Did you know? 40% of children with Cerebral Palsy are undernourished.3
Feeding challenges are common which can impact nutritional intake and contribute to growth deficits.4-6
Cerebral Palsy and Faltering Growth
Cerebral palsy (CP) is an umbrella term for a group of disorders of movement and posture, resulting from abnormal development or non-progressive damage to the brain (the cerebrum).1
It is the most common motor-neurodisability in childhood with a prevalence of ~0.2% of the population in high income countries.2
Common feeding challenges
Oral-motor difficulties
- Difficulty chewing7
- Difficulty swallowing7
- Excess drooling7
- Aspiration risk7
Physical difficulties affecting feeding
- Difficulty using utensils7
- Reduced self-feeding ability8
- Need for caregiver assistance8
Gastrointestinal complications
- Gastro-oesophageal reflux9
- Chronic constipation10
- Vomiting, bloating, retching7
Mealtime challenges
- Prolonged mealtimes11
- Feeding fatigue7
- Stress during mealtimes11
These nutritional concerns are often a low priority or under-recognised by healthcare providers.12
Malnutrition in children with Cerebral Palsy contributes to long term health consequences.7,13-15
Long term consequences of malnutrition in CP patients | |
|---|---|
Decreased: | Increased: |
|
|
“Malnutrition should not be considered normal in any child with cerebral palsy.”17
Timely intervention and nutritional management
ESPGHAN suggests the use of 1 or more of the following red flag warning signs for the identification of undernutrition in children with Cerebral Palsy.7
Dietetic referral and timely nutrition intervention should be prioritised in these children.
When nutritional intake is insufficient and the child has safe swallow, oral intake should be optimised via food fortification, texture modification when applicable, and the prescription of oral nutrition supplements. Hydration status should also be carefully monitored in children with Cerebral Palsy.10,18
Fortini provides first-line nutritional support.7,10
With the widest range of flavours, textures and formats, Fortini supports complex feeding challenges in children with Cerebral Palsy through choice.19
Food fortification with Fortini
The Fortini range includes neutral flavours which can be added to foods and recipes to help support compliance and nutritional intake.
~3 in 4 children with CP have chronic constipation.20
Fortini is the widest range of paediatric oral nutrition supplements containing a mix of soluble and insoluble fibres, clinically proven to reduce constipation and laxative use.21-23
~3 in 4 children with CP experience reflux.9
Over 8 in 10 children with CP have swallowing difficulties.4
IMPORTANT NOTICE: The Fortini Range are Foods for Special Medical Purposes for the dietary management of disease related malnutrition and growth failure in children from one year onwards, and must be used under medical supervision. Refer to label for details.
- Upadhyay et al. Clin Exp Pharmacol Physiol. 2020.47(12):1891-1901
- McIntyre et al. Dev Med Child Neurol. 2022;64:1494–1506
- Silva et al. Public Health. 2022. 205;192e201.
- Calderone et al. Ital J Pediatr. 2025 Feb 22;51(1):57.
- National Institute for Health and Care Excellence (NICE). Cerebral palsy in under‑25s: assessment and management (NG62). London: NICE; 2017
- ESPGHAN. Common gastrointestinal problems in children with neurological impairments: evaluation, treatment and monitoring. 2019.
- Romano, et al. J Pediatr Gastroenterol Nutr. 2017;65(2):242-64.
- Fogarasi, et al. Disabil Rehabil. 2022;44(22):6668-75.
- Fernando, Goldman. Can Fam Physician. 2019;65(11):796-8.
- NICE. Cerebral palsy in under‑25s: assessment and management (NG62), 2017.
- Sullivan, et al. Dev Med Child Neurol. 2000;42(10):674-80.
- Sullivan. Eur J Clin Nutr. 2013;67(Suppl 2):3–4.
- Foster, et al. Hosp Pediatr. 2020;10(12):1087-95.
- Kuperminc et al. Eur J Clin Nutr. 2013. 67(Suppl 2);S21–S23
- Fung et al. J Am Diet Assoc. 2002. 102(3):361-73.
- Huysentruyt, et al. Clin Nutr. 2020;39(2):548-53.
- Andersen. In: Nutrition and Neurodisability. Mac Keith Press; 2020. Available from: https://explore.mackeith.co.uk/wp-content/uploads/2024/10/HB-Sullivan-Nutrition-Chapter-9.pdf. Accessed: March 2026.
- Penagini, et al. Nutrients. 2015;7(11):9400-15.
- Market comparison of formats, flavours and textures of UK and Ireland paediatric ONS. MIMS. Accessed: April 2026.
- Del Giudice, et al. Brain Dev. 1999;21:307–11. 2.
- Trier, et al. J Pediatr Gastroenterol Nutr. 1999;28:595.
- Hofman, et al. Clin Nutr. 2001;20(Suppl 3):63-4.
- Daly, et al. J Hum Nutr Diet. 2004;17(4):365-70.
- Vandenplas, et al. J Pediatr Gastroenterol Nutr. 2009;49(4):498–547.
CP: cerebral palsy; ONS: oral nutritional supplement; ESPGHAN: European Society for Paediatric Gastroenterology, Hepatology and Nutrition.
^Standard 200ml 1.5kcal/ml ONS Fortini Multi Fibre vs. Fortini Compact Multi Fibre. Datacard for Fortini Multi Fibre available at www.nutricia.co.uk/hcp/pim-products/fortini-multi-fibre.html Accessed April 2026. Datacard for Fortini Compact Multi Fibre available at www.nutricia.co.uk/hcp/pim-products/fortini-compact-multi-fibre.html Accessed April 2026.
*These are indicative values only. Fortini ONS are not IDDSI batch tested, and can vary by batch, flavour and temperature. Use of Fortini range products in patients with dysphagia is undertaken on the clinical judgement of an appropriate healthcare professional.
†International Dysphagia Diet Standardisation Initiative. www.iddsi.org. Available at: Patient Handouts - Resources – IDDSI. Accessed: April 2026.
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