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Identification of children with cerebral palsy unable to maintain a normal nutritional state
1School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada.
Insights
Children with cerebral palsy (CP) have significantly impaired eating efficiency, taking much longer to chew and swallow food. This feeding difficulty necessitates early identification for potential nutritional support interventions.
Area of Science:
- Pediatric Gastroenterology
- Neurology
- Developmental Pediatrics
Background:
- Severe cerebral palsy (CP) often presents with significant growth failure.
- Feeding difficulties are a common challenge in children with CP, impacting nutritional intake and growth.
- Understanding eating efficiency is crucial for managing nutritional status in these children.
Purpose of the Study:
- To compare the eating efficiency of children with severe cerebral palsy and growth failure against healthy children of similar weight.
- To quantify the time taken for chewing and swallowing different food consistencies in children with CP.
- To establish objective measures for identifying children with CP who may require supplemental nutrition.
Main Methods:
- A comparative study involving 7 children (aged 2-16) with severe cerebral palsy and growth failure.
- Comparison group consisted of children of the same weight without CP.
- Assessment of time taken to chew and swallow standard amounts of pureed and solid food.
- Evaluation of feeding behavior using a standardized scoring system.
Main Results:
- Children with CP took 2-12 times longer to chew and swallow pureed food.
- For solid food, children with CP took 1-15 times longer than weight-matched controls.
- A higher feeding behavior score was observed in children with CP, indicating greater feeding impairment.
- Extended meal times did not fully compensate for the severe feeding inefficiencies.
Conclusions:
- Children with severe cerebral palsy exhibit markedly reduced eating efficiency compared to their healthy peers.
- Objective measurements of feeding efficiency can aid in the early identification of nutritional risks.
- Timely intervention, including consideration of ancillary feeding methods like nasogastric tubes or enterostomy, is vital for children with severe feeding impairments due to CP.
Abstract:
7 children aged 2-16 with severe cerebral palsy and growth failure were compared with children of the same weight in respect of their eating efficiency. Children with cerebral palsy took 2-12 times longer to chew and swallow a standard amount of puréed food and 1-15 times longer for solid food than did their weight-controls. A behaviour score of feeding characteristics was higher in children with cerebral palsy than in controls. Even long meal times do not compensate for the severity of these childrens' feeding impairment. The measurements of feeding efficiency provides the basis for early identification of children who cannot be adequately nourished without ancillary feeding by nasogastric tube or by enterostomy.