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Prevalence and severity of feeding and nutritional problems in children with neurological impairment: Oxford Feeding
P B Sullivan1, B Lambert, M Rose
1University of Oxford, Department of Paediatrics, John Radcliffe Hospital, UK.
Insights
Feeding and nutritional issues are widespread and severe in children with neurological impairment. Many children require nutritional assessments and interventions to improve their care and well-being.
Area of Science:
- Pediatric Nutrition
- Neurology
- Child Health
Background:
- Neurological impairment significantly impacts a child's ability to feed and maintain adequate nutrition.
- Feeding difficulties can lead to various health complications and parental stress.
Purpose of the Study:
- To determine the prevalence and severity of feeding and nutritional problems in children with neurological impairment.
- To identify the need for nutritional assessment and management in this population.
Main Methods:
- Cross-sectional study utilizing a validated questionnaire.
- Survey distributed to parents of children (4-13 years) with oromotor dysfunction.
- Response rate of 72% from 377 participants.
Main Results:
- High prevalence of feeding difficulties (89% needing assistance, 56% choking).
- Common comorbidities include cerebral palsy (93%), mobility issues (47%), speech problems (78%), and drooling (28%).
- Significant gastrointestinal issues (59% constipation, 22% vomiting) and recurrent chest infections (31%).
- Parental stress reported, with 20% finding feeding stressful.
- Low rates of nutritional intervention (8% caloric supplements, 8% gastrostomy feeding).
- Despite concerns (38% underweight), 64% lacked formal feeding/nutrition assessment.
Conclusions:
- Feeding problems are common and severe in neurologically impaired children.
- Many children experience significant distress and health issues related to feeding.
- There is a critical need for comprehensive nutritional assessment and management.
- Integrating nutritional care into routine management can improve outcomes for these children.
Abstract:
The aim of this study was to estimate the prevalence and severity of feeding and nutritional problems in children with neurological impairment within a defined geographical area. In a cross-sectional study, a validated questionnaire was sent to 377 parents of children (aged 4 to 13 years) on the Oxford Register of Early Childhood Impairments with oromotor dysfunction. The return rate was 72%. Of these, 93% had cerebral palsy; 47% were unable to walk; 78% had speech difficulty; and 28% continuous drooling of saliva. Gastrointestinal problems were commonly encountered: 59% were constipated; 22% had significant problems with vomiting, and 31% had suffered at least one chest infection in the previous 6 months. Feeding problems were prevalent: 89% needed help with feeding and 56% choked with food; 20% of parents described feeding as stressful and unenjoyable. Prolonged feeding times (3h/day) were reported by 28%. Only 8% of participants received caloric supplements and 8% were fed via gastrostomy tube. Even though 38% of respondents considered their child to be underweight, 64% of children had never had their feeding and nutrition assessed. The results highlight that feeding problems in children with neurological impairment are common and severe, causing parental concern. Many of these children would benefit from nutritional assessment and management as part of their overall care.