Gastrostomy tube feeding of children with cerebral palsy: variation across six European countries

Abstract

ABBREVIATION GTF Gastrostomy tube feedingAIM To compare the prevalence of gastrostomy tube feeding (GTF) of children with cerebral palsy (CP) in six European countries.METHOD Data on 1295 children (754 males, 541 females; mean age 5y 11mo, range 11y 2mo, min 6mo, max 11y 8mo) with CP born from 1999 to 2001 were collected from geographically defined areas in six European countries; four of the areas covered the whole country. Distribution of CP was unilateral 37%, bilateral 51%, dyskinetic 8%, and ataxic 4%. Sixty children were classified in Gross Motor Function Classification System (GMFCS) levels I and II, 6 in level III and 34 in levels IV and Vas Outcome measures were GTF, age at placement, feeding difficulties and the children's height and weight for age standard deviation scores (z-scores). RESULTSThe use of GTF among all children with CP was highest in western Sweden (22%, 95% confidence interval [CI] 16-29), and lowest in Portugal (6%, 95% CI 3-10), northern England (6%, 95% CI 3-9) and in Iceland (3%, 95% CI 0-13; p<0.001). The difference between areas was greater among children in GMFCS levels IV and V (non-ambulant); in this group, lower height z-scores were more prevalent in the areas with lower prevalence of GTF. The children's age at placement of gastrostomy also varied between areas (p<0.002).

Prevalence of orofacial dysfunction in cerebral palsy and its association with gross motor function and manual ability

“…7 The use of tube-feeding was consistent with studies made in Norway and Denmark 3 and in the south of Sweden. 5 However, the observed prevalence in the present study was about twice as high as that found in previous studies regarding difficulties with chewing and swallowing, 9 drooling, 9 and deviant lip position.…”

“…1 Impaired eating is associated with poor growth 2,3 and problems with chewing and swallowing may jeopardize respiration. 4,5 Notably, the most common causes of death in young individuals with CP are secondary respiratory diseases.…”

Care Related Behaviors of Parents of Children Fed with Gastrostomy Tube at Home

“…İhsan Doğramacı Çocuk Hastanesi Gastroenteroloji Polikliniğinde çalışan hekimlerin tümünden uzman görüşü alınarak yeniden düzen-lenip son hâli oluşturulmuştur. [1][2][3][4][5][6][7][8][9][10][11] Anket soruları, ebeveynlerin bakımla ilgili davranışlarını değer-lendirmeye yönelik soruları içermektedir. Bu form, gastrostomi ile beslenen çocukların ve ebeveynlerinin tanıtıcı özelliklerine, çocuğun hastalığa iliş-kin bilgilerine, ebeveynlerin beslenme, ilaç uygulama davranışları ve pansuman uygulama davranışlarına yönelik bilgilere ulaşılmasını sağlayan toplam 32 sorudan oluşmaktadır.…”

Psychosocial aspects of feeding children with neurodisability

“…Research across six European countries, for example, has demonstrated considerable variation in the use of GFT and the age at which they are placed, which could be attributed, in part, to variations in clinical practice. 15 Delaying surgery may add to the stress already experienced by caregivers. Ongoing assessment of parental psychosocial support needs and their ability to cope with oral/nasogastric tube feeding, with a view to moving toward feeding by a GFT, should form an essential aspect of clinical care.…”