Researchers studied over 2,200 children with cerebral palsy to understand how eating and drinking difficulties affect their growth and nutrition. They found that about one in three children had safety concerns while eating, and one in five weren’t getting enough nutrition. The study shows a clear link between how much help kids need with eating and their overall growth. This research helps doctors identify which children might need extra support with feeding and nutrition to stay healthy and grow properly.

The Quick Take

  • What they studied: How many children with cerebral palsy have trouble eating and drinking, and whether these difficulties affect their growth and nutrition
  • Who participated: 2,280 children with cerebral palsy in Sweden, ranging from newborns to 19 years old (average age about 10 years), including both boys and girls
  • Key finding: About 30% of children with cerebral palsy have safety concerns while eating, and about 20% don’t get enough nutrition. Children who need more help eating tend to be shorter and have more nutrition problems
  • What it means for you: If your child has cerebral palsy and struggles with eating, it’s important to talk with doctors about nutrition support. Early help with feeding may prevent growth problems. This doesn’t mean your child will definitely have problems, but it’s worth monitoring and getting professional guidance

The Research Details

Scientists looked at information from a Swedish program that tracks children with cerebral palsy. They collected data about how well each child could eat and drink, then compared this to measurements of the children’s height and weight. They used a special classification system called EDACS (Eating and Drinking Ability Classification System) that rates eating abilities on a scale from Level I, where kids eat and drink normally, to Level V, where kids can’t eat or drink by mouth at all.

The researchers measured each child’s height and weight and compared these measurements to what’s normal for their age. They also looked at how the child’s overall movement abilities (gross motor function) and the type of cerebral palsy they had might affect their growth. This helped them understand whether eating difficulties alone caused growth problems, or if other factors played a role.

Understanding the connection between eating difficulties and growth is important because it helps doctors know which children need extra help with nutrition. If doctors can spot these problems early, they can provide support before children become seriously malnourished or stop growing properly. This study looked at a large, real-world group of children rather than just a small sample, which makes the findings more reliable and useful for doctors and families

This study is reliable because it included a large number of children (over 2,200) from an entire country’s tracking program, not just one hospital. The researchers used standard, well-established ways to measure eating abilities and nutrition status. However, because this was a snapshot in time rather than following children over years, we can’t say for certain that eating difficulties cause growth problems—only that they’re connected. The study didn’t include information about what families were doing to help with nutrition, which might have affected the results

What the Results Show

The study found that eating and drinking abilities vary widely among children with cerebral palsy. More than half (57.5%) of the children could eat and drink completely on their own without help. About one-fifth (20.2%) needed some assistance from a caregiver during meals. Another fifth (22.4%) were completely dependent on others for eating and drinking.

When looking at safety during meals, the researchers found that about 30% of children had concerns about choking or other safety issues while eating. These children were classified in the higher difficulty levels (III through V) on the eating ability scale.

The nutrition findings were significant: about one in five children (19.9%) were undernourished, meaning they weren’t getting enough calories and nutrients for healthy growth. There was a clear pattern: children who needed more help with eating were more likely to be undernourished. The connection between eating difficulty level and nutrition problems was very strong and unlikely to be due to chance (p < 0.001).

When the researchers looked at height specifically, they found that children started showing growth problems even at the lower difficulty levels. Children at Level II (who have some eating difficulties but can usually manage) were already shorter than expected for their age. This pattern got worse at higher difficulty levels. Even when the researchers accounted for other factors like overall movement ability and the type of cerebral palsy, the eating difficulty level still predicted height problems

The study showed that the type of cerebral palsy and overall movement ability also affected growth, but eating and drinking ability remained an important independent factor. This means that even children with good movement abilities could have growth problems if they struggled with eating. The findings suggest that nutrition support needs to be tailored to each child’s specific eating abilities rather than assuming all children with cerebral palsy have the same needs

Previous research has suggested that children with cerebral palsy often have nutrition problems, but this study provides clearer evidence about how eating difficulties specifically relate to growth. The finding that growth problems start at lower difficulty levels (Level II) is important because it suggests doctors should monitor nutrition earlier than they might have previously thought. This study confirms and expands on earlier smaller studies that showed connections between swallowing difficulties and nutrition

This study took a snapshot of children at one point in time, so we can’t say for certain that eating difficulties cause growth problems—only that they’re connected. The study didn’t include detailed information about what nutrition support or therapy each child was receiving, which could affect the results. The researchers also didn’t have information about family income, food access, or other social factors that might influence nutrition. Because the study was done in Sweden, the results might be slightly different in other countries with different healthcare systems or populations

The Bottom Line

If your child has cerebral palsy, especially if they show any signs of eating or drinking difficulties, talk with your doctor about nutrition screening. Early identification of eating problems may help prevent serious nutrition and growth issues. Consider working with a speech-language pathologist or feeding specialist who understands cerebral palsy. Regular monitoring of your child’s growth (height and weight) is important. Confidence level: Strong evidence supports monitoring and early intervention for eating difficulties in children with cerebral palsy

Parents and caregivers of children with cerebral palsy should pay attention to these findings, especially if their child has any difficulty eating or drinking. Healthcare providers caring for children with cerebral palsy should use this information to identify which children need nutrition support. Teachers and school staff who work with children with cerebral palsy may also benefit from understanding these connections. This research is less directly relevant to children without cerebral palsy, though some principles about monitoring eating and growth apply broadly

Nutrition and growth problems develop gradually, so changes won’t happen overnight. If your child receives nutrition support or feeding therapy, you might see small improvements in eating ability within weeks to months. Growth improvements typically take longer—usually several months to a year—to become noticeable. Regular check-ups every 3-6 months help track progress and adjust support as needed

Want to Apply This Research?

  • Track your child’s eating independence level weekly (can they eat independently, need help, or need full assistance) and note any choking or safety concerns. Also record height and weight measurements at doctor visits to monitor growth trends over time
  • Work with your child’s healthcare team to identify specific eating goals. For example, if your child is at EDACS Level II or III, focus on one small improvement in eating safety or independence each month. Use the app to celebrate small wins and track which strategies work best for your child
  • Set up monthly reminders to review your child’s eating progress and growth measurements. Create a simple chart in the app showing height and weight over time to share with doctors. Flag any concerning changes (like sudden loss of eating ability or weight loss) to discuss with your healthcare provider immediately

This research provides important information about eating difficulties and growth in children with cerebral palsy, but it should not replace professional medical advice. Every child with cerebral palsy is different, and eating and nutrition needs vary widely. Always consult with your child’s doctor, pediatrician, or feeding specialist before making changes to your child’s diet or feeding approach. If you’re concerned about your child’s eating, growth, or nutrition, seek professional evaluation promptly. This study shows associations between eating difficulties and growth problems, but doesn’t prove that one directly causes the other in every child.