Feeding Dysfunction is Associated with Poor Growth and Health Status in Children with Cerebral Palsy
Section snippets
Methods
This study was conducted as part of the North American Growth in Cerebral Palsy Project (NAGCPP). NAGCPP is a cross-sectional, population-based study of growth and nutritional status in children with cerebral palsy residing in 6 geographic areas of the United States and Canada (4 in the United States: Charlottesville, Va; Philadelphia, Pa; Chapel Hill, NC; Rochester, NY; and 2 in Canada: Vancouver, BC and Hamilton, ON). Design of this project is described in detail elsewhere (18) and is briefly
Results
A total of 668 children were initially identified, of which 477 had moderate to severe cerebral palsy (GMFC III to V); 292 met the inclusion and exclusion criteria, and 235 subjects were enrolled and measured. Of the 235, feeding dysfunction was not assessed on 5 subjects; therefore, results from the remaining 230 subjects are presented. The mean age for this sample was 9.7±4.6 years (range=2.0 to 17.9 years), of which 59% were male, 69% white, 23% black, and 7% of other or mixed ethnicity.
Discussion
To our knowledge, this was the first large, multicenter study focused solely on children with moderate to severe cerebral palsy with the objective of assessing the relationships between feeding dysfunction, health, and nutritional status. Parent-reported feeding dysfunction was strongly associated with indicators of nutritional status and general health, as well as the severity of motor impairment. When a subsample of subjects who were orally fed (non-tube fed) was analyzed separately, a
Applications
■ Feeding dysfunction is common among children with moderate to severe cerebral palsy and is associated with poor health and nutritional status. Children with a pattern of severe feeding dysfunction were at greatest risk for poor nutritional status; even those with only mild feeding dysfunction had poor growth and inadequate fat stores.
■ A simple categorical feeding scale (mild, moderate, severe) along with a validated instrument to assess the severity of motor impairment (GMFCS) were useful in
References (41)
- et al.
Pattern of growth in children with cerebral palsy
J Am Diet Assoc.
(1996) - et al.
Life Expectancy of children with cerebral palsy
Pediatr Neurol.
(1998) - et al.
Identification of children with cerebral palsy unable to maintain a normal nutritional state
Lancet.
(1988) - et al.
Energy and nutrient intakes of disabled childrendo feeding problems make a difference?
J Am Diet Assoc.
(1991) - et al.
Energy expenditure of children and adolescents with severe disabilitiesa cerebral palsy model
Am J Clin Nutr.
(1996) - et al.
The relationship between oral motor involvement and growtha pilot study in a pediatric population with cerebral palsy
J Am Diet Assoc.
(1984) - et al.
Prevalence of feeding problems and oral motor dysfunction in children with cerebral palsya community survey
J Pediatr.
(1996) - Campbell AGM, Mclntosh N. Forfar and Arneil's Textbook of Pediatrics. 5th ed New York, NY: Churchill Livingstone;...
The frequency of other handicaps in children with cerebral palsy
Dev Med Child Neurol.
(1973)- et al.
The prevalence of cerebral visual disturbance in children with cerebral palsy
Dev Med Child Neurol.
(1992)
Nutrition and disability
Dev Med Child Neurol.
The development of eating skills in infants and young children
The causes of feeding difficulties in disabled children
Characteristics and management of feeding problems of young children with cerebral palsy
Dev Med Child Neurol.
Feeding and nutritional problems in children with cerebral palsy and myelomeningocoele
Acta Paediatr.
Feeding problems, height and weight in different groups of disabled children
Acta Paediatr Scand.
Relation between objectively measured feeding competence and nutrition in children with cerebral palsy
Dev Med Child Neurol.
Life expectancy in children with cerebral palsy
Br Med J
The health status of children with moderate to severe cerebral palsy
Dev Med Child Neurol.
Development and validation of a Gross Motor Classification System for children with cerebral palsy
Dev Med Child Neurol.
Cited by (265)
A comparative analysis of oropharyngeal functions in preterm and term children with cerebral palsy
2024, Early Human DevelopmentNutritional status and dietary intake of children and adolescents with cerebral palsy
2023, Clinical Nutrition ESPENSwallowing problems: Major components of nutritional deficits in adults with cerebral palsy
2023, Diet and Nutrition in Neurological DisordersMalnutrition and nutritional deficiencies in children with cerebral palsy: a systematic review and meta-analysis
2022, Public HealthCitation Excerpt :Studies published between 1986 and 2019 were included, but most were published between 2008 and 2019 (74.62%).2,3,5–9,14,16–18,22,24–26,35–39,41–43,45,46,48–54,57–63,65–68,72,76–80 There was a predominance of cross-sectional cohort studies (68.65%; n = 46).1,3,6–9,14–17,19,20,22–24,26,36,39–41,44–47,52–61,63,65,67–70,76–79 Regarding the methodological quality, for the studies with a cross-sectional design, it was verified that 78.26% (n = 36) of the publications1–3,6,7,9,15–17,20,22,24,26,35,36,39,40,44,46,52,54,55,58–61,63,65,67,69,74–79 clearly presented the criteria for inclusion in the sample.
Intake levels and main sources of nutrients for Japanese children with motor or intellectual disabilities
2023, Journal of Nutritional Science