Nutrition

Everyone knows that maintaining a healthy weight reduces risks of heart disease, high blood cholesterol, hypertension, and Type 2 diabetes. Tools such as the BMI (Body Mass Index) and the Canada Food Guide are available to help you watch your weight, find your healthy body weight, and discover which foods your body needs for a balanced diet. That being said, when we apply these calculations to little people, we quickly realize that they don’t apply or are inaccurate.

Many variables make it difficult for a little person to know what their healthy body weight is or how many calories they need to eat to meet their needs:

• Bone Mass : It is common knowledge that the BMI is not useful in the case of very athletic people because muscle does not weigh the same as bone or fat. We do know that little people with certain types of dwarfism, like achondroplasia, have heavier bones than normal for their height. It is therefore impossible to rely on the BMI if they want to know whether they are underweight, of healthy weight, overweight, or obese.
• Height : it is normal for a child with dwarfism to eat less than a child of regular height of the same age. There is no norm, however, indicating that a 10-year-old little person has to eat as much as a 3-year-old or a 6-year-old child of regular height.
• Physical Activity : an adult little person working in an office and doing sports from time to time needs about on 800 to 1200 calories per day. Some people think, however, that the extra effort spent trying to function normally in a world for big people (walking twice as fast, taking twice as many steps, getting on and off of benches) burns more calories.

A little person needs to learn to know their own body and recognize when they are hungry, full, or excessively tired. In this way they become familiar with how much they will need to eat in order to avoid health problems from being overweight. A healthy, balanced diet – foods low in fat and sugar, but high in fiber – is strongly recommended. When little people are watching what and how much they are eating, it is a good idea to use their own common sense instead of the generally accepted norms. A nutritionist can be helpful in finding and maintaining a healthy weight.

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Physical Activity

Sports are a great way to burn more energy. Specialists in the domain recommend that everyone commit to exercising a minimum of three times a week for thirty minutes. Little people are certainly no exception to this rule.

But sports can be stressful for little people. Having been discouraged often from doing physical activity, they sometimes feel excluded or incapable. They thus often stop doing sports and give up the accompanying physical and psychological benefits.

Sports are beneficial to and very satisfying for everyone, whether they are athletic or not. Little people should commit to regular, moderate exercise like walking, cycling, and swimming.

In the majority of cases, children with dwarfism can take physical education classes without any particular restrictions. Some precautions are necessary, however, when playing contact sports such as hockey, football, soccer, etc.

Sexuality

Since dwarfism often affects the bones, the genitals are usually untouched. Little people can therefore have a normal and satisfying sex life. Problems in this area come more from a negative attitude than from functional limitations.

Accepting and learning to love a body questioned not only by other people but also especially by themselves is no mean task for little people. They often have a poor self-image, which is sometimes compensated for by excessive sexual behavior (aggressive flirting to prove their seductive power and excessive macho behavior). Many little people withdraw into themselves, which then represses all sexual desire.

Little people need to know, however, that they have the same right to love as everyone else. Looking for a partner certainly has some difficulties, but isn’t this the case for everyone? People choose their partners according to their tastes, interests, values, and needs. Little people are free to share their preferences with another little person or a person of regular height. Couples can be very happy in either situation.

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Pregnancy

When little people start to desire children, they ask themselves 1001 questions about pregnancy and parenting. Will I have an epidural? Will I need a cesarean? Or will I be able to give birth naturally? Will I have trouble walking? Will my back hurt? Will my baby have enough space in my belly? And how do we raise a normal-sized child when at least one of us is a little person?

First of all, rest assured that a woman with dwarfism can carry her pregnancy to term, usually without any particular problems. Instead, it is surprising how well nature makes things! For example, if the mother’s pelvis is too narrow for the baby to grow sideways, the stomach will grow forwards.

That being said, certain precautions should be taken to ensure a healthy pregnancy:

• Like all women, the future mother will be monitored at the hospital. As there is no specific care for pregnant women with dwarfism, the obstetrician/ gynecologist will regularly measure the infant and the mother's pelvis to ensure a problem-free pregnancy and birth.
• Even if they are not systematically offered to mothers with dwarfism, C-sections and epidurals are possibilities, but it will up to the OB/GYN to assess the situation and decide.
• The future mother with dwarfism will need to leave work earlier, since her condition will probably make walking difficult.

There is no universal answer for all types of dwarfism. Every pregnancy is different, and with regular check-ups, the answers will come with the approaching due date.

On the other hand, future parents faced with dwarfism sometimes have a difficult choice to make. Since two little people often risk having a child with dwarfism (see the section Genetics under Dwarfism), parents can spend a long time asking themselves whether or not they want to have a child. Parents (little people or not) who already have a child with dwarfism may also hesitate before having a second child.

An exact diagnosis of the child can take up to two years, and some people find the medical steps involved with dwarfism too heavy.

Parents can have a hard time imagining themselves looking after a child with dwarfism. Here again, there is not only one answer to these questions. Sometimes we choose to have a child because we think life can be beautiful and enriching even with a physical congenital defect, and sometimes we choose not to have a child because we think life would be too painful with such functional limitations and health problems.

When a couple is confronted with these questions, it is useful to meet other people who have gone through the same process. AQPPT is here to help prospective parents and put them in touch with little people who are parents.

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