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Feeding problems in children with cerebral palsy.
A Gangil1, A K Patwari, S Aneja
1Division of Pediatric Gastroenterology and Nutrition, Department of Pediatrics, Kalawati Saran Children s Hospital and Lady Hardinge Medical College, New Delhi 110 001, India.
Indian Pediatrics
|August 25, 2001
Summary
Children with cerebral palsy (CP) experience significant feeding problems and poor nutritional status due to oral motor dysfunction. Early nutritional intervention is crucial for improving feeding, development, and overall quality of life in these children.
Area of Science:
- Pediatric Neurology
- Developmental Pediatrics
- Clinical Nutrition
Background:
- Children with cerebral palsy (CP) often face complex feeding challenges impacting their nutritional status and development.
- Oral motor dysfunction (OMD) is a prevalent issue in CP, affecting a child's ability to eat and swallow.
- Parental perception of feeding problems and nutritional status in children with CP can be inaccurate, necessitating objective assessment.
Purpose of the Study:
- To quantify the prevalence and severity of feeding difficulties in children with CP.
- To evaluate the efficacy of nutritional interventions in addressing these feeding and nutritional issues.
- To identify factors contributing to feeding problems and poor nutritional status in this population.
Main Methods:
- A prospective hospital-based interventional study involving 100 children with CP.
- Assessment included feeding skills (Gisel and Patrick score), nutritional status (anthropometry, caloric intake), neurological type/severity, and developmental age (Gesell scale).
- Nutritional rehabilitation interventions were applied, with outcomes monitored over a 3-10 month follow-up period.
Main Results:
- All children with CP exhibited oral motor dysfunction (OMD); spastic quadriplegic CP and hypotonic types showed poorer feeding skills.
- Children with CP had significantly lower anthropometric indicators compared to controls, with OMD, spastic quadriparesis, and hypotonia negatively affecting nutritional status.
- Parental awareness of feeding problems was low, and 30% of parents were pessimistic about improvement, despite significant gains post-intervention.
Conclusions:
- Poor nutritional status in children with CP results from multiple interconnected factors, including OMD and neurological impairments.
- Comprehensive assessment of feeding problems and nutritional status is essential for initiating timely and effective nutritional rehabilitation.
- Nutritional rehabilitation significantly improves feeding abilities, nutritional status, and quality of life for children with CP.