undigested food particles in stool. How can we help improve their digestion through nutrition?

Undigested food particles in the stool is a sign of Irritable Bowel Syndrome (IBS) or low digestive enzymes. To improve the digestion through nutrition- -increase the fluid intake of your child (raw vegetable juice, coconut water, smoothies, soups, to name a few) -start a good strength Probiotic supplement along with fermented easy-to-digest food preparations like Idli or Dosa.

Can we consider Idly, Dosa as probiotic food?

Yes, we can. Idli and Dosa batter are a rich source of probiotics. However, the live cultures present in the batter die upon exposure to heat (cooking). BUT, cooked form of Idli and Dosa are fermented and now can be easily assimilated by the body. Hence, Idli and Dosa can be regarded as products of fermentation by the probiotics prior to cooking. These foods are predigested, thus raising the bioavailability of the nutrients present in the food. Lactic acid generated during the fermentation process increases the growth of digestion-promoting microbes in the gut. All in all, makes for a happy gut upon consumption of these fermented foods

What are the signs of yeast infection?

Some of the most common signs include – Diaper rash colic eczema stomach discomforts such as bloating and gas ear infections vaginal infections in girls recurrent headaches hyperactivity.

What are ways to eliminate a chronic yeast infection?

Treating chronic yeast infection is not easy. Unless we have a good Probiotic included in diet, medication does not always help. Curd/yoghurt/dahi is the most easily accessible Probiotic at home. When a child has a yeast infection it is very necessary to put him/her on anti-yeast medication along with an anti-yeast diet. The medication & diet is taken for couple of days till the yeast infection gets eliminated. It should not be stopped in between.

Could you also list some home remedies which can be easily done by parents themselves?

Some home remedies for yeast infection include the following – -Elimination of certain foods like sugar, fermented preparations. – Increasing the usage of garlic, onions, coconut oil in the diet.

What can children consume in the name of Probiotics when on a Gluten-free Caesin-free (GFCF) diet?

Kimchi, Saurkraut, Kefir are certainly good examples of dairy-free Probiotics, as are Miso, kanji, pickled cucumber or Kombucha to mention a few. Though, these are not easily available in the Indian market.

Should we always clinically test for nutritional deficiencies and only supplement under doctor’s supervision? Can a child be given a good multivitamin for supplementing basic nutrition without any doctor consultation?

Parents may give nutritional supplements on their own as these supplements are available over the counter. BUT, not unless they have been researched thoroughly. Please consult with your Dietitian/Nutritionist before starting any supplements, especially for children with special needs.

What are the differences between cold-pressed, filtered and refined cooking oils?

Filtration of an oil doesn’t require any form of chemical processing, thus retaining the nutritional content of the oil, ensuring removal of just the physical contaminants. Refined oils are a product of heat and chemical extraction, which often lead to the loss of nutrients in the oil. Refined oils are often also filtered as part of their processing. Cold pressed extraction prevents the loss of most of the nutrients in the oil, as it is not exposed to intense heat during the process of extraction. Cold-pressed oils being ‘untreated’ than refined oils tend to go rancid much faster, thus have the downside of a shorter shelf life.

It is very difficult to maintain a low-oxalate diet, especially among Vegans. Can you suggest some tips to reduce the Oxalate content of some food items while cooking?

Oxalate consumption can be reduced by reducing the intake of Oxalate-rich foods, increasing calcium intake or by increasing fluid intake. Boiling Oxalate rich food may lower the Oxalate content of the food, but not always.

Earthen pots are very healthy for cooking. But, it is tough to get good quality earthen utensils without any polishing/glazing, with the added disadvantage of being expensive kitchenware. Can we use good quality stainless-steel utensils instead?

High-quality earthen pots though are a bit expensive, are the best medium for cooking. Parents can start by incorporating earthenware such as glasses and water bottles instead of using the plastic equivalents. Yes, stainless steel utensils can be used. I would also recommend using iron utensils.

Can plant-based seeds be used to enrich food and boost my child’s immunity?

Seeds are good source of many nutrients but are high in oil. It becomes very important to know the ways of preserving it (should it go rancid due to improper storage), and using it so as to ensure its bio-availability.

What is the difference between terms food allergies and food intolerance?

Allergies will have an immediate reaction such as rashes, fever etc whereas food intolerance will not have any visible reactions. Intolerant foods can be tested through tests available in all good labs, or eliminate the offending food and see if your child is getting any better.

What are some of the home remedies for UTIs?

1. Restrict carbonated beverages and caffeine 2. Encourage the child/adult to drink plenty of fluids specially water 3. Restrict sugar altogether (sweetened beverages, processed food like biscuits. Pastries, chocolates) 4. Encourage the child to empty his/her bladder frequently 5. Probiotics (good bacteria): increase the intake of fermented food like curd, rice kanji, fermented vegetable, kimchi, sauerkraut, kefir drink and probiotic supplements 6. High fibre diet if the child has constipation 7. Maintain good hygiene. Avoid using perfumed soaps/bath products for the child. 8. Consume juice rich in vitamin C (Orange, cranberry) 9. Drink barley water, which will cleanse and cause frequent urination, allowing the bacteria to flush out of the bladder.

Could you recommend a few ‘single-serve’ health foods in India (e.g. A yogurt cup-like product that has all most vital nutrients) that can provide wholesome nutrition. This could benefit kids who cannot eat food due to problems associated with chewing, te

I recommend home- made healthy foods like Ragi porridge, fermented foods, vegetable soup/juice, bone broth, & preparations made of mixed pulses and lentils (flours). There is no single serve health food that has all the vital nutrients. Preparing fresh and variety at home is recommended for the child to get all the nutrients.

What are the initial symptoms that my child needs to start taking Probiotics?

Constipation, diarrhea, irregular bowl movements, skin allergy, lack of appetite (because of antibiotics), low immunity (frequent illness) are some of the few initial symptoms when Probiotics should be started for a child.

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