Feeding Difficulties in Children with Cerebral Palsy: Prevalence and Risk Factor

Abstract

Cerebral palsy (CP) is a motor and postural disorder due to an injury on the developing brain. Children with severe motor impairment are likely to have more difficulties in feeding. This results in inadequate calorie intake which finally leads to malnutrition. A cross-sectional study was done between January-September 2015 in a pediatric neurology outpatient-clinic, at a tertiary hospital in Surakarta, Indonesia. Children with CP underwent the Gross Motor Function Classification System (GMFCS) scale, nutritional and feeding difficulties assessment. The GMFCS was evaluated by Gross Motor Function Measure-88. Nutritional status was determined and classified based on Waterlow. Spastic quadriplegic patients were also compared to Krick’s CP growth curve. Calorie intake was evaluated by dietary analysis and defined as adequate if it reached 13,9 kcal/cm body height (BH)±10%. Most of the CP patients were the spastic type (77/80,96%), dominated by quadriplegic and diplegic types. Malnutrition was found in 78% of subjects. Feeding difficulties were found in 78% of subjects, about a third of them was categorized as having high GMFCS scale. The prevalence of undernourished and severe malnutrition in children with CP is 68% and 10%, respectively. The higher GMFCS scale and CP with spastic type are risk factors of feeding difficulties in children with CP.

References
[1] Morris C 2007 Dev Med Child Neurol. 49 3-7


[2] Bax MC, Flodmark O, and Tydeman C 2007 Dev Med Child Neurol. 49 39-41


[3] Swaiman KF and Wu Y 2012 Cerebral palsy Pediatric neurology principles & practice vol 5, ed Swaiman KF, Ashwal S, and Ferriero DM (Philadelphia: Mosby Elsevier) pp 491-504


[4] Fung EB, Samson-Fang L, Stallings VA, Conaway M, Liptak G, and Henderson SC 2002 J Am Diet Assoc. 102 361-70


[5] Palmer S 1978 Cerebral palsy Pediatric nutrition in developmental disordered Palmer S and Ekvall S (Springfield: Thomas Publisher) pp 42-9


[6] Gangil A, Patwari AK, Aneja S, Ahuja B, and Anand VK 2001 Indian Pediatr. 38 839-46


[7] Palisano R, Rosenbaum P, Walter S, Russel D, Wood E, and Galuppi B 1997 Dev Med Child Neurol. 39 214-23


[8] Gorter JW, Verschuren O, Riel LV, and Katelaar M 2009 BMC Musculoskelet Disord. 10 108-10


[9] Russel DJ, Avery LM, Rosenbaum PL, Raina PS, Walter SD, and Palisano RJ 2000 Physical Therapy. 80 873-85


[10] Beckung E and Hagberg G 2000 Dev Med Child Neurol. 42 669-73


[11] Venkateswaran S and Shevell MI 2008 Dev Med Child Neurol. 50 216-22


[12] Shevell MI, Dagenais L, and Hall N 2009 Neurology. 72 2090-6



[13] Shevell MI, Dagenais L, and Hall N 2009 Dev Med Child Neurol. 51 872-7


[14] Kim JS, Han ZA, Song DH, Oh HM, and Chung ME 2013 Am J Phys Med Rehabil. 92 912-9


[15] Benedict RE, Patz J, Maenner MJ, Arneson CL, Allsopp MY, and Doernberg NS 2011 Paediatr Perinat Epidemiol. 25 88-96


[16] Sullivan PB, Lambert B, Rose M, Griffiths P, and Johnson A 2000 Dev Med Child Neurol. 42 674-80


[17] Ozturk M, Akkus S, Malas MA, and Kisioglu AN 2002 Indian Pediatr. 39 834-8


[18] Hung JW, Hsu TJ, Wu PC, and Leong CP 2003 Chang Gung Med J. 26 425-32


[19] Pfeifer LL, Silva DB, Funayama CA, and Santos JL 2009 Arq Neuropsiquiatr. 67 1057- 61


[20] Howard J, Soo B, Graham KR, Boyd RN, Reid S, and Lanigan A 2005 J Paediatr Child Health. 41 479-83


[21] Cichero J and Murdoch BE 2006 Dysphagia: Foundation, theory, and practice (England: John Wiley & Sons Ltd) pp 391-413


[22] Erkin G, Culha C, Ozel S, and Kirbiyik EG 2010 Int J Rehabil Res. 33 218-24


[23] Tahmassebi JF and Curzon MEJ 2003 Dev Med Child Neurol. 45 613-7


[24] Reid SM, Mcchutcheon J, Reddihough DS, and Johnson H 2012 Dev Med Child Neurol. 54 1032-6


[25] Weir KA, Bell KL, Caristo F, Dip G, Ware RS, and Davies PS 2013 Arch Phys Med Rehabil. 94 495-502


[26] Parkes J, Hill N, Platt MJ, and Donnelly C 2010 Dev Med Child Neurol. 52 1113-9


[27] Bandini L, Patterson B, and Ekvall SW 1993 Cerebral palsy Pediatric nutrition in chronic diseases and developmental disorders, prevention, assessment and treatment ed Ekvall SW (New York: Oxford University Press) pp 93-8