Dietary Intakes and Nutritional Issues in Neurologically Impaired Children

Abstract

Neurologically impaired (NI) children are at increased risk of malnutrition due to several nutritional and non-nutritional factors. Among the nutritional factors, insufficient dietary intake as a consequence of feeding difficulties is one of the main issues. Feeding problems are frequently secondary to oropharyngeal dysphagia, which usually correlates with the severity of motor impairment and presents in around 90% of preschool children with cerebral palsy (CP) during the first year of life. Other nutritional factors are represented by excessive nutrient losses, often subsequent to gastroesophageal reflux and altered energy metabolism. Among the non-nutritional factors, the type and severity of neurological impairment, ambulatory status, the degree of cognitive impairment, and use of entiepileptic medication altogether concur to determination of nutritional status. With the present review, the current literature is discussed and a practical approach for nutritional assessment in NI children is proposed. Early identification and intervention of nutritional issues of NI children with a multidisciplinary approach is crucial to improve the overall health and quality of life of these complex children.

Hubungan Pengetahuan Pengasuh Tentang Posisi Pemberian Makan Dengan Asupan Energi Dan Protein Anak Cerebral Palsy Di Ypac Malang

“…Sementara itu, faktor non gizi adalah tingkat keparahan neurologis anak, tingkat kecerdasan anak dan penggunaan obat antiepilepsi. 1,17,18 Masalah makan pada anak cerebral palsy haruslah dapat diatasi agar asupan makan pada anak cerebral palsy dapat terpenuhi sesuai kebutuhannya. Asupan gizi sangat diperlukan untuk perkembangan dan pertumbuhan anak.…”

Nutritional status and gross motor function in children with cerebral palsy, and implications for Zika virus infection

“…The consumption of micronutrients was also reduced (around 75% recommended age-specific dietary intake of vitamin D and E, iron, niacin, folate, and calcium). 5 It is possible that the children with CP with deficient nutrient intake, linked with food refusal and difficulty in chewing and/or swallowing solid foods, present low scores in the GMFCS. Accordingly, HerreraAnaya et al 1 have reported that 49.2% of their sample presenting with chewing difficulties, and 44.6% with food refusal, were associated with advanced levels of motor dysfunction.…”

Detection of gastroesophageal reflux in children with cerebral palsy using combined multichannel intraluminal impedance-ph procedure

“…Impairment of the brain may result in significant dysfunction in the gastrointestinal tract 1 . Oro-motor disabilities, swallowing incoordination, abnormal esophageal motility and GER are the most common problems of these children [1][2][3] . Approximately 75-90% of children with cerebral palsy (CP) have been reported to have GER in different studies [2][3][4] .…”

“…Oro-motor disabilities, swallowing incoordination, abnormal esophageal motility and GER are the most common problems of these children [1][2][3] . Approximately 75-90% of children with cerebral palsy (CP) have been reported to have GER in different studies [2][3][4] . Many factors may be involved in the etiopathogenesis of GER in CP patients, including motility disorders, seizures, supine position, and increased intra-abdominal pressure secondary to spasticity and scoliosis.…”

“…Many factors may be involved in the etiopathogenesis of GER in CP patients, including motility disorders, seizures, supine position, and increased intra-abdominal pressure secondary to spasticity and scoliosis. Recurrent episodes of GER can lead to overt or silent aspiration, vomiting, spillage, food aversion, prolonged feeding times and may result in a significant reduction in nutrient and energy intake 3 .…”