Feeding difficulties in children with cerebral palsy

  • Hikari Ambara Sjakti
  • Damayanti Rusli Syarif
  • Luh Karunia Wahyuni
  • lmral Chair
Keywords: cerebral palsy, feeding difficulty, calorie intake

Abstract

Background Children with cerebral palsy (CP) often have feeding
difficulties due to their disability. This results in inadequate calorie
intake which finally leads to malnutrition. Several studies found
that 30-90% of children with CP have feeding difficulties associ-
ated with malnutrition. There has been no sufficient published
data about this problem in Indonesia.
Objective To determine the prevalence of feeding difficulties and
malnutrition in children with CP.
Methods A cross-sectional study was done from January to
September 2005 in the pediatric outpatient clinic of Dr. Cipto
Mangunkusumo Hospital (CMH). Children with CP underwent
nutritional and feeding difficulties assessment. Nutritional sta-
tus was determined by the ratio of body weight to body height
standardized to CDC-NCHS 2000 growth curve and were
classified based on Waterlow. Calorie intake was evaluated by
dietary analysis and defined as adequate if it reached 13.9 kcal/
em BH ± 10%. Feeding difficulties assessment included history
taking, physical examination and observation of feeding skill in
the outpatient clinic.
Results Fifty-five children with CP were included in this study,
most of them were spastic type, mainly spastic diplegic and spastic
quadriplegic cerebral palsy (SQCP). Malnutrition was found in
76% subjects, most were SQCP. Feeding difficulties were found in
76% subjects, half of them were SQCP, 38% with spastic diplegic.
Thirty- eight percents of the parents whose children had feeding
difficulties was not aware of these problems in their children.
Parallel with data above, 78% subjects received inadequate
calorie intake.
Conclusions The prevalence of undernourished and severe
malnutrition in children with CP is 66% and 11% respectively.
Malnutrition in CP patients tends to be related with inad-
equate calorie intake due to feeding difficulties that is found in
78% subjects especially those with SQCP

Author Biographies

Hikari Ambara Sjakti
Child Health Department, Medical School, University of
Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
Damayanti Rusli Syarif
Child Health Department, Medical School, University of
Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
Luh Karunia Wahyuni
Department of Medical Rehabilitation, Medical
School, University oflndonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
lmral Chair
Child Health Department, Medical School, University of
Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia

References

1. Cloud H. Feeding problems of the child with special health
care needs. In: Ekvall SW, editors. Pediatric nutrition in
chronic diseases and developmental disorders, prevention,
assessment and treatment. New York: Oxford University
press; 1993. p. 203-17.
2. Palmer S. Cerebral palsy. In: Palmer S, Ekvall S, editors.
Pediatric nutrition in developmental disorder. Springfield:
Charles C. Thomas Publisher; 1978. p. 42-9.
3. Fung EB, Samson-Fang L, Stallings VA, Conaway M, Liptak
G, Henderson SC, et al. Feeding dysfunction is associated
with poor growth and health status in children with cerebral
palsy. J Am Diet Assoc 2002; 102:361-70.
4. Reilly S, Skuse D, Poblete X. Prevalence of feeding problems
and oral motor dysfunction in children with cerebral palsy:
a community survey. J Pediatr 1996;129:877-82.
5. Gangil A, Patwari AK, Aneja S, Ahuja B, Anand VK. Feed-
ing problems in children with cerebral palsy. Indian Pediatr
2001;38:839-46.
6. Socrates C. Poor nutrition is a serious problem in children
with cerebral palsy in Palawan, the Philippines. Int J Rehabil
Res 2000;23: 177-84.
7. Zainah SH, Ong LC, Sofiah A, Hussain IH. Determinants
of linear growth in Malaysia children with cerebral palsy. J
Paediatr Child Health 2001;37:376-81.
8. Haslam RAH. Encephalopathies. In: Behrman RE, Kliegman
RM, Arvin AM, editors. Nelson's textbook of pediatrics. 16th
ed. Philadelphia: Saunders; 1996. p. 1713-4.
9. Krick J, Murphy-Miller P, Zeger S, Wright E. Pattern of
growth in children with cerebral palsy. J Am Diet Assoc
1996;96:680-5.
10. Water low JC. Classification and definition of protein-caloric
malnutrition. BMJ 1972;3:566-9.
11. Hogan SE. Energy requirement of children with cerebral
palsy. Can J Diet Pract Res 2004;65: 124-30.
12. Sharma P, Sharma U, Kabra A. Cerebral palsy-clinical profile
and predisposing factor. Indian Pediatr 1999;36: 1038-42.
13. Sullivan PB, Lambert B, Rose M, Griffiths P, Johnson A.
Prevalence and severity of feeding and nutritional problems
in children with neurological impairment: Oxford Feeding
Study. Dev Med Child Neurol2000;42:674-80.
14. Ozturk M, Akkus S, Malas MA, Kisioglu AN. Growth
status of children with cerebral palsy. Indian Pediatr
2002;39:834-8.
15. Hung JW, Hsu TJ, Wu PC, Leong CP. Risk factor of under-
nutrition in children with spastic cerebral palsy. Chang Gung
Med J 2003;26:425-32.
16. Stallings VA, Zemel BS, Davies JC, Cronk EC, Charney
EB. Energy expenditure of children and adolescents with
severe disabilities: a cerebral palsy model. Am J Clin Nutr
1996;64:627-34.
17. Sullivan PB, Juszczak E, Lambert BR, Rose M, Ford-Adams
ME, Johnson A. Impact of feeding problems on nutritional
intake and growth: Oxford Feeding Study II. Dev Med Child
Neurol2002;44:461-7.
18. Reilly S, Skuse D. Characteristic and management of feeding
problems of young children with cerebral palsy. Dev Med
Child Neurol1992;34:379-88.
19. Rogers B. Feeding method and health outcomes of children
with cerebral palsy. J Pediatr 2004; 145:S28-S32.
20. Palmer JB. Drennan JC, Baba M. Evaluation and treatment of
swallowing impaim1ents. Am Fam Physician 2000;61 :2453-62.
21. Schwarz SM, Corredor J, Fisher-Medina J. Diagnosis and
treatment of feeding disorders in children with developmental
disabilities. Pediatrics 2001; 108:671-6.
22. Rudolph CD, Link DT. Feeding disorders in infants and
children. Pediatr Gastroenterol Nutr 2002;49:97 -112.
23. Senner JE, Logemann J, Zecker S, Gaebler-Spira D. Drooling,
saliva production, and swallowing in cerebral palsy. Dev Med
Child Neurol2004;46:801-6.
24. Tahmassebi JF, Curzon MEJ. Prevalence of drooling in chil-
dren with cerebral palsy attending special schools. Dev Med
Child Neurol 2003;45:613-7.
25. Bandini L, Patterson B, Ekvall SW. Cerebral palsy. In: Ekvall
SW, editors. Pediatric nutrition in chronic diseases and devel-
opmental disorders, prevention, assessment and treatment.
New York: Oxford University Press; 1993. p. 93-8.
26. Rose J, Wolff DR, Jones VK, Bloch DA, Oelhert JW, Gamble
JG. Postural balance in children with cerebral palsy. Dev Med
Child Neurol 2002;44:58-63.
Published
2008-08-31
How to Cite
1.
Sjakti H, Syarif D, Wahyuni L, Chair lmral. Feeding difficulties in children with cerebral palsy. PI [Internet]. 31Aug.2008 [cited 30Nov.2022];48(4):224-. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/572
Section
Articles
Received 2016-09-10
Accepted 2016-09-10
Published 2008-08-31