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Growth response to enteral feeding by children with cerebral palsy
1Department of Pediatrics, University of California, Davis Medical Center, Sacramento.
Insights
Early nutritional intervention improves growth in children with cerebral palsy. Prompt enteral tube feedings help reverse weight and length deficits, especially when started soon after central nervous system insult.
Area of Science:
- Pediatrics
- Neurology
- Nutritional Science
Background:
- Children with cerebral palsy often experience growth impairments.
- Nutritional deficits can exacerbate health issues in this population.
Purpose of the Study:
- To evaluate the impact of enteral tube feedings on growth in children with cerebral palsy.
- To determine if the timing of nutritional intervention influences growth outcomes.
Main Methods:
- Study involved 51 children with cerebral palsy, divided into three groups based on time since central nervous system (CNS) insult.
- Groups were categorized by initiation of enteral tube feedings: within 1 year, within 8 years, and more than 8 years post-CNS insult.
- Growth parameters (weight, length, weight-for-length) were monitored after initiating enteral feedings.
Main Results:
- Children fed enterally within 1 year of CNS insult showed normalized weight within 6 months.
- Children fed within 8 years showed improved weight but limited length gains.
- Children fed more than 8 years post-insult had minimal improvements in weight and no significant change in length.
Conclusions:
- Earlier initiation of adequate nutritional management leads to better reversal of nutritional deficits in children with cerebral palsy.
- Timely intervention is crucial for optimizing growth outcomes in this population.
Abstract:
This study evaluated the growth of 51 children with cerebral palsy after the initiation of enteral tube feedings. The children were divided into three groups according to how soon after their central nervous system (CNS) insult they were started on enteral feedings. Group 1 consisted of 14 children who were within a year of their CNS insult; they were underweight for age, but had normal length as well as weight for length. Within 6 months of initiating enteral tube feedings, most children in this group had normalized their weights. Group 2 consisted of 27 children who were within 8 years of their CNS insult; they were stunted and were underweight for both their age and their length. Within 6 months of initiating enteral feeds, the group increased both weight and weight for length to near normal, but their gains in length reached a plateau at 90% of ideal for age. Group 3 consisted of 10 children who were more than 8 years after their CNS insult. This group was severely malnourished but had some improvement in their weight for age and for length but, length for age showed no significant change. We conclude that the earlier adequate nutritional management of children with severe cerebral palsy is initiated, the more readily the nutritional deficits will reverse.