Feeding difficulties in children with cerebral palsy
AbstractBackground 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 Â± 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
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
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