Nutritional management
- Thinking ahead to maintain good nutritional status to prevent both under nutrition and overweight is essential from diagnosis throughout life. It is important that weight for age or body mass index for age is kept between the 10th and 85th percentile on national percentile charts (see resources section). Provide a wellbalanced diet with a full range of food types. Information for the whole family on eating a well-balanced diet can be found from most national sources.
- Boys should be monitored regularly for their weight and height (which can be calculated from arm measurement in non-ambulatory boys). The triggers for referral to an expert dietician/nutritionist are if a boy is overweight or underweight, if he is experiencing unintentional weight loss or gain, or poor weight gain, if major surgery is planned, if he has chronic constipation and/or if he has difficulty swallowing (dysphagia). Referral will also be made at diagnosis and when starting steroids. The diet should also be assessed for calories, protein, fluid, calcium, vitamin D, and other nutrients.
- It is recommended that people with DMD take a daily multivitamin with vitamin D and minerals.
- If there is weight loss, it is important to look for problems with swallowing. However it is important to note that complications in other systems, such as cardiac or respiratory systems, may contribute to weight loss. If there is unexpected weight loss, it may be important to check out other areas as well.
Important facts to remember
- Your son’s height and weight should be checked at every visit to the doctor.
- It is important for your son to have a wellbalanced diet, especially one that includes the right amount of calcium and vitamin D.
- Nutritionists and dieticians are important members of your son’s healthcare team, who can check your son’s diet and help him eat better.
- Your son should be evaluated if he has signs of swallowing problems.
- Getting a gastrostomy tube is another option after trying other ways to maintain your son’s weight.