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Oral-motor dysfunction and feeding problems in infants with myelodysplasia
1Department of Rehabilitation Medicine, Royal Children's Hospital, Herston, Queensland, Australia.
Insights
Infants with myelomeningocele (MMC) show significant oral motor and feeding challenges, including lower energy intake. Early intervention is crucial for managing these feeding difficulties in babies with MMC.
Area of Science:
- Pediatric Neurology
- Developmental Pediatrics
- Clinical Nutrition
Background:
- Oral motor function and feeding issues in infants with myelomeningocele (MMC) are understudied.
- Myelomeningocele can impact neurological development, potentially affecting feeding abilities.
Purpose of the Study:
- To compare oral motor skills, feeding function, and dietary intake in infants with MMC versus healthy controls.
- To identify specific feeding challenges and their potential link to neurological factors in MMC.
Main Methods:
- Objective video assessments of oral motor skills.
- Utilized Feeding Assessment Schedule (FAS), Feeding Environment Check (FEC), Tester's Ratings of Infant Behaviour (TRIB), and Infant Feeding Questionnaire (IFQ).
- Conducted 24-hour dietary analysis (DQA) for energy and nutrient intake comparison.
Main Results:
- Infants with MMC exhibited significant feeding difficulties due to sensory-motor integration issues (hypotonicity, positioning, hand function).
- Despite challenges, behavioral disruption was minimal; mothers reported no significant food aversion.
- MMC infants consumed significantly lower energy intake compared to controls, with potential nutrient imbalances.
Conclusions:
- Infants with MMC demonstrate notably altered oral motor function, possibly linked to Chiari II malformation.
- Dietary intake differences suggest altered energy requirements in infants with MMC.
- Emphasizes the need for early identification and management of feeding problems in this population.
Abstract:
Oral motor function and feeding problems have received little attention in infants with myelomeningocele (MMC). We compared objective video assessments of oral motor skills, diet and feeding function of 20 infants (aged 6 months) with MMC, with data from 20, age, gender, and socioeconomically matched healthy infants using the Feeding Assessment Schedule (FAS), Feeding Environment Check (FEC), Tester's Ratings of Infant Behaviour (TRIB), an Infant Feeding Questionnaire (IFQ), and a 24 hour dietary analysis (DQA). MMC infants had significant feeding difficulty, related to sensory motor integration problems such as hypotonicity, positioning, and hand function. Despite these problems, there was minimal behavioural disruption in infants with MMC and their mothers experienced no marked food aversion or negative feeding experiences. MMC infants consumed feedings which were significantly lower in energy than controls, with possible imbalance of other nutrients. These studies indicate that compared with healthy infants MMC infants have significantly altered oral motor function which we speculate could be early features of the Chiari II malformation. The dietary changes may reflect altered energy requirement. Early identification and management of feeding problems associated with this condition is emphasized.