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Early feeding problems in children with cerebral palsy: weight and neurodevelopmental outcomes
Sara Motion1, Kate Northstone, Alan Emond
1Unit of Paediatric and Perinatal Epidemiology, Institute of Child Health, Bristol, UK.
Insights
Feeding difficulties in infants, including weak sucking, are more common in children with cerebral palsy (CP). Early feeding issues predict later growth and developmental problems, identifying children who may need gastrostomy feeding.
Area of Science:
- Pediatrics
- Developmental Neuroscience
- Clinical Nutrition
Background:
- Feeding difficulties are common in infants and can impact growth and development.
- Cerebral palsy (CP) is a neurological disorder affecting movement and posture, often associated with feeding challenges.
- Early identification of feeding issues is crucial for timely intervention.
Purpose of the Study:
- To investigate the prevalence of feeding difficulties at 4 weeks and 6 months in children with cerebral palsy (CP).
- To assess if early feeding difficulties predict functional and growth outcomes at age 8 years in children with CP.
Main Methods:
- Utilized prospectively collected data from the Avon Longitudinal Study of Parents and Children (ALSPAC) cohort.
- Analyzed feeding data at 4 weeks and 6 months for 33 children diagnosed with CP and a control group.
- Correlated early feeding difficulties with functional impairment, growth, and developmental outcomes at age 8 years.
Main Results:
- Weak sucking at 4 weeks was significantly more prevalent in children with CP (p<0.0001).
- Significant feeding difficulties at 6 months were also more common in the CP group (p=0.017).
- Early feeding difficulties at 4 weeks predicted functional impairment, being underweight, and speech/swallowing issues at age 8.
Conclusions:
- Early, persistent, and severe feeding difficulties serve as a marker for poor growth, feeding, and developmental outcomes in children.
- These findings can help identify children with CP who would benefit from interventions like gastrostomy feeding.
Abstract:
Using prospectively collected data from 13971 births enrolled in a large population-based cohort study (Avon Longitudinal Study of Parents and Children: ALSPAC), the prevalence of feeding difficulties at 4 weeks and 6 months of age in 33 children subsequently diagnosed with cerebral palsy (CP) were investigated. It was also assessed whether early feeding difficulties could be predictive of functional and growth outcomes at age 8 years. Weak sucking at 4 weeks of age was reported in 11 of 23 children with CP and in 2206 of 12299 (18%) of the remaining population (p<0.0001), and great difficulties feeding at 6 months of age was reported in two of 21 (10%) of the group with CP and in 373 of 10941 (3.3%) of control participants (p=0.017). Feeding difficulties at 4 weeks of age were associated with the pattern of functional impairment at age 4 years (p=0.009) and at 8 years (p=0.068), being clinically underweight (p=0.01), and having speech and swallowing difficulties (p=0.005) at 8 years of age. Early, persistent, and severe feeding difficulties are a marker for subsequent poor growth, feeding, and developmental outcomes and can identify children with CP who will benefit from gastrostomy feeding.