The Down syndrome nutrition handbook.

This manual was written to guide parents, grandparents, brothers and sisters of a child, adolescent or adult with Down syndrome as well as health professionals, teachers and anyone else who knows someone with Down syndrome and wants to know more about nutrition and a healthy lifestyle. It is a very useful resource for parents, teachers and dietitians who work with people with Down syndrome. The manual has a multitude of information, suggestions and activities to help parents teach their child to ultimately make healthy food (and lifestyle) choices.

The author, Joan Guthrie Medlen, is a registered dietitian who not only has dietetic experience but is also the parent of an adolescent child with Down syndrome. She wrote this manual in response to not finding suitable, easily-accessible nutrition information for parents of children with Down syndrome when her son was born. This manual certainly fills this gap and also provides a valuable resource for dietitians and other health professionals working with people with Down syndrome.

The manual is particularly impressive as the author relates not only to the specific feeding difficulties that children with Down syndrome may encounter such as delayed oro-motor development, seating difficulties, extra time needed for feeding but she also relates to normal feeding issues such as bottle versus breast feeding, the importance of the feeding relationship, teaching children to make food choices, trusting a child's choices.

It has four sections: 'Building healthy attitudes' includes chapters on Successful eating, Breast or bottle feeding and the Feeding relationship; 'Nutrition-related concerns for people with Down syndrome' covers Nutrition, Physiology, Coeliac disease, Diabetes and Alternative therapies; and 'Teaching healthy choices to encourage healthy lifestyles' includes Teaching your child to make choices, Nutrition education, Food and school, Weight management, Fitness and activity, Cooking corner and Menu planning. The last section, 'Learning Activities', has 13 chapters with activities to teach children with Down syndrome, as well as other family members, about such topics as balanced meals and snacks, appropriate serving sizes, setting goals, learning to group foods.

There are also ten appendices covering information such as food safety, growth charts, activity ideas for children with Down syndrome, diabetes care plan. Each chapter includes highlighted anecdotes from parents as well as photos of children with Down syndrome in different eating situations. There is a section with a comprehensive list of references and suggested reading for each chapter as well as a list of resources which are less useful as they are USA-based. However the author includes the 'Nursing Mothers of Australia' (now Australian Breastfeeding Association) as a useful resource!

This manual is very comprehensive, maybe a bit too comprehensive for the average parent but definitely essential for parents wanting more detailed information and ideas, dietitians and other health professionals working with children and adults with Down syndrome.

Eve Reed

Consultant Paediatric Dietitian 

Willoughby, NSW 

Guthrie Medlen, JE, Woodbine House, Bethesda Ma, 2002, 430 pages, $39.00, ISBN 1-890627-23-2